Failure to meet national standards in children’s mental health services has led NHS Lothian to be the second new health board this year to receive extra government intervention.

Under national child and adolescent mental health services (CAHMS) standards, 90% of people should start mental health treatment within 18 weeks of referral.

Just 78.4% of those served by NHS Lothian received care within this time.

This equates to around 639 children and young people left waiting for over 18 weeks to receive care at the end of last year.

In papers from its most recent board meeting, NHS Lothian says demand for mental health treatment in the area has increased by 62% since 2021 and CAMHS Lothian faces ‘significantly higher’ numbers of referrals than other parts of Scotland.

Work is ongoing to understand the reasons for this.

It also says reductions Scottish government funding in recent years – equivalent to a cut of around £500,000 in mental health – has led to a reduction in capacity.

NHS Lothian has now been escalated to stage 3 of the NHS Scotland support and intervention framework, which will see it receive enhanced formal monitoring and support from the Scottish government.

The government has told the board to set out options to ensure the CAMHS waiting times standard is met by the end of 2025.

NHS Lothian says this would require an additional 127 new patient appointments to be carried out each month until then.

This kind of increase will mean the board will potentially need to increase its use of the independent sector, according to papers.

Health board escalation

Eight of Scotland’s 14 territorial health boards will now receive extra government support with issues around financial management, mental health performance or governance and leadership.

NHS Lothian is the second board in 2025 to be escalated to level 3 of the framework.

Last month, NHS Grampian was escalated to level 3 due to its deteriorating financial position, with it now forecasting a year end deficit of £77.4m – around 5% of its total budget – pointing to pressures across its integration joint boards.

In a letter to the Scottish parliament’s health committee, Health Secretary Neil Gray said further escalation may be required “without tangible improvements in the underlying financial position”.

Meanwhile, NHS Highland and NHS Tayside will sit alongside NHS Lothian at level 3 of the government’s support and escalation framework as a result of mental health performance.

CAMHS targets have proven challenging for NHS Highland, with recent figures showing 25% of children and young people had waited more than 18 weeks to receive treatment, while NHS Tayside is struggling to meet adult psychological therapies waiting times guidelines.

 

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