A year on … the Improving Cancer Journey Service is making a difference to people living in Fife

A ground-breaking new service which ensures cancer patients in Fife are offered emotional, practical and financial support has reached an important milestone. In the last 12 months over 600 people have now had their concerns addressed by the Fife Macmillan Improving the Cancer Journey service, a joint partnership between the Fife Health and Social Care Partnership and Macmillan Cancer Support.

The good news is that, with advances in treatment, more people than ever are surviving and people who are living with cancer are often living longer. We know that the impact of cancer does not suddenly stop when the treatment is over. People often have to deal with the long-term effects of treatment or other health conditions that can have a huge impact on health, wellbeing and independence. Many of them often don’t know where to go for help coping with the impact it can have on their lives beyond the physical effects. This is where the Fife Macmillan Improving the Cancer Journey Service (ICJ) is making a difference.

The ICJ link workers provide a person-centred approach and discuss “what matters” to the person.

Julie Paterson, Divisional General Manager (Fife-wide), Fife Health & Social Care Partnership said: “This is an extremely valuable service for those in Fife living with cancer. Everyone deals with cancer differently and we want to make sure that those impacted by cnacer are aware of the service and how we can continue to support them to live as well as possible.”

Pamela Harrower from Blairhall was diagnosed with breast cancer in April 2018

The news came as a complete shock. I had no symptoms and was the healthiest I had felt in a while. My medical team were fantastic and during treatment I was so focused on getting through it that I didn’t have time to think about anything else. However, once treatment finished I felt I needed even more support. Thankfully I had received information about the Improving Cancer Journey and gave the team a call. 

“My link worker Sharon Breeze talked through everything with me which was such a relief. It felt like the first time I had properly talked about it all. She broke down all our concerns and addressed each of them, from money worries to fitness and my mental health”.

Scottish Government and Macmillan Cancer Support announced joint funding of £18m to enable everyone diagnosed with cancer in Scotland to have access to a dedicated support worker through the Transforming Cancer Care programme.

Pamela Harrower and Sharon Breeze were invited along to the announcement delivered by the First Minister Nicola Sturgeon and Health Minister Jeanne Freeman to share their experiences.

To find out more about how the Improving the Cancer Journey can help, call the service on 01592 578076 or email

Additional information:
Improving Cancer Journey website



Out of hours urgent care – let’s talk before you walk

In 2016, Fife’s Health and Social Care Partnership began a review of how we provide out of hours urgent care in Fife, developing a system that would ensure safe, effective and sustainable services across Fife.

Following two years of analysing data, developing services and consulting and engaging with staff, communities, community groups and organisations, the Integration Joint Board agreed a new model of care at their meeting in June 2019.

What do we mean by out of hours urgent care?
This is care that is provided when your GP surgery or pharmacy is closed. This might be for chest infections, urinary tract infections, district nurse care for someone receiving palliative care at home, a child with a high temperature that is not reducing with the medicines you have at home or a minor injury.

What’s changing?
From 4 November 2019, we will begin to implement a more flexible, integrated and multi-disciplinary team approach, working from three centres and supported by home visits.

How to access urgent care out of hours
To ensure everyone gets seen by the right person and in the right place, please talk before you walk and call NHS 24 (111 – free number) first. There are a few ways you will be supported depending on your needs:

  • an advice call from a GP, nurse or paramedic
  • an appointment at a centre with a GP, nurse or paramedic
  • receive a home visit from a GP, nurse, paramedic or district nurse.

Dr Helen Hellewell, Associate Medical Director said, “We have worked closely with healthcare professionals, staff and our communities and I believe we have developed a model of care that puts safety front and centre, and that it is sustainable now and in the future for the whole of Fife. Calling 111 first, before travelling to one of the centres, will ensure you are seen by the right person and in the right place.”

Nicky Connor, Director of Fife’s Health and Social Care Partnership thanked staff and community representatives noting, “I want to thank staff and the public for their patience. Working together with colleagues and communities to design this service together has been key to developing new rotas and ways of working so that Fife has a flexible, safe and responsive service. Our new model will ensure that we can continue to see people in the right place, at the right time and by the right professionals.”

