A DECISION which will see the closure of the hospice in Dunfermline came a step closer today (Friday).

Fife Health and Social Care Partnership's Integrated Joint Board approved plans for the future of specialist palliative care services in the Kingdom.

This would see the continuation of the current model using the purpose-built hospice at Kirkcaldy's Victoria Hospital complemented with a palliative care outreach team working across Fife’s communities, care homes, hospitals and hospice.

A single inpatient hospice has been in operation in Fife since the start of the COVID-19 pandemic in 2020.

Between March 2020 and January 2022, the hospice was located in the grounds of the Victoria Hospital before moving temporarily to Queen Margaret Hospital to enable an extensive refurbishment of the Victoria Hospice before returning to Kirkcaldy in February.

A final decision will be made at next week's meeting of NHS Fife's board.

The proposals have courted controversy with Labour MSP Claire Baker accusing the health authority of removing a "vital" service from Dunfermline however IJB members were told that West Fife was better served under the new model.

Palliative care consultant, Dr Joanna Bowden, said: "One of the assurances we can give is that palliative care for everyone in Fife, including in Dunfermline and West Fife and far West Fife, is better than it has ever been.

"Many people in West Fife can be cared for at home or where home is not possible, even at the Queen Margaret. The Queen Margaret is still very much a centre of palliative care in West Fife.

"What we have heard is that really matters to them. Day to day, there is a huge amount of engagement with families and individuals. Also we have had extensive formal engagement and that has always included involvement from people from all of Fife. I can assure you the people of Fife are better served now under the current model than they have ever been."

West Fife villages councillor Graeme Downie called for the decision to be delayed saying information including transportation issues had not been sufficiently addressed.

His motion, which the board voted against on a vote of 13 to two, stated that he welcomed the "direction of change to increase capacity for palliative care at home and in a community setting" but said information didn't allow the board to take a "fully informed" decision.

He said concerns included the impact of a revised approach on staffing, transport and the flexibility of choice with the widest possible consultation with the general public and staff had not been.  "It is a definite issue we have been struggling with," said Councillor Downie.

"I do appreciate the information that has been brought forward by officers doing this. I am not suggesting we don't do this model. All I am suggesting is I would like a more formal report to the board before making the decision."

Responding to the concerns, NHS Fife's Medical Director, Chris McKenna, said it was important to ask questions of the proposals while making "brave" decisions.

"There is a real sensitivity surrounding this, we don't want to get it wrong as it feels very final. We are moving on to a different model of care," he said.

"I have been listening to my colleagues over the last few months and the passion and commitment to do what is right for the patients is what is sitting beneath all of this. There is a strong desire to do what is correct and right."

He said he believed Cllr Downie's concerns had been addressed but acknowledged the public's fears.

"I live in West Fife. I know how much this means to people," he added. "This feels like a fundamental switch but the team have one above and beyond to speak to the people of Dunfermline to say we recognise this feels really uncomfortable but listen to how this will improve things and not make them worse.

"I have heard from people who have reflected back how important the team has been. I think we have done sufficient work to hear from people."

Councillor Dave Dempsey said he was disappointed that the process had been "meshed with the broader perception" that Dunfermline was being "dumbed down" in favour of Kirkcaldy.

"In the context of palliative care and the budgets available, what we are being asked to approve is exactly what we should be approving," he said.

"I am delighted we are going to get to the point where we are going to stop talking about it and actually do it."

Director of Health and Social Care Nicky Connor said they strive for services to be local.

"In this model it is both as local as possible and as specialist as possible," she said. "Local voices have been heard in the design of this model.

"It is clinically led and we know it works and it is making a difference. We want to get it right for the people of Fife to support palliative care needs and through this model, we have a mechanism in place to support people with increased choice and support."

Fife Health and Social Care Partnership’s Head of Community Care Services, Lynne Garvey, said more people were now benefitting from the service than before with between 60 and 70 patients being looked after compared to a maximum of 16 or 17 previously.

"It is placing the person at the centre of care and in a setting they have chosen to be cared for and to die," she said. "People in the service have told us that home is where they want to die.

"For care at home to work, people need immediate access to responsive care and support. This enhanced model has made significant progress in that area. This is, without doubt, a patient and clinically led model of care."