Hospice care in Fife: NHS backs ward closure with centralised care in Kirkcaldy

It is the end of the road for Queen Margaret Hospital’s dedicated, specialist hospice ward in Dunfermline.
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In its place, the current flexible, community based end-of-life care will now continue indefinitely despite objections from Labour MSP Claire Baker and the Dunfermline Labour Party.

Fife’s Health and Social Care Integrated Joint Board (IJB) voted 13-2 in favour of the current palliative care model on Friday morning. The decision made the hospice ward closure at Queen Margaret’s permanent. The single, centralised hospice facility at Kirkcaldy’s Victoria Hospital and the extended at-home specialist care will continue as is.

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Nicky Connor, Director of the Fife Health & Social Care Partnership said: “We’re investing every penny from the previous provision into the new model. We know we cannot keep both without disinvesting in other areas. The wellbeing of the people of Fife are at the heart of this model. It’s the right care in the right place in the right setting.”

Queen Margaret Hospital, DunfermlineQueen Margaret Hospital, Dunfermline
Queen Margaret Hospital, Dunfermline

Lynne Garvey NHS Fife’s head of community care services added: “There are many more people who have benefited from specialist service than ever before. Hospice availability is greater than it’s ever been and the waiting time has halved, despite the reduction of in-patient beds. There would be significant risk in reverting to the previous model as the people of Fife would no longer have access to the specialist care required.”

However, Dunfermline Labour Party has condemned the decision. It said that there was not a broad enough consultation and that practical issues such as transportation for patients and families were not taken fully into account. It was also critical of a further withdrawal of services from the city’s hospital at a time when Dunfermline is growing rapidly.

“The decision means that while clinical palliative care will still be available at the Queen Margaret, the much-valued hospice service will be withdrawn, with Kirkcaldy now the only NHS hospice in Fife,” the party said.

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IJB member Councillor Graeme Downie (West Fife and coastal villages,Labour) opposed the IJB's decision on Friday alongside Councillor David Graham (Buckhaven, Methil and Wemyss village,Labour).

The motion welcomed the direction of change to increase capacity for at-home and community based palliative care, but sought to delay any decisions until a more formal report on the aforementioned “practical issues” was brought back to committee.

The approved model has been in place since the pandemic when NHS Fife was forced to re-provision its end of life care. In-patient palliative care was centralised, and flexible at-home care extended. For a brief period of time, the centralised hospice ward was located in Queen Margaret’s Hospital while Victoria Hospital was renovated.

The centralised facility moved back to Kirkcaldy in March. Since then, a petition with more than 2300 signatures has called for the service to be returned to Dunfermline. Petitioners feel that Queen Margaret is slowly being stripped of services for locals, and feel that bringing a dedicated hospice ward back to Dunfermline is the answer.

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Dr. Christopher McKenna, Medical Director for NHS Fife said the extended at home model is the best possible use of scarce financial resources for patient benefit.

The new model will benefit people in Dunfermline and West Fife just as much as it will anywhere else, he said adding that while it might feel “uncomfortable,” it is the right thing to do.