The 2025/26 financial context requires the Annual Delivery Plan (ADP) to be realistic and achievable within available resources, aligning with the Plan for the Future, ministerial priorities, and Scottish Government expectations. A structured, objective approach to performance evaluation is crucial to ensuring NHS Grampian delivers on its short, medium, and long-term priorities, demonstrating progress and achieving this year’s outcomes. These outcomes lay the foundation for a stronger focus on transforming models of care and prevention through the Route Map for Strategic Change, ensuring continued confidence among those who rely on our services.
Achieving this requires embedding a collaborative performance culture that drives continuous improvement and accountability. The Integrated Performance Assurance and Reporting Framework (IPARF) ensures aligned performance management and assurance, providing a structured approach to monitoring progress, evaluating effectiveness, and driving improvement. While currently focused at a strategic level, work continues to strengthen alignment across all levels as the framework matures. At its core, IPARF operates as a continuous, iterative cycle, through three interdependent stages (1. Plan and Align, 2. Do and Measure, 3. Monitor Review and Report).
As IPARF embeds, it ensures a cohesive and transparent approach, where performance management drives improvements and performance assurance reinforce monitoring, governance, and risk oversight. This continuous cycle of improvement sustains progress, enhances accountability, and supports NHS Grampian’s strategic ambitions amid financial challenges. Over the past year, we have strengthened performance management and assurance in the reporting of the Annual Delivery Plan via the Chief Executive Team (CET), PAFIC and Board’s Performance Reports, ensuring greater clarity, accountability, governance, and strategic alignment. Key improvements focused on:
Performance Management Enhancements:
- Performance culture: Improved performance reporting has resulted in a positive shift in performance culture and dynamics amongst senior leaders, CET, Assurance Committees and the Board in the discussion and review of performance information and data.
- Refined Key Performance Indicators (KPIs) & Stronger Strategic Alignment: Refined KPIs utilising SMART principles have resulted in clearer linkages to Deliverables and Outcomes, improving visibility into long-term performance.
- Enhanced Insights & Early Warnings: Introduced Spotlight Criteria Framework and Circle Marker statuses have enabled proactive risk identification and trend analysis.
- Improved Reporting Structure & Accessibility: Developed an Alignment Map, refined reading guides, and clearer performance definitions led to ensure easier navigation and interpretation of complex data.
- Expanded Tiered Performance Coverage: An extension to existing tiered reporting (Tier 1: high-level view, Tier 2: in-year deliverables) provided better coverage for exception reporting of significant delays and a clearer risk overview.
Performance Assurance Enhancements:
- Strengthened Governance & Oversight: An enhanced and embedded multi-tiered performance assurance governance process from system wide refinement and standardisation of templates have improved and supported performance review across Chief Executive Team (CET), Board Assurance Committees (PAFIC), NHS Grampian Board, satisfy requirements for onward assurance to external bodies e.g. Scottish Government, auditors and the public.
- Review and Accountability: Board Assurance Committees now have a clearer role in performance assurance, ensuring stronger review processes and feedback loops between Committees and CET.
- More Transparent & Aligned Reporting: Refined PAFIC and HAWD performance reports have improved tracking of ADP progress and alignment with the Plan for the Future, ensuring greater public and external accountability.
- Improved Risk Oversight & Proactive Mitigations: Developed structured ADP milestone tracking and risk-based exception reporting have enabled early intervention and better decision-making.
The Framework will support the development of 2025/26 KPIs for Scottish Government and NHS Grampian, with Delivery Plan progress reported via PAFIC and public “How Are We Doing” reports, accessible through NHS Grampian’s website.
Our 2025/26 key developments and areas of activity for enhancing organisational performance management and performance assurance are:
- Utilise the IPARF to strengthen and embed a positive shift in performance culture that increases engagement, participation in the review of performance presented in the ADP across senior leaders, CET, Board Assurance Committees and the Board.
- Improve focus on supporting senior leaders and teams to make tangible progress in delivering the 2025/26 Delivery Plan by ensuring that all deliverables are realistic and achievable.
- Develop and align SMART strategic objectives, tangible outcomes and critical KPIs for 2025/26 ADP and the Route Map to ensure clarity, focus, accountability and effective performance management.
- Refine and improve the standardisation of performance reports to reduce duplication, enhance visibility, transparency and coverage of organisational performance, and address risks and mitigations for assurance.
