The number of inpatient beds on Martin Ward at Ramsey and District Cottage Hospital is set to be reduced from 31 to 20 following a sustained fall in demand.

Manx Care said occupancy on the ward dropped from more than 95% during 2023/24 to 70% in the final quarter of 2024/25, as more rehabilitation services have been delivered in the community rather than in hospital.

Health chiefs said people with frailty and complex needs account for a large proportion of hospital demand and that demographic trends on the Isle of Man mean this is expected to rise.

However, the arms-length health organisation pointed to clinical evidence that shows recovery and rehabilitation are often better supported at home, with help from community practitioners, rather than in a hospital setting.

The first stage of the reconfiguration involves removing 11 beds - a reduction of around 35% - and expanding access to step-down rehabilitation beds and home-based support.

Manx Care said the phased change is intended to maintain safe, high-quality care despite staffing pressures, while avoiding unnecessary hospital stays and reducing long-term dependency on care packages.

Since it was established in 2021, Manx Care has developed several community-based services for people with frailty.

In 2024, Intermediate Care was introduced, providing six weeks of domiciliary care and rehabilitation to allow earlier discharge from hospital. The service also includes a ‘Crisis Response’ function, enabling urgent referrals and the start of support within an hour for people struggling at home.

A Frailty Clinic was set up in Ramsey in 2023, offering follow-up care after discharge and support from a consultant geriatrician, a frailty lead GP and an advanced clinical practitioner. The team also provides home visits.

Also in 2023, a Care Home Review Team was established, carrying out geriatric assessments and medication reviews for nursing home residents. Manx Care said this had reduced hospital admissions from nursing homes by 65% and was funded through savings from optimising medication use.

In 2022, Ward 6 at Noble’s Hospital became a specialist Frailty Unit, with more therapy staff and increased consultant geriatrician presence. The focus is on reducing the length of hospital stays and enabling discharge home with support.

Under the changes at Martin Ward, two nurses will rotate to the Noble’s Frailty Unit to build experience in acute frailty care. Manx Care said there will be no redundancies as a result of the reduction in bed numbers.

Two social workers from the hospital social work team are also now part of the multidisciplinary team on Martin Ward, aiming to shorten stays by starting discharge planning earlier for patients needing home care or a care home place.

Oliver Radford, interim executive director of partnerships, performance and improvement, said: ‘This redesign is about getting people back to their lives faster and with less dependency - not about cutting services, but improving them in the right setting.

‘We’d like to thank all partners and staff involved in this work, and will continue to engage with stakeholders, including MHKs, unions, and community organisations, to ensure transparency and shared ownership of this important change.’