St Andrews Community Hospital provides services to patients in NE Fife.
In 2018, Fife Health and Social Care Partnership (FHSCP) (a combination of NHS Fife senior staff, elected Fife Councillors and some patient representatives) wanted to close the out of hours (OOHS) and minor injuries (MIU) services at St Andrews Community Hospital. This was an attempt to save money from their overspend.
Such changes would have entailed a trip to Victoria Hospital, Kirkcaldy, via rural roads for urgent care – OOHS, MIU, A&E – and often in the night – for patients of all ages including single parents with children, elderly, non-drivers, visitors/tourists, as well as students.
There was a public outcry. Eventually, all 26 Community Councils in NE Fife (unprecedented) put in a Participation Request lead by RBSTACC (the Royal Burgh of St Andrews Community Council). A Participation Request (PR) is a legal process (Part 3 of the Community Empowerment Act 2015) which enables communities to request to participate in decisions and processes which are aimed at improving outcomes. Whilst, it is enshrined in legislation, as we found out then and have since reported, the Act has no real teeth as far as communities are concerned. Nevertheless, we were successful. The outcome was that by late 2019, OOHS and MIU at St Andrews Community Hospital were retained, albeit with reduced hours.
NHS Fife wishes to be climate neutral soon. One way to assist this goal is to reduce staff travel in the course of their work. Rather by default, they are putting the onus on patients in NE Fife to travel additional mileage to Kirkcaldy or to Dunfermline, initially on rural roads, and dealing with potholes, parking problems at the hospitals, travel time, roadworks, road traffic accidents, financial costs to the patients, etc, etc which all add stress to the already-ill person and thus makes their physical symptoms worse.
Since then, we (OOHS group members) have researched, attended workshops as well as meetings, given presentations to, and worked with and prepared discussion papers for: FHSCP, NHS Fife, Scottish Community Development Centre, and the Scottish Government, as well as providing feedback on relevant legislation. We, in NE Fife, and a few interested other Community Councillors from all over Scotland, have prepared potential nation-wide important documents as well as developing, via the Glasgow School of Art, a Participation Request Tool Box for communities throughout Scotland.
The OOHS group in NE Fife, have continued, since 2018, to be in dialogue with FHSCP and with NHS Fife about Health and Care services in NE Fife. During lockdown and the pandemic, we turned our attentions to more overarching strategic matters. We researched and sent papers with suggestions to the Scottish Government as well as the UK Government. Some of our suggestions were adopted, nationally.
Services at St Andrews Community Hospital are one of our goals on our LPP (Local Place Plan).
Following the most recent request to RBSTACC members to highlight issues with healthcare locally, Judith Harding raised the issues surrounding pre-surgery assessments. In 2025, there were 1000 pre-surgery assessments on NE Fife residents. That means 2000 return journeys (car or bus or train) and associated pollution as well as stress. Recently we (OOHS group members) had a meeting with NHS Fife senior managers to discuss pre-surgery assessments. Currently patient must travel to Kirkcaldy or to Dunfermline to have the following recorded pre-surgery: blood pressure, height, weight, ECG (Electrocardiogram), medical and medication history. These measurements could be taken locally in St Andrews Community Hospital either in person or with the use of technology, remotely/online/video. Results, as necessary, can then be sent electronically and instantly to the specialist centres in Victoria or Queen Margaret Hospitals for the specialist’s opinion. Our arguments on this matter were accepted and NHS Fife is developing a trial project on the matter starting in July 2026.
If anyone now has any other topics about local Healthcare that they wish raised in the future with FHSCP and/or NHS Fife, then please let me know.
Penelope Fraser St Andrews Community Councillor 16 08 2026