Manx Care is continuing to face significant financial pressures due to ongoing expenditure challenges. Two key factors are driving this challenging situation: off-Island referrals, appointments and procedures as well as increasing costs associated with the delivery of clinical and social care services.
In October 2024, the Manx Care Board announced a series of measures required to come into financial balance. At that time those measures were expected to reduce the forecast overspend to circa £10m for 24/25 however, despite extensive efforts to manage costs, our current expenditure levels continue to rise. Manx Care is now forecasting an overspend of £15m.
There is a clear requirement from government to stay within our agreed financial envelope and consequently Manx Care has to further increase our efforts, using the below actions to reduce costs for the remainder of the financial year. These actions were agreed by the Manx Care Board in early January and subsequently we have been working on the implementation plans and discussing the details of these actions with the DHSC prior to formal announcement.
Following a Treasury Board meeting with Manx Care and DHSC yesterday, it has been today (Thursday 30 January) confirmed that some additional spending has been approved by Treasury to support Manx Care. This means that some of these planned actions have been able to be reduced, however Manx Care will continue to drive efficiencies and there will continue to be some disruption to services during February and March 2025.
It is important to state that these actions are not being taken in response to the recently announced settlement of the pay dispute with the British Medical Association (BMA).
Our priority continues to be maintaining the safety of our services to the Island’s population, responding to the urgent and emergency needs of our community. These measures further focus on optimising resources, controlling costs, and improving financial governance while maintaining our core commitment to patient safety and essential services. Our patients and service users are central to all our actions and decisions as we navigate these necessary changes.
Key Measures Being Immediately Implemented
Temporary Reduction of Elective Care: For the remainder of the financial year Manx Care will be reducing the amount of elective care undertaken both on the Island and off-Island:
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Off-Island – we have requested our NHS partners providing specialist care in Liverpool and Manchester to pause non-urgent procedures and appointments until 31 March 2025. This will include routine new and follow-up appointments, operations and investigations. Excluded from this request are patients awaiting cancer or clinically urgent intervention, as well as those undergoing a course of treatment where any delay will impact on clinical outcomes. The decision about whether an appointment is urgent or semi-urgent has been made by a clinician.
We are also asking NHS providers to review individual patient pathways with a view to discharging them from specialist care, converting appointments to virtual or repatriating care back to Manx Care teams. Patients who have had their operation off-Island cancelled will be rescheduled after 31 March 2025. If you receive contact from an NHS provider to postpone your treatment, please contact the Patient Transfer Office to inform them so your travel arrangements can be cancelled.
- On-Island – Thanks to the additional spending approval that has been secured today we will be reinstating as many planned procedures and appointments as possible over the next two months. Details of this are being worked through now with a view to minimising disruption wherever possible. Cancer and urgent cases will continue and are not affected by these changes. We will seek to rearrange any disrupted procedures as early as possible from April 2025 and will offer dates for readmission at the time
Benefits of These Measures
While these measures are challenging, they are critical to ensuring the long-term sustainability of our services. They include:
- Enabling a full clinical validation of all waiting lists, held both on and off island, to assess whether current pathways are the most appropriate
- Embedding a new way of working with our off-Island hospitals through the launch of an Off-Island Transfers Team and new commissioning framework that is cost and clinically effective for the Isle of Man
- Reducing the inpatient bed complement will reduce reliance on additional or temporary workforce, thereby ensuring continuity of care and improved cost effectiveness
Acknowledging the Impact
We understand the difficulties these changes will bring for the community and our workforce. These decisions have not been made lightly and we recognise that there may be some impact on waiting lists; nonetheless we are committed to minimising disruption wherever possible. Ensuring the sustainability of our services within the agreed financial envelope is a vital objective at this critical time.
Manx Care remains steadfast in its commitment to the health and safety of our community, and we thank you for your understanding and continued support as we navigate these challenges together.
If you have any questions or concerns, including about any cancelled or postponed appointments, please contact MCALS on +44 1624 642642 or email mcals@gov.im.
