New maternity standards to improve consistency and quality of care
Clear information about the standards women and their families can expect during their maternity care has been published by Healthcare Improvement Scotland.
The standards set out that patients should receive safe and compassionate care throughout pregnancy, birth and the postnatal period, regardless of where they live or their individual circumstances, and that care should be responsive to each woman’s individual needs.
The standards cover all aspects of maternity care, from antenatal appointments through to postnatal support, emergency care, mental health and wellbeing, and bereavement care. They apply across all settings, including hospitals, community services, midwifery units, and home births, and support NHS boards to actively work to reduce health inequalities and improve outcomes for women and their babies.
Once implemented, Healthcare Improvement Scotland will use the standards to drive this improvement, informing inspection and assurance activities across NHS boards.
Public Health and Women’s Health Minister Jenni Minto said: “The safety of women and babies is paramount.
“We commissioned Healthcare Improvement Scotland to develop the Maternity Care Standards, and I am grateful for their work to improve the quality and consistency of maternity care for women, babies, and families across Scotland.
“Every woman deserves to feel safe, supported and listened to during pregnancy and beyond. These standards recognise that some women face additional barriers to getting the care they need and set out a clear commitment to making sure maternity services work equally well for everyone — whatever their background or circumstances.”
Melissa Dowdeswell, Director of Nursing and Integrated Care, Healthcare Improvement Scotland, said: “We are pleased to have published maternity care standards that set clear expectations for how maternity care should be delivered in Scotland.
“The standards aim to promote consistency and improve the quality of maternity services across the country. They set out a blueprint for what good maternity care looks like and detail the levels of high-quality care and support that all women should expect to receive before, during and after birth.
“During the development of the standards, we spoke to women from many different backgrounds, who shared their experiences of being pregnant and giving birth in Scotland. Their voices were central to the creation of the standards.
“We heard that women need to feel confident that a high-level of safe, effective and person-centred care will be consistently delivered in all maternity units across Scotland regardless of individual circumstances or needs.
“The development of these standards is a commitment to making sure this happens.”
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Healthcare Improvement Scotland yesterday (Thursday 13 November) published a report relating to a Safe Delivery of Care inspection of Acute Adult In patient services at Royal Edinburgh Hospital, NHS Lothian. The inspection took place between 17 – 19 June, 2025.
Our safe delivery of care inspections of adult mental health services aim to take account of the changing risk considerations and sustained service pressures currently across NHS Scotland.
During our inspection of Royal Edinburgh Hospital, we inspected wards, spoke to staff and patients and reviewed policies and procedures. Throughout July and August we held several discussion sessions with key members of NHS Lothian staff to discuss the evidence provided and findings of the inspection.
Speaking of the Royal Edinburgh Hospital report, Donna Maclean, Chief Inspector, Healthcare Improvement Scotland, said: “During our inspection we saw good multidisciplinary team working to provide person-centred care and treatment and kind and respectful interactions between staff and patients.
“Staff were open and transparent about the current challenges they face in relation to the use of non-standard care areas throughout the hospital. During our inspection we raised several concerns with senior managers relating to the care of patients within non-standard care areas.
“We also raised concerns with senior managers around risk assessments, a lack of approved process to support staff decision making and lack of privacy for patients in non-standard care areas. Issues around unassessed ligature points, environmental challenges and the ability of staff to be able to carry out continuous observations were also highlighted.
“We also raised concerns relating to the fire risk assessments and the lack of appropriate fire doors.
“Several requirements have been given in relation to a lack of effective systems in place to support the delivery of safe care within non-standard care areas. We will return to carry out a follow-up inspection to assess and monitor improvement in response to these concerns.
“Other areas identified for improvement include staff training in areas such as life support and fire safety as well as improving communication with patients and families.”
Eddie Docherty, Director of Quality Assurance and Regulation at Healthcare Improvement Scotland, said: “Our previous mental health inspection programme was focused on infection prevention and control.
“It was agreed with Scottish Government to widen the inspection focus from infection prevention and control to a broader assurance function, creating a new and revised ‘safe delivery of care’ assurance model in NHS adult mental health units.
“We believe it is important to provide public assurance that adult mental health units in Scotland are safe for patients and staff, provide quality person-centred care, with clear leadership and a focus on improvement.”
