Fife accident and emergency services could be consolidated on one site prior to the new wing at Victoria Hospital in Kirkcaldy opening.
At NHS Fife’s annual review, chaired by health secretary Nicola Sturgeon, medical director Dr Brian Montgomery said he would like to see the contingency measure of downgrading Victoria’s A&E to a minor injuries unit overnight phased out before the service is moved permanently to the new build in 2012.
He said an “interim state” for A&E services would have clinical advantages.
It is understood this could mean emergency services are consolidated at Queen Margaret Hospital in Dunfermline in the run-up to them moving to Kirkcaldy.
Dr Montgomery said, “Having the contingency itself is not a comfortable place to be.
“It’s not a good idea to continue with a situation where you don’t know what’s happening until three o’clock in the afternoon.”
He added that before the new wing opens, staff would have to familiarise themselves with the new way of working.
At the moment Queen Margaret and Victoria deal with emergency cases, but under the Right for Fife process services are being reconfigured and will eventually be centralised at the new Victoria, which will take care of A&E, acute medical cases and maternity.
Although the August intake of junior doctors has gone some way to resolving difficulties in drawing up out-of-hours doctors’ rotas for both Queen Margaret and Victoria A&Es, NHS Fife can give no guarantees that sickness absence or doctors leaving to take up other posts later in the year will not lead to the contingency being used again.
Fife Health Board spent over two hours being grilled by Ms Sturgeon and Scottish Government colleagues before a question and answer session.
Ms Sturgeon asked the board what steps they were taking to ensure the contingency was only rolled out as a “last resort.”Funding pressureThe issue of public funding pressures was also on the agenda and, with salaries being the health board’s biggest outlay, Fife health bosses were quizzed on how frontline services would be affected.
NHS Fife has identified a potential saving of £2.3m in staffing costs equivalent to 54 full-time posts.
Director of human resources Rona King said the staffing cuts, which have not been confirmed, amounted to less than 1% of NHS Fife’s total workforce of between 7500 and 8000 employees.
Director of finance Chris Bowring said the board was looking at reducing the second largest expense, prescribing costs, and making other efficiency savings.
She said, “We’ve tried to concentrate on all the initiatives that don’t impact on the delivery of clinical services.”
Alan Kennedy from action group Save Our Dispensing Surgeries raised the issue of the commercial pharmacy in Leuchars.
The pharmacy has caused controversy since it opened earlier this year because of the impact it had on the local doctors’ surgery, which subsequently lost revenue from dispensing.
Ms Sturgeon said she was powerless to intervene, but said the regulations for granting licences for independent pharmacies were under review.
A public consultation on the matter closed at the end of June and the findings are to be considered.
Meanwhile, Councillor Andrew Rodger asked why ward 13 at Victoria was shut when Fife hospital beds are running at almost full capacity.
John Wilson, chief executive of NHS Fife’s operational division, said the move was possible because more patients were being treated as day cases and hospital stays were being shortened.