Audit of critical care in NHS Scotland
Reporting on 2025

About this release

This release by Public Health Scotland (PHS) and the Scottish Intensive Care Society Audit Group (SICSAG) provides a summary of the activity, quality indicators, interventions and outcomes of critical care services in NHS Scotland during 2025. Critical care units are specialist hospital wards for the most severely ill or injured patients. They treat patients with a high level of complexity, and this can be in either an Intensive Care Unit (ICU), a combined unit which acts as both an ICU and High Dependency Unit (HDU) or a standalone HDU.

Main points

• During 2025, there were 16,555 admissions to Intensive Care Units (ICUs) and combined units (ICU/HDU). There were 21,441 admissions to High Dependency Units (HDUs).
• Mortality in ICUs/combined units was 11.6% and in HDUs was 4.9%. After allowing for differences in case-mix and illness severity, no ICU/combined unit had a significantly higher standardised mortality ratio than the national average.
• Delayed discharges continue to be challenging, with 61% of ICU/combined patients delayed for more than 4 hours. This has remained at the same elevated level since 2022 which was a substantial increase from 52% in 2021, reflecting bed pressures across hospitals. A similar increase was seen in HDUs, where 59% of patient episodes ended with delay in 2025, compared with 52% in 2021.
• Among patients with a delayed discharge, one in 11 were discharged directly to home or normal residence rather than via a ward.
• Four out of 22 ICUs did not achieve compliance with at least one of the SICSAG minimum standards and quality indicators (MSQIs), with multidisciplinary team (MDT) staffing challenges contributing to the reason for non-compliance.
• Twelve out of 26 HDUs did not achieve compliance with at least one of the SICSAG MSQIs, 6 of these units were noted only to have one area of non-compliance. Staffing challenges were again amongst the main reasons for this.
• The majority of units not meeting MSQIs have provided a summary of how they plan to achieve these in the coming year.
• The number of pregnant or recently pregnant patients requiring admission to intensive care in Scotland has increased over recent years. This rise has been largely driven by admissions after childbirth, particularly those related to severe bleeding (major obstetric haemorrhage), as well as complications arising during pregnancy or following pregnancy-related surgery. Further work is needed to understand the reasons behind this increasing demand for critical care among this group of patients.

Background

This audit includes all ICUs and the majority of HDUs in NHS Scotland during 2025. It is not possible to provide an accurate figure on the number of HDUs due to differing provisions across all specialties and NHS boards. However, it is estimated that more than 95% of all HDUs participated in this audit. The audit covers nearly 38,000 patients admitted to critical care units in NHS Scotland during 2025. SICSAG aims to improve the quality of care delivered to critical care

patients by monitoring and comparing activities and outcomes. The audit of critical care is a co-ordinated quality improvement programme which provides data, analysis and feedback to raise standards and continued improvement in patient outcomes. The majority of critical care units have provided detailed comments where any MSQIs have not been met.

Further information

The next release of this publication will be 7 September 2027.