The Royal Edinburgh Hospital inspection resulted in six areas of good practice, four recommendations and 21 requirements.
An improvement action plan has been developed by NHS Lothian to meet the requirements.
NHS Lothian says it is continuing work to improve Adult Mental Health services after accepting a report published by Healthcare Improvement Scotland (HIS) yesterday (Thursday 13 November).
Significant work has been ongoing since March 2025 to meet the considerable increase in demand for beds, which regularly exceeded capacity, and address system pressures.
A detailed improvement plan to address the requirements from the HIS report is also well underway, with many of the actions already complete or in progress.
The HIS inspection took place in June during efforts to meet demand. While it identified many areas of good practice within teams and the care provided, it highlighted more needs to be done.
Jim Crombie, Deputy Chief Executive, NHS Lothian said: “We take patient safety extremely seriously and took immediate action to address many of the concerns raised in the report.
“A structured plan to reconfigure wards to add extra permanent beds where needed is almost complete. This will end the use of temporary, non-standard areas and the divert suite, which were set up in response to demand.
“Additional leadership oversight and staff training are in place to improve the quality and consistency of ligature inspections, assessments and observations to further reduce the risk of patient self-harm or suicide.
“We have also recently recruited 97 newly qualified nurses, and 30 healthcare support workers. This will allow us to meet increasing service demand and provide more resilience, while significantly reducing the use of bank and agency staff.
“We are committed to providing safe, effective care for patients and ensuring staff are well supported. We are grateful to HIS for their guidance and will continue to work with them and other professional bodies to improve our services.”
Since the initial improvement work began, considerable progress has also been made in reducing delayed discharges. This includes working closely with the health and social care partnerships and other specialist care providers to ensure patients can return to the community with appropriate support.
Improvements are also underway to enhance patient and carer communications, building on the positive work noted in the report of proactively obtaining their feedback. More widely, an ongoing programme of work to transform mental health services to meet the changing needs of mental health care and future proof services also continues.
We carried out an unannounced inspection to Royal Edinburgh Hospital, NHS Lothian, on Tuesday 17 June to Thursday 19 June 2025 using our safe delivery of care inspection methodology. We inspected the following areas:
Balcarres
Braids
Caanan
Craiglockheart
Cramond
Divert suite
Fairmile
Harlaw
Hawthorn
Hermitage
Margaret Duguid unit
Meadows
Merchiston
Myreside
Orchard
During our inspection, we:
inspected the ward and hospital environment.
observed staff practice and interactions with patients, such as during patient mealtimes.
spoke with patients, visitors and ward staff.
accessed patients’ health records, monitoring reports, policies and procedures.
This inspection resulted in six areas of good practice, four recommendations and 21 requirements.
Healthcare Improvement Scotland: Inspection report Royal Infirmary of Edinburgh, NHS Lothian
Healthcare Improvement Scotland today (Wednesday 29 October) published a report relating to a Maternity Services Safe Delivery of Care inspection visit to the Royal Infirmary of Edinburgh, NHS Lothian.
We carried out the unannounced inspection of maternity services at the hospital on 23-24 June 2025.
Speaking of the report, Donna Maclean, Chief Inspector, Healthcare Improvement Scotland, said: “During our inspection of the maternity services we saw staff working hard to provide compassionate and responsive care in very challenging circumstances. All interactions observed during inspection between women, babies and families were positive and respectful.
“We saw good teamwork and innovation within the maternity triage department involving extended members of the multidisciplinary team including obstetricians, midwives and the healthcare support team.
“However, during the course of this inspection, we escalated serious concerns within NHS Lothian to senior staff and Scottish Government. These concerns related to culture, oversight of patient safety and staff wellbeing within Edinburgh Royal Infirmary maternity services.
“Some staff were complimentary and described their line manager as supportive. However, the majority of the multidisciplinary team we spoke with were frustrated at staffing levels and told us this presented a safety risk, which they’d raised on multiple occasions with managers.
“They shared their concerns and feelings of being overwhelmed, unsupported and not listened to. They said this has impacted staff confidence to escalate staffing concerns.
“During the inspection we observed delays to the induction of labour process of up to 29 hours and other delays to women who required ongoing care within the labour ward due to lack of staff availability, capacity and the complexities of patient conditions.
