Healthcare Improvement Scotland has ordered NHS Western Isles to address 17 areas for improvement following an unannounced inspection of the Acute Psychiatric Unit at Western Isles Hospital in February 2026.
The findings were contained in Healthcare Improvement Scotland’s unannounced inspection report following a visit to the Acute Psychiatric Unit at Western Isles Hospital on February 17 and 18, 2026.
Inspectors said NHS Western Isles must strengthen oversight of policies and procedures, ensure staff are properly trained and supported, and put clear arrangements in place for patients whose complex mental health needs cannot be met locally. The health board was also instructed to improve risk management, including compliance with safety guidance on ligature risks and plastic bags, enhance fire safety training, and ensure lessons from incidents are used to improve care.
The report also calls for improvements in patient documentation, maintenance of the care environment, staffing arrangements, patient involvement in care planning, access to meaningful activities, and the protection of patients’ privacy and dignity. Healthcare Improvement Scotland said the required actions are intended to ensure compliance with national healthcare standards and improve safety and outcomes for patients and staff.
NHS Western Isles has been instructed to take action to ensure services meet national standards and provide safe, effective care for patients.
Speaking of the Western Isles Hospital report, Donna Maclean, Chief Inspector, Healthcare Improvement Scotland, said: “Staff in the unit had high levels of compliance with mandatory eLearning however the practical elements of mandatory training, including immediate and basic life support and violence and aggression training, were identified as requiring improvement.
“Staff were providing therapeutic support to reduce distress and support trauma informed care and promote wellbeing.
“We observed good compliance with infection prevention and control standards.
“There were challenges due to the remote and rural location and the capacity of inpatient mental health services in the Western Isles, including accessing beds for patients with complex needs and those requiring specialist treatment”.
Eddie Docherty, Director of Quality Assurance and Regulation at Healthcare Improvement Scotland, said: “Our previous mental health inspection programme was focused on infection prevention and control. It was agreed with Scottish Government to widen the inspection focus from infection prevention and control to a broader assurance function, creating a new and revised ‘safe delivery of care’ assurance model in NHS adult mental health units.
“We believe it is important to provide public assurance that adult mental health units in Scotland are safe for patients and staff, provide quality person-centred care, with clear leadership and a focus on improvement.”
The Western Isles Hospital inspection resulted in two areas of good practice and 17 requirements.
An improvement action plan has been developed by NHS Western Isles to meet the requirements.
The full inspection report is available to view here.