Strategic plan consultation – are we getting it right for Fife

What do you think about the future of the health and social care services in Fife? Your views are important – let us know what you think by completing our short survey.

Launch message from Michael Kellet, Director Fife’s Health & Social Care Partnership, Fiona McKay, Head of Head of Strategic Planning Performance and Commissioning anc Cllr Rosemary Liewald, Chair of the Integration Joint Board.

Fife Council and NHS Fife are working together as the Fife Health and Social Care Partnership in line with Scottish Government policy (known as the Public Bodies (Joint Working) Act), with the aim of offering seamless services and better experiences of care, especially for people with long-term conditions and disabilities.

The challenges and opportunities that we face together are enormous with:

Fife’s population getting older:

  • • the number of people aged over 75 years predicted to increase by 44.6% by 2024; and
    • many more people living with more than one long-term condition.

The plan is a fantastic opportunity for all of us; individuals, staff, partners, communities and representatives from the third and independent sectors to use our collective experience, knowledge and skills to drive forward new and innovative ways of working in local communities and achieve change.

Since 2016 we have made significant progress in a number of areas and will continue to redesign and consult on new ways of working by looking at the needs of the population of Fife and continue to shape our plan around those needs.

Using feedback from various groups we have produced a draft plan.

We now need more views. Do you think the plan will meet your needs not just for now but for the next three years? We will listen to what you tell us, and then produce our final Strategic Plan for 2019-22. Please have a look over the draft plan before completing the survey.

Please take the time to complete the survey – your views will help inform what our health and social care priorities are for the next three years.

Online survey 

If you would like either the draft Strategic Plan or online survey questions in an alternative format or a paper copy then please phone us on 01592 583136.

The closing date for responses is Sunday 12 May 2019.

Out of Hours contingency measures to continue

Contingency measures for the overnight Primary Care Emergency Services (PCES) in Fife are to continue for a further six months.

Current arrangements in place:
From 6pm to midnight (Monday to Friday) and 8am to midnight (weekends and public holidays) PCES will continue to be delivered as normal from:

  • Queen Margaret Community Hospital, Dunfermline
  • Glenrothes Community Hospital, Glenrothes
  • St Andrews Community Hospital
  • Victoria Hospital, Kirkcaldy

There will continue to be no changes to the operation of the Minor Injuries Unit at Queen Margaret Hospital.

The contingency measures apply between midnight to 8am, where Primary Care Emergency Services (also known as GP Out of Hours) will be only be available at the Victoria Hospital, Kirkcaldy. The contingency measures were put in place on 9 April 2018 and this will remain in place until the end of August 2019 when a further update will be provided.

This decision has been taken as a result of on-going nursing and medical staffing difficulties and has been taken to ensure patient safety.

Michael Kellet, Director, Fife Health and Social Care Partnership said: “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. Staff shortages continues to be the biggest challenge.”

Michael continued:  “Fife like many other areas across the UK is experiencing the impact of national shortages of key staff in this area. 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. We will continually review performance over the next six months and provide an update at the end of July.”


Access Therapies Fife – launch of new mental health website

One in four of us in the UK will experience a mental health problem each year – and the most common mental health difficulties are stress, anxiety and depression. To make it easier for adults in Fife to obtain psychological help for common emotional problems we’ve launched a new website, Access Therapies Fife.

Research has shown that people can really benefit from attending courses and working with groups to learn new skills to manage stress, anxiety, low moods or how to become more confident and assertive – these changes and skills can lead to improvements in mental health. Taking this first step by using the help and advice tools available may also avoid the waits sometimes associated with going through your GP or another health professional.

What does the website offer:

  • Courses – Step on Stress, Back on Trac, Assertiveness and Improving Well-being – these courses help to focus on the relationships between thoughts, behaviours and feelings and how to deal with these.
  • Change Up – a weekly therapy group which helps people overcome a range of emotional problems.
  • Self-help options.
  • Information on local support and resources.

All courses and groups are held across Fife and run regularly throughout the year.

