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Health and Social Care Review

Independent Health And Social Care Review logo

Fundamental review of the Island's health and social care system

The objective of the Review is to determine change options to provide a modern, fit for purpose health and social care system for the Island.

The Review is an opportunity to:

  • look at the bigger picture
  • take stock of what is and isn't currently working for the Isle of Man
  • advise on options for structures and funding arrangements to best meet the needs of the Island in the years to come

Sir Jonathan’s Progress Report was presented to Tynwald on 15 January. This report was an update on the issues identified while examining this evolving and highly valued public service. His Final Report and recommendations will be published in May.

Tell us what you think

As the outcome of the review will ultimately affect all Island residents it is important that everyone has the opportunity to have their say.

Initially public engagement was focussed through an online ideas hub (open between 26 June and 7 August 2018), with suggestions also accepted by post, email, dedicated drop boxes, telephone and in person. Public workshops were also held in September and October 2018 and in January and February 2019.

View suggestions

Submissions can continue to be made to the Review Secretariat team at or +44 1624 650759.

Background to the review

In March 2018 the Government announced that a fundamental review of the Island’s health and social care system was going to take place led by Sir Jonathan Michael.

Sir Jonathan Michael has extensive board, managerial and clinical experience in healthcare across both the public and private sectors. He has significant experience of supporting hospitals and other healthcare providers and advising governments, health departments and regulators both in the UK and internationally. He was knighted in 2005 for services to the NHS.

The terms of reference for the review were established by the Council of Ministers and Sir Jonathan is tasked with setting out recommendations to address the current and long-term health and social care challenges facing the Isle of Man.

The particular areas under review are set out within the terms of reference and cover a broad range of issues including the:

  • scope and delivery of services
  • quality and safety
  • funding
  • staffing
  • technology
  • sustainability of services

This work will build on the Department’s Five-Year Health and Social Care Strategy as well as a number of other reports, including the work of the West Midlands Quality Review Service. The review is seeking to identify why other initiatives have not worked and will set out what is required to ensure that its recommendations are implemented after

The Department is currently working to its Service Delivery Plan, which aims to address a number of your comments and ideas from public engagement sessions in January 2016, including the following that are already being progressed:

  • Communication: publishing more on the DHSC website, facilitating workshops on the future of residential and nursing care, working alongside Southern Community Initiatives around a Community Partnership pilot and working with residents and stakeholders through engagement events in the West

  • Care in the Community: plans to introduce far more locally delivered care from teams based in the community

  • Minimise waste: undertaking restructuring to reduce duplication and layers of management, including the formation of the Community Care Directorate, which combined four previous Divisions

  • Technology: roll-out of Patient Access (for GP appointments, prescriptions and test results), text message reminders for GP appointments instead of letters and instant update of patients' electronic records following out of hours GP consultations

This ongoing work is due in part to your comments, which will also be considered as part of the Review, but we want to hear more about the areas that the Review will specifically cover.

Who is involved with the review

The Review is being led by Sir Jonathan Michael and he will have full editorial rights over the final report.

As outlined within the terms of reference, Sir Jonathan Michael is supported on Island by an Advisory Panel and a Secretariat who work under his direction.

The Advisory Panel is made up of the following representatives:


  • Hospital Doctor Representatives
  • General Practitioner Representative
  • Hospital Nursing Representative – Lisa Hall
  • Community Nursing Representative – Bree Tomlinson
  • Allied Health Professional Representative

Senior officers

  • Senior Health and Social Care Representative – Michaela Morris
  • Social Care Representative
  • Mental Health Representative –  Paul Jackson
  • Public Health Representative

Political Representatives  

  • MLC - Mrs Jane Poole-Wilson MLC
  • MHK - Mr Chris Robertshaw MHK    

Third Sector Representative – David Gawne, (Substitute: Jackie Betteridge)

Business Sector Representative

Health Services Consultative Committee Representative – Sue Gowing (Substitute: David Trace) (lay person)

Nobles' Patient Experience and Quality Committee Representative – Andre Grenier (lay person)

Private Care Representative – Bernie Smith (Substitute: Neil Maclean)

Healthcare Review Secretariat Administrative lead - Clair Barks

Isle of Man Government Technology Services Representative – Richard Wild

The Advisory Panel is solely to provide advice to Sir Jonathan Michael in relation to the setup of services on the Island and guidance on any added complexities within the Island community. They are also key to ensuring that the views of all stakeholders are represented within the Review.   

The Secretariat team, which is independent of the Department of Health and Social Care, consists of 4 people:

  • Head of Healthcare Review Secretariat - Clair Barks
  • Healthcare Review Manager – Nicola Igoea
  • Healthcare Review Executive – Phil Cain
  • Healthcare Review Officer - Nikki McCarthy

Additionally, specialist support in relation to health economics and commissioning models and generalist support in transformation of healthcare services is being provided by ASE Consulting Ltd/PPL Ltd. The specialist consultants are:

  • Robin O’Connor
  • Tim McKell
  • Toby Irving
  • Julia Simon
  • Folarin Majekodunmi
  • John Wilderspin
  • Rachel Lewis

Should you wish to contact any representatives involved in the Review, please in the first instance,  email the Secretariat Team ( or call +44 1624 650759.  The team will then pass on your details or respond as appropriate.

Areas of health and social care

We will categorise your suggestions by the area(s) of health or care to which it relates:

  • Hospital care – including Noble’s Hospital, Ramsey and District Cottage Hospital and the ambulance and the air ambulance services

  • General Practitioners – including all GP practices and the Manx Emergency Doctor Service

  • Dentists – including those run by the Government (Central Community Health Centre) and those run privately

  • Mental Health – including acute community and mental health services for children, adolescents, adults and older people, Drug and Alcohol Team, Crisis Response and Home Treatment Team, the Memory Clinic, Next Step and Brunswick Gardens

  • Social services for adults and for children and families – including older people’s, vulnerable adults and disabilities social work teams, children and families social work team, adoption and fostering services

  • Therapies – including physiotherapy, occupational therapy, speech and language therapy, and dietitics

  • Community care – covers a vast array of services including:
    • Community nursing (health visiting, district nursing and school nursing)
    • Family planning
    • Podiatry services
    • Prison healthcare
    • Day services (for older people and people with a learning disability)
    • Reablement services
    • Home care
    • Learning disability residential and respite services 

  • Care homes – including residential and nursing care
    • the Department runs 3 care homes for older people and 3 care homes for people with dementia (the rest are provided privately)

  • Public Health – aims to protect and improve the health and wellbeing of the island’s whole population rather than treating the individual, including by improving lifestyles and our environment, and by championing approaches that support people taking responsibility for their own health and wellbeing

  • Off-Island care – including referrals to UK specialist hospitals and patient transfers

  • Third sector/charitable sector

  • Other

What we will do with your suggestions

More than 180 suggestions and 430 comments were submitted during the initial public engagement period. A report on these has been presented to Sir Jonathan Michael and the Advisory Panel and was considered as part of the progress report laid before Tynwald in January 2019.

Open public workshops were held during September and October 2018 and a summary of the feedback from these was also presented to Sir Jonathan Michael and the Advisory Panel. The suggestions have been considered, along with other research and engagement, and used to help shape some possible recommendations. These draft recommendations were shared with the public at workshops in January and February 2019, and further feedback was gained to inform the final recommendations.

Any further feedback gained from the public will be combined with other suggestions received as part of our wider engagement process. The findings will be transformed into evidence for consideration as part of the Review in order to inform the Final Report to Tynwald in May 2019.

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