Despite significiant parts of the health service being praised, several areas of immediate concern are noted in the latest review.

The concerns come from the eighth and final report into the system by the West Midlands Quality Review Service.

A common theme througout the report were concerns over communication at Noble’s Hospital.

The report said: ’There is a clear theme in many areas of this review about poor communication of incident reports and a lack of learning and feedback to staff, both in the area that raised the concern, but also more widely.

’There appears to be a failure of communication to staff on the outcome of and learning from incidents.

’Many staff told us that they did not know what happened or what should be done differently.’

The process for monitoring mandatory training was seen as inconsistent across the teams the WMQRS reviewed.

While the Coronary Care Unit was praised, there were immediate risks raised by the reviewers.

’Temporary (transcutaneous) pacing was available in the Isle of Man during normal working hours.

Reviewers heard that the skills within the Isle of Man to deliver this service were limited to one individual who was fully trained.

However, when this worker was not available, patients were stablised and transferred off-island, the methods of which the WMQRS was concerned could result ’in a patient’s deterioration’.

Response

In the report, the government’s reponse was that it was ’not appropriate to train a large number of staff to undertake the temporay pacing due to the low level of need in the island.

Reviewers were also concerned of a backlog in cardiac services letters of between 10 and 16 weeks.

Most worryingly, some of those letters were instructions for GPs for a treatment plan.

The government said that temporary staff have been hired to help with the letter backlog.

Furthermore, the workload of cardiac consultants was seen as a concern as consultants are working 14 programmed activity sessions (PAs) per week, whereas the normal consultant contract is for 10 PAs per week.

Another area of concern for the reviewers was in the endocrine service where patients are treated with radiation for thyroid issues in Liverpool.

Despite this, the airlines concerned are not informed of the patients being radioactive to avoid issues of them being unable to travel.

The report said: ’Standard guidance for patients after therapy is to avoid close contact with individuals (especially pregnant women and young children) for up to seven days.

’Patients travelling on airlines are in close confines with other passengers and the time of each flight (with possible delays) can be longer than expected.’

The government said in response that a consultant in nuclear medicine from the Royal Liverpool University Hospital was satisfied the risk is minimal due to the flight time from Liverpool of usually about 30 minutes.

However, the WMQRS advised further checks due to the potential for flights such as these to be delayed with passengers waiting in close areas.