Elective procedures at Noble’s Hospital were suspended last week after bed occupancy reached 98.9% during a period of operational pressure.

The suspension remained in place from May 12 until May 18 and followed what was described as an ‘exceptional’ rise in demand which saw services escalate to ‘Opal Four’ – the highest level the hospital’s pressure framework.

During the 48-hour peak period, around 280 patients attended the emergency department, with approximately 60 admissions.

Adult bed occupancy and critical care capacity both reached 98.9%, while around 12 patients were waiting for inpatient beds within the emergency department, highlighting the scale of internal flow pressures.

Health and Social Care Minister Claire Christian said the suspension was necessary to prioritise urgent and emergency care when hospital capacity became critically stretched.

‘This is only the second occasion in the past 18 months in which Manx Care has had to apply a true Opal Four response,’ she said.

‘Bed occupancy was exceptionally high, and further escalation action was required as discharges were not keeping pace with admissions. Services must prioritise urgent and emergency care in order to protect patient safety and dignity.

‘No one could have anticipated that on any given day in the Isle of Man.’

The escalation was linked to several factors, including admission rates rising above the typical range of 17 to 19 percent, ward refurbishment works and temporary disruption to services at Ramsey Cottage Hospital, while ambulance crews responded to more than 100 calls during the same period.

To ease pressure on the system, elective activity was scaled back, with 19 procedures postponed and 28 beds freed across Ward 11 and Ward 12.

Ms Christian said urgent and cancer-related treatment, along with children’s procedures, continued as normal, while affected patients were being contacted and rebooked according to clinical priority and waiting time rather than being returned to the back of the queue.

She added: ‘Analysis is happening currently so that Manx Care can identify what triggered the escalation. We want to strengthen resilience, improve flow, and reduce the risk of a similar escalation happening again.’

Although pressures eased within 48 hours, with the hospital stepping down from Opal Four to Opal Three, services have continued to experience sustained pressure.

Manx Care has since commissioned an urgent independent review into bed capacity at Noble’s Hospital, with stakeholder engagement already underway and findings expected before the end of May. The review will assess whether bed numbers and patient flow arrangements remain adequate.

‘This is an urgent review of bed capacity at Noble’s which has been issued,’ Ms Christian said.

‘This review is not only important to look at the decisions that have been made recently, but also in terms of a [potential] additional 14 beds.’

The minister also confirmed that early-stage planning is underway for a reconfigured and expanded emergency department, acknowledging the current facilities are no longer properly aligned with modern demand.