NHS Grampian advised to replace 40% of staff with AI to cut costs

NHS Grampian has been advised by private management consultants KPMG to consider replacing up to 40% of its back-office staff with AI to save money.

The recommendation is one of 27 cost-cutting measures suggested by KPMG to the Scottish health board as part of a larger review.

NHS Grampian is the worst financially performing board in Scotland, with current forecasts showing it will overspend by almost £50m in 2025/26.

According to the board’s recovery plan, it needs to find at least another £4.2m of savings – on top of the £60.4m already identified – to meet government expectations by the end of the financial year.

KPMG’s report, published on 9 October 2025, states that “a significant opportunity exists for NHSG to leverage the latest technology developments (including the use of GenAI tools) to drive efficiency and right-size headcount”.

It adds that “leveraging technology to support or replace much of the administrative work performed by staff” could save the board up to £15.6m by 2030.

Pay costs for administrative staff at NHSG across Bands 1-4 was £39m in 2024/25.

KPMG recommends that NHS Grampian commissions “a review of systems, processes and technology in the middle and back office to identify where automation can be employed to reduce staff numbers”.

“A 30%-40% phased reduction in back-office roles realised by investing in technology, attrition and re-organising internal roles would save £11.7m-£15.6m.

“This will require some investment in technology such as Robotic Process Automation and AI and could take approximately 12 to 36 months (or beyond depending on pace and attrition rates) to realise,” KPMG adds.

Scottish NHS Boards cannot make staff redundant, so KPMG suggests pausing recruitment to these posts to support the 30-40% reduction over the next five years.

“The use of GenAI tools across HR, finance and procurement can free up staff for more value-add activities,” KPMG adds.

The review estimates that if NHS Grampian adopted the full list of savings proposals it could save an additional £26.7m this year, but these additional savings will still fall short of delivering financial balance to the board in the short-term.

Neil Gray, health secretary, said that the government will make an additional £5.9m available to NHS Grampian this year to help drive immediate improvements in A&E and unscheduled care performance.

“It is critical that NHS Grampian prioritises action that improves capacity, makes the most impact and drives real, sustainable change,” Gray said.

Laura Skaife-Knight, chief executive at NHS Grampian, who is leading the board’s savings and improvement programme, said: “All savings schemes will continue to be carefully considered to ensure patient experience, clinical care and staff wellbeing is maintained or improved.

“We are grateful to the Scottish government for the additional funding provided to NHS Grampian to further improve access to our urgent and emergency services and reduce waiting times for operations and appointments (planned care) for the populations we serve.”

Meanwhile, in May 2025, NHSE awarded a ‘tiger teams’ contract worth £13.3m to KPMG to support trusts unlikely to meet the March 2026 electronic patient record target.