NHS FIFE has pledged to protect its own maternity and children’s services ahead of helping neighbouring health boards to cope with a shortage of paediatric doctors.
Fears were prompted for the safety of services at the Victoria Hospital, Kirkcaldy, amid revelations that there are too few trainee doctors to cover the out-of-hours rota there and at four other hospitals in Edinburgh, Livingston and Melrose.
NHS Fife has joined forces with NHS Lothian and NHS Borders and is pooling resources in an attempt to solve the problem.
The joint initiative, being coordinated by the South East and Tayside Planning Group, has prioritised services at Edinburgh’s Royal Hospital for Sick Children and the Simpson Centre for Reproductive Health over those at Victoria Hospital.
However, the risk of ward closures is greatest at St John’s Hospital, Livingston, where a lack of staff led to the children’s ward being closed to new admissions for three weeks during the summer.
Public and staff consultation is expected soon on options for providing cover at the five hospitals, but NHS Fife chief executive John Wilson said there was only so far the kingdom’s health service would go in supporting the other units.
He told NHS Fife board yesterday: “While we are prepared to be helpful and cooperative, there is a limit beyond which we cannot go. Although our own service in Fife is secure at present, it is part of a wider picture.”
The board, he said, needed to be mindful of the impact of joint solutions proposed on its own provision.
He added: “We will continue to work with the neighbouring boards, but we will not go beyond steps we feel prejudice our own paediatrician service.
“Anything that would affect the safety of the services we provide, we would not be able to accommodate or agree to.”
There was also a warning that staff shortages were affecting other services, including obstetrics, gynaecology, emergency medicine and anaesthetics.
The three NHS boards issued a joint statement in November, admitting that from February they will be short of trainee doctors to cover the out-of-hours rota.
Across the three areas, it is expected at best there will be only 34 of the 47 paediatric trainees needed for out-of-hours cover.
The nationwide shortage has been blamed on a reduction in the hours trainees can work and experienced trainees taking jobs elsewhere.
There has also been an unprecedented level of maternity leave, more trainees working reduced hours and, due to immigration rules, a lack of available and experienced locum doctors.
Mr Wilson also said the board had predicted the nationwide shortage of doctors when it was redesigning health services in 2002, resulting in the decision to centralise acute services in Kirkcaldy and the construction of the new £170 million wing at Victoria Hospital, where maternity and children’s services are based.
While the centralisation had allowed Fife to benefit from “economies of scale and efficiency”, the board heard that the shortage of trainee doctors remained a challenge.
Until now, that has been met through a combination of the service reconfiguration and changes to the workforce.
These have included changes to consultants’ job plans, the introduction of non-training specialty doctor posts and the transfer of a number of tasks previously undertaken by doctors to nurses with enhanced training and skills, including advanced paediatric nurse practitioners and advanced neonatal nurse practitioners.
cpeebles@thecourier.co.uk