Health bosses defend closure of out of hours services in Fife

Under-fire health bosses have spoken out to justify their decision to temporarily close out of hours services at three Fife hospitals.

Friday, 27th April 2018, 10:46 am
Updated Friday, 27th April 2018, 11:05 am

Facing a growing backlash from politicians and members of the public, Fife Health and Social Care Partnership has issued a raft of data to back its actions.

The figures came from this week’s board meeting, together with a robust defence of the three-month closure which will see patients referred to the Victoria Hospital in Kirkcaldy.

The board said that, three weeks into ‘‘contingency measures to protect patient safety during the hours of midnight and 8.00am’’ the numbers presenting overnight at the Vic’s Primary Care Emergency Service (PCES) have remained at their usual levels – around eleven people.

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Michael Kellet, director of Fife Health and Social Care Partnership

The decision to closure OOH services in Glenrothes, Dunfermline and St Andrews came on the back of staff shortages, but sparked a huge backlash in the communities.

Glenrothes fought successfully to keep the service five years ago, and there is a clear move to launch a new campaign to reverse this decision.

A public meeting held this week saw no-one from FHSCP attend.

Following the board’s regular meeting this week, a detailed statement was issued analysing the impact of the closure so far – and re-iterating the background.

Michael Kellet, director of Fife Health and Social Care Partnership

It said there were 150 GPs with PCES contracts, but only 68 provided regular sessions. This means that GP cover has to be negotiated and arranged on a day to day basis.

At the beginning of April, 43 out of 84 overnight sessions in a four-week period were permanently vacant.

Michael Kellet, director, FHSCP, said the decision to close three OOH service was taken in discussion with NHSFife.

He said: “PCES has had staffing challenges for some time.

‘‘Before the end of March, through careful planning and strenuous efforts of staff, we managed to sustain the existing service which involved three centres being open for appointments overnight.

“One figure is telling. At the end of March, looking into April, only four of the 28 overnights were fully staff with GPs.

“The clinical advice was clear that in the face of those challenges seeking to maintain three overnight centres wasn’t sustainable and would compromise patient safety. ‘‘

He said the partnership’s governance committee was briefed and NHSFife informed – and defended how the closures were announced to communities now fighting to ensure the service is saved.

“On hearing of the challenges the service faced, the committee supported the plan. Clinical and care governance having supported the decision, we then set about communicating the decision to staff, to the board, to local and national elected members and to the public.

“Ideally, of course, it would have been useful to have given more notice to everyone of the new arrangement but we were in an emergency situation and had to act accordingly.”

The contingency plan included an arrangement with NHS Tayside for patients living in North East Fife, which has yet to be utilised.

– to date this has not been utilised.

Seonaid McCallum, associate medical director, backed the plan.

She told the board: “We have a duty of care to provide safe care for the whole of Fife.

“It would have been unacceptable and clinically unsafe to have adequate cover in some areas of Fife and not others.

“The only clinically safe option was to ensure we entered into a contingency which allowed flexible working with medical staff across Fife so that we could respond to clinical need.

“Moving to contingency measures has ensured we can still see patients at a treatment centre, but also respond flexibly to see people at home across Fife in a fair and equitable manner.”