Two health boards required multimillion-pound loans to break even

Two health boards needed large loans from the Scottish Government to break even in the last financial year, figures show.

Audit Scotland said NHS Grampian and NHS Ayrshire & Arran both received multimillion-pound loans.

NHS Grampian received £65.2m in 2024-25 and is projecting a £68m overspend in 2025-26.

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.

Stephen Boyle, Auditor General for Scotland, said NHS Grampian will need a “significant redesign” of its health and social care system.

He 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.”

NHS Ayrshire & Arran needed a £51.4m loan in 2024-25 to break even. It now has outstanding loans totalling £129.9m – the highest amount across the NHS in Scotland.

The board is forecasting a deficit of £33.1m in 2025-26.

Mr Boyle continued: “The severity of the financial challenge facing NHS Ayrshire & Arran is unprecedented, and the board is relying on an overly optimistic savings plan 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.”

The Scottish Government, NHS Grampian and NHS Ayrshire & Arran have been approached for comment.