NHS Fife review: public scrutiny as board faces increased pressure on services

It was the first time since the pandemic that the public has been able to meet face-to-face with them to scrutinise performance and decisions. Annual reviews are a formal part of the accountability process for NHS boards, and provide an opportunity for health boards to outline the key progress and challenges looking back over a 12 month period.

Alistair Morris, acting chair, said the review was a key component of making sure NHS boards are held to account for the significant public investment made in them. In total, NHS Fife spends about £1 billion every year across the Kingdom to deliver day-to-day services.

“Our role is to serve the whole of Fife’s population with equity of access to our services and care. The session looked back at the board’s performance, allowing us collectively to take some time to reflect on what has been achieved and what more needs to be done,” Mr Morris said, opening the public meeting.

He said it was “often all too easy to focus on the negatives and what has not gone well” and listed a number of achievements from the past 12 months.

The new Fife Orthopaedics National Treatment Centre opened its doors on time and within budget in March, and the state-of-the-art simulation and training centre opened at Dunfermline’s Queen Margaret Hospital in February 2022. The ongoing Covid-19 and flu vaccination programme was also highlighted along with the ongoing robotic assisted surgery technology for procedures in Fife.

However, the medical authority is facing some serious challenges and increasing demand on services on top of an ageing population.

Carol Potter, chief executive, said the health authority provides services to over 330,000 people and added: “The challenges that we’re facing in 2023 and that we have faced over the last 12 months are not new,” she added. “The health and care service was under pressure well before the Covid19 pandemic but the situation has certainly been exacerbated by it. We know there are financial pressures across the public sector and also within society in terms of what people have in their own pockets. We have workforce challenges and staffing pressures within a number of areas.”

“In terms of demand on our services, we are seeing increasing attendances for urgent and emergency care. We also know that we have a backlog of outpatient appointments and people who are waiting for inpatient treatment. We know all of that causes for concern for our population.”

In terms of performance, NHS Fife is experiencing more demand than before the pandemic - especially in A&E Departments.

“We have seen increasing numbers of people attending for urgent and unscheduled care and that has increased by about a third - from around 2,000 patients to around 3,000 each week. That is a huge number,” she said.

After presentations from both Mr Morris and Ms Potter, the board answered questions from the public for about 40 minutes. They covered topics such as support for carers, concerns about the future of the Queen Margaret Hospital in Dunfermline, transparency and more.

Chris McKenna, medical director, said at A&E department in west Fife was simply not possible.

“A&E Departments are the front door of an acute hospital and supported by many other specialties. You can’t run and A&E without all of those support services around you because you won’t be able to safely look after patients,” Mr McKenna said. “Decisions were taken a number of years ago to create a single acute hospital in Fife - which is the Victoria Hospital in Kirkcaldy. That’s where we have to deliver acute care. While we aren’t able to provide an A&E department at Queen Margaret’s there are many things we can do, and our urgent care services meet the needs of many people.”