This new website will make it easier and quicker for adults across Fife to access high quality psychological help – the options available are important additions to the psychological services provided in Fife,” said Dr Frances Baty, Consultant Clinical Psychologist and Head of Adult Health Psychology, Fife Health & Social Care Partnership

At the launch of the new website at Lynebank Hospital, Julie Paterson, Divisional General Manager (Fife-wide), Fife Health & Social Care Partnership added, “Within the mental health service we hope to help people achieve their aspirations, while offering help when they need it. This website is a significant development in psychological therapies through self-referral and builds on our ambition to remove barriers that deter people from seeking help”.

For info:
Access Therapies website –


Dr Frances Baty| Consultant Clinical Psychologist and Head of Adult Mental Health Psychology, Fife

Hazel Williamson| Communications Officer, Health & Social Care Partnership


Carers Strategy for Fife 2018-2021 – check out the improvements to support carers in Fife

The Carers (Scotland) Act 2016 came into effect on 1 April 2018.  The Act places new duties to identify and support carers.

The duties include:

  • offering an Adult Carers Support Plan or Young Carers Statement;
  • supporting carers of people who are being discharged from hospital to become involved in pre-discharge decisions, and
  • provide universal information, advice, guidance and advocacy support to carers.

Fife’s Health and Social Care partnership has consulted with carers and developed and published a Carers Strategy for Fife 2018 – 2021.  It demonstrates the commitments we will make in Fife to improve support for carers as well as helping carers to become more self-sufficient in helping themselves.

For more information about the improvements being made to support Fife’s carers, contact Scott Fissenden by e-mailing


Out of Hours Contingency Measures To Continue

Contingency measures for the overnight Primary Care Emergency Services (PCES) in Fife are to continue.

NOTE:  From 6.00pm to midnight (Monday to Friday) and 8.00am to midnight (weekends & public holidays) PCES will continue to be delivered as normal from:

  • Queen Margaret Community Hospital, Dunfermline
  • Glenrothes Community Hospital, Glenrothes
  • St Andrews Community Hospital
  • Victoria Hospital, Kirkcaldy

There will continue to be no changes to the operation of the Minor Injuries Unit at Queen Margaret Hospital.

The contingency measures apply between midnight to 8am, where Primary Care Emergency Services (commonly known as Out of Hours) will be only be available at the Victoria Hospital, Kirkcaldy. The contingency measures were put in place on 9 April for a period of 3 months.   They will be extended for a period of a further six months with a full review to take place at the end of January 2019.

The move is a result of on-going nursing and medical staffing difficulties and has been taken to ensure patient safety.

Michael Kellet, Director, Fife Health and Social Care Partnership states: “The on-going challenges we face have left us with no other option but to extend the contingency measures to ensure patient safety.  We have taken and will continue to take every step available to us to try and resume services. This includes advertising to recruit Nursing and GP staff and working with GP leads to encourage our existing workforce to support the service wherever possible.”

Over the contingency period out of hours service activity has seen continued to see an average of 11 people attend the Victoria Hospital overnight an average of 8 home visits.

Michael continued:  “Fife like many other areas of Scotland is experiencing the impact of national shortages of key staff in this area.  In response we have put in place the contingency measures to ensure a safe and reliable service.  In addition, we must look at solutions to secure safe and sustainable services in the immediate and long term.  This requires transformation of traditional health and social care ways of working and service models.

“We will launch the Joining Up Care consultation on the 2 July 2018 to that end.   Through the consultation we want to hear the widest range of voices possible from right across Fife.  From the North East to the South West and everywhere in-between, we are open to hearing ideas and suggestions as to how sustainable services can be developed at a local and Fife wide level. This includes the re-design of Out of Hours as one of three main programmes of change. The consultation will last 14 weeks and the re-design of Out of Hours care is one of three main programmes of change.  I would like to pay tribute to staff in PCES for the on-going commitment to the people of Fife during this period of uncertainty and change.”

Find out what this means for you in the Primary Care Emergency Service Frequently Asked Questions.



Scottish Government announce £632k Health & Work Support pilot

To increase health and employability support for people living with disabilities and health conditions, a pilot Health & Work Support service has been launched across Fife and Dundee.

