Frustration over decision to stop out-of-hours service at St Andrews Hospital

The service will be stopped for three months.
The service will be stopped for three months.

Fife Health and Social Care Partnership has been urged to reverse its decision to close the Out-of-Hours service at St Andrews Hospital.

The hospital was one of three in Fife, which had the service closed – along with hospitals in Glenrothes and Dunfermline. This means just one hospital in the Kingdom is providing services between midnight and 8am.

Kirkcaldy’s Victoria Hospital will now be the only medical centre dealing with emergencies in the whole of Fife during the night hours.

The changes came into effect on Monday, with the partnership saying it was introducing contingency measures overnight in the Primary Care Emergency Services (PCES) in response to “nursing and medical staffing difficulties”.

PCES (commonly called out-of-hours services) provides urgent care to the people of Fife when GP practices are closed. Contact with the service is via NHS24, with urgent care provided by a team of healthcare professionals in centres across the county.

The contingency measure will be in place for a three month period, while efforts will be made to resolve the staffing issues.

North East Fife MSP Willie Rennie said it was “unacceptable that people in east Fife are being treated this way”.

He added: “It’s a long way to Kirkcaldy for people who live in this part of the world and the journey will be even more difficult if you are unwell.

“I am sorry to say that this situation is a direct result of poor workforce planning by the Scottish Government.

“I have repeatedly warned about the shortage of GPs but was dismissed repeatedly by ministers. Now we are suffering the consequences.

“The action taken on the new GP contract is welcome but far too late and now we see services like this being hit.”

MP Stephen Gethins said he was seeking assurances that every effort was being made to increase staffing levels at the hospital to ensure the services continue.

“These local services are vital to my constituents and while patients can still receive this care at the Victoria Hospital, it is important that local provision is reinstated as quickly as possible,” he said.

Callum McLeod, chairman of the community council, added: “This news is very disturbing and disappointing indeed.

“As a parent I made many midnight trips with a sick child to Ninewells or Kirkcaldy from the East Neuk and St Andrews – surely one of the reasons for investing in a hospital in St Andrews was to put an end to that kind of long and distressing journey.

“Without wishing to sound too political, as a country we manage to find billions of pounds for bridges and nuclear weapons but cannot seem to find money for a nurse or doctor to see someone who is unwell outwith the working day within a reasonable time and distance.

“Being ill is never in or out of hours. I hope service providers and managers will have another look at this decision.”

St Andrews councillors also raised the issue of the distances involved.

Cllr Jane Ann Liston said: “When emergency treatment is required it is clearly better that the patient has as short a journey to access it as possible. It is therefore worrying that St Andrews and East Neuk patients will have longer to travel for such care.”

Cllr Brian Thomson added: “This is going to inconvenience a huge amount of people, and is particularly problematic for those who rely on public transport. The bigger concern is that it’s a precursor to permanent closure.

“The SNP Government needs to provide a commitment that the out-of-hours service will continue at St Andrews.”

Councillor Dominic Nolan said the closure was part of a wider problem.

He stated: “I hope this will prove to be temporary, however, this is not a unique situation we find ourselves in. Throughout Scotland there is a shortage of GPs as up to 3000 have left to work elsewhere. The Scottish Government needs to step up its recruitment of GPs and encourage those who have left to return by giving doctors an incentive to remain in Scotland.”

Dr Alan McGovern, clinical director (West Division), Fife Health and Social Care Partnership, stated: “The safety of every single patient is in Fife is our first priority.

“As with most areas in Scotland, difficulty in recruiting GPs and Primary Care medical staff for out of hours work has put enormous pressure on delivering the service.

“In Fife, the out of hours service has only been able to maintain cover through daily monitoring and enormous efforts by all staff. Unfortunately we are now in a position where we are unable to cover all the overnight shifts, meaning we have had to move to contingency measures to ensure patient safety.

“Between midnight and 8am, around 11 people attend Queen Margaret Hospital, Glenrothes Hospital and St Andrews centres in any one night. They will now go to the centre at the Victoria Hospital, Kirkcaldy.

“Home visits, for those who require them, will not be affected.”

Michael Kellet, director, Fife Health and Social Care Partnership, said: “We’ve had to take immediate action to ensure we can continue to deliver a clinically safe and sustainable service over the next few months.

“As we do so we will continue to develop our plans for the longer term measure for urgent care. We will consult the public on those longer term plans before any permanent decisions are made.”