Two Scottish health boards 'reliant on loans and financially unsustainable'
Audit Scotland highlighted serious challenges facing NHS Grampian and NHS Ayrshire and Arran
Two health boards required multi-million pound loans from the Scottish Government and are still financially unsustainable, the spending watchdog has said.
Audit Scotland sounded the alarm over NHS Grampian and NHS Ayrshire and Arran, with the latter facing “unprecedented” financial challenges.
The Scottish Conservatives said the “jaw-dropping” figures exposed the scale of the SNP’s mismanagement of the NHS.
NHS Grampian received a £65.2 million loan in 2024/25 and is projecting a £68 million overspend in 2025/26, Audit Scotland said.
In May, the health board was escalated to stage four of NHS Scotland’s support and intervention framework due to concerns about financial sustainability, leadership and governance, and service performance.
Meanwhile, NHS Ayrshire and Arran needed a £51.4 million loan in 2024/25 to break even, and now has outstanding loans totalling £129.9 million, the highest amount across the NHS in Scotland.
The board is forecasting a deficit of £33.1 million in 2025/26 and does not have a clear plan for achieving financial sustainability, the watchdog said.
Stephen Boyle, the Auditor General for Scotland, said: "These two health boards are not alone in finding it difficult to achieve financial balance, but their situations are currently the most pressing.
“In the case of NHS Grampian, it won’t be possible for the board to return to financial balance without a significant redesign of its health and social care system.
“The severity of the financial challenge facing NHS Ayrshire and Arran is unprecedented, and the board is relying on an overly optimistic savings plans that may not be achievable.
“For both health boards, effective leadership and close working with the Scottish Government and other partners will be vital to improving their financial sustainability and the delivery of services.”
Scottish Conservative shadow health secretary Dr Sandesh Gulhane MSP said: “These jaw-dropping figures expose the scale of SNP mismanagement of our NHS. It’s appalling that health boards have been driven into crippling debt and are reliant on huge bailouts just to stay afloat.”
Laura Skaife-Knight, NHS Grampian chief executive, said: “I welcome this opportunity for learning, alongside all other means of support the organisation is receiving to see the improvements that are necessary for our patients, community, and staff, and we will fully engage with the parliamentary review process.
“Our focus remains delivering the improvements we have committed to, including those related to leadership, governance, the timeliness of planned and emergency care for our patients, and our financial performance.”
She said the health board has already begun a programme of improvement, adding: “We’re developing an improvement plan in close collaboration with our staff and partners, building on work already under way recognising this is how we will meet the challenges we face and that lie ahead.”
Gordon James, chief executive of NHS Ayrshire & Arran, said: “The report provides a valuable opportunity to reflect and improve. We welcome this support and are fully committed to the parliamentary review process.
“NHS Ayrshire & Arran acknowledges the challenges we face but remain committed to delivering a plan to make improvements in our financial performance. We work closely with the Scottish Government and other partners to deliver sustainable transformation and change and will continue to do so to improve our position.”
Health Secretary Neil Gray said: “We note the reports from Audit Scotland and continue to work closely with NHS Grampian and NHS Ayrshire & Arran to drive improvements across all services, not just in finance.
“We have provided additional funding and support to both boards aimed at improving financial sustainability. We continue to monitor the financial position for both boards through regular engagement with the NHS Scotland Financial Delivery Unit and meetings with their finance teams.”
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