Healthcare Improvement Scotland carried out an unannounced maternity services inspection at Orkney’s Balfour Hospital on Monday 23 March and Tuesday 24 March 2026.
The inspection resulted in 12 areas of good practice, two recommendations and nine requirements.
Sam Thomas, Executive Director of Nursing, Midwifery, AHP’s and Chief Officer Acute Services at NHS Orkney said:
“I’d like to thank everyone for supporting the visit and to the HIS team for carrying out such a comprehensive inspection.
“Our priority now is to build on the strong foundations identified in this report while implementing sustainable improvements that will further strengthen safety, governance and staff support. Progress will be closely monitored through our clinical governance structures and reported appropriately.
“I’d also like to thank all the patients and families who contributed to the inspection.
“Last, but not least, I must highlight the dedication and compassion the maternity team show to our patients and their families every single day. Their commitment remains central to us delivering safe, effective, and person-centred maternity care for our community.”
The combined antenatal, labour suite and postnatal ward was inspected with inspectors speaking to a range of people: women, visitors, and ward staff.
Click on this link to access: Unannounced Inspection Report – Maternity Services Safe Delivery of Care Inspection, Balfour Hospital.
The report notes that in 2025, there were 100 births recorded at NHS Orkney.
The following areas were inspected: Combined antenatal, labour suite and postnatal ward.
- inspected the ward and hospital environment
- observed staff practice and interactions with women and birthing people, such as during mealtimes
- spoke with women, birthing people, visitors and ward staff and
- accessed women and birthing peoples health records, monitoring reports, policies and procedures.
Summary of Findings
- Throughout our inspection we observed staff providing person-centred, compassionate and responsive care to women and their families.
- Good teamwork was evident throughout the inspection between obstetricians, midwives and the health care support team. The senior midwifery and senior obstetric leadership teams were visible with respectful, friendly and supportive interactions observed. Staff described being supported by senior managers and felt able to raise concerns.
- Staff were actively engaged with their own learning and development with plans in place to ensure they all complete their mandatory training.
- Women and their families were complimentary of their care and would recommend NHS Orkney to friends and family.
During inspection, some areas of improvement were identified. These included:
- The improved oversight and governance of the review of policies, guidelines and procedures.
- Further improvements are required to ensure timescales of adverse events are achieved. This includes feedback to staff to support and improve the safe delivery of care.
- NHS Orkney must ensure that clinical leaders have protected time to lead to fulfil their leadership roles.
- Improvement in the completion of the electronic staffing tools was also identified to ensure the service is safe to start and that mitigations to ensure patient safety are consistently recorded.
There were 12 areas of good practice.
2 recommendations – A recommendation relates to best practice which Healthcare Improvement Scotland believe the NHS board should follow to improve standards of care
9 requirements – A requirement in the inspection report means the hospital or service has not met the required standards and the inspection team are concerned about the impact this has on women, birthing people and families using the hospital or service. We expect all requirements to be addressed and the necessary improvements implemented. The NHS board must prioritise the requirements to meet national standards.
