Joint mobilisation plan for Fife

NHS Fife has published its draft plan on how it intends to restart a range of healthcare and clinical services placed on hiatus at the height of the response to the COVID-19 pandemic.

All non-urgent activity has been stood down in Scotland’s hospitals since mid-March 2020 to enable Health Boards to respond to the challenge of COVID-19, and prioritise patients with the most urgent clinical needs to ensure that they could continue to receive life saving treatment safely during the pandemic.

In March 2020, Fife submitted a Joint Mobilisation Plan to Scottish Government Health & Social Care Directorates in response to the declared worldwide COVID-19 Pandemic. This Plan detailed the expansion of services to accommodate the expected increase in admissions of patients with COVID-19.

A draft copy of this plan was shared with members of Fife NHS Board at the end of March. On 24 April, the Interim Chief Executive of NHS Scotland confirmed that the Scottish Government was content in principle with the plans for acute services set out in the Fife Joint Mobilisation Plan and the activities undertaken to date.

View the joint mobilisation plan for Fife


NHS Fife Remobilisation oversight group

A Remobilisation Oversight Group was established to oversee the restarting of health and care services in Fife, with a specific remit to remobilise clinical services paused since the start of the COVID-19 pandemic. The group is co-chaired by NHS Fife’s Medical Director and Director of Nursing, with clinical representation from the Fife Health and Social Care Partnership. This NHS Fife lead group will be responsible for driving forward the reintroduction of clinical services in a safe, measured and COIVD-19 sensitive way.

The group will report through NHS Fife's Clinical Governance Committee which in turn will provide assurance to the Health Board on the safety and quality of services during the implementation of the Plan.

Next steps

Over the coming weeks we will be able to provide further information on the remobilisation of services and we will keep the public up to date via our social media channels and via this website.


Scottish Government Re-mobilise, Recover, Re-design: the Framework for NHS Scotland.

On 31 May, the Scottish Government published Re-mobilise, Recover, Re-design: the Framework for NHS Scotland. The Framework set out how services should safely and gradually prioritise resumption of some paused services, while retaining sufficient capacity to deal with COVID-19.

NHS Fife submitted its initial mobilisation plan to Scottish Government in March 2020. The plan outlines how both hospital and community-based healthcare services intended to safely and incrementally resume non-essential services in the period up to the end of July 2020.

Useful Scottish Government links:


Current changes to services

Whilst we appreciate all people are doing to help the NHS during this time, it’s vital those with non-coronavirus health concerns still seek help as they would have before the outbreak.

The NHS is here for you, so don’t ignore the warning signs. You are not being a burden, you are looking after yourself and our NHS by doing so.

If your hospital appointment has not be cancelled you should still attend. COVID-19 patients and those displaying symptoms are treated separately.

For further information visit nhsinform.scot



Emergencies and Minor Injuries

For emergencies and minor injuries NOT related to coronavirus, operational times are as follows:

  • Victoria Hospital: operates 24/7
  • Queen Margaret Hospital: operates 24/7
  • Adamson Hospital: operates Monday to Friday 8am-6pm*
  • St Andrews Community Hospital: operate Monday to Friday 8am-6pm*

*Out with these times and on public holidays call NHS 24 on 111.


Cancer

Do not delay in getting potential cancer signs and symptoms checked. During COVID-19 your GP practice is still here for you. It’s probably nothing serious, but it’s best to get checked, as the earlier cancer is found the easier it is to treat. Information on the common signs and symptoms of cancer can be found at getcheckedearly.org.


Fast-Deteriorating Conditions

If you or anyone in your household notices a rapid deterioration in their health, seek help immediately. Don not ignore the early warning signs of serious conditions such as heart attacks, strokes, severe asthma, or diabetic collapse. The NHS is still here for you. Call 999 for an emergency or your GP in normal hours and 111 for out of hours support.


Relaxing of visiting restrictions in maternity services

What does this mean for me?

