What are NHS Fife going to do to create/improve access to assessment for adults (without a learning disability) for an autistic spectrum disorder, ADHD, and other neurodevelopmental conditions? Currently, adults in Fife who suspect they are neurodivergent are having to spend £thousands on private assessment because their mental health hasn't deteriorated enough to warrant admission to hospital to be considered for assessment, yet poor enough to impact on their ability to work and participate in healthy activities . This is not in line with the vision of the Population Health and Wellbeing strategy to live well, work well and flourish.
NHS Fife acknowledges the significant concerns raised regarding access to assessment for adults without a learning disability who suspect they may be living with autism spectrum disorder (ASD), ADHD, or other neurodevelopmental conditions. We recognise that delayed or limited access to diagnostic services has led some individuals to seek private assessments. NHS Fife and Fife Health and Social Care Partnership is committed to improving pathways and accessibility for neurodevelopmental assessments. To address this, we are undertaking the following actions:
- NHS Fife is actively working to increase the capacity of neurodevelopmental assessment services. This includes recruiting additional clinical staff with expertise in ASD, ADHD, and related conditions, and investing in training to ensure that diagnostic services are widely available and of the highest standard.
- We are reviewing and refining referral processes to make it easier for adults to access assessments earlier in their care journey, without needing to reach a crisis point. This includes improving communication between primary care providers and specialist services and removing unnecessary barriers to referral.
- To reduce pressure on hospital-based services, we are increasing access to community-based neurodevelopmental support services. These services will include early screening, support for individuals while awaiting assessment, and post-diagnostic support to ensure a holistic approach to care.
- We are committed to working closely with individuals with lived experience, carers, and advocacy groups to better understand their needs and co-design services that reflect the lived reality of neurodivergent adults in Fife.
- NHS Fife remains committed to ensuring that all individuals have timely access to neurodevelopmental assessments. We are exploring models of care that will allow individuals to be assessed based on need rather than the severity of mental health deterioration, ensuring that assessments are more widely available.
These measures are designed to address the current gap in services, improve timely access to assessments, and ultimately better support neurodivergent adults in Fife, in line with our Population Health and Wellbeing strategy.
What is being done to reduce wait times? Two years to be seen by a specialist when symptoms have an impact on daily life is not acceptable.
NHS Fife apologises for the delay that you are experiencing in waiting to see a specialist. We would advise that if you feel that your symptoms have worsened that you should get in contact with your GP who can contact the specialty that you have been referred to determine if you need to be seen sooner.
NHS Fife is taking action to reduce the number of people waiting for elective care. The pausing of activity as a result of the pandemic as well as levels of demand that exceed the available capacity have contributed to people waiting longer for an out-patient appointment and for elective surgery. NHS Fife will continue to focus on urgent an urgent suspicion of cancers referrals as well as long waiting patients.
As well as adopting local improvements and participating in national elective campaigns, NHS Fife has sought to be as innovative as possible in addressing backlogs for care, using the resources available.
In 2023/24 NHS Fife:
- Opened a local procedure room at QMH releasing theatre capacity by carrying out procedures that are suitable to be performed out with theatre.
- Moved day surgery activity from the Victoria Hospital to Queen Margaret Hospital to ensure the best use of theatre time and capacity.
- Carried out its 500th case of Robotic Assisted Surgery
- Operationalised the Fife Elective Orthopaedic Centre.
- Developed a proactive approach to support the health and wellbeing of patients whilst they await surgery.
- Implementation of Advanced Clinical Referral Triage and Patient Initiated Review (ACRT/PIR)
- Improvement work to increase pre-assessment capacity from 480 to 524 appointments per week.
- Initiated an increased focus on health inequalities within Elective Care
- Commissioned additional diagnostic capacity and scheduled care capacity to reduce backlogs.
Please can you outline what strategies to reduce the waiting times for ASD assessment and the subsequent follow up children can receive in terms of ongoing management like changing sleep patterns, eating issues, mental health. The waiting times and protocols for this are archaic and need radically changed so children (and parents) can get the support desperately needed.
