Noble’s Hospital is beginning the new year under intense pressure.

Manx Care is asking people to go elsewhere if they can and has even issued a plea for qualified nurses to report for work as sickness has taken a toll on working staff.

Director of nursing Paul Moore says it has been difficult to run the hospital safely.

He said: ‘We have been under pressure. We haven’t had as many discharges that we would like to have had because people are unwell.

‘It’s put a lot of pressure on the system. If you add in staff absence, it makes it very difficult to run a safe system.’

There have been a high number of ill patients requiring immediate treatment or admission for further care.

Many of those attending have been suffering from flu or other respiratory illnesses.

Over the festive period, all of the services operated by Manx Care were busy, with a significant increase in attendances across most sites compared with 2021.

Mr Moore said that the number of flu cases in hospital had stabilised over the weekend but said they would rise.

He said: ‘My expectation is that, as people return to work after Christmas and children return to school, the numbers will increase.

‘In all probability, I think we’re expecting the peak of flu to be towards the middle and end of January before it starts to come down.

‘There’s still some way to go yet before we’re out of the woods.’

The hospital operates under the OPEL (operational escalation level) framework, which is used daily across the UK NHS to describe the operating pressures on a hospital, and is a recognised framework for managing patient flow and demand across acute healthcare settings.

Noble’s Hospital is currently at OPEL 4 (the highest), meaning the facility is operating under extreme pressure.

A plan was activated last week when this began to manage this and ensure patient safety was maintained at all times.

‘We’re still operating under OPEL 4,’ Mr Moore added. ‘What that means is you can’t function in the way that you would normally function and safety can be compromised. You have to take immediate management interventions to focus and prioritise.’

Manx Care is now urging the public to ‘choose well’ with regard to where they seek healthcare support – a message the organisation is still pushing.

It recommends going to the Minor Injuries and Illnesses Unit (MIU) at Ramsey Cottage Hospital.

The nursing director said: ‘It’s an important and proactive step that we take every year but it means a lot this year. Most of the problems people experience over winter, like flu and Covid, can be dealt with by the vast majority of people with access to over-the-counter medicines or a chat with a pharmacist.

‘For a small number of people it doesn’t. Those are the ones we’d encourage to phone their GP where they can be dealt with.

‘In very rare circumstances the virus can affect your lungs and give you pneumonia. They’re the ones who need to come to hospital.


‘Our “choose well” campaign means that instead of a load of people turning up to hospital out of hours feeling a bit grim, they don’t need to. Most of them can manage their own condition.

‘That will ease the pressure enormously because everyone who comes to hospital has to be seen and assessed.

‘That puts a tremendous amount of burden on the staff and if you don’t need to be there it means we can cope better with the workload.’

Despite this, Manx Care says Noble’s Hospital is not turning people away. ‘The team does signpost people to other services, such as the Minor Injuries and Illnesses Unit (MIU) and the Manx Emergency Doctor Service (MEDS), but this is based on an initial triage by an experienced member of clinical staff,’ Manx Care said.

‘The team do not send people home unless they have been assessed and are deemed fit for discharge by a member of the medical team or qualified nurse practitioner.

‘If a [patient chooses to leave], it’s not because the team asked them to do so.

‘The hospital is very busy, but the emergency department will always treat those who require urgent or emergency treatment, and beds will be provided to those who need them.’

It added that there have been delays in transferring patients to wards due to how busy the hospital has been, but ‘those who need beds do get them’.

Mr Moore added: ‘We’ll always make an assessment of everybody who turns up but we might advise some people to go home or to go to the MIU in Ramsey, which is a fabulous facility that’s not used as much as I would like.

‘It’ll see you straight away and there’s very little wait time there. You can get your bloods done, X-rays done, and be seen by an advanced practitioner.

‘It saves messing and waiting around in the hospital where it can take a long time.’

Health Minister Lawrie Hooper said: ‘The health service is already seeing higher admissions than we would usually see at the peak – and we are a few weeks away from the actual peak – so the ask is for people to seek medical help in the right place and not to default to A&E.’

Meanwhile, Manx Care also issued a plea for qualified nurses to get in touch due to staff shortages.

It issued a statement on Sunday to say: ‘We’re struggling with staffing levels due to high levels of sickness. Your help would be very much appreciated.’

Mr Moore explained how much an absence can affect the hospital.


‘We’ve had difficulties over the weekend with short-term absence combined with the number of patients needing to be admitted to hospital and their level of illness being quite high,’ he said.

‘The three factors together have meant we’ve needed every bed to be opened and all the staff to be available and with new year’s eve, it’s always a challenge.

‘Because we don’t have much room to manoeuvre. A small number of people not being able to come to work has a big effect on the running of the hospital. That’s why we were putting out an appeal over the weekend to encourage people who were not working to come forward and assist us.’