Health & Work Support will streamline existing health and employability services by providing a single point of contact for those at risk of falling out of work or who have recently left due to ill health. The service will help more people stay at work, get back into work and tackle inequalities in the labour market by providing advice and support to employers on health, disability and work issues.

The Scottish Government will invest £632,000 in the service with additional funding coming from the UK Government.

Launching the service, Employability Minister Jamie Hepburn said:

“Every year, thousands of people in Scotland leave their jobs as a result of a health condition or disability. We want to provide early support to enable more people to stay in employment before they reach this point.

“Health & Work Support will act as a single point of contact for health and work support for people in Fife and Dundee, as well as employers, and will allow them to get fast access to the help they need.

“This new service integrates healthcare and employability support so that individuals with disabilities or health conditions can benefit from a service that more closely matches their needs.”

Michael Kellet, Director, Fife Health and Social Care Partnership said:

‘‘Fife Health and Social Care Partnership recognises the importance of employment in maintaining health and well-being and is delighted to be able to host this innovative pilot project here in Fife. We recognise the work that has gone into making this happen and wish the project every success.’’

Chairman of the Integration Joint Board, Dundee Health and Social Care Partnership, Councillor Ken Lynn said:

‘‘This is an extremely important development and I am pleased that Dundee is helping to trial the project along with Fife. We are working hard to make Dundee a better place for everyone, and that means not leaving anyone behind. We want to help all those who wish to get back into work, or remain in work. I will be very interested to see the progress this scheme will make for people in the months ahead.’’


Internet Safety guidance for adults with autism or learning disability first of its kind in Scotland

Staying safe online has never been more important.  For some adults who have autism or a learning disability navigating the internet safely and legally can be complex.

To support them, carers and family members, Fife Adult Support and Protection Committee and child protection charity, Stop It Now! Scotland, have produced a resource pack, the first resource of its kind in Scotland, which provides vital guidance and advice. Just as importantly, the pack also educates in an easy read format. (Stop it Now! Scotland is a child sexual abuse prevention campaign run by child protection charity, The Lucy Faithfull Foundation).

Alan Small, Chair of the Fife’s Adult Support and Protection Committee, talks about the process and engagement that went into developing the materials:

“Internet safety, accessing inappropriate child imagery and the risk of grooming is a very sensitive subject.   It is important that we educate and guide all adults on this topic. In particular ensuring that those who may be more at risk or susceptible to the misuse of the internet because of an additional vulnerability are given guidance and advice how to keep themselves and others safe. This includes providing guidance around the inappropriate and unlawful sharing or use of child images.

The resource is a suite of documents which uses direct and simple language supported by photographs and simple line drawings, so they are very accessible and easy to read.  These are the tools we will use to help develop awareness and importantly a full understanding of what is the right and wrong use of the internet: what is inappropriate and unlawful: how to keep safe: and the actions and behaviours that can have serious consequences. All in a simple and easy to understand format.  This is the result of many months of hard work and many conversations and we would wish to thank everyone involved, particularly people we worked with how may use the resource and their families.”

To keep people safe and reduce and prevent offending in this way, the project involved working very closely with Stop It Now! Scotland, Police Scotland, Scottish Autism, Autism Rocks and other relevant organisations. Consulting widely over the course of a year ensured the views of a range of people including professionals such as adult and child protection practitioners as well as members of the public with an interest in the subject.

National Manager for Stop it Now! Scotland, Stuart Allardyce, said:

“Our focus has always been to prevent children from being sexually abused, both online and offline. That’s why we work tirelessly to make people aware that accessing sexual images of anyone under 18 online is both illegal and harmful to the children in the images. But until now, there has been no resource specifically for adults in Scotland with learning disabilities. So we were delighted to work with colleagues on the Fife Adult Support and Protection Committee to produce this resource that fills a real gap in child safeguarding. The resource pack will play a vital role in keeping children in Scotland safe from online abuse. And just as importantly, it will help keep vulnerable adults in Scotland safe from getting into trouble online.”

Resources available are:

Copies of the new resources are available online at: and at on the ‘Internet Safety’ section.