“Staff described suboptimal skill mix and challenges in providing and maintaining one to one care for women within the labour ward, as well as delays to observations or escalation of clinical concerns.
“Our inspection has highlighted gaps in incident reporting and a reluctance to submit incident reports, with staff describing a culture of mistrust. These are concerning issues that may have significant impact on the learning from adverse events in the system and reduce opportunities to improve safety.
“Women told us of mixed experiences within the hospital, whilst some were complimentary of their care, they also informed inspectors of poor communication that left them feeling uninformed and with no ‘voice’ in their care.”
Other areas for improvement identified included fire safety requirements, safe storage of cleaning products and improvements to the environment.
Speaking of our expansion of Safe Delivery of Care inspections into maternity services, Eddie Docherty, Director of Quality Assurance and Regulation, said: “In response to Healthcare Improvement Scotland’s Neonatal Mortality Review in 2024, we made a commitment to expanding our Safe Delivery of Care inspection approach to include inpatient maternity services.
“The maternity inspections will provide women, and families with an assessment of the quality of care provided by their local maternity service and an independent review of any required improvements.
“Our organisation is also producing a set of standards for maternity services, which will in time support our inspection process for maternity services.”
The maternity services inspection at the Royal Infirmary of Edinburgh resulted in five areas of good practice, two recommendations and 26 requirements.
An improvement action plan has been developed by NHS Lothian to meet the requirements for maternity services.
The full Lothian maternity inspection report is available to view at:
Pre-empting the report, NHS Lothian issued a statement yesterday:
KEY MESSAGES FOR PATIENTS
You are likely to read or hear some stories in the media this week about maternity services in NHS Lothian.
A new BBC documentary will air on Tuesday and will explore challenges in maternity services across Scotland. It is looking at situations and cases in the bigger units of Glasgow and Edinburgh and is following up on the improvement work that is already underway in NHS Lothian.
Then on Wednesday, Healthcare Improvement Scotland (HIS) will publish a report into Women’s Services following two unannounced visits in June.
You might understandably have some questions or concerns about what is going on. It is also to be expected that you may feel more anxious than normal.
We can reassure you that your health, and that of your baby, is our main priority.
If you have any questions at all, please raise them. If your expert midwife can’t answer them, they will be able to find someone else who can help.
A phoneline has also been established to help answer any questions or concerns. It will be manned by our Patient Experience Team with a local contact in Women’s Services for any specific issues.
You can make contact on: Tel 0131 536 3370 (open Mon-Fri, 9am to 2pm) and on email: LOTH.Feedback@nhs.scot
Many of the things to note are:
We know these reports will be concerning and we apologise to women, people who use the service, and their families and can reassure them that these issues are being taken extremely seriously.
A major improvement programme began last year and is already underway across women’s services in NHS Lothian.
Many of the points we expect to be mentioned in the BBC documentary and many of the findings in the HIS report actually reinforce the work that is already underway and serve to strengthen the improvement plan.
The issues are being taken extremely seriously, and we have always been clear that wider ranging matters, such as staffing, recruitment and working culture within the department, will take time to resolve.
Significant investment and improvements have already been made, and many new posts have been filled, but there is still more to do to ensure our staff feel supported at work, safe to raise concerns and able to thrive.
We are working to enhance patient safety, quality of care and improve working conditions for our teams.
The first and ongoing phase of improvement work focussed on patient care. The second phase is focussed on staff working culture, training and environment.
As part of the programme, we have improved triage and escalation increased staffing, boosted training, altered placement rotation and created robust patient pathways.
The report highlighted some areas of good practice, particularly our maternity triage system which is one of areas already targeted by the ongoing improvement programme.
The first in a series of visits to Child and Adolescent Mental Health Services (CAMHS) Inpatient units has found a mix of concerns for the safety and wellbeing of young people, alongside committed staff and positive initiatives at the Melville Unit in Edinburgh.
The joint unannounced visit was carried out in May 2025 by the Mental Welfare Commission for Scotland together with Healthcare Improvement Scotland, following a commitment from the Minister for Social Care, Mental Wellbeing and Sport to address national concerns about the care of young people in mental health units.
