Main updates 

In-person briefing session

Follow-up information

Following our MPs and MSPs in person briefing meeting at QMH on 13 December a number of topics and themes were discussed and addressed;

A&E pressures

Our A&E has been extremely busy in recent weeks, and we expect to see this continue as we move into winter – a common challenge for health boards across the country.

We prepare for the traditionally busier winter period for many months in advance, and whilst we have several initiatives in place to help manage the increased demand, it can be a challenging time for our services.

An average of around 180 patients attend our A&E each day, all of whom must be thoroughly assessed, treated and either transferred to an appropriate ward or discharged. The A&E does not operate in isolation from the rest of our acute hospital and is affected by the high demand we are seeing for inpatient care. As a result, some patients will safely remain within the A&E and under the care of clinical staff there while awaiting an appropriate bed elsewhere in the hospital

Importantly, patients who are most unwell are given the greatest priority, which means those presenting with less severe complaints will wait longer. This is a particularly important point as we

look to manage demand and promote alternative healthcare services that benefit both NHS Fife and the needs of the patient.

Waiting Times

Waiting times for outpatient appointments have lengthened since the COVID-19 pandemic, not only here in Fife but across the country.

It’s important to say that the vast majority of patients wait much less than 52 weeks to be seen, with the median waiting time in Fife for a new outpatient appointment at 124 days according to the most recently published statistics.

It is true, however, that some people are waiting far longer than we would like to be seen, and there are a number of reasons why this is the case. We have seen a marked change in the health of our population since the pandemic, which has increased the demand across many healthcare services and led to greater numbers of people requiring to be seen for new outpatient appointments. Like all Health Boards, we follow national guidance to help us prioritise patients and ensure those with the greatest need are seen most quickly.

Despite the increased demand for healthcare services, we remain absolutely committed to minimising waiting times. This means continually working to find new and innovative means of maximising capacity within the finite resources we have, in order to help us reduce the length of time that patients wait to be seen. The NHS Fife Patient Access policy, available to view online at: https://www.nhsfife.org/about-us/policies-and-procedures/general-policies/patient-access-policy/

Winter Ready

We have been using our social media channels to promote resources on our website that reinforce messaging around winter, the pressures it brings, how to remain well, and how to seek appropriate care if it’s needed. Examples include:

As winter approaches it’s vital that we work together to help ensure that people across Fife know about the options available to them for non-emergency care and, by working together with our elected members, we hope to help to enhance the community’s understanding of how best to access services and contribute to ensuring efficient use of healthcare services in Fife.

Encouraging those eligible to protect themselves against flu and Covid this winter 

Our winter vaccination campaign began in late Autumn and we are have been actively encouraging all of those who are eligible for vaccination to take up that offer.

Patients in Fife who are eligible should have received a letter with an appointment at one of our clinics, a prompt to visit a local pharmacy or an invitation to book their vaccination via the national online portal. While these scheduled appointments have now come to an end, those who are eligible and who still require vaccination can attend any of our drop-ins clinics across Fife. These clinics are running throughout the festive season and into January with no appointment necessary. Details of these are available on our website at: www.nhsfife.org/dropin

Importantly, with peak flu season still likely ahead of us, it’s not too late to get vaccinated and help protect against the worst effects of the virus.

Campaign encouraging staff to get vaccinated

We are encouraging our staff across Fife to take advantage of their free winter vaccines to help protect against flu and COVID.

All healthcare workers are eligible for the free flu jab, regardless of whether they have patient contact or not. The strains circulating change constantly and the vaccine offered this year gives the best protection against catching and spreading the virus. There are a range of options available to you to help make flu vaccination as easy and straightforward as possible for our staff, including visiting an appointed local clinic by booking online, visiting a drop-in, or visiting one of the many a visit from one of our 120 peer vaccinators, who working across acute and community services. and are taking their vaccines on the road. Staff can also visit one of our 50 participating community pharmacies.

Lochgelly and Kincardine Health Centres

Following the recent budget, there has been renewed interest in the development of the proposed new health centres in Kincardine and Lochgelly.

You will recall that NHS Fife was advised last year that the funding to develop these new health centres would not be made available until the second half of this decade at the earliest. We can confirm that we have received no further updates from Scottish Government which would indicate a change in this position.

As a Board, we remain committed to the development of these new centres and we continue to do the necessary preparatory work to ensure we are well placed to progress the project as soon as the necessary capital funding is made available.

Fife HSCP Recovery Plan

Fife Health and Social Care Partnership’s financial recovery plan actions continue at pace including significantly reducing reliance on bank and agency staffing, which currently costs around £18 million annually.

Staff have also been asked to consider and submit other ways to reduce costs in this financial year, and to reduce non-critical spending immediately. This has proved successful with SLT taking these actions forward. Updates on recovery plan actions will be reported through appropriate governance routes in the new year.

