Following a comprehensive programme of engagement, proposals outlining the future direction and expanded reach of the specialist palliative care service will be presented to the Fife Health and Social Care Partnership’s Integration Joint Board and the NHS Fife Board at their respective board meetings later this month.
The proposals, which have been developed by palliative care clinicians, follow extensive engagement carried out prior, during and after the COVID-19 pandemic with patients, family members and the members of the Fife local public participation network and set out a future direction for specialist palliative care services across the whole of Fife.
Currently the majority of palliative care in Fife is delivered by local healthcare teams, co-ordinated by GPs and provided by district nurses. For those with complex palliative care needs, this is provided by Fife’s Specialist Palliative Care Service in a range of settings, including hospice, care homes, hospital and at home.
Dr Jo Bowden is a consultant in palliative medicine and provides care and support to patients and families across Fife. Dr Bowden said: “At the start of the COVID-19 pandemic, our service had to adapt and provide a much greater balance of specialist palliative care in Fife’s communities to help keep vulnerable patients safe and away from our hospital sites. These changes have proven to be hugely beneficial, both for patients and their carers, and enable us to care for far greater numbers of people than we could have previously.
“As clinicians, we want to be able to provide patients with personalised care, in a place of their choosing, whether that is at home or in a hospital. In the past, we couldn’t offer that choice, with many people unable to be cared for at home with their loved ones around them.
“Post-pandemic we are now able to offer patients a real choice in terms of where they wish to be cared for, whether that is at home, in a care home, in hospital or hospice.”
Prior to the start of the pandemic, it was acknowledged across Scotland that it was necessary to extend palliative care to greater numbers of those with life-limiting conditions. The Scottish Government’s Strategic Framework for Action on Palliative and End of Life Care stated that everyone in Scotland who required palliative care should have access to it.
Work to extend access to specialist palliative care in Fife was accelerated in its introduction by the pandemic and the need to keep vulnerable people safe. The proposals, which will soon be taken to the Integration Joint Board and NHS Fife Board, will seek approval to continue the extended model, which has been embedded over the course of the last three years and has been shown to better meet the needs of the population.
Under the pre-COVID model of care, Fife’s Specialist Palliative Care Team could look after a maximum of 19 patients at any given time, across two hospices units at the purpose-built specialist Victoria Hospice and a hospice ward at Queen Margaret Hospital.
The move to a single hospice during the pandemic allowed many specialist palliative care staff to provide outreach care in the community, where they were able to apply their specialist knowledge in providing multidisciplinary care for patients and families in their own homes.
The creation of the palliative care outreach team means the service can now care for as many as 60 patients at any time, across Fife’s communities, care homes, hospitals and hospice.
The ability to care for patients at home has meant that waiting times for a hospice bed have significantly reduced, with very many of those admitted currently waiting no time at all.
For those who are unable to, or who would prefer to be cared for in hospital or require hospice care, there continues to be access to inpatient palliative and end of life care beds in 5 community hospitals across Fife, including at Queen Margaret Hospital in Dunfermline, in addition to the centrally located Victoria Hospice in Kirkcaldy.
Fife Health and Social Care Partnership’s Head of Community Care Services, Lynne Garvey, said: “We want to ensure that patients across the whole of Fife, their families and loved ones, can get access to the very best care and support possible, particularly in the final months and weeks of their life.
“It’s vitally important that we provide patients with greater choice around all aspects of their care, and we are now in a position to do this by expanding the way we deliver specialist palliative care across Fife, giving patients and families greater choice.
“The proposals will also help us better meet the needs of our population by widening and ensuring equity of access, while enabling far greater numbers of patients in Fife to receive specialist palliative care.”
For more information on specialist palliative care in Fife, please visit: https://www.nhsfife.org/palliativecare/