The Commission listened to the experiences of the young people in the unit during the visit. While young people reported feeling listened to by staff and staff were praised for their clear commitment and passion, the visit identified several critical areas requiring immediate action.
Key findings on safety and wellbeing of young people
The report presents a mixed picture of the care provided at Melville. On one hand, the Commission observed positive interactions between staff and young people, who reported feeling listened to by dedicated and passionate staff.
However, there were concerns for the safety and wellbeing of young people. A significant issue was the use of restraint. The report calls for urgent improvement when this highly restrictive response is used, noting a lack of detailed care plans and incomplete records.
Of particular concern is the practice of nasogastric tube feeding under restraint, which requires immediate review to ensure it follows best practice and respects young people’s involvement in decisions about their care.
The unit has also yet to ensure all care is lawful under the Mental Health Act, as our previous recommendations have yet to be fully acted on and embedded. The quality of care planning and communication with parents also requires improvement.
Young people and their families reported a lack of activities, especially in the evenings and on weekends. Some young people said this meant they spent “too much time thinking their own thoughts,” which directly impacts their recovery.
The physical environment was also noted as requiring attention to ensure the safety of both staff and patients.
Julie Paterson, Chief Executive of the Mental Welfare Commission and Robbie Pearson, Chief Executive of Healthcare Improvement Scotland said: “Inpatient care provides intensive support for children and young people experiencing acute mental health crises and it is crucial such care meets both legal requirements and standards for the safe delivery of care.
“This report has identified areas for improvement as well as good practice. It is important the NHS Lothian addresses the recommendations and requirements with appropriate urgency.”
Claire Lamza, Executive Director (Nursing) of the Mental Welfare Commission for Scotland, said: ““The safety and wellbeing of vulnerable young people in specialist inpatient mental health units is a key priority for the Mental Welfare Commission. Several findings from our visit to Melville were concerning as they did not provide the quality of lawful care and treatment every young person has a right to.
“We recognize the dedication of staff at Melville who genuinely advocate for young people. However, decisive action from NHS Lothian is needed to address the issues identified in this joint report and in previous Commission visit reports. This must include honest reflection on why previous action plans and intentions have yet to deliver meaningful change for young people and their families.”
Nicola Killean, Children and Young People’s Commissioner Scotland, said: “I’m deeply concerned about the findings from the Mental Welfare Commission into the care of children at Melville Unit, which highlight potential rights breaches including the safe and lawful use of restraint.
“This is further worrying evidence about the use of restraint on children living in some of the most vulnerable situations. Alongside partners I have been raising my concerns with the Scottish Government about the use of restraint on children in mental health provision for over two years.
“Following my recent letter before action, I am pleased that the Scottish Government has now confirmed that it will revise the statutory code of practice to include human rights-based guidance and put in place mandatory recording and reporting of restraint and seclusion.
“I have also been given assurances that it will designate the Mental Welfare Commission as the appropriate monitoring body. These steps must be taken urgently to protect children from harm.”
NHS Lothian says it is working to improve services for young people at the Melville Inpatient Unit after it accepted a joint report published today (Thursday 23 October) by Healthcare Improvement Scotland (HIS) and the Mental Welfare Commission (MWC).
A robust action plan is already well underway to address the report recommendations and improve care in the specialist Child and Adolescent Mental Health Service (CAMHS) unit which supports up to 12 young people with complex needs.
CAMHS has made significant progress in recruiting and retaining more skilled staff and developing new care pathways, with the report also highlighting positive staff interactions and their commitment and passion for working with young people.
However, Jim Crombie, Deputy Chief Executive for NHS Lothian, said that wider improvements were continuing across the unit.He added: “We want to reassure young people and families that we are committed to delivering safe, high-quality and effective care and we take the findings of the report extremely seriously.
“The safety and care of young people and staff is always our top priority. Restraint is only ever used in the unit as a last resort to prevent harm for young people or to staff or other patients.
“We introduced an initiative to reduce the use of restraint further, which was observed by HIS during the inspection, and has shown positive results. Systems are also in place to improve the recording, monitoring and auditing of restraints.
“We want to thank staff for their ongoing dedication and HIS and MWC for their expertise and guidance in shaping improvements to the mental health care of young people. We will welcome any forthcoming national guidance or best practice from these essential reviews.”
