An external assessment has found several shortcomings in the health system in the island in a series of reports.

The assessment was carried out by the Care Quality Commission, the health regulator for England and Wales.

The review of the health service was recommended by Sir Jonathan Michael in 2019 after looking into the services provided by the Department of Health and Social Care at the time.

The reports highlighted various issues in the services at all levels.

Safeguarding was an issue highlighted by the report, with it stating that there needs to be more coordination between services.

It says: ‘A lack of data sharing arrangements appears to be a significant barrier that prevents services discussing and sharing safeguarding concerns.

‘At the moment, there are no formalised transitional safeguarding arrangements in place to support the safety of children and adolescents who have transitioned to adult services.’

In 61% (eight out of 13) of dental practices it was found that staff needed their training brought up to standard and more awareness was needed of safeguarding referral pathways.

Staff training was another issue raised in the report, with low levels of mandatory training found across Manx Care.

The report says: ‘Manx Care told us that data on mandatory training needed to improve and this is part of the quality improvement programme.’

Another staffing issue found was recruitment, which was found to be insufficient, with the vacancy rate at the time of the assessment being 22%.

The current rate of vacancies is ‘19 to 20%’ according to Manx Care’s head of nursing, Paul Moore.

However, he did say that the organisation was taking significant steps towards improving the staffing issues within Manx Care.

The report said: ‘Although the recruitment issues are understandable due to the challenges of being an island, some specific areas of recruitment need to be improved.

‘For example, pre-employment recruitment checks were not consistent between services, and information was often held on separate systems that did not communicate with each other, making it difficult for services to have effective oversight.’

The report found that there were instances where some employee checks were not carried out.

It also found that some of the premises and equipment maintenance was ‘inconsistent’ in standards throughout the service, with examples including, carpeted clinical areas with no arrangements for deep cleaning, damaged wall and floor coverings and damaged toilets and sinks.

It also found that hazardous material such as amalgam (a mercury-based alloy used in dental fillings) wasn’t able to be disposed of safely.

There is also no provision for the removal of amalgam and other dangerous materials from the Isle of Man.

The storage and handling of medicines was also an issue that was pointed out, with blank prescriptions often found in unlocked drawers or printer trays.

In the adult social care assessments, 74% found concerns around safe medicines management and oversight.

Other issues found within the service included data sharing and patient records, patient outcomes, person-centred care, strategic direction, legislation, leadership, governance and risk management.

The report says: ‘Manx Care is a new organisation, and it acknowledges it has come a very long way in a short space of time, but that there is more work to do.

‘Senior leaders had the skills, knowledge and experience for the roles they held. They had identified and understood the challenges Manx Care faced.

‘However, there was no strategy in place to develop future leaders or implement a succession plan.

‘The Isle of Man Department of Health and Social Care can use these baseline assessments to work with Manx Care, agreeing on priorities that will support the Isle of Man government to deliver its Island Plan, in which health and care transformation is the number one priority.

‘This will help to shape what regulation on the Isle of Man might look like in the future.’

The reports are available to be read in full from the government’s website at