Manx Care celebrated one year of operation on 01 April 2022. To mark the occasion, the organisation’s Chief Executive, Teresa Cope, shared an open letter with colleagues highlighting its successes alongside its challenges, and thanking colleagues for their dedication and commitment to the delivery of health and statutory social care on the Island across the last 12 months.
A copy of the letter is outlined below.
Happy first anniversary! I’ve thought long and hard about how we mark today given the pressure which our colleagues and our services are currently facing – and whether in fact we do mark it today. There’s a very sombre mood given the large number of colleagues we have off sick, and the fact that we’re currently looking after the highest ever number of Covid-positive patients in Noble’s – more so than at any other time in the pandemic. Thank you so much for your resilience and hard work – we absolutely recognise how difficult a situation this is at the moment for all of our colleagues, as well as for members of the public who have friends and loved ones in hospital. Our senior leadership team is doing everything possible to support you, and we are always available to talk to if you’d like to so please feel free to reach out.
I will go ahead and mark today because I would like everyone – when you have the time to – to look back at the last 12 months and take some pride in what you’ve personally achieved in the face of adversity. It honestly doesn’t seem a year ago that Manx Care began life, yet similarly it feels like we’ve been in existence for so much longer than that due to the sheer volume of what we’ve dealt with and achieved in that time! For a fledgling organisation, I’m incredibly proud of our first 12 months and I truly hope that you are too.
I want to share what I feel have been some of my key highlights and challenges across the last year – and I’ll be as transparent about our challenges as our successes – but let you know that this will be a snapshot as we’re planning to hold an event in late May where we’ll reflect on our first year in more detail, as well as take a look at our strategy for 2022-23. This event will be for all of our colleagues as well as members of the public, and you’ll hear more on that in due course.
So, where to start…
Manx Care began life in rather unprecedented circumstances, with the Island in lockdown and with our health and social care services battling the effects of the Covid-19 Delta variant. A number of our colleagues have described Covid as one of our biggest successes and yet similarly one of our biggest challenges, and I’d absolutely agree. Covid has impacted Manx Care in terms of our people and our services in an unprecedented way, yet across the last year we’ve broadly maintained the delivery of our services despite the fact that, at times, we’ve experienced a staff sickness rate in excess of 15%. For example, we successfully delivered two of our school-based vaccination programmes for flu and HPV, kept the Blood Clinic open and continued to deliver the ARMD (Age Related Macular Degeneration) injection programme. Managing the impact of Covid sickness absence has been incredibly difficult, and shouldn’t be underestimated.
We’ve learned to adapt the way we do things and embrace digital technology to enable us to deliver appointments virtually where required, and we should continue to capitalise on digital technology and new ways of working developed as a result of the pandemic. We’ve opened and staffed dedicated Covid wards in Noble’s Hospital where, very sadly a number of our patients succumbed to the virus, and managed outbreaks in our adult residential care homes – and you’ve worked selflessly to provide cover for your colleagues who’ve been sick, or redeployed into other areas. We’ve also established some very strong relationships with tertiary care providers in the UK as a result of Covid, one being the Cheshire and Merseyside Critical Care Network who’ve supported us in the treatment of some of our most seriously ill patients, which at one point included flying specialist critical care staff to the Island as we struggled to meet the demands of Covid.
Talking of redeployment, many of you have worked in the Vaccine and Swabbing Teams across the last year, notably so in the run-up to Christmas where we delivered thousands of Covid booster vaccines per day in a monumental effort to protect as many members of the public as possible. I remember seeing the queues of people stretching from the front doors of the Chester Street hub right the way back along Market Street and up past the church on the Saturday that we started doing walk-ins, which we were stunned by to say the least. I’m really glad the Manx weather co-operated and the sun shone for us that day!
There’s been a lot of focus on our Covid swabbing and testing across the last 12 months, and I want to share some stats from Steve Doyle, our Head of Pathology, which are quite staggering and put into context the level of work that we’ve done across the entirety of Manx Care. Congratulations!