The action plan also includes work underway to improve multidisciplinary team dynamics through enhanced meeting structures, communication, collaboration and decision making to work more effectively with young people.
Since May 2025, a system has been in place to monitor legal authority for treating young people under the Mental Health Act, with enhanced managerial oversight and daily checks by registered nurses to ensure documentation is in place before administrating care.
Work also continues to expand meaningful evening and weekend activities for young people with regular reviews planned. Nurses will also receive refresher training to strengthen their therapeutic skills in individual and group settings.
A review of the physical environment of the Melville Unit, including looking at options for how best to provide care safely while meeting the needs of young people, is also well underway.
A copy of the report is available from Healthcare Improvement Scotland.
New review process will ensure lessons are learned from each case
‘a thousand words’ commissioned by Scottish Womens Aid and Zero Tolerance. Copyright Laura Dodsworth
Legislation to help reduce the number of domestic abuse-related homicides and suicides in Scotland has been passed unanimously by Parliament.
The Criminal Justice Modernisation and Abusive Domestic Behaviour Reviews (Scotland) Bill will legally require a new robust review process following the death of a partner, ex-partner, or child where abuse is known or suspected.
The reviews, which are expected to start next spring, will mean that where there has been a death of this nature, justice, health, social care, local government and third sector agencies must work together to identify and agree any areas for change and improvement so further deaths may be prevented.
Justice Secretary Angela Constance has commissioned Healthcare Improvement Scotland to work with partners, those with direct experience of domestic abuse and families bereaved in these circumstances, to develop national standards to support how the reviews are undertaken and the multi-agency and multi-disciplinary response to domestic homicide and suicide.
The Bill will also help to modernise the justice sector by supporting greater use of digital technology, including evidence-sharing, and efficient processes.
It will make permanent a number of temporary measures that were put in place during the COVID pandemic in 2020 which improved how the criminal justice system works. The reforms include allowing more virtual attendance at criminal courts, electronic signing and sending of documents in criminal cases, and greater use of digital evidence from crime scene to court room.
As well as benefiting victims and witnesses, these reforms will help efforts to support frontline policing – sparing officers from unduly waiting around in court buildings.
The Justice Secretary said: “Any death following domestic abuse is one too many. The new Domestic Homicide and Suicide Review Model, backed by national standards, will help to ensure lessons are learned following such deaths, so that services are improved and victims are better protected.
“I hope that identifying what needs to improve will mean there are fewer deaths of this kind.
“Legislation alone is not enough, though. The real change we need to see will only happen when those who perpetrate domestic abuse – the majority of whom are men – change their actions and behaviour.
“This Bill will also provide resilience to the criminal justice sector by embedding efficiency and modernisation in procedures – making sure Scotland’s criminal justice system can meet current and future demands.
“This includes greater use of digital technology, including evidence-sharing, and efficient processes such as allowing more virtual attendance at criminal courts and electronic signing and sending of documents in criminal cases.”
Fiona Drouet, who founded the EmilyTest charity in memory of her daughter, and who chairs the Domestic Abuse Related Suicide Group under the Domestic Homicide and Suicide Review Taskforce, said: “The introduction of statutory reviews into domestic abuse homicides and suicides is a hugely important step.
“Like so many families, we were left to piece together the devastating circumstances that led to our daughter Emily taking her own life, all whilst in the most painful time of our lives.
“Doors closed on us, and the desperation to make sure no one else ended up in Emily’s shoes felt all-consuming – a responsibility we should never have had to carry.
“Having comprehensive reviews in place means there’s less risk of lessons being missed and future tragedies prevented. Domestic abuse-related suicides now outnumber domestic homicides, which is why giving equal priority to these deaths is so vital.
“As Chair of the Group under the Domestic Homicide and Suicide Review Taskforce that is informing Scotland’s suicide reviews, I see firsthand the depth of expertise partners bring to the process, and am confident in a system that puts lived experience at its heart.
“The wider provisions in the Bill to strengthen existing practices and protections are also welcome, bringing greater consistency and safety across Scotland.”
Scottish Women’s Aid CEO Dr Marsha Scott said: ““Scottish Women’s Aid warmly welcomes this legislation.