NHS Fife recognises the challenges families face when waiting for autism spectrum disorder (ASD) assessments and follow-up support. We are committed to improving access to timely assessments and ongoing care for children with ASD. To address the current waiting times, NHS Fife is actively working on several strategies, including:
· Increasing Capacity for Assessments: We are investing in additional clinical staff and training to expand our capacity to carry out ASD assessments. This includes recruiting more specialists and exploring the use of multidisciplinary teams to streamline the assessment process.
· Service Redesign: We are reviewing our current pathways and protocols to make the assessment process more efficient. This includes exploring new models of care and digital tools to reduce waiting times and improve access to services for families.
· Early Intervention: While awaiting formal diagnosis, we are working to strengthen early intervention services to provide support for children and families dealing with common ASD-related issues, such as sleep disturbances, eating difficulties, and mental health challenges. This may include guidance from paediatricians, psychologists, and other support services.
· Post-Diagnosis Support: Following diagnosis, we are enhancing the support available for families, including tailored advice on managing specific concerns like sleep, nutrition, and emotional well-being. We are also collaborating with community partners to ensure families can access wider support networks, including parenting programs and specialist autism support services.
· Working with National Partners: NHS Fife is in active discussions with national health bodies to advocate for improved resources and more radical changes to how ASD services are delivered across Scotland. We are committed to addressing the growing demand and ensuring that all children and families receive the care and support they need in a timely manner.
We understand how difficult it can be for families to wait for assessments and support, and we are working hard to implement these changes.
What is the plan in Lochgelly with concerns to NHS dentists and doctors. Currently both are full and not taking in new patients. A new development is in planning and likely to bring an extra 300 plus houses and possibly 1000 plus people to the area. Where are these people going?
Thank you for raising your concerns about access to NHS dentists and doctors in Lochgelly, particularly with the planned housing development and its potential impact on local services. NHS Fife is aware of the growing population in Lochgelly and the pressure this places on existing healthcare services.
In terms of GP services, we are working closely with local practices, the Health and Social Care Partnership, and the Scottish Government to ensure that capacity is increased in line with the needs of the growing community. This includes exploring options for expanding current GP services, with multi-disciplinary teams including physiotherapists and phlebotomists based in practices as well as looking at recruiting additional staff, and investing in new facilities when capital funding becomes available.
For NHS dental services, we recognise the challenge posed by full practices and are working to increase the availability of dental care in the area. NHS Fife is collaborating with dental practices to explore ways of expanding capacity, as well as encouraging new practices to establish themselves in growing communities like Lochgelly.
The planning process for new developments includes careful consideration of local infrastructure, including healthcare services, and we will continue to liaise with Fife Council to ensure that healthcare provision is taken into consideration when planning consent is being considered.
What progress has been made on providing services for those with Myalgic Encephalomyelitis and long COVID following the death of the only nurse specialist in Scotland. Other chronic illnesses have specialist nurses and consultants but there is nothing in place to support those and their families who suffer from these illnesses.
When is Fife going to take active steps to set up a service for M.E. sufferers as provision previously was woefully inadequate and a TEAM, headed by a specialist consultant is needed plus training for GPs.? There is, frankly, no excuse for the apparent total lack of interest in this extremely vulnerable population. Can you explain why it has not been and is not prioritised? Thank you.
In the 3+decades I have had Myalgic Encephalomyelitis (ME) services have declined to becoming non-existent. What plans do the NHS have to put the NICE Guidelines in place and will the Delivery Plan being implemented in England be applied to Scotland and, Basically In relation to Myalgic Encephalomyelitis ME - Implementation of NICE Guidelines Delivery Plan for England ME Specialist Nurse Post in Fife. Where are we with all of these. We seem to have gone backwards since I was diagnosed 36 years ago in relation to services, basically being non existent.
Following the loss of Scotland’s only specialist nurse for Myalgic Encephalomyelitis (ME) and long COVID, NHS Fife acknowledges the significant gap in dedicated services for those affected. We are actively working with key stakeholders, including national health bodies, to assess how best to address this need. While other chronic conditions have established specialist support, we recognise the urgency in developing a sustainable service model for ME and long COVID patients. In the interim, we are exploring multidisciplinary approaches to ensure patients and their families receive appropriate care and support. I This specialist nursing post is currently out for advert and there has been a number of applicants, and we hope to appoint in the near future and further updates will be provided in due course.
