NHS Lothian facing £140m funding gap amid 'concerning' maternity report

One of Scotland’s largest health boards is facing a funding gap of over £140m by the end of the decade, it has said.

NHS Lothian has warned that the coming years will bring financial pressures, but it will continue to find more efficient ways of delivering services.

The health board met its budget for this year by managing to find £60m of savings, but expects to have to cut a similar figure in the coming year.

In its annual review, the health board stated that a growing population – the region is expected to account for 40% of Scotland’s total population growth in the years to come – and the ageing demographics, which will lead to increased demand on health and social care, will bring financial pressures.

The health board’s maternity services are also facing an escalation in its support and scrutiny by the Scottish Government after inspectors raised “serious concerns” during an unannounced visit.

Staffing shortages and a “culture of mistrust” led to delays and patient harm at the Royal Infirmary of Edinburgh, a review by Healthcare Improvement Scotland (HIS) found.

Inspectors found 26 areas where required standards had not been met.

Edinburgh & East

‘I was left alone and given an empty gas canister during childbirth’

An unannounced inspection at one of Scotland’s largest maternity units has raised ‘serious’ concerns about its operation.

Scottish health secretary Neil Gray told MSPs last month that he was “deeply disappointed and concerned by the findings in the report”.

The health secretary said NHS Lothian had already made “some improvements” to its maternity triage services and invested £1.5m in staffing, which has been used to recruit 70 new midwives since June, with 30 already in place.

He told MSPs last month he “nearly lost” his wife during pregnancy after “inaccurate assessments” were carried out.

What did inspectors find?

Inspectors raised “serious concerns” after carrying out an unannounced inspection of one of the country’s largest maternity units.

Staff spoke to inspectors about their “overwhelming feeling of helplessness, frustration and worry for not only patient, but staff safety”.

The inspection said some women waiting for labour to be induced had experienced delays of more than 24 hours.

Politics

Scrutiny of maternity services escalated after ‘concerning’ report

Inspectors found staffing shortages and a ‘culture of mistrust’ has led to delays and patients being harmed at the Royal Infirmary of Edinburgh.

Inspectors also spoke to women who “described being left alone in a triage room for long periods of time following their initial assessment”.

A review of incident reports showed “evidence of medication errors occurring involving student midwives”, the report revealed.

Donna Maclean, chief inspector at HIS, said: “During the course of this inspection, we escalated serious concerns within NHS Lothian to senior staff and the Scottish Government.

“These concerns related to culture, oversight of patient safety and staff wellbeing within Edinburgh Royal Infirmary maternity services.”

Professor Caroline Hiscox, the chief executive of NHS Lothian, accepted the report was “concerning”.

She said: “I apologise to women, people who use the service, and their families and can reassure them that these issues are being taken extremely seriously.”

She said an improvement plan was “ongoing” after whistleblowers raised concerns in 2024, with Prof Hiscox saying, however, that “wider-ranging matters, such as staffing, recruitment and working culture within the department, will take time to resolve”.

But she stressed: “Significant investment and improvements have already been made.

“More than 70 additional midwives have been recruited and will be in post by the end of December. Thirty of those are already in post and we are now fully compliant with healthcare safe staffing legislation.

“The other 42 have been recruited to provide additional resilience and to future-proof our maternity service.”

Prof Hiscox continued: “I want to reiterate the apology we made to staff earlier in the year when they told us about their concerns over staffing numbers and about a working culture that was difficult, and where bad behaviours were tolerated.

“That is not acceptable in any workplace.”

She added: “The inspection report from HIS rightly picked up on the actions which are still ongoing.

“We are grateful to HIS for their expertise and remain committed to working with them and other professional organisations to improve our service for our women, people who use the service and our teams.”