Children were repeatedly put at risk due to widespread managerial incompetence at one of Scotland's largest health boards, according to a damning independent review. The report found serious concerns about safety, quality, clinical governance and leadership at NHS Grampian.
Healthcare Improvement Scotland (HIS) said it had lost confidence in health bosses in the north-east after they were ordered to halt all paediatric surgery at Dr Gray's Hospital in Elgin, but then continued to operate on some children until early August.
Serious weaknesses in frontline management
The report identified serious weaknesses in the management of the frontline workforce across NHS Grampian, including a lack of planning, poor recruitment controls, and significant concerns over how doctors are managed.
Eddie Docherty, HIS director of regulation, said: "We raised significant concerns with NHS Grampian in July 2026 about the delivery of safe and effective care for critically unwell paediatric patients."
Concerns related to staff training levels to support the safe delivery of paediatric care across the hospital, and an increase in reported adverse events relating to the timely transfer of critically ill children. As a result, a temporary suspension of all elective paediatric surgery was put in place on July 9, alongside the existing suspension of emergency paediatric surgery.
Breach of suspension and loss of confidence
However, NHS Grampian later notified Healthcare Improvement Scotland that elective paediatric dental and ENT surgery continued until August 6. Docherty said: "This affected our confidence in the reliability and consistency of the information received from NHS Grampian."
Alexander Burnett, MSP for Aberdeenshire West, said: "It's horrifying that repeated failures within NHS Grampian have caused unnecessary harm to patients. Not only has Healthcare Improvement Scotland lost confidence in the management of the health board, but patients and staff have as well."
Burnett added: "Less than two months since NHS Grampian declared a critical incident, the true impact of this is resulting in tragic consequences as the health board approaches another winter emergency. Lives are being put at risk, staff are under intolerable strain, and patients are bearing the brunt of the crisis that is continuing to unfold at NHS Grampian."
Health Secretary calls for urgent action
Angela Constance, the Health Secretary, said: "The findings of this report are extremely serious and will be deeply concerning for patients, families, local communities and staff across Grampian. It identifies significant failings in leadership, governance, accountability and organisational culture."
Constance said she had written to the chair and chief executive of NHS Grampian and expected decisive and urgent action. She added: "Given the seriousness of these findings, I expect the board to immediately make changes in medical leadership and to carry out any further necessary changes at a senior level to restore confidence in services."
The chief executive of NHS Grampian, who took up post in September 2025, asked Healthcare Improvement Scotland to carry out this review in May of this year in response to growing concerns about the safety and quality of care, particularly at Dr Gray's Hospital in Elgin. NHS Grampian has established a dedicated helpline to ensure patients, families and local communities have a clear route to raise concerns, seek advice and access support.
