Main updates
NHS Fife Board meeting – 30 January
The NHS Fife Board met last week (January 30) for its first meeting of 2025. The agenda covered several topics including our financial position, workforce and vacancy information, waiting times, and progress on public health and wellbeing initiatives.
Relative to our financial position, which was widely reported in the media in the run up to the Board meeting, we continue to face an extremely challenging financial situation, largely due to increased demand and costs across both health board and health and social care services.
While our projected overspend for 2024-25 is expected to remain within the £37 million brokerage cap set by the Scottish Government, we remain mindful that the situation requires ongoing vigilance.
At the start of the financial year, we projected a financial gap of £54.8m, which reduced to £51.4m due to additional funding received. We remain confident of achieving efficiency savings of £24m. This requires us to deliver a further £0.5m of savings in in the final months of this financial year. The papers from the Board meeting, including the financial update, can be viewed in full here.
Storm Eowyn
Storm Eowyn's severe weather brought significant challenges to our services. To ensure the safety of staff and patients, regional and organisational resilience groups were activated, leading to the postponement of routine clinic appointments, diagnostics, and planned surgeries. Patients affected by these postponements are being contacted about rescheduling as soon as possible. The storm also impacted primary care, with several health centres, GP practices and pharmacies experiencing closures or reduced operating hours.
To maintain essential patient services, staff were asked to attend work where possible, but only if it was safe to do so. The postponement of routine appointments also allowed for temporary staff redeployment to support safe staffing levels in clinical areas and on-call services.
While Storm Eowyn caused some notable damage, including to Linburn Health Centre and St Clair Pharmacy, as well as minor damage to other parts of our estate such as barriers and car parks, the proactive efforts of our estates and facilities colleagues minimised the overall impact of the storm. Their work to secure, repair, and clear our sites helped enable a quick return to normal service this week. The response and recovery to Storm Eowyn is a testament to the ongoing dedication and hard work of all our staff, who continue to go above and beyond in extremely challenging conditions.
We understand that elected members want to be kept directly informed during significant incidents like Storm Eowyn. However, our teams are extremely busy during such events. To ensure timely and accurate information, we encourage elected members to follow our official social media channels. These channels will provide regular updates, enabling them to effectively share information with constituents.
Employment tribunal
You will likely be aware of an employment tribunal involving NHS Fife that is scheduled to begin this week. Whilst there has been widespread coverage in news outlets and on social media, we consider it inappropriate to comment during the hearing.
However, we also believe it is important to recognise that at the heart of this case are two employees, who should be treated with kindness and respect. As an organisation, NHS Fife remains committed to upholding its duty of care to all employees.
Reconfiguration of Cairnie ward, Stratheden Hospital
As part of a review of NHS Fife’s mental health services, all of which are delegated to the operation of the Fife Health and Social Care Partnership (FHSCP), the FHSCP mental health directorate was required to carry out an assessment of the number of inpatient beds in operation and how to ensure the best use of our staffing resource and the buildings at the service’s disposal.
The mental health service is focused on ensuring the optimal use of our clinical environments and enabling our staff to provide a consistent, high-quality level of care to our patients. At the time of the review, Cairnie ward, a 10-bed unit, at Stratheden Hospital in Cupar, provided care for older adults with dementia and complex needs, had six patients, three of whom were identified as delayed discharge and were awaiting community care provision.
The ward was also experiencing sustained challenges around staffing with a combination of staff vacancies, sickness absence and unfilled consultant posts that required cover bank and agency staff cover and locum staff at a substantial cost. Following engagement with the senior clinical team, and nursing, it was assessed that there would be significant clinical benefit from providing a stable, consistent nursing workforce across all remaining inpatient areas. This approach enables staff development and investment, ensuring continuity and high standards of care and treatment.
Senior clinical staff wrote to patients and families of those in Cairnie ward, offering meetings to discuss the move and outline the planned changes to service delivery. These meetings enabled families to raise any concerns they may have and allowed us to address these. The meetings also outlined our commitment to community and home-based support, which aligns with national and local priorities to provide more personalised care closer to home wherever possible. Following staff and patient engagement the six patients were moved in December to other suitable wards on the Stratheden site or care settings, to ensure that their care needs continue to be met. Cairnie ward has now been temporarily closed and work is underway to look at opportunities to repurpose the ward to support an alternative function.
