NHS Grampian is bracing for another major financial shortfall, with projections showing a £76 million deficit for the 2026/27 financial year, according to board papers due to be discussed on Thursday.
The health board, which serves Aberdeen and the north-east of Scotland, has been warned it cannot exceed an overspend of £36 million if it wishes to secure brokerage funding from the Scottish Government.
In the documents presented to board members, the Director of Finance describes the situation as a “significant financial challenge” for the year ahead.
NHS Grampian has already borrowed more than £92 million from the Scottish Government to stabilise its finances. While this support does not need to be repaid immediately, repayment is contingent on the board returning to financial balance.
The latest projections indicate that a further £40 million in savings must be identified next year, on top of approximately £62 million in savings already delivered this financial year.
The board has been operating under enhanced scrutiny after being placed in stage 4 of the Scottish Government’s support and intervention framework — the highest level of oversight. An independent review has also been conducted.
Officials had previously expressed concern over the board’s financial trajectory and imposed a requirement that the deficit must not exceed £45 million by the end of the current financial year.
Chief executive Laura Skaife-Knight said meeting that target would represent an “incredible achievement and the result of continued hard work across the organisation.”
However, future deficit support from the Scottish Government will be progressively reduced. The board papers state: “The level of deficit support funding will also reduce from £36 million in 2026/27, to £25 million in 2027/28 and £15 million in 2028/29.”
NHS Grampian has attributed its financial crisis to multiple rising costs, including staffing, healthcare provision, employer National Insurance contributions, energy bills, food supplies and maintenance.
The combination of inflationary pressures and workforce expenses continues to place strain on health services across Scotland.
The board will also be updated on the escalating costs of the Baird Family Hospital and Anchor Cancer Centre in Aberdeen.
Originally scheduled to open in 2020 at an estimated cost of £160 million, the project is now expected to exceed £438 million.
The cancer centre is anticipated to open this summer, with the maternity hospital projected to follow in June 2027. However, the board has cautioned that “dates for bringing each building into operation will be subject to review on a weekly basis.”
The development has faced significant setbacks, including water system failures, ventilation issues and design complications.
NHS Grampian must submit its final financial recovery plan to the Scottish Government by 16 March.
With borrowing levels already substantial and government support set to decline in the coming years, the board faces mounting pressure to restore long-term financial stability while maintaining patient care standards across north-east Scotland.