Tim Davison: Health board ready to face future challenges The NHS is one of the most beloved and iconic institutions in our country. It provides care, free at the point of contact, and I am privileged to say I have worked for it for as long as I have. It is clear that the NHS needs to continue to develop to keep pace with the ever -changing world around us. We know that, with the challenges we face we are going to have to do some things differently in the future to ensure we can continue to provide safe effective and high quality care to the people of Lothian. Our population is expected to grow from around 850,000 today to around 1.1 million people in the next 20 years. There will be a significant increase in people living longer and living with multiple and complex long-term conditions. We also know that, in the current economic climate, public sector funding will continue to be a challenge. We are taking a strategic approach to planning healthcare for the future which takes account of the integration of health and social care and will help us deliver Scotland's vision for achieving sustainable, quality health care services and a healthier future for everyone. Earlier this year the board approved a set of key principles and aims that will help shape and deliver health care services over the next seven years and beyond (Our Health, Our Future - Strategic Clinical Framework). We are now looking at how we will use this framework to design and implement new ways of delivering care that allow NHS Lothian to meet the needs of the growing population.To begin with, we are focusing our attention on three key areas: the provision of unplanned or unscheduled care and how we can increase capacity to improve the speed with which people can access the care they need and reduce the length of time people spend in hospital. This includes improvements to support in the community to reduce the need for hospital care in the first place. Secondly, increasing capacity within planned or elective care to reduce the need to offer patients treatment within the private sector. This includes looking at the provision of some non-emergency surgery and diagnostic tests seven days a week, as well as one-stop clinics and test and treat options. Thirdly, ensuring that community services and GPs are in a position to respond to the future healthcare demands of the growing population. Improving how we work with the third sector and ­carers and families will help us provide the care and support people need in their own homes. Key to the delivery of all these plans will be having the appropriate ­buildings and facilities - both acute hospitals and community settings. We have committed to developing services around four major hospital sites: the Royal Infirmary of Edinburgh (which will include the replacement for the Royal Hospital for Sick Children, Child and Adolescent Mental Health Service and the Department of Clinical Neurosciences); St John's Hospital, Livingston, the Western General Hospital and to redevelop the Royal Edinburgh Hospital. As part of the commitment to these four key sites, we are looking at the services delivered at each, the opportunities to expand and develop these facilities and which services can be co-located. A full review of our other premises will ensure we have the right type of facilities providing the right number of beds and the right level of care. We need to plan now to ensure we have the staff and facilities in place to meet these increasing demands on our health service and to continue to provide the best care for the people of Lothian. Tim Davison is chief executive of NHS Lothian