Royal Edinburgh Hospital is facing a shortage of inpatient mental health beds, resulting in patients being cared for in areas not designed for standard clinical use, according to a recent inspection report. The review, conducted by Healthcare Improvement Scotland (HIS) in June 2025, highlighted both strengths and areas requiring urgent improvement.
Inspection Findings: Strengths and Concerns
The inspection identified six areas of good practice, including strong multidisciplinary teamworking. However, it also listed four recommendations and 21 requirements for improvement. Inspectors raised concerns over patient privacy, unassessed ligature points, inadequate fire doors, and the hospital’s capacity to maintain continuous observation of patients in non-standard care areas.
Donna Maclean, Chief Inspector at HIS, stated, “Staff were open and transparent about the current challenges they face regarding the use of non-standard care areas throughout the hospital. We also raised concerns with senior managers relating to risk assessments, the absence of an approved process to support staff decision-making, and the lack of privacy for patients in these areas.”
Hospital Response and Planned Improvements
NHS Lothian, which operates Royal Edinburgh Hospital, acknowledged the inspection findings and emphasized ongoing efforts to enhance adult mental health services. Jim Crombie, Deputy Chief Executive for NHS Lothian, said the organization is taking immediate steps to address the highlighted issues.
“We take patient safety extremely seriously and have already acted to mitigate many of the concerns raised,” Crombie noted. He added that a structured plan to reconfigure wards and add permanent beds is nearing completion. This reconfiguration is expected to eliminate the use of temporary, non-standard areas that were established in response to rising demand.
Enhancing Safety and Staff Oversight
The hospital is also increasing leadership oversight and staff training to improve ligature inspections, environmental risk assessments, and observation procedures. These measures aim to reduce the risk of patient self-harm and suicide, ensuring that clinical safety standards are consistently met.
Crombie highlighted recent workforce improvements, noting that the hospital has recruited 97 newly qualified nurses and 30 healthcare support workers. “Considerable progress has been made in reducing delayed discharges, which also contributes to better patient flow and care quality,” he said.
Commitment to Ongoing Quality Improvement
NHS Lothian emphasized its commitment to providing safe, effective care while supporting staff. Crombie concluded, “We are grateful for the guidance from Healthcare Improvement Scotland and will continue to work with them and other professional bodies to enhance our services.”
The report underscores the ongoing pressures on mental health inpatient services in Edinburgh, reflecting broader challenges in the UK’s mental health care system, where demand often outpaces available resources.
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