A National Clinical Strategy for Scotland - Summary

We're going to change the way our
hospitals work

We're looking at two big areas of change in hospitals - the processes that we have in place to care for patients - seeking to make them more efficient and of greater value to patients - and the structure of specialist services, recognising that we have to change to get the best outcomes and to make best use of our skilled staff and our financial resources.

Much has been achieved in recent years in streamlining patients' journeys within hospitals, but more needs to be done. That's why we're focusing on ensuring that once patients have had the treatment they require and their condition is stable, they are discharged as soon as possible, supported where necessary by the strengthened primary and community care teams.

Returning people to their communities quickly after a hospital stay promotes their independence and means they can get back to their normal lives more quickly. It requires the integration of health and social services, working together in common purpose.

We are also looking to change the way people are recalled to reviews in outpatient departments. We believe we can provide better alternative arrangements that give people faster access to test results, enable them to be seen more rapidly when unwell and cause less disruption to their lives.

We need to look seriously at the range of specialties our hospitals provide. There is now overwhelming evidence to suggest that some complex (and many less complex) operations should be performed in specialist hospitals. Patients do better when they are treated by teams who frequently perform the complex operations they need. Evidence shows that they tend to have fewer side-effects and spend less time in hospital.

So we are proposing that some specialist hospital services should be planned on a population basis, rather than on a geographical basis. Some cancer surgery in Scotland is currently arranged in this way.

This would mean that some patients may have to travel further to receive some types of surgery and other complex care, but they would be getting a first-class service from highly specialist clinical teams. Any diagnostic and follow-up services they needed would still be delivered locally. And most of the services they require - those that are not highly specialist - will continue to be provided by local hospitals.

Developing networks of hospital services in this way, with expertise concentrated in specialist centres, will produce better results for patients. Making these changes will be complex and will require close collaboration among existing services. But it will ensure that we make better use of our skilled workforce and promote safe, effective and person-centred care for every patient, every time.