Manx Care went live on Thursday in what is being seen as the biggest shake-up of the island’s health service in decades.

The new organisation’s chairman Andrew Foster, who has yet to arrive in the island due to lockdown restrictions, admitted: ’I would have hoped for a slightly different start.’

First of its kind in the island, Manx Care is an entirely new statutory body designed to operate at arms’ length from the Department of Health and Social Care and focused on the delivery of services to the public.

Those services and the funding for them are defined in a formal agreement with DHSC known as the Mandate, giving Manx Care scope to provide services either directly or by commissioning them from others.

The organisation will be led by a newly-appointed executive leadership team and becomes the employer of around 2,500 health and care staff.

Manx Care, whose setting up was recommended in the independent Sir Jonathan Michael review has been running in shadow form alongside DHSC since the start of the year.

Mr Foster said: ’I came into the picture in September last year. There has been a huge amount of preparation by a lot of people.’

So how will we measure its success? He said it was all about the ’golden triangle’ of performance, finance and quality.

Performance focuses around getting waiting times down, for instance in A&E and with first appointments.

Manx Care starts just as lockdown has only increased waiting lists.

Mr Foster said tackling waiting lists will be done by prioritising them according to patient safety, graded one to five.

The most important part of the triangle is quality, he said. ’It’s about improving clinical outcomes, about improving the patient experience and patient safety.’

In term of finance, Mr Foster said: ’The criticism of healthcare in the island is that it always overspends. We’ve been given increases to the budget and we are expected to live within that budget.’

He accepted that it would be seen as a failure if Manx Care overspends.

Mr Foster said the organisation is allowed to ask for more money for specific things like waiting list initiatives. y

But it is required to make at least 1% efficiency savings.

There are certain elements of expenditure that are not in Manx Care’s gift to control - such as the cost of drugs and off-island patient treatment.

Mr Foster said: We can’t control prices of new drugs but significant savings can be made by purchasing biosimilar drugs.’

He said as far as possible procedures should be done on-island but in those areas where off-island treatment is necessary, ’we would expert tertiary providers to make savings too as we have’.