Good and bad news in health service review

Noble's Hospital

Noble's Hospital

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The findings of a second of a series of independent assessments of the health service in the Isle of Man have been announced.

The West Midlands Quality Review Service (WMQRS) today published the second of its intended 13 quality assurance reviews.

The first review was damning, highlighting staff shortages, weak management and a culture of blame.

The second review focussed on acute medical admissions at Noble’s Hospital and the care of people with long-term conditions in both the hospital and outside.

The latest report contains a mixture of positives and negatives.

Problem areas include:

The effectiveness of IT systems. But the department countered that it had now secured major upgrades to both the main Noble’s Hospital and GP computer systems

The need to work on reducing inappropriate admissions to Noble’s Hospital and improving support at the point of discharge to avoid delays.

The department says it is already aware of the need to enhance community care options in both community health services and social care services by continuing to develop joint working that cuts across teams and which moves to further integrate care. This was one of the key drivers for the merging of the departments of Health and Social Care earlier this year.

The challenges government continues to face in providing a comprehensive health service for a small island community. For example, instances where the island has a single specialist and the impact this has on the ability to provide adequate out-of-hours and holiday cover.

Minister for Health and Social Care Howard Quayle MHK said: ‘Although there are areas where we need to make changes it is important that we do not overlook the positives of which we can be proud. There are several “good news stories” and the WMQRS found many examples of best practice and commended these achievements.’

Examples include:

The development of the island’s diabetes service over the past decade.

The island’s cardiac rehabilitation service, which met 92 per cent of the WMQRS quality standards

The enhanced patient care and information available through strong links with local charities and support organisations such as the local branch of the British Heart Foundation

The island’s respiratory service, where the WMQRS felt that staff provided care which goes ‘above and beyond that which could reasonably be expected’.

Mr Quayle added: ‘We have already begun work in several areas where the WMQRS has identified scope to enhance and develop our services. In addition we are moving swiftly to address any concerns that they raised. The one immediate risk – out-of-hours cover for issues with pacemakers – has already been addressed and the WMQRS has confirmed that it is content with this measure.’

The findings from the WMQRS will however assist the department in continuing this work and such findings are likely to be recurring and consistent themes across all 13 reports.

Mr Quayle said: ‘We will need to continue to think carefully and creatively about how we address issues where we have limited specialists given the island’s size and location when compared to trusts in England for example.

‘Despite some of the findings, work is already well underway with real and tangible progress being made. In my first four months as minister I have been impressed by staff in the department and their tireless work, not least in commencing the major projects to address the long term challenges facing us, for which I thank them.’

The department’s senior team is being reshaped following a review by management consultants Beamans in 2013.

The review also recommended a new governance board for Noble’s Hospital, which is planned to be developed later this year.

The department has seen the appointment of a new chief executive and the imminent appointment of a new managing director for acute care and a new medical director at Noble’s Hospital.

The department is also now able to bid for additional money from a special fund established as part of the 2014/15 Budget which can be used to implement changes as a result of the WMQRS quality assurance reviews.

The Minister concluded: ‘As with the first report I have requested that a robust and comprehensive action plan be developed as a matter of urgency. This will be published and progress will be monitored to ensure that we do not lose momentum.

‘I appreciate that some members of our community may be concerned by some of the report’s findings.

‘It is important to remember that these reviews have been proactively initiated by the Department as part of a constructive and professional process of continual improvement for the island’s health services.

‘We will not shy away from the findings and I want no stone left unturned. Only then can we be sure that we have the best possible health service, ready to face the challenges that lie ahead.’

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