  • You will be asked to provide the name and contact details of your birth partner and designated support person/visitor in the event that we need to carry out any COVID-19 contact tracing.
  • Your birth partner and designated visitor must remain the same throughout your pregnancy, birth and stay on the ward. This will enable us to monitor who is present within the hospital and will enable us to contact trace quickly, should this be required.
  • If your birth partner or designated visitor has any of the signs of COVID-19 infection they must not attend hospital with you.
  • You and your birth partner/designated visitor will be asked to wear a face covering for your scans and antenatal appointments.
  • Your birth partner and designated visitor will be asked to wear a face covering when they are with you during your labour, birth and on the ward and they will be asked to wash their hands and use hand gel frequently.
  • You will not have to wear a face covering when you are in labour and on the ward.
  • Staff will continue to wear Personal Protective Equipment when caring for you.
  • Your birth partner and designated visitor will not have unattended access to other parts of the department and wider hospital. This includes the immediate outside entrance to the unit which remains a screening area for maternity.
  • Please be aware that NHS Fife is a smoke free environment and to ensure everyone’s safety smoking or vaping is not allowed within our unit, this includes our screening areas.
  • Only one person can stay overnight with you in the hospital (if you have a single room). Your birth partner is no longer required to remain within the unit for the duration of your stay with us and will now be able to leave and return to visit you.
  • Dependent on the amount of people attending the unit at any one time your designated visitor may be asked to leave for a while of time to ensure infection control measures are adhered to.

Additional information

The full ranges of birth options are currently available across NHS Fife, including home birth. The full national routine schedule of antenatal care and postnatal care with face to face appointments in home or clinical setting will resume from 31 July, subject to appropriate physical distancing and hygiene measures in waiting areas The use of digital technology and home monitoring to supplement routine care in maternity and neonatal services will continue. Antenatal and postnatal Group Sessions will be resumed virtually or face to face subject to appropriate physical distancing and hygiene measures and the availability of venues from 31 July. Dates and booking process will be communicated nearer the time.


Visiting

Visiting restrictions are beingeased in Fife hospitals from July 13. Find out more.


Outpatient Appointments

All scheduled outpatient appointments have been cancelled. Please do not attend for your outpatient appointment. Your appointment will be rescheduled when possible.


Elective Procedures

All routine procedures have been cancelled*. Your procedure will be rescheduled when possible.


Pharmacy and Medicines

There are currently no medicines shortages as a result of COVID-19. There is no need to stockpile medicines or request additional prescriptions. If you are experiencing symptoms and need to stay at home, family members or neighbours can collect prescriptions on your behalf. If you normally have your prescription medicines delivered and are symptomatic, this will not change, however, doorstep procedures may be implemented.

Due to unprecedented demand, there may be occasions when your community pharmacy may be closed for a short time. If this happens there will be clear signage on the entrance to the pharmacy as to when they will be open again or directions to an alternative open pharmacy.

NHS inform has a complete list of pharmacies, visit - https://www.nhsinform.scot/scotlands-service-directory/pharmacies where you can search for the nearest pharmacy if your usual pharmacy is temporarily closed. Please be aware that prescriptions may take much longer than usual to be processed.

 

Prescription Delivery Service

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Note: Fife Council have taken the decision to stop provision of medicine delivery, a service currently provided by Fife Voluntary Action(FVA), with deliveries stopping after Saturday 15 August.

It is hoped that this will give patients enough notice to make alternative plans for their medicine needs.

FVA will start advising patients who contact them to request delivery that the service will not be available after 15 August and they will update their website and advertising materials accordingly.

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NHS Fife and Fife’s Health and Social Care Partnership are working with Fife Voluntary Action to provide a priority home delivery service for vulnerable, elderly and at risk people who are unable to collect their prescription medicines. 

To access this service, and arrange a delivery please complete the online form at  fva.org/prescription.
 
You can also telephone Fife Voluntary Action on 0800 389 6046 (9am - 5pm, Mon - Fri) or email [email protected] (anytime).

To have your medicines delivered you should:

  1. Contact your GP Practice to request your prescription.
    Tell your GP Practice which community pharmacy you would like the prescription sent to. For many people, you will have already done this and the GP Practice will know. If not, you should suggest a community pharmacy near to your home.
  2. Next, contact the delivery service online, by phone or email.
  3. You should provide your name, your GP practice, the community pharmacy, your home address and on which date you ordered the prescription from your GP.
  4. You should also advise of any special instructions for delivery, if there are items which need to be stored in the fridge, or how to operate the buzzer if you live in a flat.

Managing Prescribed Sharps Safely

Due to the Covid-19 pandemic and significant demand being placed on local pharmacies, it may not be possible for them to take prescribed sharps waste.  In this case, we would ask that you retain your sharps waste safely within your home.

Please ensure that you:

  • Do not overfill the sharps waste container and seal when the recommended level is reached.
  • Store filled and sealed containers safely at home until community pharmacies can accept the waste again.
  • Do not put sharps waste into your household waste.

Patients can obtain additional empty sharps waste containers from their community pharmacy.

If you are unable to store this waste safely at home or do not have someone who can help you to store this safely, please contact: Pharmacy Services - 01383 565351.