Arrangements have been put in place to enable GPs to refer patients with ME/CFS to other services for those with long-term conditions, mirroring the provision available in all other health boards in Scotland.
In the absence of the nurse specialist at this time, we are working with our nursing colleagues to educate them via a CPD-accredited learning module on the signs and symptoms of ME/CFS, so that they are able to support patients with the condition as they come across them. Along with additional training opportunities we have also been reviewing our model for service delivery to continue the excellent work initiated by our previous specialist nurse, with the ambition of developing a dedicated ME/CFS multidisciplinary team, when a nurse specialist is appointed.
Scotland's NHS Dental Access Crisis is due in no small part to a dentist recruitment crisis. All over the country practices can't find dentists. Meanwhile, I know overseas dentists on Tesco checkouts, kitchen portering, delivering pizzas and, if they're lucky training as dental nurses. This is a waste of assets, a blight on careers and an example of misrule. If the Scottish Government offer overseas dentists the right sort of help and a Scottish LDS to obtain GDC registration dentists would flock here and fund that help themselves. It needs political impetus and hard work which, Jenni Minto MSP the minister responsible. Will she commit to creating a route for overseas dentists to gain registration with a Scottish LDS.
NHS Fife is aware of the broader national challenges in recruiting dentists and recognises the importance of fully utilising the skills of qualified professionals already in Scotland.
While NHS Fife does not have direct control over regulatory processes, we agree that creating a clearer route for overseas dentists to gain General Dental Council (GDC) registration could help address the current recruitment gap. The introduction of a Scottish LDS (Licentiate in Dental Surgery) or a similar pathway could offer a practical solution, allowing overseas-trained dentists to contribute to NHS dental services more quickly.
NHS Fife is committed to working with the Scottish Government and national bodies to explore all avenues for increasing dental workforce capacity. We will continue to engage with policymakers, including the Minister for Public Health and Women’s Health, Jenni Minto MSP, to support initiatives that would streamline the registration process for overseas dentists and enhance recruitment efforts.
What is your plan to introduce more NHS Dentists in Dunfermline. Having been in our dental practise for 40 years it has become private, and we are suddenly faced the age of 70 having to go private! There are no dental practises in Fife accepting NHS patients other than one in St Andrews. On an old age pension, it is unaffordable, monthly payment and exorbitant charges for work to be done! what help can you give pensioners and young families who are struggling with the cost of living to be able to have dental and medical treatment that they may need at an affordable cost.
NHS Fife recognises the difficulty many patients are facing in accessing NHS dental care, particularly in areas like Dunfermline, where several practices have transitioned to private care. We understand the impact this has on pensioners, young families, and others dealing with the rising cost of living.
To address these challenges, NHS Fife is working on several initiatives:
- Expanding NHS Dental Capacity: We are actively engaging with local dental practices to encourage more to offer NHS treatment and exploring options for expanding NHS dental services in the region. We are also working with the Scottish Government to explore longer-term solutions to the shortage of NHS dental provision in Fife.
- Recruitment and Retention: NHS Fife is supporting efforts to recruit more NHS dentists and retain them in key areas like Dunfermline.
- NHS Fife recently successfully applied to the Scottish Dental Access Initiative (SDAI) to include Glenrothes, Kirkcaldy and Dunfermline. SDAI provides grants to support NHS dental provision in areas where access to general dental services is low. These grants incentivise new practices and dentist retention through significant payments.
- Accessing NHS Dental Care: While the availability of NHS dental care is currently limited, patients in urgent need of dental treatment can contact the NHS 24 dental helpline for advice and to be directed to emergency care if necessary. NHS Fife’s Public Dental Service also provides care for people who cannot be treated in regular dental practices or have not been able to register with a local practice due to it being at capacity.
- Financial Support for Dental Costs: We understand that private dental care can be unaffordable, especially for pensioners and families on low incomes. If you are receiving certain benefits, you may be entitled to free or reduced-cost NHS dental care. We encourage you to check your eligibility for support through the NHS Low Income Scheme or other financial assistance programs.
We acknowledge the frustrations around the current situation and are committed to working towards increasing NHS dental provision in Fife.
