An independent rapid review into bed capacity at Noble's Hospital has warned that simply increasing the number of beds will not solve all of the issues facing the healthcare system.

Growing concern among senior clinicians over pressure on inpatient services and patient flow prompted the Department of Health and Social Care (DHSC) to commission the review.

Earlier this year, the Medical Staff Committee (MSC), which represents around 75 senior doctors and consultants, called for urgent government intervention.

The MSC has previously highlighted what it described as a 'critical shortfall in inpatient bed capacity', warning that the situation is affecting emergency admissions, planned operations and patient safety.

Independent healthcare consultants PSG Health carried out the review and have now published their findings, which include nine recommendations.

Collectively, the recommendations conclude that a wider, system-wide approach is needed to improve services.

The report states: 'Beds alone do not define the capacity of a hospital to deliver care. It is a whole-system approach too.

'Ambulation, admission avoidance, use of alternative pathways and protecting acute hospital capacity for the sickest patients are all part of modern healthcare.

'Teams and services deliver care, not beds, and the effectiveness of these working consistently and in line with best practice will generate better outcomes for patients.

'Patients are the single common currency of any healthcare organisation and clinicians. Leaders and commissioners should therefore galvanise efforts to deliver safe, high-quality, consistent, effective and timely care as their primary objective.'

However, the reviewer was also critical of Manx Care and the way the organisation operates.

The report states: 'There are a range of other underlying issues that the reviewer believes are influencing service cohesion and delivery and which were not part of the review, but it would be remiss not to allude to them.

'Complex issues such as trust, discretionary behaviours, questionable consultant job plans, silo planning and circumvention of normal governance systems appear evident.

'These are deep-rooted behavioural and cultural issues which may also be distracting from delivering responsive and efficient services.

'My concern for the current executive leadership team and future appointees is that Manx Care becomes ungovernable and, for key groups within the workforce, there are ulterior motives to building services comparable with modern and more efficient healthcare organisations.'

Recommendations include reducing pressure on A&E through an integrated urgent care model, creating clearer pathways back to GPs, pharmacies and minor injuries services.

The review also recommends turning the Acute Medical Unit at Noble's into an Acute Assessment Unit, allowing patients to access specialist treatment more quickly.

It says bed management systems require digital transformation, including live patient information to provide a clearer picture of demand.

The reviewer also called for a greater focus on community-based care to help prevent hospital admissions.

The report identifies a skills and experience gap which slows decision-making because there are too few staff able to make key decisions.

The reviewer spoke to frontline health and social care staff, Manx Care leadership and members of the Medical Staff Committee.

The review was commissioned amid continuing debate over capacity at Noble's Hospital, with clinicians warning that bed shortages are contributing to delays in the Emergency Department and the postponement of operations because of a lack of post-operative space.