With industrial action by members of the Royal College of Nursing (RCN) on Tuesday 25 July 2023 now confirmed, we would like to provide you with an update on the working arrangements that we have put in place across our services that day. This is based on what we know now, but may change depending on staffing levels on the day.
A number of services have been deemed as ‘essential’ by the RCN and will remain open as planned. These include inpatient services at both Noble’s and Ramsey and District Cottage Hospitals, the Emergency Department at Noble’s Hospital, the Jane Crookall Maternity Unit, the Eric and Marion Scott Oncology Day Unit, in-patient Mental Health services provided at Manannan Court, some community-based services, Dialysis services and Critical Care provision, alongside maintenance of urgent cancer services and emergency surgery cases. Even if a service is deemed as being essential or there to preserve life, RCN members who work in those services may choose not to attend work during a strike period as part of the mandate given to them by their union.
Before outlining the planned service provision, it is important to clarify Manx Care’s position with regard to industrial action. We wish to make it clear that we respect and support the decision by RCN members to take industrial action, and equally support the decision of any RCN member working for Manx Care to participate in strike action next week.
To clarify: The term ‘derogation’ may be used publicly over the coming days. Derogations from the RCN are an agreement to enable colleagues to attend work to ‘preserve life’ without breaking a strike, for example in a service which is deemed as essential (a derogated service) such as the Emergency Department at Noble’s Hospital. However, members of a union who work in a service which is deemed as being essential may still choose not to attend work.
Attending planned appointments– Tuesday 25 July 2023
A number of services will close on Tuesday due to the strike action, or some will operate on a Christmas Day schedule. However, this may change depending on how many colleagues attend work on Tuesday, resulting in some unavoidable last-minute closures. If you have an appointment booked for Tuesday, you will be contacted via phone by your clinical team by 17:00 on Friday 21 July if this is going to be cancelled and rescheduled. This will be followed up by letter. If you have not been contacted in this timeframe, please attend your appointment as planned. Please be aware that we may need to cancel some appointments on the day for reasons outlined above, although we will try to avoid this as much as possible.
Urgent and emergency care – Tuesday 25 July 2023
The Emergency Department (ED) at Noble’s Hospital will continue to operate 24 hours a day, albeit this may be on reduced staffing levels. People should continue to attend the ED for urgent and emergency care as planned, but use an alternative service for advice and treatment for non-urgent matters. Alternatively, they should call 999 for an Ambulance in the event of an emergency or life-threatening situation.
The Minor Injuries and Illnesses Unit (MIU) in Ramsey will close for the day. People who may have used this service should attend an alternative service which is appropriate for their clinical need.
The Mental Health Crisis Team will operate as normal.
The full list of Manx Care’s urgent and emergency care and community-based services can be found by visiting www.gov.im/signposting.
Appointments and service provision – Tuesday 25 July 2023
The Blood Clinic at Ramsey Cottage Hospital will close on Tuesday. However, the Blood Clinic at Noble’s Hospital will operate as planned. There are no blood donation or transfusion services planned on Tuesday.
Around 120 face-to-face outpatient appointments have been cancelled, and patients impacted by this are being contacted in the timeframe already outlined. Some virtual appointments will go ahead as planned. A number of outpatient appointments are unaffected by the strike and will go ahead as planned. If you have a hospital appointment booked for Tuesday and have not been contacted to advise this has been cancelled, please attend as planned.
Endoscopy appointments for patients on the urgent two-week wait pathway for a suspected cancer diagnosis will go ahead. All other Endoscopy appointments have been cancelled.
All other appointments for patients on the urgent two-week wait pathway for a suspected cancer diagnosis will also go ahead. This includes suspected Gynaecological and skin cancers.
All elective theatre sessions have been cancelled. However, there will be some theatre provision for management of urgent, emergency and trauma patients.
Appointments for anyone due to receive oncology treatment at the Eric and Marion Scott Oncology Day Unit, haemodialysis treatment or any other urgent therapy will continue as planned.
The Macmillan Cancer Information and Support Service (MCISS) will be open as usual, alongside picking up voicemails on 650735, and will respond to emails sent to MacmillanCancerInformationCentre.Nobles@gov.im.
In-patient services for Manx Care’s Integrated Mental Health Service provided within the Manannan Court facility at Noble’s Hospital will continue as planned. However, some mental health outpatient appointments will be rescheduled including those provided through the Child and Adolescent Mental Health Service (CAMHS). The Mental Health Crisis Team will operate as normal.
Maternity appointments will continue to take place on Tuesday, including routine appointments, scans and services provided through the Early Pregnancy Assessment Unit at Noble’s. The Jane Crookall Maternity Unit will operate as planned. As usual, if any pregnant woman has any concerns or needs advice, they should not hesitate to contact our Maternity Unit on 650030 where our Midwives will be happy to help.
Children’s Ward services will continue as planned, alongside Paediatric outpatient appointments.
The GUM Clinic at Noble’s Hospital will close on Tuesday. Additionally, the Fertility Clinic and Family Planning services will also close.
Urgent and time-sensitive termination appointments will be maintained as planned.
Clinics and home visits for both adults and children provided by Manx Care’s Community Nursing Team will be cancelled, unless these are deemed as being critical. District Nurses will carry out essential and clinically urgent interventions only. Other non-essential visits will be cancelled.
Critical School Nursing and Health Visiting appointments will also go ahead as planned. Service users and parents will be advised if their visit will be impacted by the strike action.
The Diabetes Centre on the Noble’s Hospital site will maintain its medically-led appointments. However, its Nurse-led clinics will be cancelled.
Therapies outpatient appointments planned for Tuesday will continue as planned.
Diagnostic appointments provided through the Noble’s Hospital Radiology Department and Ramsey and District Cottage Hospital (for example X-Rays, MRI, DEXA and CT scans, and ultrasound) will continue as planned. Routine breast screenings will go ahead as planned.
The Island’s GP practices are unaffected by the RCN strike action. This includes Ballasalla Group Practice which is operated by Manx Care. If you have a GP appointment, this will go ahead as planned unless you are contacted by your practice to change this. Please be reminded that the Manx Emergency Doctor Service (MEDS) is for issues that happen outside of core working hours.
Queries or concerns
Please be aware that circumstances may change on Tuesday depending on staffing levels. This will only be determined on the day. We would urge people to check Manx Care’s Facebook page (@ManxCare) for any updates, and share details with friends, relatives or neighbours who may not readily have access to social media.
Equally, the Manx Care Advice and Liaison Service (MCALS) will be available to answer any queries you may have via the phone (01624 642642) or via email (mcals@gov.im). The MCALS phone number is a freephone number. On Monday 24 and Tuesday 25 July, it will run an extended service between 08:00 and 17:00 in the event members of the public require additional support that day. It will also remain open until 17:00 today (Friday 21 July).
Manx Care’s CEO, Teresa Cope, commented:
“First and foremost, I wish to reiterate Manx Care’s position with regard to industrial action, which is that we respect and support the decision by RCN members to take industrial action, and equally support the decision of any RCN member working for Manx Care to participate in strike action next week. The decisions we have taken with regard to cancelling appointments and closing services have not been taken lightly. However, it’s vital that we work to maintain safe staffing levels across those services that are deemed as being essential or there to preserve life, particularly access to urgent or emergency care, whilst respecting and acknowledging our colleagues’ right to take industrial action. I’d urge anyone with any queries about this to contact the Manx Care Advice and Liaison Service (MCALS) in the first instance.”
