Publication: NHS in Scotland 2025 - audit scope

Scotland’s NHS has faced growing financial and operational pressures in recent years. Our 2024 report highlighted growing waiting lists, unmet performance standards, and a number of NHS boards struggling to break even despite a real terms increase in funding. It outlined the need for system-wide reform across the NHS in Scotland.

This year’s audit aims to consider the financial and operational performance of Scotland’s NHS in 2024/25 and consider how well the NHS is addressing these challenges and supporting reform.

The audit will focus on three key questions: the financial performance of NHS Scotland in 2024/25 and its medium-term outlook; how well the NHS is managing operational pressures and meeting national commitments; and whether the Scottish Government’s 2025 reform plans – Operational improvement, Service renewal, and Population health – clearly outline a path to sustainable change.

To conduct the audit, Audit Scotland will analyse a wide range of data sources, including NHS board accounts, national performance data, and government strategies. Interviews with senior officials will also take place.

The audit seeks to provide transparency and accountability to the Scottish Parliament and public, offering insights into the sustainability and reform of NHS Scotland. The final report is scheduled for publication in December 2025.