 


Prescriptions from Hospital Specialist Service

If your medicines are prescribed by a hospital Specialist Service please contact the appropriate hospital below to confirm that your medicine is ready for collection:

Pharmacy Dispensary at Queen Margaret Hospital, Dunfermline
Telephone: 01383 623623 ext 24734
Opening times:
Mon - Fri (09:00 – 17:00)

or

Pharmacy Dispensary at Victoria Hospital, Kirkcaldy
Telephone: 01383 623623 ext 21542
Opening times:
Mon - Fri (09:00 - 18:00) (09:00 - 17:00 on Public Holidays)
Sat (09:00 - 13:00)
Sun (10:00 - 13:30)

If your medication is not ready, please contact the Prescriber to arrange a prescription.

If your medicine is ready and you have a representative who can collect this for you,  please ask them to collect it.  They will be required to show some identification (driving licence, a bank card or passport).

If there is no one who can collect your medicine you can contact: Fife Voluntary Action, who can provide a delivery service for people who are unable to collect their prescription medicines during the Covid-19 pandemic.

To arrange a delivery please complete the online form: fva.org/prescription.
 
You can also telephone Fife Voluntary Action on:
0800 389 6046 (9am - 5pm, Mon - Fri) or email [email protected] (anytime).


Optometrist Services

If you have concerns about your eye(s) or vision you should phone your normal optometry practice as a first step. If it does not offer telephone support (or if calls are not transferred to another practice) then phone the closest local practice that does. You will then be given further help and advice from an optometrist. If it is then decided that an emergency appointment is required, then this will be arranged for you. This will normally be at an optometry practice but, only if absolutely necessary, hospital consultations can also be organised. 

Please click this link to check optician practice availability or scan the QR code with your phone: https://bit.ly/2yN65em

From 7 April emergency eye appointments in the community are only available from a limited number of practices. These have the Personal Protective Equipment (PPE) required to reduce the infection risk for both patients and practitioner.


Dental Services

Updated text for NHS Fife COVID website Phase 3

On July 9 the First Minister announced that Scotland is moving into Phase 3 of the Scottish Government route map for recovery. This means that NHS Dental Practices throughout the country can also move to the next stage of recovery. During Phase 3, dental care will continue to be provided in a careful and planned way.

It is important that we continue to make progress towards stamping out COVID-19 in our community. This means that the dental care available is still limited and some dental treatment may need to be provided in designated Urgent Dental Care Centres rather than at your own dental practice. . Currently treatments such as routine scale and polish with an ultrasonic scaler or treatments requiring the use of a dental drill for non urgent problems are not permitted. That is because there is a risk from those treatments of producing an aerosol that could contain the virus that causes COVID-19. Plans for the recovery of NHS Dentistry are led by Scottish Government.

Your NHS Dentist will be able to provide a limited service that includes urgent dental care for pain and swelling or to check for signs and symptoms of oral cancer. Treatments that do not involve the use of dental drills and do not require other equipment that can produce an aerosol are permitted to take place at your own dental practice. Treatment for urgent dental problems that requires the use of a dental drill or similar will be provided in urgent dental care centres throughout Fife.

During Phase 2 NHS Fife has been working closely with all local dental practices that provide NHS dental services to help them safely re-open. The focus of this work has been to ensure that NHS dentistry can be provided safely as we continue to drive COVID-19 out of our communities. This requires assessing each practice on a case by case basis, ensuring PPE is available to staff and that staff providing care are healthy. As a result all dental practices are now open and are providing urgent dental care.

As we move into Phase 3 further work is required to take into account greater numbers of patients and treatment. This may mean that initially some dental practices continue to provide only urgent dental care. Local dentists continue to work on recovery plans for their own practice with support from NHS Fife to broaden the range of treatment and numbers of patients that can be treated safely.

As you will understand, the way that you receive dental treatment will be different. We have produced a short video to help patients understand what to expect when they attend the dentist. In addition to what is included in this video we would ask that you consider wearing a face covering when attending a dental practice.

Note: This video was produced before current guidelines on face coverings were introduced.

Advice for a patient currently registered with a dentist:

Access to dental surgeries will continue to be carefully planned during phase 3 of recovery. Dentists will provide a limited service.

Do not visit your dentist unannounced - you should telephone your practice on their usual number.

If you feel you have an urgent dental need, in normal working hours, you should contact your dental practice, who will provide advice, reassurance or a telephone assessment. The NHS Inform website has a postcode search function to aid with accessing your dental practice contact details.

Your dentist will be able to give you advice and assessment.

