Review rejects call for more beds at Manx hospital
BBCAn independent review has rejected calls from healthcare workers on the Isle of Man to increase the number of inpatient beds at Noble's Hospital in Douglas.
The report found overcrowding was being driven by delays in patient flow rather than a bed shortage.
It recommended reforms to Accident & Emergency (A&E) services, discharge planning and community care services.
While hospital capacity has fallen from 313 beds in 2003 to 233 today, the report's authors said "process improvements" should be prioritised over expansion.
'Patient flow issues'
The review was commissioned by the Department of Health and Social Care in April following concerns about repeated periods of severe pressure on services at Noble's Hospital.
Doctors warned that patient capacity was insufficient to manage demand safely.
The review was tasked with examining whether increasing bed numbers would provide a long-term solution.
An independent reviewer spent 10 days analysing hospital performance data, meeting clinical and managerial staff and observing services across Noble's Hospital.
The report concluded that the capacity challenges were being driven more by "patient flow issues" than by a lack of beds.
Delays in discharging medically fit patients, people using Accident & Emergency instead of seeing GPs, and a lack of community support services should be tackled, the review recommended.
'Modernise systems'
Particular concern was raised about the A&E department, which currently deals with a broad range of patients including those who might otherwise be treated through primary care, urgent care or specialist pathways.
The review found the hospital's emergency department received about 120 patients each day.
Fewer than one in five ultimately require admission, however.
A recurring theme in the report was the need to strengthen services outside the hospital.
The report argued that greater investment in community care, rehabilitation, admission avoidance schemes and support for older people would help reduce pressure on acute services and better prepare the island for an "ageing population".
The review also identified opportunities to improve discharge planning and modernise bed management systems through digital technology, enabling staff to track patient movement more effectively.
The report concluded that while there may be a case for increasing capacity in the future as demand grows, current efforts should instead focus on making better use of existing resources and addressing inefficiencies across the wider health and care system.
Responding to the review's findings, Health and Social Care Minister Claire Christian said they would help shape both immediate actions and longer-term planning.
She said there was "no single solution" to the challenges facing the Isle of Man's health service.
Officers from the Department of Health and Social Care and Manx Care have already met to consider the recommendations and will now work together on developing a formal action plan.
Read more stories from the Isle of Man on the BBC, watch BBC North West Tonight on BBC iPlayer and follow BBC Isle of Man on Facebook and X.