Mental Health Services

Each year, around £1 million is invested to maintain and improve inpatient mental health wards. This work is ongoing, and is about making sure the people in our care have a space that feels homely, supportive, therapeutic and safe. Part of this work also includes the reconfiguration of some of our existing mental health inpatient wards, realigning them to current needs and demands as well as reflecting best practice and increasing demand for care at home.

Work also continues with clinicians, services users and partners to continue to adapt and change to ensure safe and sustainable services with the resources available.

Mental Health Data

The Scottish Government's Psychological Therapies Referral to Treatment Standard applies to a range of evidence-based psychological therapies delivered by Fife Health and Social Care Partnership. Data on a person's first appointment is captured for the statistics, but it is worth noting the Partnership also provides extensive clinical support and therapy to many people in Fife on a daily basis, which isn't measured by this standard.

FHSCP is committed to ensuring timely access to psychology services and the performance against this standard in November 2024 was 82.9%. The Partnership is determined to minimise the length of time people in Fife wait for evidence-based psychological therapies and continue to work towards delivering the Scottish Government’s ambition that 90 per cent of individuals will be seen with 18 weeks of referral.

CAMHS

Fife CAMHS has achieved the National Referral To Treatment Target (RTT) for three consecutive months with services undertaking a range of actions, including a specific focus on recruitment of specialist staff and working with partner organisations to improve service delivery and sustain waiting times under 18 weeks. Referrals for assessment and diagnosis of ADHD and Neurodevelopmental disorders continue through the FHSCP Children's Neurodevelopmental Pathway.

Mental Welfare Commission Report

The Mental Welfare Commission programme of inspection has continued on a monthly basis to Fife Mental Health and Learning Disability Inpatient wards. A report is published after each visit. A link to the full reports can be found online on the Commission’s website here. Every year the Commission visits around 150 wards and units for people with mental ill health, learning disability, dementia or related conditions in Scotland. During the visits Commission visitors talk to patients, relatives and staff, and examine records.

SAS Triage Test of Change

This pilot project in Levenmouth provides out-of-hours mental health crisis support by car.The project began at the start of June, thanks to funding from Fife Council’s Levenmouth Area Committee. The response car operates in the Levenmouth and has recently been extended to the Kirkcaldy area at weekends, ready to mobilise to help people who need it. Emergency services who receive calls during that time assess if urgent mental health support is required, sending the car with trained professionals out to the person in need.

The service involves a range of partners including Fife Health and Social Care Partnership, Fife Council, NHS Fife Scottish Ambulance Service, and Police Scotland. There will be an evaluation of the project at the end of the year which will help inform future planning.

Additional Information

New elected member enquiry inbox

Our corporate communications directorate now co-ordinates a dedicated mailbox at fife.electedmember@nhs.scot This mailbox is monitored Monday to Friday between 9.30am – 10.30am (excluding public holidays). A dedicated webpage has also been set up to support elected members enquiries and can be viewed at: www.nhsfife.org/electedmembers

Since we launched the new mail box system on the 4 November we have received over 40 enquirues with a 100% response rate within the 10 working days and around a 75% average of responses being sent within 5 days.

However this mail box has also recieived around 20 enquiries relating to constituent care and medical treatments. These need to be passed to our Patient Experience team, with appropraite consent forms for the team to respond to in line with existing arrangements.

We also ask that you note that we are unable to expediate waiting times on the request of an elected member. Waiting times vary depending on factors such as clinical priority, available resources, and ongoing service demand.

Walking aid return and refurbishment

NHS Fife and Fife Council, through the Fife Health and Social Care Partnership, launched a campaign to encourage people to return their walking aids and equipment so they can be refurbished and used again. We estimate that around 98% of returned walking aids can be refurbished or reused. More information is available here.

Not only does it have environmental benefits, but it also has a financial benefit too. Equipment can be returned to a local Recycling Centre - staff at the recycling centre can direct to the community equipment recycling container. The equipment can then be refurbished and used again if it is in good condition.

Anyone who can’t get to a recycling centre, can call the Fife Equipment Loan store (FELS) support team to arrange for an uplift on 01592 583252. Any items originally loaned from FELS should also be returned to them by calling the number above. People are reminded not to take any equipment to be recycled to hospitals, health centres or Fife Council offices.

Prostate cancer awareness raising

Following Sir Chris Hoy’s high profile prostate cancer diagnoses, we have published a webpage dedicated to raising awareness of the disease, its symptoms, and how to seek checks and treatment. The page has been promoted on our social media platforms, which has led to a notable spike in visits.

Sharing our messages

We appreciate the support of elected members in sharing our health messages with constituents on your webpages and via your social media accounts.

Board papers and statistics

NHS Fife Board: Papers from the latest Board meeting on Wednesday 25 September can be viewed here. The next meeting takes place on Tuesday 26 November.

Performance: A wide range of research, guidance and statistical publications relating to NHS Fife can be viewed here.

Workforce: Statistics on staffing and vacancies are published quarterly by NHS Education for Scotland. The latest publication can be viewed here.

Waiting times: Statistics on current waiting times can be viewed here