This week Manx Care, an arm’s length health provider for island residents came into existence. To get a sense of what this means for the island, Gef sat down (virtually) with the chairman of Manx Care Andrew Foster about what he wants to see it achieve and what difference it will actually make for Manx residents.
What is it?
Essentially Manx Care is now running the delivery side of Manx health and social care, aside from the name on the door and some letterheads, nothing will really change for the average user of services on the island.
What Has Changed?
Mr Foster said: ‘The first thing to ensure is that as far as the public is concerned they see no disruption at all on day one, they certainly shouldn’t. Basically as far as receiving health and social care is concerned, it will be business as usual but our ambition is to substantially improve waiting times, improve quality, improve patient and service usership, improve the morale of staff, so that’s what we want to be seeing over a period of time.’
Before the pandemic waiting times were a constant concern for patients and health leaders, we asked Mr Foster how Manx Care can improve waiting times which would prove a challenge at the best of time, let alone during a global pandemic.
He said: ‘Really there are two ways to reduce lists. You can effectively pay for extra capacity or you can be more productive and more efficient in reducing the waiting list and from my experience working elsewhere, I’m very used to doing both of those.
‘There are such large waiting lists on the Isle of Man. We are going to do a clinically prioritised approach to it, in other words, those waiting lists which are most clinically sensitive are the ones which will be dealt with first and that way, I hope, we can make the biggest difference in the shortests amount of time.’
Mr Foster said that where possible, procedures will be done on the island, but for people requiring major surgeries or specialised treatment, this will have to be done in the UK.
He said: ‘It is quite often the case that where people are using the tertiary provider in the north west, those can be the clinically sensitive ones, this is where we’re talking about cancer or highly complex surgery so it may well be that those areas will get that first priority.’
Like waiting times, concerns over mental health provision on the island is something that has suddenly come about because of the pandemic. Mr Foster said there will likely be a hybrid approach to improving the situation on the island by working with the third sector and community groups, but also improving the effectiveness of existing provisions and where possible expanding on them.
A big feature of the future of healthcare on the island is decentralising services where possible away from Noble’s and into the community. This is something that Mr Foster said Manx Care will also be focusing on delivering, as it is better to treat people at home and prevent or decrease the number and length of stays in hospital where possible. Predominantly the main reasons for people attending hospital are for long term conditions such as diabetes and respiratory conditions that Manx Care wants to be able to treat people at home as much as possible, in turn this not only releases bed space at Noble’s but also allows patients to stay in the comfort of their own home for their treatment.
He said: ‘It is something I have a lot of experience of in my previous job, I went to work in a hospital which when I started had 800 beds and when I left had 450 beds and that is done by reducing the number of people who go into hospital, by getting them out quicker and by having alternative facilities in the community and I know that is very much what the Isle of Man wants to achieve as well.
‘Frankly, a visit to hospital is to be avoided unless it’s absolutely necessary and there are lots of viable alternatives, so you can have Hospice at Home schemes, Care in the Community schemes, you can have advanced practitioners looking after some people with specialist skills so there are range of things that can be done that are fundamentally to the benefit of the patient themselves but also enable the resources of healthcare as well.’
Mr Foster said Manx Care is really keen on improving data collection through the island’s health and social care.
He said: ‘I really want to see better data about patients, better clinical data, because its very beneficial having high quality information about patients and patient outcomes so you know where you can improve services the most. At the present, there is a lack of clinical data on the Isle of Man, it’s there in primary care, such as GP surgeries, but it’s not there in the hospital and other aspects of care.’