I have this week written to Alex Neil the Health Secretary raising once again my concerns about the ability of NHS Fife to meet the health needs of the people of Fife. I am calling for an independent review of the practice, policy and finance of NHS Fife. I believe there are serious failings within NHS Fife which are leading to local people having bad experiences or not receiving the kind of service they should.
The staff working in our hospitals and across all sections of health and social care are working under immense pressure and we owe it to them to ensure that the proper resources and policies are in place to meet the health needs of the people of Fife.
My letter to Alex Neil:
Dear Cabinet Secretary
I write to raise my concerns and worry about the ability of NHS Fife to meet the health needs of the people of Fife.
You will recall we had a brief discussion in the Garden Lobby some four weeks ago about the relationship between Fife Council and NHS Fife and their ability to fund more care places in the community. I have followed this up with meetings with the Chief Executive and Leader of Fife Council to discuss the issues that the Council are dealing with. I was to meet with the Chief Executive of NHS Fife today but this was cancelled as he is once again on sick leave.
I intended to raise a number of issues with him but feel that they are serious enough to merit bringing them to you and indeed for me to call for an independent review of the performance of NHS Fife and its ability to meet the health needs of the people of Fife.
There are many issues and concerns, not least the level of pressure that staff have been working under, and continue to work under. I outline below some of my key concerns.
NHS Fife have acknowledged they have at least 40 consultant places that are currently not filled and that they are struggling to recruit for these posts whilst doing their best to plug the gaps with locums. As you know this is a very expensive way to try and deliver health services and is perhaps one reason why the acute budget was overspent by over £8 million last year, and also casts a big shadow over the future transfer of funding from acute to community where we are now seeing a major problem with lack of resources.
However, we also need to know what the impact is on people and their ability to access services when there are over 40 missing consultants.
NHS Fife have also confirmed that they are failing to meet targets when it comes to psychological services and indeed have created a second waiting list to remove people from the first list which provides the benchmark for the targets. They do not know how many people are even on the second list. I wonder how that can be, but note that NHS Fife say they simply do not have the financial resources to deliver these services.
I also understand, from my discussion with Fife Council, that there are concerns around GPs being able to support step-down beds which the council have been purchasing to try and take some pressure away from the hospital. Is there an issue with capacity of GPs in Fife as it has also been suggested to me that GP locums are being used more and more in Fife?
With reference to the number of beds available within the NHS in Fife there seems to be conflicting information available. For example, earlier this year information provided by the Information Services Division showed that in March 2012 there were 1,470 beds and that this had fallen by 166 in December 2013 to 1,304. More recently there seems to be a different set of figures being presented in a different format.
I also understand that when the new Victoria Hospital was established there was a reduction of some 200 beds within the system based on the new hospital being designed to work with zero delays. However the cost savings from those bed closures was not reinvested within community services which left the community sector unable to support the zero delay assumptions.
This leads me to question the modelling that was carried out when the majority of acute services were centralised into one site at the Victoria Hospital in Kirkcaldy. We need to know what assumptions were made and if the performance has reflected the modelling that took place. It is my view that since the new Victoria Hospital was opened it has bounced from crisis to crisis and there must be a review of all assumptions that were made in the planning that led to the decision to centralise service on one single site.
Can you confirm that NHS Fife has amongst the lowest numbers of adult acute beds of any territorial health board area in Scotland at 2.0 per 1000 against the Scottish average of 3.1 per 1000 population?
I also note that the Director of Nursing seems to have left the post, or at least there is speculation to this effect. Given the seniority of this position at the Victoria Hospital it is concerning to learn that this person seems to be no longer in post at a time when there are clear difficulties and massive pressures on frontline staff.
I would ask are you confident that we have the leadership and resources that are required in place to steer NHS Fife through the many difficulties and challenges it is experiencing?
Given the serious concerns I am raising with you around NHS Fife’s ability to meet the health needs in Fife I hope you will consider my request for an independent review of NHS Fife.
I look forward to hearing from you.
Alex Rowley MSP