NHS Fife has been making moves to ensure its services are ready as the board prepares for the anticipated increase in demand on services brought about by coronavirus.

A significant amount of work has been undertaken over recent weeks to reconfigure services, both in hospitals and in communities.

This work has been carried out to ensure that healthcare services in Fife are as resilient as they can be as the pressure intensifies on healthcare in the coming weeks.

A number of service changes have also been made to minimise the risk of coronavirus transmission in hospitals, and safeguard those most vulnerable to the effects of the virus.

Routine Outpatient and Diagnostic Appointments see that from Monday March 30, all non-urgent appointments are being postponed. Those patients affected are in the process of being contacted.

Planned Operations - Routine procedures at the Victoria Hospital are now being postponed. Affected patients are being notified directly and procedures will be rescheduled in due course. Emergency surgery, cancer surgery and planned caesarean sections remain unaffected and continue as normal.

Procedures at Queen Margaret Hospital are continuing as planned for the time being.

On the Diabetes Service - services currently delivered from the Diabetes Centre, at the Victoria Hospita,l will cease temporarily to accommodate the new COVID-19 Assessment Centre. A limited service will be offered from the Carnegie Unit, at Queen Margaret Hospital, in Dunfermline, and patients are currently being notified of the change of location.

Primary Care Virtual Hub - From Monday March 23, patients calling NHS 24 (111) will be triaged and either offered advice on self-care at home, or redirected to the Primary Care Virtual Hub. The Hub will be operated by a skilled team of clinicians, who will conduct a more thorough assessment by phone or video call.

If it is deemed that a face-to face assessment is required, patients will instead be seen at the COVID-19 Assessment Centre, located within the Diabetes Centre, at Victoria Hospital.

COVID-19 Assessment Centre – This new service will operate 24/7, through which the majority of patients with possible COVID-19 in Fife will be assessed. Those well enough to return home will be provided with self-care and public health advice, with those requiring immediate intervention taken directly to the Victoria Hospital for inpatient treatment.

Reconfiguration of Victoria Hospital – Within our acute services, plans have been enacted to manage the anticipated increase in the numbers of critically ill patients requiring hospital care.

The Victoria has been divided into two distinct zones to optimise capacity and reduce the risk of COVID-19 spreading. The first zone (red) applies to the emergency department, critical care, infectious diseases and one medical ward at present, with scope to expand this further– this zone will accommodate those patients confirmed as carrying COVID-19.

The remaining areas of the hospital are in the second zone (green), and this definition also currently extends to Queen Margaret Hospital.

Medicines Advice and Information – There are currently no medicines shortages as a result of COVID-19. There is no need to stockpile medicines or request additional prescriptions.

If anyone is experiencing symptoms and needs to stay at home, family members or neighbours should be asked to collect prescriptions on their behalf. For those whose prescription medicines are usually delivered and are symptomatic, this will not change, however, doorstep procedures may be implemented.

The Board are keen to stress that additional service changes are very likely to be required in the coming weeks as the response to coronavirus develops - updates will be issued on NHS Fife’s website, Facebook, Twitter and Instagram pages as soon as any changes are made.

NHS Fife Chief Executive, Carol Potter, said: “It’s crucial that we put the necessary measures in place to prepare our services for the significantly increased demand over the coming weeks and months.

“In any other set of circumstances these actions would seem drastic, however, with the challenges facing us, we believe this is an appropriate and measured response which enables us to continue to provide a good standard of care.

“In the face of great adversity, NHS Fife’s staff have again risen to the challenge and continue to be a credit to this organisation. On behalf of the executive team, I want to assure them that they have our unwavering support, and our confidence that the people of Fife are in the best possible hands.

“Similarly, I want to thank the public we serve for the understanding shown over recent weeks as we sought to put these contingency measures in place. I want to urge them to take the very best care of themselves, and their more vulnerable friends and family members, and follow the advice on the NHS Inform – nhsinform.scot/coronavirus.”

The Board are also keen to stress that hospital’s switchboard is currently experiencing significant volumes of calls from patients and loved ones about their upcoming appointments.

Mrs Potter continued: “We absolutely understand the natural anxiety of patients regarding their clinic appointments and procedures – understandably people want to know one way or another whether their appointment is going ahead.

“The message from us is clear – we will contact you if your appointment is postponed, either by phone of by letter, to give you the clarity you need. Patients should rest assured also that any procedure cancelled with be rescheduled as soon as is practically possible.”