As a carer there is very little support for middle aged working people. After contacting Social Work and waiting months all that is offered are peer to peer groups during working time. Or poorly organised care companies. What are the plans to increase care providers within Fife?"​ (J from Lochgelly)

NHS Fife acknowledges the work of unpaid carers and the immense support they provide for their loved ones.

The Fife Carers Centre provides a range of support to unpaid and family carers over the age of 18 in Fife, helping them to sustain their caring role without compromising their own health and wellbeing.

The service offers personalised information and support, including advocacy, emergency planning and befriending. In partnership with the NHS, they offer a range of condition-specific training and information sessions for carers. The service operates an open referral system and, where appropriate, works alongside the carer to complete an Adult Carers Support Plan (ACSP) to support carers to work towards identified goals, including accessing self-directed support.

Fife Carer’s Centre also provides flexible, local support to adult carers to improve their own mental health and wellbeing. Activities are developed in collaboration with carers and other partners include walking groups, arts and crafts groups, book clubs, social cafes & picnics. A hybrid approach to delivering groups has been adopted, offering a range group activities both face-to-face and online.

Dunfermline is one of the fastest growing cities in Scotland. Why are services including an A&E being removed from Queen Margaret Hospital in Dunfermline? (M from Kelty)

Queen Margaret Hospital is a thriving site and is often described as our “jewel in the crown” due to the wide range of services offered for patients across Fife.

While some services have moved from Queen Margaret, several other services have returned to the site as part of the recovery following the COVID pandemic. Queen Margaret Hospital remains incredibly busy, however, and offers a wide range of treatment and diagnostic services.

In addition to housing inpatient mental health and older people’s wards, Queen Margaret is home to Renal Dialysis, Dermatology, the Urology Diagnostic and Treatment Centre and our Pain Clinic. A range of services for children and young people are offered from the purpose-built Carnegie Unit, a host of Outpatient clinics are also carried out at Queen Margaret Hospital, as well as rehabilitative services like physiotherapy.

Diagnostic services are a significant part of the offering at Queen Margaret with MRI, CT, X-Ray, Mammography and Ultrasound are all available at the site. The hospital is also home to NHS Fife’s Regional Endoscopy Unit, which opened in 2014 at a cost of £1.8m.

In recent years, QMH has become a centre of excellence for day surgery, serving patients from across the length and breadth of Fife and carrying out around 7,400 procedures each year. The hospital has been at the forefront of pioneering new cutting-edge surgical procedures in several specialities including cancer, urology and gynaecology.

The unique setup for day surgery at Queen Margaret meant that the hospital was able to continue its surgical programme throughout almost the entirety of the COVID-19 pandemic, helping to minimise waiting times when most other parts of the country had to pause all non-urgent surgery due to the pressures on services.

We continue to invest in our day surgery services at Queen Margaret, recently opening a new £2m procedure unit to increase the number of procedures carried out on the site.

The topic of an A&E department has been a suggestion brought up previously.   An A&E is effectively the front door to a hospital. The department does not operate in isolation and cannot function without many other supporting departments including Intensive Care, Medical, Surgical and Trauma, Paediatrics and Maternity. There also needs to be full 24/7 access to laboratories and pharmacy.

The hospital does have a fully functioning Minor Injuries Unit provides urgent care for a huge range of needs for patients who self-present or who are referred by NHS 24.

What is being done to speed up communication on diagnoses? I had a scan in Oct 2022, and took until 19th Jan 2023 to advise my  condition. Communication needs to be quicker to help save lives!​ (K from Dunfermline)

We recognise the importance of communicating the results of any diagnostic testing quickly to the patients involved.

Generally, tests are requested by medical or nursing staff, with the results then returned to the clinician to assess the outcome and advise of any treatment necessary. The requesting clinician will then inform the patient of the outcome of the testing and discuss any follow-up treatment. There are several protocols and procedures in place to ensure reports are communicated back to patients quickly.

Urgent referrals are prioritised. If a reporter finds anything significant, the clinician requesting the test is notified quickly by e-mail. Routine reporting turnaround times are closely monitored, with the target being that 80% of examinations are reported within 6 days of any diagnostic test. The clinician then needs to assess the findings before discussing further with the patient.

I am 60 years old and have never been invited for a health check. I am really concerned that potential heart problems e.g. high blood pressure, high cholesterol levels, as well as type 2 diabetes will be missed leading to more serious conditions.​ (G from Lochgelly) 

There are several national screening programmes e.g., for bowel or breast cancer. However, conditions like high blood pressure, high cholesterol and diabetes are not part of the regular programme.

There are several options to support individuals with their health needs and concerns. These include contacting their GP Practice for a health check from a member of the Practice team e.g., Practice Nurse.

The Well is also available to individuals: https://www.fifehealthandsocialcare.org/your-community/the-well). People can be referred by practice staff or can self-refer if they wish.

