Healthcare Improvement Scotland (HIS) publishes inspection report on acute hospital services at The Balfour highlighting compassionate patient care, strong teamwork, supportive leadership and a positive culture across NHS Orkney

The unannounced inspection, undertaken in March 2026, examined care within the Emergency Department, Inpatients 1 and Inpatients 2 wards. Inspectors identified eight areas of good practice and recognised the commitment of staff in delivering safe, effective and person-centred care despite the challenges faced by remote and rural health services.

Highlights include:

• Calm, well-organised ward environments with strong multidisciplinary teamwork
• Positive feedback from patients and carers, who described staff as “kind”, “compassionate” and “responsive”
• Effective hospital-wide safety huddles supporting patient safety and operational oversight
• Strong support for student nurses, newly qualified nurses and international nurses
• A positive workplace culture, with staff describing The Balfour as a good place to work

The inspection identified seven requirements relating to governance processes, training compliance, adverse event review timescales, protected leadership time and the further embedding of new workforce planning systems. NHS Orkney has agreed an action plan and work is already underway in these areas.

The report notes ongoing improvement work including enhanced training programmes, leadership development initiatives, strengthened workforce planning arrangements, quality improvement activity relating to paediatric care, and a programme of whole-system redesign to improve patient flow and reduce delays in transfers of care.

Finally, NHS Orkney’s strong performance in key areas was acknowledged including, emergency care performance, patient flow, patient experience, support for workforce development and collaborative working with regional partners.

Michelle Mackie, Deputy Director of Nursing at NHS Orkney said: “We are pleased that HIS recognised the high standard of compassionate, person-centred care provided by colleagues and of the positive culture that exists across The Balfour and NHS Orkney. We fully acknowledge the areas identified for further improvement and welcome the external scrutiny provided through the inspection process. As a small remote and rural health board, we continually seek opportunities to learn, improve and strengthen our services. We are committed to ensuring that the required improvements are fully implemented and that we continue to provide, safe, effective and high-quality care for our community.”