Emergency care

Accident and Emergency (A&E)

NHS Fife's A&E is centrally located within the Victoria Hospital in Kirkcaldy, our major acute care facility. Its location helps provide equitable access for people living across Fife and it is designed to handle serious, life-threatening illnesses or injuries that require immediate attention. 

A&E is open 24/7 and is equipped to deal with a wide range of life-threatening conditions such as heart attacks, strokes, severe bleeding, major trauma, and acute respiratory distress. 

Staffed by emergency medicine specialists, our A&E has access to comprehensive diagnostic tools like CT scans, MRIs, and an array of surgical facilities, enabling them to provide rapid, and often very complex interventions when time is of the essence.

Importantly, A&E is for emergencies only. Using A&E for non-urgent conditions can put unnecessary strain on the service and could delay treatment for those who need it.

If you suspect a life-threatening emergency, call 999 or head directly to A&E.

Minor injuries units (MIU)

MIUs focus on less severe medical issues, but ones that still require prompt attention. MIUs manage conditions such as minor fractures, sprains, cuts, burns, and minor head injuries. 

MIUs in Fife are located within our community hospitals or health centres, and while they may not be open 24/7, they offer extended hours to accommodate patient needs. 

Staffed by nurse practitioners and GPs with training in emergency care, MIUs provide quick assessments and treatments, often without the long waits associated with A&E. MIUs may refer to A&E if they believe a patient’s condition is worse than they originally assessed or require the expertise and resources only available at A&E.

Fife’s MIUs are located at:

• Victoria Hospital, Kirkcaldy (within A&E)
• Queen Margaret Hospital, Dunfermline
• Adamson Hospital, Cupar
• St Andrew’s Community Hospital

Attendance at MIU is usually co-ordinated through NHS 24 by calling 111, who can arrange an appointed time and location that is most appropriate to your needs.

If your child is aged 5 or under this means you could be directed to A&E at the Victoria Hospital in Kirkcaldy.   

This differentiation between A&E and MIU helps make best use of our resources by ensuring that A&E can focus on the most critical cases, whilst MIUs provide care for less serious injuries, reducing pressure on emergency services.

GP out of hours (urgent care services)

When GP services are closed, generally between the hours of 6pm and 8am on weekdays, weekends, and public holidays, you can still access a wide range of care through Fife’s urgent care services. They offer a wider range of care for conditions that need attention and cannot wait until their GP re-opens. They are not equipped for life-threatening emergencies.

People are directed into the urgent care service through NHS 24 by calling 111. NHS24 will provide initial clinical assessment and if a referral to the urgent care service is required you will be provided support in the following ways:

• Telephone or video consultation
• Urgent care centre appointment (in-person)
• Home visit (if appropriate)

Fife’s urgent care centres are located at the Victoria Hospital, Queen Margaret Hospital and St Andrew’s Community Hospital and can only be accessed through a direct referral. 

Major trauma centres (MTCs)

MTCs are highly specialised facilities within large city hospitals, designed to provide comprehensive care for patients with severe, life-threatening injuries. 

NHS Fife does not have an MTC, but patients who have experienced major trauma may be taken to the Royal Infirmary of Edinburgh as part of the South East of Scotland Trauma Network, or Ninewells Hospital in Dundee as part of the East of Scotland Trauma Network. They will often be transferred via ambulance from where the trauma has occurred.

Patients admitted to a MTC will be looked after by a multidisciplinary team. This team can include nurses, doctors, mental health professionals, occupational therapists, physiotherapists, speech and language therapists and dietitians depending on what care they require.  All patients will also be seen by a major trauma coordinator who is responsible for co-ordinating their care whilst in hospital and supporting their discharge.

In Scotland, MTCs are located at:

• Aberdeen Royal Infirmary
• Royal Infirmary of Edinburgh
• Queen Elizabeth University Hospital, Glasgow
• Ninewells Hospital, Dundee

The Scottish Ambulance Service (SAS)

The Scottish Ambulance Service can be engaged by calling 999 when someone is seriously ill or injured and their life is at risk. Such instances where you should call an ambulance include:

• Loss of consciousness
• Cardiac arrest
• Heart attack
• Stroke 
• An acute confused state 
• Chest pains
• Breathing difficulties
• Severe bleeding that cannot be stopped
• Severe allergic reactions 
• Severe burns or scalds 
• Major trauma, such as a road traffic accident or fall from a height

The Scottish Ambulance Service will often be first on the scene and paramedics may deliver interventions at the scene. They are highly skilled and will make an informed decision around where your care is best delivered – that may be in A&E, a Major Trauma Centre, or elsewhere.

Aside from emergency care, the Scottish Ambulance Service is also involved in patient transport, including dedicated support for young people via ScotSTAR paediatric and neonatal services.