Health care changes outlined as Manx Care looks to 'Home First' model

Lower hospital bed capacity, changes to prescriptions and reduction in bank staff

Manx Care is planning to reduce hospital bed capacity, change prescription eligibility criteria and increase private healthcare options as part of efforts to save money.

The health body has set out a number of initiatives as part of its Operating Plan for 2025/26.

The plan sets out how the Mandate to Manx Care, for the same period, will be delivered.

Both documents are due to go before Tynwald later this month.

Manx Care’s budget for the next financial year is £361.8 million – a £14.8 million increase on the previous year - however it also imposes a two percent efficiency target.

‘Difficult Decisions’

To stay in budget the health body has warned that ‘difficult decisions’ will need to be taken in order to deliver services within the funding allocation.

“The financial outlook for Manx Care for 2025/26 remains challenging. However we are fully committed to working within the agreed funding envelope and providing the highest standards of care that this allows. There may need to be some very difficult decisions regarding service provision in light of the pressures outlined.” – Manx Care

Manx Care says much of its spend is largely ‘demand led, volatile and difficult to predict’.

But to stay in budget it’s warning that ‘constraint’ is needed in terms of elective activity and the following initiatives will be required:

• Reduction in acute hospital (mental/physical) bed capacity to support out of hospital care models
• Changes to prescription eligibility criteria
• Enhanced rostering controls and oversight to further reduce spend on bank and agency staff
• More cost effective delivery of care in hospital and community
• Reduced spend on off-Island provision through greater control and repatriating activity
• Reduced spend on consumables
• Reductions in corporate service provision
• Increased private healthcare and commercial income
• Job planning
• More cost-effective commissioning models in social care

‘Home First’

Manx Care says it wants to develop out-of-hospital provision – in dental, GP and pharmacy services – and accelerate a ‘home first approach’ to move more services into the community.  

This, the heath body claims, will ‘focus on unlocking improvements and productivity’ within the system and focus on prevention and early intervention.

“The biggest area of spend is within hospital care, and whilst urgent and emergency and cancer care will always be protected, providing healthcare at the point of crisis often does not result in the best outcomes.” – Manx Care

Health and Social Care Minister Claire Christian said: “The department and Manx Care have worked together to produce this clear plan to deliver safe and high-quality services which represent the best value for money for the taxpayers.

“This mandate recognises that to provide better services we must improve productivity and modernise our approach.

“The most important part of this is changing the way we provide care, moving from the hospital to closer-to-home.

“Manx Care will be focussing on increasing the amount of care you can receive in the community through primary services like GPs and dentists so hospital appointments are available for those who need them most.

“This shift from hospital care to care close-to-home is fundamental as I know that the public want improved GP access and, if we are to be sustainable, we need to make best use of all elements of our health and care services.  

“The joint working and governance, demonstrated by these documents, needs to continue throughout all that we do to ensure we deliver sustainable, high-quality health and social care.”

‘Locality Hubs’

Under the plan Manx Care says more support and intervention will be available within four locality hubs which will be clinically led.

Over the next year GP appointments will also be changed so that primary care specialists ‘utilise their time with individuals who most need them’.

This, it’s said, will enable other professionals to provide more support and transfer management of specialist care from hospital to GP surgeries.

Find out more

You can read the Mandate to Manx Care HERE.

You can read the Operating Plan HERE.