NHS Lothian is working to improve services for young people at the Melville Inpatient Unit after it accepted a joint report published today (Thursday 23 October) by Healthcare Improvement Scotland (HIS) and the Mental Welfare Commission (MWC).
A robust action plan is already well underway to address the report recommendations and improve care in the specialist Child and Adolescent Mental Health Service (CAMHS) unit which supports up to 12 young people with complex needs.
CAMHS has made significant progress in recruiting and retaining more skilled staff and developing new care pathways, with the report also highlighting positive staff interactions and their commitment and passion for working with young people.
However, Jim Crombie, Deputy Chief Executive for NHS Lothian, said that wider improvements were continuing across the unit.
He added: “We want to reassure young people and families that we are committed to delivering safe, high-quality and effective care and we take the findings of the report extremely seriously.
“The safety and care of young people and staff is always our top priority. Restraint is only ever used in the unit as a last resort to prevent harm for young people or to staff or other patients.
“We introduced an initiative to reduce the use of restraint further, which was observed by HIS during the inspection, and has shown positive results. Systems are also in place to improve the recording, monitoring and auditing of restraints.
“We want to thank staff for their ongoing dedication and HIS and MWC for their expertise and guidance in shaping improvements to the mental health care of young people. We will welcome any forthcoming national guidance or best practice from these essential reviews.”
The action plan also includes work underway to improve multidisciplinary team dynamics through enhanced meeting structures, communication, collaboration and decision making to work more effectively with young people.
Since May 2025, a system has been in place to monitor legal authority for treating young people under the Mental Health Act, with enhanced managerial oversight and daily checks by registered nurses to ensure documentation is in place before administrating care.
Work also continues to expand meaningful evening and weekend activities for young people with regular reviews planned. Nurses will also receive refresher training to strengthen their therapeutic skills in individual and group settings.
A review of the physical environment of the Melville Unit, including looking at options for how best to provide care safely while meeting the needs of young people, is also well underway.
A copy of the report is available from Healthcare Improvement Scotland.
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