NHS Fife has confirmed that eight dedicated non-specialist palliative care beds will remain at Dunfermline’s Queen Margaret’s Hospital if current end-of-life care proposals are approved.

Specialist palliative care – end of life care for those with complex needs – will still be centralised at Victoria Hospital in Kirkcaldy. However, NHS Fife has said  non-specialist palliative care will remain available at Queen Margaret’s.

The health authority said eight other non-specialist palliative care beds will be spread across other community hospitals in Fife in addition to the central Victoria Hospital unit in Kirkcaldy. 

The clarification came after a contentious debate in Fife Council chambers last Thursday. 

Councillor Gordon Pryde (Labour) put forward a motion asking elected Health and Social Care Integration Joint Board (IJB) members to “oppose any move to close the hospice service at Queen Margaret Hospital and invited those members to consider the community concern when considering the Board decision.”

The motion was passed, but some SNP members opposed it, calling it “borderline lobbying.” 

“We cannot be directed here by council as to what we do at IJB,” said SNP opposition leader David Alexander. 

“The whole motion is borderline lobbying and that is totally unacceptable. It’s totally against the councillors code of conduct that we sign up to go to IJB.” 

Council officers agreed that it is not appropriate for council to direct the way IJB members vote.

The IJB is made up of eight representatives from Fife Council. Other members represent NHS Fife and other public partners. It  is responsible for making plans and allocating resources for services delegated to it and ensuring service outcomes are met. 

At the next meeting, the IJB is set to consider NHS Fife’s proposal to continue the current palliative care model. 

Lynne Garvey, head of community care services with the Fife Health and Social Care Partnership, said palliative care service in the region moved to a single inpatient hospice at the start of the pandemic, enabling a greater balance of at-home care to be provided.

“This model remains in place and continues to evolve to meet the changing needs of patients,” she said.

NHS Fife has said that the majority of its palliative care patients wish to be cared for in their own homes. Those with the most complex needs are still cared for at inpatient facilities. 

According to the local authority, prior to 2020, around four per cent of deaths in Fife occurred in an inpatient hospice yet they accounted for around 80 per cent of the total palliative care resources.

The creation of an at-home outreach team meant the service could care for as many as 60 patients at any time, and the ability to care for patients at home has meant waiting times for a hospice bed have significantly reduced. 

There has been community and political backlash following the relocation of patients from Dunfermline to Kirkcaldy. An online petition to bring the central hospice back to Queen Margaret has more than 2,250 signatures. 

However, NHS Fife has clarified that non-specialist palliative care will remain at Queen Margaret’s if the plan is approved. 

NHS Fife said proposals outlining the future direction of the region’s specialist palliative care service will be presented to the Fife Health and Social Care Partnership’s Integration Joint Board and the NHS Fife Board at their meetings later this month.