However difficult, hospital included (6)
I believe the answer is:
though
'however' is the definition.
('though' can be a synonym of 'however')
'difficult hospital included' is the wordplay.
'difficult' becomes 'tough' ('tough' can be similar in meaning to 'difficult'**).
'hospital' becomes 'h'.
'included' means one lot of letters goes inside another.
'tough' placed around 'h' is 'THOUGH'.
(Other definitions for though that I've seen before include "Even if" , "Nevertheless" , "Despite the fact that" , "However" , "Concessive conjuction" .)