Main updates
Financial update
Since the announcement of the Scottish Government’s 2024/25 draft budget, we have been working diligently to revise financial plans and create the necessary framework of reform and transformation to achieve the required savings, which we currently anticipate to be around 7% across the organisation.
We have identified four initial themes of medicines, workforce, service delivery and design, and infrastructure, to focus our efforts upon and a reporting structure has been introduced to drive progress in making efficiencies across these areas.
Several early actions have already been taken, including the introduction of stringent new vacancy management control measures, and we are also carrying out a review of our estate to assess whether we can reconfigure its footprint to release savings associated with utility costs, repairs, and maintenance.
Further, as part of a national directive, the Scottish Government has asked us to pause any new capital projects while it realigns what it has termed a ‘revised pipeline of infrastructure investment’, which we expect to be published in Spring.
Importantly, we remain committed to being as open and transparent with our staff as possible throughout this challenging time. We are providing regular updates through organisational briefings, and we have also created a dedicated line of contact where staff are being empowered and encouraged to identify inefficiencies and potential savings in their own areas.
Clarification around ambulance services
Having been asked by local media to respond to a press release around calls for a review of ambulance capacity and ambulance waiting times at the Victoria Hospital, we are also providing clarification within this briefing.
Ambulance waiting times in Fife have been discussed at length at the previous standing meetings between our chief executive and local MPs and MSPs, where it has been stressed that there are various reasons why ambulances may be parked outside the Victoria Hospital.
To reiterate, these reasons include a combination of factors including patients being transferred to wards across the hospital, vehicles restocking vital supplies, and during periods of high demand patients may wait within ambulances with trained paramedics before being transferred to A&E.
Call before you convey pilot
In partnership with the Scottish Ambulance Service, the ‘call before you convey’ initiative is being trialled in Fife after being rolled out across several Scottish Health Boards to help residents in care homes reach the most appropriate part of our urgent care system as quickly as possible.
Previously, residents were routinely brought to A&E. However, with the implementation of this new protocol, trained paramedic staff now conduct assessments before collaborating with an emergency medicine consultant to determine the most suitable specialty for patient care, tailored to their specific needs.
Where patients need to be seen in A&E, the clinical team can prepare for their arrival in advance and prioritise accordingly. Where A&E is not required, the patient can instead be taken directly to the most appropriate ward, where treatment can be initiated earlier than if they were admitted via A&E.
In addition to the benefits for patients, ’call before you convey’ is also intended to improve ambulance turnaround times by making decisions around care much earlier in the admission process.
Neonatal mortality review
Earlier this week Healthcare Improvement Scotland (HIS) published its Neonatal Mortality Review for 2021/22. This review was initiated after a rise in neonatal mortality across the country and noted no single cause for the national increase reported.
During 2021 we experienced an unexpected rise in neonatal mortality in Fife, which the team recognised and highlighted to the Scottish Government prior to the national review being commissioned. During this time, the mortality rate in Fife was over 5% higher than equivalent-sized neonatal units elsewhere in Scotland – although, as the report also points out, in statistical terms this translates to a single death more than should have been expected.
There were no concerns regarding care provision.
Neonatal deaths in Fife have since reduced, as they have done in other areas of Scotland, and remain very rare, although each is devastating for the families involved.
NHS Fife first in Scotland to offer prostate procedure as outpatient appointment
NHS Fife has become the first Health Board in Scotland to offer a pioneering treatment for enlarged prostate as an outpatient appointment.
The Rezum procedure, which was first introduced in 2020 to treat patients with benign prostatic hyperplasia (BPH), sees small jets of steam injected directly into the prostate to destroy excess tissue. This causes the prostate to shrink and helps relieve the symptoms associated with an enlarged prostate.
Unlike more traditional surgical procedures for BPH, Rezum takes less than 20 minutes and patients can return home shortly after.
KY clubs helping people get drug and alcohol support closer to home
We are working with ADAPT substance recovery to help promote their innovative new KY clubs. The clubs take place in areas identified as having high levels of people experiencing drug and alcohol challenges (Methil, Templehall, and Lochgelly) and make it easier to get support closer to home. The informal sessions bring together a range of services and support in safe, warm spaces over a hot drink and bite to eat:
- rapid access to NHS Fife addiction and recovery services
- housing and mental health support
- blood borne virus testing
- dental hygiene
- access to technology
- travel pass
- food parcels
SAMH providing mental health peer support at A&E
The Scottish Action for Mental Health (SAMH) Sam’s Café team are perhaps best known for their peer-led cafés, which offer mental health drop-in and one-to-one support, seven days-a-week across Fife.
Working in partnership with ourselves and the Fife Health and Social Care Partnership, the team have now taken their peer-support approach into our A&E at the Victoria Hospital, offering peer-led support for people aged over 16 and in crisis.
Fife consultant helping drive down late miscarriage
Consultant obstetrician at NHS Fife, Dr Graham Tydeman, is partnering with medical simulation company, Limbs & Things, and other leading premature birth specialists to help prevent late miscarriage and premature labour across the world.
The breakthrough medical development could significantly reduce number of pregnant women having unnecessary or ineffective surgery to prevent premature births.
Performance and statistical information
NHS Fife Board
Board papers: papers from the latest meeting of the NHS Fife Board on January 30 2024, including the latest Integrated Quality and Performance Report (IQPR), can be viewed here.
NHS Performs
As referenced at the top of this document, NHS Performs brings together a range of information on how NHS Fife is performing, including A&E performance, cancelled operations, delayed discharges, and diagnostic waiting times. The latest information can be viewed here
Workforce information
NHS Education for Scotland publishes a quarterly update on workforce related information, including the number of staff directly employed by NHS Fife and the number of vacant posts for nursing and midwifery staff, allied health professions, and medical and dental consultants.
The interactive dashboard also outlines trends over time and references other useful information such as sickness absence rates, staff age profile, and spend on agency and bank. The latest publication was published in June and can be viewed here.