With industrial action by members of the Royal College of Nursing (RCN) on Thursday 14 September 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 on the day. This is based on what we know now, but may change depending on staffing levels on the day.
Strike action will take place for twelve hours on 14 September 2023 (all of the day shift for 24-hour services, and 8am to 8pm for non-24-hour services).
Certain 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, in-patient Mental Health services provided at Manannan Court, some community-based services, Dialysis services and Critical Care provision, alongside maintenance of chemotherapy provision and emergency/trauma surgery. 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.
Most outpatient services will close during strike periods, which we recognise will have a huge impact on many patients. Nurses are critical to Manx Care’s workforce, and difficult decisions have had to be made to ensure safe staffing levels for essential services on these days.
Manx Care remains open to dialogue with RCN members. However, our options remain limited due to our financial constraints and having exhausted our funding envelope. All funding that has been received by the organisation to be used for pay awards has already been used to fund pay awards. Given the current financial position that Manx Care faces, making any further pay offer at this point is not possible and would be in breach of our Financial Regulations. Manx Care is seeking support from DHSC to assist in resolving this matter. 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.
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 – Thursday 14 September 2023
A number of services will close on 14 September 2023 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 the day, resulting in some unavoidable last-minute closures. If you have an appointment booked for this day, you will be contacted by your clinical team if this is going to be cancelled and rescheduled. If you have not been contacted by the end of Wednesday 13 September, 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 – Thursday 14 September 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 such as a Community Pharmacy. Alternatively, they should call 999 for an Ambulance in the event of an emergency or life-threatening situation.
Members of the public are asked to take great care on Thursday, and to do what they can to minimise the chance of an accident occurring, in order to take pressure off the Emergency Department.
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 the Signposting page.
Appointments and service provision – Thursday 14 September 2023
The Blood Clinic at Noble’s Hospital and Ramsey Cottage Hospital will close.
The vaccination programme will pause for the day.
Around 290 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. If you have a hospital appointment booked for the strike day and have not been contacted to advise this has been cancelled, please attend as planned.
All endoscopy appointments have been cancelled.
All elective theatre sessions have been cancelled. However, there will be some theatre provision for management of urgent, emergency and trauma patients.
Chemotherapy treatment delivered at the Eric and Marion Scott Oncology Day Unit and Haemodialysis treatment will continue as planned.
The Macmillan Cancer Information and Support Service (MCISS) will be open as usual, alongside picking up phone calls on +44 1624 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, 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.
Paediatric outpatient appointments will be cancelled, however Children’s Ward inpatient services will continue as planned.
The GUM Clinic at Noble’s Hospital, the Fertility Clinic and Family Planning services will close.
Termination appointments will not be available.
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.
The School Nursing and Health Visiting service will not operate on the day of the strike.
The Diabetes Centre on the Noble’s Hospital site will maintain its medically-led appointments. However, its Nurse-led clinics will be cancelled.
Physiotherapy outpatient appointments will continue as normal.
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) and routine breast screenings will continue as normal.
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 the affected day 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 at +44 1624 642642 or via email at email@example.com. The MCALS phone number is a freephone number. The team will be working on extended hours (8am to 5pm) on 13 and 14 September.
Manx Care’s CEO, Teresa Cope, commented:
'We respect and 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, our nursing workforce is critical to our services, and so industrial action is bound to have a huge impact. 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. Anyone with queries about this is encouraged to contact the Manx Care Advice and Liaison Service (MCALS).'