NHS Fife: Update on waiting times after festive period

The latest figures presented to members of the board at a recent meeting showed that the number of people in line for cancer, emergency, and several other types of treatment are well above the targets set by Holyrood.

Of those visiting A&E at Victoria Hospital, 70.1 per cent waited less than four hours, below the 95 per cent expected by the Scottish Government.

In November, the most recent reporting period, 615 people waited more than eight hours, compared to 655 in October, while 168 waited more than 12, a month-on-month decrease of 14.

Claire Dobson, director of acute services, said: "In terms of acute performance for November, the four-hour access target did improve and we performed above the improvement trajectory that we have agreed with the Scottish Government.

"Our long waits have remained high, this was due to capacity challenges downstream within the hospital which was demonstrated in the waits for beds.

"Unfortunately demand through the emergency department and our front door has remained high and was, as was mentioned earlier, unrelenting over the festive period.

"We are working hard on some improvement work through the development of a rapid triage unit and through the use of the minor injuries unit at Queen Margaret Hospital."

There were also delays for those waiting for inpatient or day case setting treatment, with just 50.6 per cent receiving an appointment within 12 weeks of decision to treat, almost half of the targeted 100 per cent.

Monthly performance in this area has stabilised in the last four months and is around 15 per cent lower than it was a year ago, however the health board remains within the top quartile of mainland Scottish health boards.

The waiting list has increased in each of the last 17 months and is more than 50 per cent higher than in October 2021.

Ms Dobson added: "In terms of the patient treatment time guarantee, performance has stabilised and is very positive in comparison to other mainland boards in Scotland.

"Demand for patient day case surgery does remain high and capacity challenges at Victoria Hospital mean that other than cancer and urgent cases we're not able to accommodate routine surgery on the site.

"However, we are continuing to maximise the use of Queen Margaret Hospital.

"We are keeping a close eye on the long waiting targets that were set by the Scottish Government in the summer, but unfortunately the two-year target will not be sustained by March in some of our specialities.

"We are also keeping a really close eye on the 18-month and 12-month target as we are concerned about sustaining those targets too."

The report presented at the meeting confirmed that additional activity is not possible given the level of funding received and restrictions at Victoria Hospital.

Departments which will not meet targets are general surgery, orthopaedics, and gynaecology, with an increasing number of patients waiting more than a year for orthopaedics, urology and general surgery.

A focus remains on urgent and cancer inpatients, as well as long waiting day cases which can be performed at Queen Margaret Hospital.

Only 50.2 per cent of new outpatients were seen within 12 weeks from referral, with revised trajectories now submitted to Holyrood showing that the majority of specialities will not meet 2-year or 18-month targets by March.

Of those who are referred urgently with a suspicion of cancer, 68.3 per cent begin treatment within 62 days of receipt of referral, below the target of 95 per cent.

The report stated: "As anticipated, there was a further fall in performance in October.

"In the 3 months ending October, there were 53breaches out of 225 patients starting treatment, with 35 of these being in the Urology specialty.

"NHS Fife was below the Scottish average for the first time since January."

It continued: "Prostate remained our most challenged pathway where delays leading to breaches were seen in almost all steps.

"Introduction of robotic prostate surgery in Fife has already improved the waits to surgery and are expected to reduce the current backlog of surgical patients who have breached without a treatment date.

"Breaches seen in lung were attributed to a delay to surgery and referral from another cancer pathway."