Change to health board escalation

NHS Lothian de-escalated to Stage 2.

Following performance improvements in relation to the delivery of Children and Adolescent Mental Health Services (CAMHS) and Psychological Therapies, NHS Lothian Health Board has been de-escalated to Stage 2 of NHS Board performance escalation framework.

Robust measures will remain in place to ensure NHS Lothian continues to receive support to help maintain improvements.

NHS Lothian was originally escalated to Stage 3 for mental health performance in July 2019.

The improvements to CAMHS and Psychological Therapies has resulted in a significant decrease in the number of children, young people and adults waiting to start treatment compared to the period prior to escalation.

Health Secretary Michael Matheson said:

“Escalating a health board is never done lightly and, following progress to improve the provision of mental health services, care and support, I am pleased that we are now able to de-escalate NHS Lothian. This is a positive step forward.

“Staff have worked hard to support the improvement work while delivering high quality patient care. It has been a challenging time for them, as well as patients and families, and support for the Board will continue to improve services even further for patients.”


Of the children and young people waiting to start treatment at end November 2022, 96 children and young people (6.4%) had been waiting longer than one year for treatment in CAMHS, an 82.4% decrease from the number at the end of December 2021 (547).  

While 3,933 patients were waiting to start Psychological Therapies treatment at the end November 2022, a 4.9% decrease from 4,136 in September 2022 and a 22.6% decrease from 5,082 at the same time last year.

The decision on a Board’s Stage 3 Escalated position sits with the Director General for Health and Social Care, as detailed in the NHS Scotland Board Performance Escalation Framework. Any further decisions regarding NHS Lothian’s position would be undertaken through the appropriate governance channels.

NHS Board performance framework


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