Out-of-hours GP services have been suspended for a further five months.
The emergency contingency measures imposed in April 2018, due to a shortage in nurses and doctors, will continue until at least the end of August.
The extension in emergency measures, resulting in a loss of out-of-hours services, will affect the St Andrews Community Hospital along with Glenrothes and Queen Margaret hospitals.
For the last 11 months, those hospitals have not provided services between midnight and 8 am, meaning those in need of out-of-hours services must instead visit Kirkcaldy or Dundee.
At the time of closure, an NHS spokesperson stated, “NHS Fife has made clear that this contingency should be temporary and that the FHSCP (Fife Health and Social Care Partnership) makes all efforts to both recruit and reinstate the service as quickly as possible.”
Fife’s overnight GP services have been centralised in Kirkcaldy during the absence of their own services.
Speaking to The Courier, Willie Rennie, North East Fife Liberal Democrat MSP, emphasised his disappointment with the announcement, stating, “The recruitment challenges need to be addressed and we need to see a swift solution for a primary care emergency service that can work for everyone in north east Fife too.
“Students at the University of St Andrews and sabbatical officers of the Students’ Association have worked to fight the removal of out-of-hours services. Around a dozen students attended an emergency protest on 21 November 2018 outside the Victoria Hospital in Kirkcaldy. The protest came after the Fife Health and Social Care Partnership announced their potential plans to close-out-of-hours services at three Fife hospitals, centralising them at either Victoria Hospital or both Victoria Hospital and Queen Margaret Hospital.
Nick Farrer, Director of Wellbeing for the St Andrews Students’ Association, dismissed the two plans in place by the partnership.
He said, “The fact there was no option considered to keep out-of-hours services in St Andrews was pretty abysmal.
“The plans present a very grave and serious threat to all students in St Andrews and all our neighbours in the East Neuk at large, and we can’t just stand back and watch it happen.”
In August 2018, the University announced their plans to provide a Student Health Hub at the St Andrews Community Hospital to relieve pressures on local GP services, just months after the initial announcement from FHCSP of the temporary closure in out-of-hours services.
Targeted at reducing the number of students seeking consultation with general practitioners for non-emergencies, the initiative has been predicted to provide an additional 7,000 appointments per year whilst minimising waiting times for the wider community.
Since the start of the academic year in September, the community of St Andrews has campaigned against the closure of out-of-hours services in Fife.
In January, the out-of-hours closure was reassessed, with members of the community, including students and locals of St Andrews, having their say in whether the services should remain. A petition launched in September by Mr Rennie has garnered over 6,000 signatures from St Andrews students, staff, and local residents.
Last May, Principal Sally Mapstone of the University of St Andrews wrote to health professionals, Stephen Gethins MP, and Willie Rennie MSP in a letter regarding the closure of out-of-hours GP services, calling the decision “a grave concern to the University.”
She said, “Between midnight and 8 am, it is likely that many of those who use the St Andrews MIU will be students. Very few students have access to a car and the MIU is their only recourse for medical assessment unless they call out GPs, a process likely to place further unwanted strain on NHS resources.
“The alternative to the MIU, Kirkcaldy’s Victoria Hospital, is simply inaccessible for most students faced with an emergency at night … The only alternative for students is the Ambulance Service, which is already severely stretched: we have experience of staff waiting 45 minutes for an ambulance to appear, even in serious emergencies.”
Principal Mapstone added, “This situation is beset by risks to our students’ health, with a real chance that an emergency will go unassessed and untreated due to the absence of accessible facilities.”
In September, the Joint Councils of the Students’ Association voted to resist the closure of out-of-hours GP services, resolving to urge students to participate in the consultations and to explain why any closure of the services places them at risk. Additionally, the Councils resolved to urge students to sign the petition resisting the closure, and to write to the President of the Students’ Association and the Director of Wellbeing to testify their resistance to the closure and experience with out-of-hours services.
Nick Farrer, the current Director of Wellbeing, has spent much of his tenure campaigning to keep the Out of Hours service at Pipelands Medical Practice open.
No decision has been made regarding the long-term fate of the out-of-hours services in Fife, after proposals to permanently close the services in St Andrews and Glenrothes were objected by the public.
Fife Health and Social Care director Michael Kellet emphasised patient safety as their main concern in this time. He said to The Courier, “Our patients are our main priority, keeping them safe and providing a quality service. To ensure this happens we need to extend contingency measures for out-of-hours care for a further six months.”
He continued, “Staff shortages continues to be the biggest challenge … Recruitment of GPs and nursing staff remains a focus for us and feedback from the recent Joining up Care consultation will help to inform how we move this forward.”