Paper copies for Fife organisations can be requested by emailing: or call 03451 55 55 55 ext 442134.

Partnership Board to consider ‘Joining Up Care’ consultation proposal

On the 22 May 2018, Members of Fife’s Health and Social Care Partnership Board will be asked to consider and approve a proposal for consultation on the transformation of health and social care services.

Set out in 3 parts, the ‘Joining Up Care’ consultation is in response to the:

  • growing demand for services
  • increasing complex care needs
  • publics’ desire to live well at home for longer, and;
  • national recommendations

The 3 parts are as follows:

Part 1: Community and Wellbeing Hubs

Introduce more joined up ways of working between professionals to co-ordinate care and appointments, help reduce waiting times and improve the care experience through proactive intervention and working locally in communities.

Part 2: Re-designing Out of Hours Urgent Care

When the GP surgery is shut, these are the services that see members of the public who are looking for a GP or a nurse (advice, treatment centre care and home visits).  As well as minor injury services and the evening and night District Nursing service. It is important to state, that this is not Accident and Emergency at the hospital.

There are two options being proposed within this section. They will both have:

An Urgent Care Resource Hub

Will be an area where staff from a number of health and social care urgent services work together to coordinate service delivery. It will direct how services work in the out of hours period to make best use of resources and support so people access the right service as quickly as possible.

Urgent Care Centre(s)

This will deliver urgent care in a safe place that the public can go to. It will provide GP services, and minor injury services and can act as a base for a range of other urgent care services.

These changes are being proposed in response to the national and local challenges in regards to GP shortages, national recommendations in regards to Out of Hours and are to ensure the on-going clinical safety of patients.  The proposal does not relate to in-hours minor injuries service provision.

Part 3:   Bringing Care Closer to Home – Community Hospital bed based care

Once people no longer need hospital care, it is better for them to get home or continue their care journey in a homely setting as quickly as possible. We know our current model could be more efficient, as some people are staying in hospital for longer than their needs require. We need to move some of our resources from hospitals to community based teams and provide care at home or in homely settings.

The aim is to:

  • Support people to leave hospital earlier
  • Proactively support people at home or in a homely setting so they can regain skills and confidence and stay independent for longer
  • Make sure people have access to the right type of bed at the right time, wherever they live in Fife, and;
  • Focus the use of Community Hospital beds on people with complex health conditions who need round the clock nursing care.

The proposal is to seek the public’s thoughts on the Partnership’s initial thinking where they are seeking to redefine models of care, considering where care should be in a hospital bed and where else people could best be cared for to improve their experience.

The collective goal of the ‘Joining Up Care’ proposition is to establish a fully integrated 24 hours, 7 days a week community health and social care model that ensures sustainable, safe and more individual experience of care.  If approved, the proposals will go forward for a 14 week public consultation.

Michael Kellet, Director, Fife Health and Social Care Partnership explains:

“From the youngest to the oldest, the fittest to the frailest we want people to live well in Fife. Ensuring the right care, from the right person at the right time is vital, whether this is responding to a poorly child after the GP is shut, being more proactive to support independence and wellbeing or giving complex round the clock medical care to those with long term conditions.

We know people value their local services highly, but the challenges are such that leaving services as they are is not a safe, sustainable or responsible option.  To meet modern demands, we need to adapt systems and change ways of working that have been in place for many years. We need to join care across communities and hospital services so we can continue to respond to peoples’ physical, emotional and social needs.  This includes peoples’ desire to stay independent and at home for longer.    We must also think of frontline staff and the increasing pressures they face.

“The future of Fife’s integrated care services involves all of us all.  By bringing together the review of Urgent Care Out of Hours, development of community health and wellbeing hubs and community hospital re-design under one ‘Joining Up Care’ proposal, the aim is to create a comprehensive approach to evolving services, one which will involve full consultation with the public before any change is made.  We await the decision by Members on the 22 May.”

Full copies of the ‘Joining Up Care’ Consultation proposal papers are now available on Fife Direct.    A draft ‘Joining Up Care’ Consultation Summary document is included and you can find that here.