Delayed discharge reporting
Following widespread media coverage related to a Freedom of Information (FOI) request about delayed discharge, we thought it would be useful to provide clarity and context around the figure that was attributed to NHS Fife in the reporting and our presentation as an outlier.
The initial FOI request sent to all Health Boards asked that of the patients who are medically fit for discharge but are delayed, what is the average length of delay, and what is the longest delay. NHS Fife responded that the average length at the time of writing was 854 days, and the longest delay was 2,576 days.
However, it appears that this enquiry was interpreted differently across Health Boards, and whilst some responded by reporting ‘standard delays’, other responded including patients with conditions that requires highly specialist care, or who are gradually transitioning from hospital care to the community. Such patients are not ordinarily included within the regularly published statistics on delayed discharges and are excluded as what is referred to as ‘code 9’ or ‘code 100’ non-standard delays. Information on the coding of delayed discharge is available on the Scottish Government website.
According to the most recently published statistics by Public Health Scotland, the average standard delay in Fife was 14 days at the point of discharge, excluding ‘code 9’ delays.
Continued A&E pressures
Over the festive period our hospitals faced significant pressures period due to a well-documented surge in flu and other winter illnesses, leading to a substantial increase in patients requiring inpatient care. This national trend continues to impact hospitals across the country.
Whilst the number of flu-related admissions has begun to reduce from the peak at the turn of the year, our hospitals remain very busy, and A&E is still experiencing a high demand for inpatient beds.
Importantly, patient prioritisation is based on clinical need, ensuring the most unwell are seen first. This may mean that patients with less urgent conditions may experience longer waits.
Especially during winter, it is crucial that people use healthcare services appropriately to minimise waiting times. A&E is for life-threatening emergencies only. For non-life-threatening conditions, please contact NHS 24 on 111. This guidance, while not new, helps reduce A&E waiting times and allows staff to focus on those who are most unwell.
Lochgelly Health Centre planning permission granted
We are pleased to note that Fife Council has granted planning permission for a new health centre in Lochgelly. While a national freeze on major capital projects has been enacted by Scottish Government, NHS Fife remains committed to the development of two new purpose-bult community health and wellbeing centres in Lochgelly and Kincardine.
Having submitted our full business case, work is ongoing in the background to ensure we are ready to deliver these centres as soon as possible when we receive confirmation that capital funding is available.
Supplementary staffing
As has been reported in previous updates, we have been working extremely hard to reduce our use of supplementary staffing from outside NHS Fife and we continue to make progress in doing so.
This represents a shift from the period during and immediately following the COVID pandemic, when it was necessary to supplement our workforce with agency staff, including locum consultants and nurses. This was in addition to recruiting a considerable number of staff on permanent and fixed term contracts for the same purposes.
Supplementary staffing helped us care for larger numbers of those who were acutely unwell and provide cover for higher levels of staff absence resulting from COVID infections. The safety of staff and our patients is always our priority and the increased use of locum and agency staff during this time, along with our local nurse bank, helped us support staff and provide patients with safe and effective care during the most challenging period in the history of the NHS.
New director of finance appointed
Susan Dunsmuir has been appointed new director of finance for NHS Fife. Susan will formally assume the role on 1 April, succeeding Margo McGurk.
Susan brings over 20 years of finance experience to the role and is currently director of finance and corporate services at the Scottish Society for the Prevention of Cruelty to Animals. More information on Susan’s appointment is available here.
Director of planning and transformation appointed
Ben Hannan has been appointed new director of planning and transformation, taking up the role last month (6 January).
A registered pharmacist, Ben joined NHS Fife in 2020 and has previously served as interim director of reform and transformation, director of pharmacy and medicines, chief pharmacist, and controlled drugs accountable officer. More information on Ben’s appointment is available here.
Assessment and Rehab Unit at Queen Margaret Hospital
We were contacted by a local media outlet in relation to rumours they had heard around the future of the Assessment and Rehabilitation Unit at Queen Margaret Hospital.
