NHS Fife is never going to be the same again

And it has been given added responsibility for trying to halt the spread of infection and save lives in the Kingdom's care homes.

Last week's online meeting of the health board also heard that costs associated with battling COVID-19 had reached £3.7 million by the end of March – it's expected this will be covered by the Scottish Government.

NHS Fife chair Tricia Marwick said they were planning to re-start elective procedures but added: "I don't want to raise expectations too quickly that we can somehow return to what was before.

"We are never going to return to what we had before. There's a new normal but we have to take people with us and tell them."

She said they were only able to contemplate a return to clinical services due to the hard work and dedication of staff and the willingness of the public to stick with tough lockdown measures.

Ms Marwick said: "Some have lost friends, family and neighbours to this disease and I'd like to extend my condolences on behalf of the NHS Fife family.

"There is some degree of hope that we in Fife are managing to control the virus; admissions are at the lowest level since March but it's important we're not complacent as there could be a second wave in the future."

The resumption of services – all but the most urgent work was postponed due to the virus – will include social distancing while contact tracing to identify people at risk of the infection is also set to begin.

Medical director Dr Chris McKenna said: "While we may be over the peak of COVID-19, the presence of the virus is changing the way we need to deliver services.

"We need to recognise that everything we do needs to be sensitive to the presence of the virus in our society.

"That's going to change the way we deliver something as simple as attending an A&E department and that comes down to the rules of social distancing."

He added: "How do we protect patients from the impact of COVID-19? This is really important when we think about returning elective care because COVID-19 introduces a new element of risk to these services that didn't exist before.

"We have to carefully plan so the risk to patients is minimised.

"Going forward, things will feel different, so virtual consultations will be the norm and things will probably feel a little bit slow within the system as we have to take account of all the infection prevention guidelines we need in order to protect patients and staff."

The board acknowledged there were "national and local concerns regarding the increased risk of infections, outbreaks and deaths in our care homes" and a report outlined the steps they've taken, following regular correspondence from the Scottish Government.

A multi-agency Care Home Oversight Group was set up and a Fife Care Home Action Plan drawn up after a "rapid assessment" of local care homes.

Senior leaders at NHS Fife have been passed "responsibility and accountability" for the professional oversight of care homes, as well as analysis of issues, development and implementation of solutions.

The board has "direct responsibility" for ensuring staff are tested, that contact tracing is undertaken where required, that home testing is delivered and, together with Fife Council, that resources are provided to ensure staff rotas are maintained.

Director of nursing Helen Buchanan said: "We've been working closely with the chief social worker about joint visits, we've established daily contact with care homes, and we're planning a series of visits over the next two-to-three weeks to support care homes, particularly about fundamental nursing care.

"We're committed to help with workforce issues and establishing a specialist nursing team for areas such as dementia care and food and nutrition."

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