“We have been calling for a Scottish response to domestic abuse deaths for almost a decade, and this new law delivers a unique approach that was developed in an inclusive, thoughtful, and evidence-based process.
“Implementation, as always, must be resourced supported by the expertise of specialist services, but this law gives us the tools to make a difference.’’
Victim Support Scotland Head of Communications and External Affairs Carol Eden said: “Victim Support Scotland welcomes legislation in both parts of this important Bill.
“Much of what is being put into legislation reflects what has been in practice for several years now as a result of COVID. Victims and witnesses have become accustomed to and expect the level of flexibility this offers, and to not make permanent these powers would be a retrograde step.
“Equally, Victim Support Scotland is supportive of legislation to underpin a Domestic Homicide and Suicide Review model to help to develop a better understanding of how domestic abuse impacts communities in Scotland.
“We have been heavily involved in these developments as an active member of the Domestic Homicide and Suicide Review Taskforce and associated sub-groups, with our work informed by our Support for Families Bereaved by Crime service, which provides practical and emotional support to families bereaved by murder and culpable homicide.”
Funding for projects to benefit patients and clinical staff
A total of £1.5 million funding in 2024-25 is supporting 12 projects to continue providing direct and personalised support to patients with cancer.
The Single Point of Contact (SPoC) pilots provide patients with ongoing contact to support them, putting them at the heart of all decisions and actions involving them throughout their care journey.
The NHS Lothian SPoC uses a centralised digital hub delivering telephone communication and support to patients with a range of cancer types.
Around 40% of calls are diverted away from Clinical Nurse Specialist workload, which has led to improvements in the quality of their telephone contacts. Patient engagement work carried out by NHS Lothian and Healthcare Improvement Scotland has indicated high satisfaction with the service.
Confirming the funding, which is included in the 2024-25 Budget, as he met nurses at Edinburgh Cancer Centre with experience of the service, First Minister John Swinney said: “We are fully focused on improving cancer survival, and delivering excellent and accessible care is at the core of how we do that.
“The Single Point of Contact Service meets requirements identified by Boards to deliver improvements in communication and support for patients with navigating cancer care.
“By taking in the region of 2,000 calls per month and providing person-centred support to those patients throughout their care journey, the Edinburgh Single Point of Contact project provides consistent access for patients to have conversations about their care, freeing up capacity for specialist staff to focus on the most complex cases.”
Katie Gibson, Neuroendocrine Tumour Clinical Nurse Specialist at the Edinburgh Cancer Centre, said: “I’ve seen first-hand how the SPoC service has transformed our ability to care for cancer patients.
“The centralised system streamlines communication and allows us to spend more quality time with those who need it most.
“As a result, patients are aware of who to contact for the support and advice they require from diagnosis , treatment and beyond.”
Over £1.5 million will support 12 pilot projects across Scotland to deliver a single point of contact to people diagnosed with cancer.
Funding has been delivered in response to needs identified by individual Boards and proposals submitted by them, pilots vary by cancer type and location:
NHS Lothian has received £ 343,740 to support the telephone-based SPoC service at Edinburgh Western General, serving boards within the South East Scotland Cancer Network
NHS Borders has received £82,000 for 3 cancer care co-ordinators, providing support across a variety of cancer sites
NHS Dumfries and Galloway has received £71,000 for 2 cancer co-ordinator posts, providing a telephone-based support service across a range of tumour sites
NHS Fife has received £107,354 to staff a Single Point of Contact Hub, dealing with all urgent suspected cancer referrals.
NHS Forth Valley has received £67,556 for 2 healthcare support workers (HCSW) providing a single point of contact for 7 tumour groups
NHS Ayrshire and Arran, NHS Forth Valley, NHS Greater Glasgow and Clyde, and NHS Lanarkshire have received total funding of £202,668to develop a regional approach to digital remote follow up of prostate cancer patients in the West of Scotland
NHS Greater Glasgow and Clyde has received £67,566 for 2 support workers to augment specialist gynaecological nursing support and £141,324 for 4 SPoC roles across GGC sites to smooth and facilitate the patient journey, for people diagnosed with lung cancer
NHS Grampian has received £84,500 for 3 posts to provide a joint service with Macmillan Navigators, providing support following an Urgent Suspicion of Cancer (USC) referral
NHS Highland has received £270,680 for 7 Cancer Support Workers providing tailored support throughout diagnostic pathway and onto treatment
NHS Tayside has received £33,288 to provide support for people diagnosed with advanced Upper Gastrointestinal or Hepatopancreatobiliary tumours and lung, renal and prostate cancers
NHS Western Isles has received £68,000 for 2 HCSWs, as part of the Macmillan Team, to support people with all types of cancer
Health Improvement Scotland is currently carrying out a scalability assessment of all 12 projects in order to identify best practice and how best to scale and expand these pilots.
