Number plate cameras could be used to tackle parking problems at Ninewells Hospital in Dundee, according to an NHS Tayside report.
The health board launched a review following complaints that patients, staff and visitors regularly faced long queues to get a parking space.
A traffic survey showed about 7,000 vehicles normally enter the site between 07:00 and 15:00 on weekdays, despite there only being 2,500 available spaces.
Parking fees at the hospital were scrapped by the Scottish government in 2021, but there are claims that some drivers use it as a park-and-ride to travel into the city centre.
Health chiefs said some patients can face waits of up to an hour, making them late or forcing them to miss appointments altogether.
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At present, Ninewells visitors using short-stay car parks must display a free ticket on their vehicles, but can be fined if they stay beyond the four-hour time limit.
During 2025, more than 14,500 fines were handed out at Ninewells car parks – a rise of more than 3,500 on 2024.
The health board said this "indicates that the existing arrangement and approach is not sufficient to prevent or deter parking violations".
A report presented to the NHS Tayside board set out measures proposed for both Ninewells and Perth Royal Infirmary.
During the first phase, NHS Tayside will renew its car park management and enforcement contract at both hospitals.
It will also cost the introduction of automatic number plate recognition (ANPR) cameras in three car parks at Ninewells to enforce the four-hour limit.
NHS Tayside hopes these cameras will "improve turnover" in high-demand public parking areas closest to the main entrance, and provide more reliable real-time information on parking use which can "support future decisions about parking allocation and traffic management".
The second phase of the plan involves "operational changes to improve traffic flow and better align parking provision with the needs of patients, visitors and staff".
These include changing drop-off areas and additional provision for blue badge holders.
The health board says it will also introduce "transparent, evidence-based permit criteria" for staff and the "redefinition of staff and public car parking areas".
Speaking at an NHS Tayside board meeting, director of infrastructure Rose Jenkins said that "everybody recognises there's a long-term issue" around parking at the hospital.
"There is no intent to put charges back in," she said.
"If you don't follow the rules, you'll get a ticket, and therefore you'll be expected to pay a fine for that.
"Overall, we are hoping this will make improvements."
There is no current timescale for the introduction of the new measures.