Last year we took the very difficult decision to pause our elective surgery programme because we weren’t in a position to safely staff all areas of Noble’s Hospital and had to prioritise non-elective and emergency activity. Taking any decision of this nature is a last resort but, quite simply, we cannot compromise on patient safety. When Manx Care was established, we very quickly began to see the extent of the long-standing vacancies and recruitment gaps impacting every single one of our services across the Island, and the impact this was having not only on our ability to deliver services quickly, but on our colleagues who’ve been working so hard to keep services running for our patients and service users. The position we inherited on 01 April was, on reflection, a more challenging one than our initial baseline position highlighted. This was further acknowledged by Sir Jonathan Michael when he returned to the Island and undertook a mid-point review of progress against the original 26 recommendations in his 2019 report into the future provision of health and social care here.
We’ve worked hard to determine what our staffing levels should be, and are working incredibly hard with our Recruitment colleagues to attract talent to the Island, and to Manx Care. Whilst this is beginning to pay off, it’s not easy. Across the British Isles there’s an estimated shortage of around 10,000 Doctors and 40,000 Nurses – and the Island is competing with NHS Trusts across the UK for the same small group of colleagues. Additionally, there are severe shortages in a number of specialist areas – what you might hear us refer to as ‘hard to recruit posts’. All health and social care systems are desperately trying to restore and recover their services after Covid, and so the demand for health and social care staff has never been as high. This makes our position all the more difficult.
However, despite the challenges, a highlight across the last 12 months has been us welcoming a number of new Nurses from India, Nigeria, Ghana, Malawi and Lesotho through our relationship with a new recruitment agency, GTEC, and well as recruiting from the UK NHS. Our GTEC recruits are settling in very well and we’re looking forward to many more new colleagues joining us through this relationship in the coming weeks and months. Equally, all of the nurses graduating here in 2021 got jobs on the Island, and we’re looking at how we can work to develop our current colleagues so that they can fulfil their career ambitions here, whether or not we can increase the number of Nurse training places we can offer here on Island through Keyll Darree, and what else we can do to develop our home-grown talent. We want to be in a position where we can train people locally and then retain their services within Manx Care, rather than see them train in the UK and stay to work there once qualified.
Despite our current vacancy rates and the impact of Covid-19 across our entire health and social care service, it’s truly humbling to witness the incredible resilience, commitment and passion that you’ve demonstrated – and continue to demonstrate – by supporting not only some of the most vulnerable members of our community, but in the way you’re working together as a team to ensure safe and effective delivery of care. Thank you so very much for everything that you’re doing here – it is really difficult to articulate how much I appreciate your dedication.
It would be remiss of me not to mention our financial position before I move onto sharing with you some of our successes. Nigel Wood, one of our Non-Executive Board Directors, recently reflected on Year One as a ‘year of discovery’ and I think that very eloquently sums it up. When we began life, the baseline assessment of our operating position didn’t really reflect the true position we faced. We encountered a number of pressures that it would have been impossible to budget for at year-start and, managing those, along with managing rising drug costs, high-cost patients and our reliance on costly agency staff to backfill our vacancies, created a funding gap for us. Across the year we’ve proactively managed our finances and established a robust governance regime here, identifying a number of savings and efficiencies which we’ll start to see in Year Two. It’s probably fair to say that much of the progress we’ve made and the success we’ve achieved hasn’t been particularly visible. I’d use the analogy of renovating a house; you need to invest in fixing your foundations and basic infrastructure before you can start to make any really visible progress. We have a finite amount of money with which to deliver our services and living within our means is something we need to achieve in Year Two, even if this does mean making some difficult choices.
Now, successes – where do I begin?
The last 12 months has really demonstrated more than ever the power of what we can collectively achieve if we have a shared vision, we all understand the role we have in achieving this, and we have the drive and determination to succeed against all odds. I think it’s only fair to share with you the list of successes that our senior leaders shared with me from across our teams. They’re brilliant, and actually capture just what a diverse range of services we provide. Please click here to read their long list, which I’ve tried to add my own perspective on as well. I hope that you’re able to take a few minutes with your colleagues to reflect on what you’ve achieved personally over the last 12 months, and I hope you’ll be as proud as I am.
Manx Care will continue to be as open and honest about our challenges as our successes moving forward – it’s important we’re transparent about this – so that we can continue to change mindsets and think transformatively, and build trust and stronger relationships with all of our key stakeholders. It’s a privilege to lead such a wonderful group of colleagues who take so much pride in your work, and who do amazing things every day with an unwavering focus on delivering exceptional care.
Thank you for everything that you’ve done, and continue to do. I can’t wait to see what we can achieve together in Year Two!