Queen Margaret Hospital should have an A&E department given the size of the city and more houses to come. Given the wait for ambulances to go to Queen Vic in Kirkcaldy. My Mum in her 90s waited in pain from early evening and overnight until the following morning 7/30 am for ambulance she passed away a couple of days later. The staff are amazing but services are so stretched, which in turn must cause extra stress to staff doing their job and dealing with the public. Staff need to be respected and looked after too.
Firstly, we would like to express our deepest condolences for the loss of your mother. We understand how distressing this experience must have been for you and your family, and we appreciate you taking the time to share your concerns.
Regarding your suggestion about an A&E department at Queen Margaret Hospital, NHS Fife continuously reviews service provision across the region to ensure that care is delivered in the most effective and safe way possible. Decisions around emergency services are based on several factors, including clinical safety, the availability of specialist care, and the need to maintain high standards across all sites. While Queen Margaret Hospital does not currently have an A&E, we are committed to providing comprehensive services and ensuring that urgent care needs are met efficiently.
We recognise the challenges within the ambulance service and the pressures faced by our A&E staff, who work tirelessly to provide the best possible care under difficult circumstances. We are actively working with the Scottish Ambulance Service and other partners to address these issues, reduce wait and improve handover times.
A Scottish Government spokesperson was recently quoted as saying that one million patients had been seen in the second quarter of 2024 and this in some way was evidence of success for dentists payment reform. Given that the total was over a million in the second quarter of 2023 and 1.3 million in the second quarter of 2018, can we be told who that spokesperson was?
NHS Fife does not have access to the specific details of Scottish Government spokespersons or their statements. We recommend that you contact the Scottish Government directly for clarification on this matter. Our commitment remains to ensure that dental services across NHS Fife meet the needs of all patients, and we will continue to work closely with the Scottish Government on any developments in this area.
How many vaccination and outpatient appointments are missed because NHS FIFE are still sending letters out via Royal Mail? Here's what I know so far....the immunisation team told me today that they "lost" 2000 appointments sent out via post including my shingles vaccination appointment.
NHS Fife monitors very carefully the attendance and utilisation for all appointment activity, in hospital, community or primary care settings, including appointment provided by telephone or video systems including Near Me. Where patients do not attend, every attempt is made to contact the patient to offer an alternative and to understand if the communication approach has not been successful. While NHS Fife continues to utilise Royal Mail for the sending of appointment letters, work continues to extend the capability of Digital Hub, to provide an option and where appropriate to send letters electronically to patients.
I should like to ask why GP practices in St Andrews now automatically have patients sent to Victoria Hospital or Queen Margaret for clinics, scans etc. People living in Guardbridge, three miles away, or Cupar are sent to Ninewells for treatments, nearer and with more frequent transport services. There is a direct bus and train from Cupar to Kirkcaldy BUT from St Andrews there are no direct bus services to Kirkcaldy and the direct bus to Dunfermline after ninety minutes drops the patient at the foot of a seeming mile long hill. The same will be true for patients from the East Neuk villages. I was quoted £95 as a taxi fare from St Andrews to Queen Margaret hospital. If one asks a friend, it is eighty miles round trip and more than two hours of their time. Are clinics and services being withdrawn from St Andrews hospital due to paying petrol money to those staffing them? I believe the new government policy is health should begin at home. I do not complain of clinical care given at the Victoria or at Queen Margaret but at the difficult, lengthy, and expensive journey to attend. Please explain why we in St Andrews are now directed there.
We understand the concerns regarding travel to hospitals for clinics, scans, and treatments, especially for residents of St Andrews and the surrounding areas.
Without knowing the specifics of your care needs, we are unable to provide any detail around the reasons for you being referred to Queen Margaret Hospital,
NHS Fife looks to provide care as close to home as possible; however, certain specialist services, equipment, and clinical teams are centralised at specific hospitals to ensure patients receive the highest quality care. This centralisation allows us to maintain a high standard of care by concentrating expertise and resources where they are most needed.
We appreciate that travel can be challenging, particularly when public transport options are limited or expensive, and we are mindful of the impact this has on patients from St Andrews and East Neuk villages. We are continually working with transport providers to explore options for improving access to healthcare services. In some cases, where travel presents significant difficulties, patients may qualify for support with transport costs or can be referred to alternative services, such as patient transport.
If you would like us to respond directly on the specifics of your care, please contact our Patient Experience Team fife.patientexperience@nhs.scot