Providing older people with a safe alternative to hospital
The number of patients using Hospital at Home in Scotland rose by almost a quarter last year, it has been revealed, as funding allocations for NHS boards were announced.
A total of 13 local healthcare providers have been allocated a share of £3.6 million for Hospital at Home for older people to help ease pressure on frontline acute services.
Hospital at Home offers a safe alternative to admission to an acute hospital, with almost 15,000 older patients using the service in 2023/24 and this funding will support the continuation and development of existing programmes.
NHS Borders has been allocated £600,000, with a further 12 healthcare partners also receiving a share of the allocation.
14,467 patients used Hospital at Home in 2023, up from 11,686 in the previous year
total bed numbers increased by 58%, ahead of the Scottish Government’s 50% target
an estimated £14.9 million was saved in traditional hospital admission costs
a further estimated £36.3 million was saved in post-hospital care due to a reduction in re-admissions
Health Secretary Neil Gray said: “I am very pleased to see the progress that local health providers are making on delivering Hospital at Home services and the positive impact it is having, particularly on elderly patients.
“Hospital at Home allows patients to receive acute treatment in an environment that they feel comfortable and familiar with.
“There are more Hospital at Home beds for older people available and an increasing number of patients are choosing to use the service.
“Hospital at Home gives people greater independence during their recovery. Evidence shows that those benefitting from the service are more likely to avoid hospital or care home stays for up to six months after an acute illness.
“It is also one of a range of measures that we have put in place to tackle delayed discharge numbers and free up beds within our hospitals.”
Belinda Robertson, Associate Director of Improvement, Healthcare Improvement Scotland said: “We know that patients benefit from receiving safe, patient-centred care in the comfort of their own home whilst continuing to benefit from the support they are used to from families, friends and carers.
“Our latest annual report for Hospital at Home across Scotland shows that more and more NHS boards and Health and Social Care Partnerships are providing acute hospital care to people in their own homes.
“Four new services for people living in and around Dumfries, Galashiels, Lerwick and Oban have been established in the last year, and Hospital at Home services across the country have prevented over 14,467 people spending time in hospital.
“We would like to commend the Hospital at Home services for the fantastic work they’ve done to establish and grow their services. In the year ahead, we look forward to continuing to support NHS boards and Partnerships to further develop the services they provide, and to share learning across all Hospital at Home services.”
As a girl who began watching ballet at the age of 10, little did Safia Qureshi realise that one day her interest in dance would lead to a career in helping to improve people’s health and wellbeing.
Safia is currently Director of Evidence and Digital at Healthcare Improvement Scotland, the national improvement agency for health and care in Scotland, whilst also being a volunteer with Scottish Ballet. She is involved with them as part of a ground-breaking initiative that uses dance as an alternative to medication.
Safia, from Penicuik, is one of 3485 NHS volunteers each month, who give up their time to help others. In total, NHS volunteers donated 584,000 hours in 2023-24 – the equivalent of 24,333 days.
She is encouraging others to do their bit and give up some of their spare time, as part of Volunteers Week, which runs from Monday, 3 June until Sunday 9.
Safia said: “I grew up loving ballet. I went to see it with my mum when I was a little, so I’ve always gone to see it when I can.
“I was doing a leadership development course run by the Scottish Government called Project Lift when I first came into contact with Scottish Ballet in a work setting. and they had this idea which they called Colliding Perspectives.
“I was involved in an initiative where small groups of people who were on the course came together with folk from different industries, and one of the companies involved was Scottish Ballet.
“They were looking for help with developing their Dance Health programme so I was straight at the front for that one, saying ‘Let me help!’
