DHSC flags "unsustainable" deficit and growing waiting lists in Manx Care assessment

The department says Manx Care’s £15.6 million shortfall highlights weaknesses in financial governance

The Department of Health and Social Care (DHSC) has warned that Manx Care’s current financial position is “unsustainable”, following an official assessment of its performance during the 2024/25 service year.

The report - which government is required to publish by law - noted the healthcare provider ended the year with a structural deficit of £15.6 million, driven by rising off-Island treatment costs, inflationary pressures on contracts, and higher spending on medicines.

While DHSC acknowledged that many of the cost pressures were outside Manx Care’s control, it concluded that weaknesses in financial governance had “materially contributed” to the deficit.

A Financial Recovery Programme is now under way to strengthen oversight and reduce expenditure.

The assessment also raises concern about waiting times for elective care, describing performance as having “continued to deteriorate”. By March 2025, 17,829 people were waiting for a first consultant-led appointment - up by more than a thousand on the previous year - and 6,835 had waited over 52 weeks. Only 47 percent of urgent GP referrals were seen within six weeks, well below the 85 percent target.

However, the report recognises progress in several key areas, including the rollout of Primary Care at Scale, the establishment of wellbeing hubs across the Island, and improvements in early intervention for mental health through the Talk service.

It also commends the development of the Manx Care Record business case and the implementation of 33 NICE Technology Appraisals to improve patient access to treatments.

The department says it remains committed to supporting Manx Care in delivering reforms through initiatives such as Getting It Right First Time and the Home First model, which aims to provide care closer to home and reduce reliance on hospital services.

In a letter accompanying the report, Health and Social Care Minister Claire Christian expressed thanks to Manx Care’s board and staff for their “continued dedication”, but added that greater financial discipline, transparency, and timely reporting would be essential.

Manx Care says the assessment will be formally considered at its November board meeting. It expects to issue a full response in due course.