THE NHS proposals to relocate the Glenrothes ‘out-of-hours’ GP service to Victoria Hospital in Kirkcaldy have galvanised both political and community objection.
Susan Manion, general manager for the Dunfermline amd West Fife Community Parnership and lead nurse Jenette Brogan explained to the Gazette some of the rationale behind the proposals.
Both feel that changes are urgently needed to the primary care structure currently available in Fife.
In particular it’s the Glenrothes service that is in need of an overhaul, as Susan explained.
“The overiding issue is that with Glenrothes being the only-stand alone primary care emergency service, when you look at the quality of what it is we are providing and the clinical care we don’t think it is as good as it could be.
“That’s why we want to transfer the services from Glenrothes to Kirkcaldy, we feel it’s not fit for purpose as a primary care centre any longer.”
Janette added: “The best primary care is that which has continuity, offering a single pathway of care that works as seamlessly as possible and with the patient’s medical needs at the heart of that process.
“Above all we wanted to take advantage of what we call clinical adjacencies, those different services that can work closely alongside each other, supporting each other.
“What we have to stop is an urgent care need becoming an emergency care need, and what we had found was that there were times that patients who were attending didn’t have the support of other services, who later beacame acutely unwell and needed to be transferred.
“So there was a time delay and we didn’t have the support of other services, particularly at Glenrothes, to be able to maintain that persons well being.
“We were relying heavily on support from the ambulance service and yet no other immediate support, which we have in every other area that we work.
“We need to effectively manage what comes to our door and we now have enough data and experience that we can look at and we can assess the patient journey through our service and we know that we have enough information to say that we need a safer clinical service.
“For us that vision is to transfer the Glenrothes service to Victoria, where we can guarantee a sufficient and efficient service of care.”
The proposals to move the out of hours service have sparked angry reaction from political figures, with both Glenrothes and Central Fife MP Lindsay Roy, and MSP Trica Marwick, putting aside their political differences to mount a joint campaign to stop the proposals from being implemented.
With seemingly no alternative plans for the Glenrothes service, other than to move it to Kirkcaldy, many are suggesting that the move is already a ‘done deal’, but Susan disagrees.
She said: “We have been asked why we haven’t come up with an alternative range of options and to be honest, there isn’t really any for us, it’s either do nothing and just document the clinical risk or move the service.
“We are quite straightforwardly offering this plan and saying this is what we want to do.
“In the community consultations so far we have been quite clear that we have not made any final decision, but simply said what we would prefer to do.
We’ve asked what are the issues that you are worried about and have tried, and will continue to try and answer those concerns.”
The lack of public consultation has also been a bone of contention for many within the region, especially as many residents are not actually represented by a community council.
Susan explained how they had conducted their public engagement.
“With any proposal such as the one here we approached the Scottish Health Council and they advised us of the type and the level of public consultation to be undertaken.
“The advice from them was that this was not a major service change and thus we would ‘engage and inform’ and at that point there was no need for formal consultation process.
“What we have done though is offer an action plan and through that have gone over and above what we were as a service required to do. “The concerns raised by the community councils that we have met with will be taken back to the CHP and the area committees and they will then take a view as to whether to support our proposals.
Further criticism has suggested that the closure of the Glenrothes out-of-hours service is nothing more than a cost cutting exercise by NHS Fife, something both Susan and Janette strongly refute.
Susan said: “This proposal is certainly not driven financially.
There is a saving to be had from relocating the service to the Victoria Hospital, thought to be in the region of about £200,000 but with having a budget of over £4 million, it’s obvious that this is not being proposed as a cost-cutting measure.
“We are not planning to close the Glenrothes hospital, that’s not what this is all about and that’s why we have had health board members and councillors attending the community meetings to help explain this fact.
“And we can add that there will ne no loss of staff, or GPs, if a move was to take place. Every member of staff affected by this issue will be redistributed to elsewhere within NHS in Fife, that can be assured.”
Throughout the process, NHS bosses have highlighted a number of statisics to support the move, including ‘patient satifaction surveys, a ‘patient feedback report’ conducted between December 28 and January 11 which sought the views of patients attending the four PCES at Glenrothes, Kirkcaldy, Dunfermline and St Andrews.
The concern for those against the proposed move is that only 39 (from a total of 240 responses from over 2,500 patients asked) were received from those specifically attending the Glenrothes service in that period rendering the response to be too small to be of any meaningful significance.
With community consultation meetings now well underway, Susan and her colleagues now expect their out-of-hours proposals to go before the next Glenrothes and North East Fife CHP meeting scheduled for November.
“We want to conclude the community meetings and add any recommendations or changes that those meeting have thrown up before we present the paper for discussion at the CHP so that councillors are fully informed of the issues that have been raised.
“We would not expect to make a final decision before every concern has been dealt with.”