Further supports include:

  • NHS Inform – this national website provides a huge range of information on common ailments and provides useful information on topics like healthy eating, physical activity, and women's health.
  • Right Care, Right Place - information and self-help guides detailing the local healthcare support available, such as stop smoking services, minor ailments and Pharmacy First. 
  • On Your Doorstep  https://www.onyourdoorstepfife.org/) - a Fife guide to all opportunities and services available in Fife including a wide range of community, third and statutory sector services and organisations. 

The NHS Fife and Fife Health and Social Care Partnership websites also contain information on a range of conditions, and how to improve your overall health and wellbeing.

 I am currently waiting on a knee operation. I have been offered an appointment in November or December in Inverness. This is very strange as I understand Kirkcaldy has a new orthopaedic department. Can I ask why coming from Fife we are not considered to go to this hospital? (G from Gauldry)

The National Treatment Centre (NTC) for Orthopaedics opened at the Victoria Hospital in Kirkcaldy in March 2023, and is one of a number of specialist sites across Scotland.

The NTC is operated by NHS Fife’s Orthopaedic Team. Care for patients in northeast Fife is often provided by NHS Tayside due to their closer proximity to Ninewells Hospital in Dundee. NHS Tayside currently has an arrangement with NHS Highland to enable some orthopaedic patients to be treated at the NTC at Raigmore Hospital in Inverness – NHS Fife has a similar arrangement which sees patients from NHS Lothian to undergo procedures at the NTC in Kirkcaldy.

NHS Fife recognises this is frustrating for patients in northeast Fife. The NTC in Fife was the first of the new NTCs to open in Scotland, with others due to open in the coming months and years across a range of specialities. Such issues are being addressed nationally to ensure that moving forward patients can be seen as close to home as possible.

NHS Fife as an organisation that provide health care and social work services have a legal obligation to abide by the procedures laid out under the duty of candour Act; my question is ‘On how many occasions since February 2017 has NHS Fife implemented the Duty of Candour procedures that resulted in a final report being submitted to the Duty of Candour Monitoring and Reporting Group?’ (H from Dunfermline)

The figures below detail the number of concerns reported each year since reporting began in 2018/19:

  • 2018/19 – 56
  • 2019/20 – 38
  • 2020/21- 31
  • 2021/22- 41
  • 2022/23- 29 (to date)

There can be a lag in reporting due to the time taken to investigate certain concerns. This means that it can be necessary for reports to be added later.

A series of questions were posed about the support available for those with Myalgic encephalomyelitis (ME), Chronic Fatigue Syndrome (CFS) or Long COVID

  • The Scottish Governments proposals on Long Term Conditions do not include ME/CFS under Neurological Conditions or Long Covid, despite several needs assessments 2002 and December 2020 (ScotPHN), revised NICE Guidelines 2021 and a debate in the Scottish Parliament recently. The only specialist nurse in Scotland, based in Fife, recently sadly passed away. He was clearly under pressure but was admired and a welcome health professional for the ME Community who will be dearly missed. What budget is provided by the Health Board for this position, is it ring fenced, how effective was it and when/if will this remarkable health professional be replaced. (H from Inverkeithing) 
  • We campaigned for help for our wonderful specialist ME nurse, who was inundated with patients especially with long covid added. Long term patients could only see them for a period 6 months whereas we wanted an annual check-in. New patients could wait 2 years for an appointment. Our campaigning was ignored. How soon will a replacement specialist nurse, or preferably 2, be employed by NHS Fife? ​(A from Cupar)
  • Are there any plans in place to set up clinics/support groups for those suffering from ME/CFS, Long COVID? Other chronic illness conditions have specialist support many of us feel isolated and unsupported from NHS and are left to “just manage”.​ (L from Lochgelly) 
  • What plans are in place to help support patients with post viral fatigue syndromes like M.E. / CFS and long covid? There is no real effective support offered to patients suffering these long- term chronic conditions now.​ (G from Glenrothes)
  • What is the future service to ME/CFS and Long Covid Patients in Fife? To provide support and education for us with this debilitating illness.​ (V from Lochgelly) 
  • What help/support and specialist services are going to be put in place to help people with ME/CFS and long covid? Urgent help is needed. ​(A from Dunfermline) 

The ME/CFS service provided a valuable service for the population of Fife suffering from this debilitating condition, offering advice, support and assistance to manage their condition. The passing of our specialist nurse is a loss felt by all of those who worked with Keith, or who were treated by him. 

Since January 2023, the service has been paused. This was due there being no suitably experienced specialist nurse in ME/CFS to provide cover, with the provision in Fife having been the only such service in Scotland.

New temporary arrangements were put in place to enable GPs to refer patients with ME/CFS to other services for those with long-term conditions, mirroring the provision available in all other Health Boards in Scotland.

All GPs and existing patients were contacted in October 2023 to update them on the service provision.  GPs have been advised they can make use of the other services that exist to appropriately treat those with long-term conditions to enable patients to be seen as quickly as possible. 

There continues to be a shortage of specialist ME/CFS trained health professionals across the UK. Despite this, it remains our intention to recruit an appropriately trained specialist nurse to continue the excellent work initiated by our previous specialist nurse. It is not our intention to close the service and we aim to restart provision as soon as practically possible.