A shake-up of endoscopy services should have been carried out earlier.

A Council of Ministers report says the delay meant that there was a number of years where the endoscopy service was not as effective or efficient as it could have been.

CoMin has made its response to recommendations set out by a Tynwald scrutiny committee, which investigated the decision to withdraw the service at Ramsey Cottage Hospital and centralise it at Noble’s Hospital in May 2017.

The social affairs policy review committee report and CoMin’s response will be laid before Tynwald today (Tuesday).

In CoMin’s response it states: ’The Council of Ministers supports the Minister and his senior officers in their efforts to modernise the department, while noting that many aspects of its culture must change in order to achieve this.

’Had an improvement system as simple as, for example, ’plan, do, study, act’ (’PDSA’) been in place in 2011 then the endoscopy consolidation in Douglas would more than likely have happened when the new suite was commissioned.

’That the consolidation was not planned and implemented at an earlier date was indeed a missed opportunity that resulted in a period of some years during which the endoscopy service was not as effective or efficient as it could be.’

CoMin continued saying that the Department of Health and Social Care (DHSC) had already taken steps to address the ’root causes’ of the patient safety problem identified last year.

It said that the management system was ’not well-designed’ or ’well-run’ to keep up with the increase in demand for endoscopies.

’As regular performance data were not collected, and performance targets were not set, the demand on the system compared to its apparent capacity to deal with demand led many routine appointments being replaced by urgent cases,’ the response read.

CoMin then clarified that the DHSC will publish endoscopy performance information on a quarterly basis, along with an annual report to Tynwald for the next three years.

It would also consider ways to ensure that all Ministers and departmental members understand their roles and responsibilities.

The DHSC’s decision to consolidate endoscopy in a new purpose-built facility at Noble’s Hospital, estimated at £1.6m, was announced in May 2017. This decision was made without consulting Ramsey MHKs, the Ramsey Cottage Hospital League of Friends or the hospital’s welfare trustees who had funded much of the equipment and operating theatre.

Safety

The Tynwald scrutiny committee investigation concluded that the move had prevented a patient safety crisis by tackling a backlog in follow-up endoscopy appointments and that the department deserved credit for increasing capacity without spending extra money.

However, the report called the announcement of the move to Noble’s a ’communication disaster’, saying that it had disregarded the sensitivities of its own staff and the two charities associated with the Ramsey Cottage Hospital.