If your dentist confirms that you have an urgent dental need that requires a face to face appointment, the dentist will make arrangements for you to receive face to face care either in your normal practice or another branch practice as deemed appropriate.

Outside normal working hours, if you feel you have an urgent dental need, please contact NHS24 on 111.

For routine issues and enquiries you can contact your dental practice directly during normal working hours.

Advice for a patient currently unregistered with a dentist:

Access to dental surgeries will continue to be carefully planned during phase 3 of recovery. Dentists will provide a limited service focused on urgent dental problems only.

For urgent Dental Problems you can call the NHS Fife Dental Advice Line on 01592 226555 to access advice and assessment. If our clinical team assess that you have an urgent dental problem you may be provided with an appointment to attend an urgent dental care centre.

Outside normal working hours, if feel you have an urgent dental need, please contact NHS24 on 111.

Do not visit a dental surgery unannounced - if you wish to find out if you can access urgent or routine treatment at your nearest dental practice you should telephone the dental practice in advance. The NHS Inform website has a postcode search function to aid with accessing your nearest dental practice contact details.


Care at Home

Fife HSCP is appealing to everyone receiving help from home carers to stick to social distancing guidance.

We understand that these are very difficult times especially for those who are more vulnerable. Our front-line home carers are there to provide the vital support they need to live at home and maintain their independence. For the safety of home care workers and the protection of service users we are asking that no family members or friends, who do not live in the household, are in the house when home carers go in to do their work. Although this is not a situation that is arising often, we are appealing to everyone to stick to the social distancing guidance that we have all been given.


Care homes

Guidance on care homes can be found on the Scottish Government website


Immunisation Programmes

The Scottish Government has committed to maintaining its national immunisation programmes, where safely and practicably possible. This will assist in avoiding outbreaks of vaccine-preventable diseases and allow us to provide important protection to children and other vulnerable groups. It will also avoid increasing further, the numbers of patients requiring health services and hospitalisation from vaccine-preventable diseases.

Whilst it is crucial to maintain our routine immunisation programmes, especially at this time, it is also recognised that the delivery of some programmes, such as school based immunisation programmes and shingles immunisation for adults aged 70 and over, will be logistically difficult due to COVID-19 restrictions and official advice. Please see the below updates on current national immunisation programmes:

Infant and preschool vaccinations

Routine childhood immunisations are continuing as high priority, where possible and safe to do so.

Providing those attending for vaccination (including parents of babies) are well, are not displaying symptoms of COVID-19 or other infections and are not self-isolating because they are contacts of suspected COVID-19 cases, immunisation should proceed.

School programmes

As Scottish schools are currently closed, school programmes continue to be temporarily suspended.

Adult Programmes

Immunisations for pregnant women and post-natal women should continue (pertussis and MMR).

The routine shingles programme has been suspended temporarily in line with the current COVID-19 advice for adults aged 70 and over. However, if a patient is well and presents for any other scheduled appointment, they can be vaccinated.

Pneumococcal vaccination for those in risk groups from 2 to 64 years of age and those aged 65 years and over should continue. Those aged 70 years and older can be opportunistically vaccinated if presenting for another scheduled appointment.

At-risk individuals

Children and adults in at-risk clinical groups should continue to receive immunisations in line with advice in the Green Book.

Travel vaccines

In light of COVID-19 travel advice and restrictions, travel vaccination is a low priority and should only be offered if essential.

Influenza Vaccination Programme 2020-21

The Scottish Government’s annual influenza vaccination programme CMO letter will be issued as soon as possible.

For further information around vaccination, please visit:

nhsinform.scot/immunisation
twitter.com/NHSImmuniseScot

Screening Services

Screening programmes have been temporarily paused. For more information visit nhsinform.scot/screeningupdate.

Temporary changes to the Health Visiting Service

The Health Visiting Service across Fife is scaling back some routine contacts in line with Scottish Government resilience planning, and as part of Fife NHS / Health & Social Care Partnership (H&SCP) Contingency Arrangements.

This means that you may not receive a full health visiting service and your child may not receive their next routing child health review. Scheduled home contacts will resume as soon as realistically safe to do so.

You can find the following information in your child’s red book
• Full contact details for your Health Visiting Team - (24hour answer machine checked regularly)
• Details of routine health reviews
• Information which describes age typical development

Important:
Immunisations appointments will continue to be offered as per NHS Health Scotland immunisation schedule. If you have any queries please contact the immunisation team direct on: (01383) 565 456.

Some useful resources


If you have any health concerns about your child please consult NHS Inform www.nhsinform.scot and/or call NHS 24 on 111