Review of hospital-based complex clinical care NHS Lothian May 2016 Healthcare Improvement Scotland is committed to equality. We have assessed the inspection function for likely impact on equality protected characteristics as defined by age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex, and sexual orientation (Equality Act 2010). You can request a copy of the equality impact assessment report from the Healthcare Improvement Scotland Equality and Diversity Officer on 0141 225 6999 or email
[email protected] © Healthcare Improvement Scotland 2016 First published May 2016 The publication is copyright to Healthcare Improvement Scotland. All or part of this publication may be reproduced, free of charge in any format or medium provided it is not for commercial gain. The text may not be changed and must be acknowledged as Healthcare Improvement Scotland copyright with the document’s date and title specified. Photographic images contained within this report cannot be reproduced without the permission of Healthcare Improvement Scotland. www.healthcareimprovementscotland.org Contents Executive summary 4 Context 5 About this review 7 Part 1: Hospital-based complex clinical care 8 Part 2: Governance, leadership and workforce 11 Part 3: Safe, person-centred and effective care 20 Part 4: Sustainability and capacity to improve 35 Appendix 1 – Recommendations 44 Appendix 2 – Review team and assurance group 47 Appendix 3 – Methodology 48 Review of hospital-based complex clinical care: NHS Lothian - May 2016 3 Executive summary Key messages • The NHS across Scotland is facing a number of challenges, due to an ageing population, particularly in areas providing care to patients with complex care needs.