The vision set out in our Plan for the Future remains as important as ever and we remain steadfast in our commitment to it, but we must also acknowledge that much has changed since its publication. Reform of health and care services - both locally and nationally - is a long-term goal, and the NHS Grampian Board agreed in December 2024 to extend the timeline of the Plan for the Future from 2028 to 2032 to allow a realistic, safe and sustainable approach to implementing the necessary reforms to our health and care system.
The national landscape is shifting, with the Scottish Government’s focus moving away from the Annual Delivery Plan (ADP) toward the Operational Improvement Plan (OIP) for 2025/26. Alongside these plans, the publication of the national Service Renewal Framework and Population Health Framework provide boards with a long-term vision to ensure people of all ages can live well, with the right support, and lead healthier and more fulfilling lives in Scotland.
In May 2025, NHS Grampian was escalated to Stage 4 of the Scottish Government’s Escalation and Support Framework due to concerns around the Board’s financial sustainability, the deterioration of the Board’s financial position during 2024/25 and leadership and governance. An Assurance Board was set up by Scottish Government to support us back to financial sustainability and a readiness for change. Therefore, our focus until March 2026 will centre on two key components:
- Three Change Programmes (Planned Care, Value and Sustainability and Unscheduled Care)
- Operational Improvement Plan.
These components represent the organisation’s strategic delivery priorities through which our performance will be managed and assured. The refocused How Are We Doing (HAWD) Report tracks our progress and will be submitted to the NHS Grampian Board on a quarterly basis to provide assurance on these priorities as they move forward.
NHS Grampian Route Map for Strategic Change – Our Bridge to the Future
The Route Map for Strategic Change was endorsed by the NHS Grampian Board in December 2024 as a system-wide approach to strategic transformation. It sets out how we connect short-term stabilisation with long-term redesign, with national frameworks at its heart - including the Operational Improvement Plan and the Population Health and Service Renewal Frameworks.
The Route Map provides a practical method for delivering on NHS Grampian’s Plan for the Future across the three areas (horizons):
- Horizon 1: Stabilising the system
- Horizon 2: Scaling and embedding transformation
- Horizon 3: Designing the future system
Since its endorsement, the Route Map has evolved from a strategic idea into a shared delivery framework. This has been achieved across our health and social care system in Grampian by involving people, partners, and communities. Working together, we have developed a set of core components that now demonstrate how we continue to plan, test and deliver positive change based on the priorities set out in Plan for the Future.
For further information please see the links below:
NHS Scotland Performance & Monitoring Framework
Scotland’s Population Health Framework 2025-2035
NHS Scotland Operational Improvement Plan
Health & Social Care Service Renewal Framework 2025-2035