This is perhaps the clearest view of the extended Royal Hotel, which is almost in the centre of the picture, before it was partially destroyed by fire at Eastertime of 1929 - the year after the guide that this image is scanned from was published. The photograph was taken from the top of Cat Tor.

There is more information about the hotel and the fire on:
Matlock Bath: The Royal Hotel
The Royal Hotel & Baths (2)
Matlock Bath : New Bath Hotel shows a photograph taken after the fire.

The buildings bottom right are Bath Terrace Hotel, which became part of the New Bath, and Portland House at the bottom of Clifton Road. Holy Trinity Church and both the Old and New Pavilions are the other large buildings. The Old Pavilion or Palais Royal is top left, surrounded by woodland. Beside the river, on the left bank, are the grounds of the Derwent Gardens and part of the Switchback Railway can be seen.