“Some colleagues and I were invited for a visit, to meet them and talk about what they were looking for.
“When I was there, I wondered if Healthcare Improvement Scotland might be able to help them, because one of their challenges was persuading healthcare professionals that dance could be used as an alternative to medication.”
Safia initially volunteered with a programme which helped people with Parkinson’s Disease.
She explained: “Having heard about their dance health programme at a high level, I got the opportunity to volunteer with the Dance for Parkinson’s programme that Scottish Ballet was running in Peebles, so I volunteered with them, probably on and off for maybe a year-and-a-half, and that was what really did it for me.
“It was just the most amazing experience, as the classes were run by professional dancers and they treated everyone who was in the room as a dancer. It was all really respectful and the programmes are based on whatever Scottish Ballet are working on, so there’s always a connection back to the company.
“The class became this real community, where people with Parkinson’s and a friend or a partner would come, and we’d all do the class together. It was great for helping people to relax and unwind.
“There were times when I would be blinking back tears at the positivity and community in the room. There’s something really special about the way that dance helped and united us all. I got such a lot from it personally, and it made me more determined that we need to show other people this is something that is amazing.”
With her knowledge as a health and care professional, Safia has been delighted to bring her professional expertise, her contacts within the world of healthcare professionals, plus her love of ballet together, and in turn has made many friends.
She said: “I helped Scottish Ballet set up their research committee and bringing in clinical experts.
“Having been a volunteer for a while, I was thinking some of the exercises that Scottish Ballet do might benefit people with Long COVID.
“We asked some of the patient representatives who’d supported us develop a clinical guideline for people with Long COVID guideline if they would meet with Scottish Ballet and talk them through what might be useful. They then introduced Scottish Ballet to more people in the Long COVID community. There was a real example of thinking differently, and using what you do in a different way to help people.”
Safia added: “When I was 10 years old and going to the ballet with my mum, I wouldn’t have believed this was all possible and that one day, I’d be working with Scottish Ballet. It still catches me every time I go.
“Through volunteering, you meet fascinating people who you would never otherwise have met and you also get to learn about yourself as you broaden your horizons. It’s very rewarding.
“Volunteering makes you feel good in lots of different ways, by doing something that takes you out of your day-to-day routine. I’ve been part of a community I never knew existed, which is lovely and I couldn’t recommend it highly enough.”
£3.6 million investment as capacity increases by 57% to exceed targets
The Scottish Government is continuing to invest in Hospital at Home for Older People with £3.6 million allocated for 2024/25, bringing total funding allocation for the initiative to over £15 million since 2020.
Recent statistics released by Healthcare Improvement Scotland (HIS) show that last year the Hospital at Home service for Older People, which provides a safe, alternative to being admitted to an acute hospital, exceeded targets in several key areas between April 2023 and March 2024, including:
total bed numbers have increased by over 57%, ahead of the Scottish Government’s 50% target
14,467 patients used Hospital at Home, up from 11,686 in the previous 12-month period
the Hospital at Home service is now the eighth biggest “hospital” for older people emergency inpatients, alongside Forth Valley Royal Hospital in Stirling.
Health Secretary Neil Gray said: “These figures from HIS show that Hospital at Home is becoming an increasingly popular care alternative for elderly patients to receive acute treatment in a place they feel comfortable and familiar with.
“There are more Hospital at Home beds available and an increasing number of patients choosing to use the service.
“Hospital at Home gives people greater independence during their recovery process. Evidence shows that those benefitting from the service are more likely to avoid hospital or care home stays for up to six months after an acute illness.
“It is also one of a range of measures that we have put in place to tackle delayed discharge numbers and free up beds within our hospitals.”
Belinda Robertson, Associate Director of Improvement, Healthcare Improvement Scotland said: “This announcement of additional funding will continue to improve access to Hospital at Home services and make them more sustainable to the benefit of patients across Scotland.
“It’s heartening to see that Hospital at Home services prevented over 14,400 people spending time in hospital over the past year.
“Moreover, with our support we’ve witnessed more NHS boards and Health and Social Care Partnerships embracing Hospital at Home by establishing and developing services.
“We look forward to continuing to help services develop and share learning in the year ahead.”