We are clarifying that there are no plans to close the assessment and rehabilitation service at Queen Margaret Hospital. The focus of the service is to optimise the health, wellbeing and independence of frail people across Fife. We are keen to make our services as accessible as possible and we've done a lot of work to enhance the Fife-wide model so we can move to delivering services in people's homes. This will ensure equity of access for everyone, especially those people that are frailer and might find it challenging to attend an appointment.
This approach will not be appropriate for all patients and so the assessment and rehabilitation service will also continue to provide care and treatment from its existing base at Queen Margaret Hospital, with gym and clinic space still available for those people that need to be seen in this type of setting to use specific equipment.
Adamson Minor Injuries Unit temporary closure
Due to staff sickness, the Minor Injuries Unit (MIU) at the Adamson Hospital in Cupar had to be temporarily closed on Tuesday 14 January.
Contingency plans were put in place, with the public requiring access to minor injuries services being re-directed to St Andrews Community Hospital. The MIU at Adamson Hospital re-opened on Monday 20 January.
Sexual health clinic temporary closure
Due to long term staff absence, our young person's sexual health clinic at Lochgelly is currently closed.
The clinic has temporarily relocated to Cowdenbeath Health Centre. Appointments are also available at our dedicated young person's clinics across Fife. Appointments can be booked online or by calling 01592 647979.
Land agreement struck to support Fife animal charity
We have entered into an agreement with north-east Fife animal charity, Lucky Ewe, to help them expand the experiences they offer people with additional support needs.
Lucky Ewe provides hands-on opportunities in farming, animal care, and food production.
The charity has entered a 25-year lease for land within the grounds of Stratheden - allowing them to grow their flock and explore other opportunities, including honey and fruit production. More information is available here.
NHS Fife whistleblowing co-ordinator appointed
Debbie McGirr has been appointed NHS Fife's dedicated whistleblowing coordinator. In this role, Debbie manages all aspects of the national whistleblowing procedure, encouraging staff to raise concerns and ensuring they are aware of the available support and reporting mechanisms.
Her remit covers all areas of acute, community, and primary care, working closely with existing staff support services. A former nurse, Debbie has experience across acute, community, and third-sector services in both clinical and managerial roles, as well as extensive experience in nurse education. Staff can contact Debbie confidentially via a dedicated email address.
Mental health support for young people in distress
Colleagues in the Fife Health and Social Care Partnership have partnered with Our Minds Matter and the Shout text messaging service to offer free, confidential mental health support to young people who are experiencing distress.
Young people can text ‘FIFE’ to 85258 any time of the day or night. And a trained advisor will connect with them and listen to their worries and concerns through text message conversation.
Use of the service is free of charge and will not show on their phone bills.
Feeling overwhelmed, upset or worried can make young people feel isolated and alone – speaking with a trained advisor confidentially, can help them process their thoughts and prevent them from escalating to distress and crisis.
Enquiries regarding constituent waiting times
We often receive enquiries from elected members related to a constituent’s position on a waiting list. In such instances we always require written consent from the constitution to release any personal information or take further action.
Once we receive this permission, we will forward the query to our patient experience team, who will contact the relevant service to provide an update. However, we would reiterate that waiting times are determined by clinical priority, and NHS Fife is unable to expedite waits based on requests from elected representatives.
The consent form can be downloaded from our elected members webpage, here.
Vaccination
Open access vaccination clinics
To help move away from ad-hoc drop-in clinics and provide more settled vaccination options, we have started a program of open access clinics. The ambition for these clinics is to provide specific clinics at the same times, venues, and days each month, where members of the public can currently attend for flu, covid, RSV, pneumococcal, or shingles vaccination.
Initial sessions having been running throughout January and we expect this to continue as we move further into 2025. Constituents with any questions around eligibility can visit the dedicated open access webpage.
They can also drop-in to a venue and speak to one of our vaccination team.
Sharing our messages
We appreciate the support of elected members in sharing our health messages with constituents and on social media.
Board papers and statistics
NHS Fife Board: Papers from the latest Board meeting on Thursday 30 January can be viewed here. The next meeting takes place on Tuesday 25 March.
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.
All Information correct at time of publishing. Issued by the corporate communications service.