Frustration as funding pressures hit return of Fife’s pioneering mental health car

The initiative was piloted in Levenmouth between June 2024 and 2025 and later extended to Kirkcaldy and Cowdenbeath.

Funded by Levenmouth Area Committee, it was staffed by a paramedic from the Scottish Ambulance Service and a band six mental health nurse and resulted in a “huge reduction” in the time police had to attend A&E at the Victoria Hospital in Kirkcaldy

Councillor Eugene Clarke had asked for an update at Wednesday’s meeting of Fife’s Health and Social Care Integrated Joint Board after becoming frustrated at the lack of progress.

“That was initially funded by Levenmouth area committee, and from all the evidence, it seems to have been very successful,” he said.

“It finished over a year ago and there has been no indication of the progress made towards extending the scheme to the rest of Fife. I understand it is difficult because you have got multiple services, multi committees but how far have we got down the process of putting it into action? Has there been an evaluation to come to the conclusion that is is not going to work because it is too difficult to get everybody working together?

“We have had the test of change. It has worked and not much seems to be happening. I feel particularly disappointed that what has seemed to be a good thing started in one area doesn’t seem to be any closer to being rolled out.”

Lynne Garvey, director FHSCP, confirmed the test of change pilot scheme had been “very successful” with fewer admissions and presentations to the emergency department.

She said: “People were being supported prior to real crisis – that early intervention. The test of change report demonstrated a real difference.

“We are in the process of taking it to partners to look at how we can substantially fund the model.

“It is very expensive to run. Cash is a bit tight, so we are looking at the best way of working with partners including the police and Scottish Ambulance Service at how we fund this. We are just working through some of the practical issues in how we make this happen.”

Dr Chris McKenna, NHS Fife medical director, warned that budget pressures may make it difficult to revive the service.

“I am not disputing its value but just a reminder that the IJB has had significant savings plans imposed. It is quite an expensive service that was not part of the financial plan and we have to make £3m of additional savings.

“These decisions are not easy to make but that is an unfunded service. If the IJB cannot find a way of funding something, as fantastic as it is, that is a challenge.

“We have the massive challenge of savings delivery so it is a bit of a double-edged sword.

“I am on everybody’s side about trying to find resources to deliver that but with the financial position that NHS Fife and the IJB are facing, difficult choices will have to be made.”

Following the meeting, Cllr Clarke described Dr McKenna’s response as “dispiriting.”

He added: “It is very unfortunate that such a pilot scheme which has been so successful may not happen.

“The reason given was that the scheme was not in the budget but presumably all tests of changes are in the same situation so does this mean we do not do anything about all tests of changes because there’s no money?

“What is frustrating is the Levenmouth Area Committee took a risk to fund it.”