A root-and-branch reform in health and social care is to be undertaken by government.

David Ashford, Health and Social Care Minister has now outlined details of the reform.

The ageing population and high cost of providing hospital treatment in the island - and at specialist UK centres - is ’unsustainable’ he said.

Also the government can’t afford the current benefit system at residential and nursing homes.

Mr Ashford’s report - Delivering Longer Healthier Lives - includes the warning the current quality of services cannot be maintained ’if we continue to deliver them as we currently do’.

Integration of services is one part of the solution and there are moves to reduce duplication.

The focus is on keeping people out of hospital, nursing or residential homes and providing more care in the community.

There will be a shift towards encouraging people to take control of their own care. - plus a greater emphasis on prevention and early intervention.

The report draws on feedback from the community given at focus groups in the south from January to March 2017 and the west in December 2017.

Too many people are trapped in cycles of unnecessary and expensive emergency admissions resulting in increased dependencies on formal care.

There is ’too great a reliance on hospital-based care and a need to modernise our community and primary care infrastructure’.

The transformation will involve a ’significant shift of resources’ out of hospital and into the community into ’hubs’.

A professional - such as a GP, nurse or social worker - will co-ordinate care, shaping services around the person, creating a joined-up system and dramatically reducing the fragmentation of delivery’.

Action will be taken to reduce health inequalities from before birth.

Safeguarding’ will be a statutory responsibility of the DHSC and a board comprised relevant professionals will be responsible for this role.

Some areas require more immediate action such as the low rate - compared with the UK - of breastfeeding (70.1%) and death at home (40.6%).

Those of working age will be encouraged to self care. Some currently ’bounce between a range of different services (primary care, benefits payments, criminal justice, emergency department, mental health and social care) without improving their outcomes and at a cost to the system. A coordinated integrated approach will significantly reduce this unsettling ’bounce’ effect.’

GPs are at the centre of the transformation of primary care, but the report recognises that ’difficulties in recruiting and retaining GPs means that the primary care system is under significant pressure ... Exhaustion and fatigue and disengagement of the GP workforce could be a major barrier to GP led integrated care models.’

By December 2021 the department aims to have collaborated with stakeholders and have implemented - or be on the way to implementing - the new system.

’The Isle of Man has a historic opportunity to provide world-leading integrated health and care services,’ said Mr Ashford. ’Our vision is to become the best small island-based health and care system ... but we are a long way off achieving this vision.’