Proposals for Reconfiguration of Minor Injuries units in North East Fife

Minor injuries units are designed for the assessment and treatment of injuries of a potentially painful, but non-life-threatening nature including:

• cuts

• minor burns

• sprains or strains

• broken or fractured bones

MIUs do not provide a walk-in service. You should call NHS 24 on 111 to be triaged and given an appointment at an MIU.

An MIU would also not be for people who needed treatment for:

• injuries which occurred more than seven days ago

• chronic or long term health conditions

• minor ailments

Or for those who have life threatening injuries or emergencies such as:

• suspected stroke

• chest pain

• shortness of breath

In an emergency always call 999

We explored this as an option within the clinically led options appraisal, however as advised, it has not been progressed as a recommendation for consideration.

We’ve identified risks to the sustainability of the services, including sustainable staffing.

We need to make sure services are safe and effective now and in the future.

Minor Injuries care services are dependent on staff who have a very specialist skill set.

Services at both sites are nurse led with two Emergency Nurse Practitioners (ENPs) and a Health Care Support Worker at both sites. 

ENPs are highly skilled senior practitioners who have been specially trained to treat minor injuries.

Because of this, resource to cover for absence is not readily available from across the workforce, meaning frequent challenges and potential risks to sustainability in the future.

The clinically preferred model means seamless care in one location, effective and efficient care and ensures people receive the right care at the right time and in the right place.

If approved, it will also allow patients to be assessed and treated in a more effective and efficient manner and improve the long term sustainability of the service.

In addition, the x-ray at Adamson is only available three and a half hours a day Monday to Friday.

Often, this means people are assessed at Adamson and then need to be redirected to St Andrews Community Hospital for x-ray and treatment.

The x-ray machine at Adamson is also coming to the end of its life, with no capital funding available to replace it.

Modern x-ray facilities are available at St Andrews Community hospital ensuring patients have access to high quality imaging services with staff and resource to provide safe and effective care.

As outlined above, the clinically preferred model was chosen as part of a detailed clinically led options appraisal, based on several factors.

We’ve identified risks to the sustainability of the services, including sustainable staffing.

We need to make sure services are safe and effective now and in the future.

St Andrews offers more modern, up-to-date facilities including modern x-ray facilities.

As we’ve said above, Minor Injuries care services are led by Emergency Nurse Practitioners (ENPs), a specialist, highly skilled role to provide expert care for minor injuries.

If the clinically preferred model is approved, it would mean we are able to consolidate the existing workforce, ensuring safe and sustainable staffing now and for the future.

Robust plans will be put in place for any transition to ensure minimal disruption to services if proposals to implement the preferred clinical model are approved.

Those plans will be shared with all stakeholders to ensure a seamless transition of services.

We will update and inform the public and key stakeholders, including community councils through a range of communications channels throughout to minimise disruption and ensure a seamless transition of services.

X-ray services at Adamson will require to be decommissioned in April 2025. The current x-ray machine has reached the end of its life and due to its age can no longer be repaired.

Unfortunately, replacing it would cost over £300,000 and there is no available capital funding for this.

The clinical decision not to replace the machine is also based on usage figures which show the number of x-rays carried out at Adamson was very low – on average 75 a week.

Patients living in Cupar requiring x-rays will be referred to St Andrews Community Hospital, Glenrothes Hospital or NHS Fife’s main acute hospital – the Victoria Hospital in Kirkcaldy, where full x-ray services and additional diagnostic services are available.

The x-ray service at St Andrews Community Hospital is available Monday to Friday from 9 am until 4.30 pm and in addition, the x-ray service at Glenrothes will be extended to Monday to Friday 9 am until 4.45 pm, to increase capacity to assist in the accommodation of those patients redirected from Cupar, ensuring patients have access to high quality imaging services with staff and resource to provide safe and effective care.

The hospital can be accessed by the A915, and car parking is available on-site.

St Andrews Community hospital has approximately 130 car parking spaces including Blue Badge spaces and 1 hr drop off spaces.

Adamson Hospital in Cupar has approximately 110 car parking spaces including Blue Badge spaces and 1 hr drop off spaces.

The hospital is served by several bus routes. 

Five of those buses currently run through the day ever 30 mins.

Up to date information and maps can be found on the TravelFife website here: Maps | Travel Fife

TravelFife also have an interactive mapping service available online here: Fife Bus Map

In addition, route information can also be found online at Travel Line Scotland or the Stagecoach website 

Fife Council’s transportation team advise some operator changes may take place to routes around March 24th 2025.

You may be able to claim your travelling expenses.

In order to claim, you must provide evidence that you are in receipt of one of the following benefits:

• Disability Working Allowance, Family Tax Credit, HC2 or HC3 Certificate from the DSS, Income Support, Job Seekers Allowance, War Pension

Find out more information by reading: NHS Fife Travel expenses information for patients.  

NHS Fife Community Transport Services information can be found online.

Patient transport provided by Scottish Ambulance Service is available for some patients travelling to pre-arranged appointments, but does require booking in advance. More information can be found online.

NHS Fife and Fife Health and Social Care Partnership remain fully committed to providing high quality healthcare services at Adamson Hospital.

If the option for the clinically preferred model is approved to be implemented, only minor injuries care services will relocate.

Adamson Hospital will remain a key hub for healthcare, offering a wide range of services tailored to the needs of our local population.

The following services will continue to be delivered from the Adamson Hospital:

• GP surgeries
• Tarvit Ward
• Dental access services
• Community (district) nurses
• Physiotherapy
• Occupational Therapy
• Podiatry
• Dietetics
• Speech and language therapy
• Range of outpatient clinics
• Hospital at Home hub
• Community Treatments And Care (CTAC) who provide a range of services including:
• Wound care – all wounds, including post operative wounds, chronic wounds and leg ulcer management.
• Taking out sutures and staples
• Phlebotomy (blood tests you’ve been told to get by a health professional in a hospital)

We will also work with the Fife HSCP Locality Planning groups to investigate any opportunities to enhance the community support services available on the Adamson site – including the Well, Link Life Fife, and access to Community Link Workers.

The housing site development in Cupar will not impact the relocation of the MIU to St Andrews.

The new housing development is not imminent, and the relocation of the MIU is based on other factors as outlined above.

We will continue to keep our position under review, exploring new opportunities to enhance services as they arise.

Future developments, including housing in Cupar, will be considered as part of ongoing assessments.