A review of Manx Care governance has highlighted a lack of accountability and ownership of actions, duplication of roles and the need for clearer focus on strategic priorities.

The independent review carried out by the Management, Internal Audit Agency (MIAA) outlines a range of areas where the governance arrangements in place require strengthening.

Each year, the DHSC sets out a mandate to Manx Care outlining the government’s objectives and requirements for the island’s health and social care services for the year ahead.

But the MIAA review found there has been a lack of clarity about what the mandate represents - whether it is a set of commissioning intentions for Manx Care or whether it is more aspirational.

This has in turn impacted upon the development of longer term vision and strategic plans, the report notes.

‘There is currently a lack of clarity across the board and the committees in terms of their alignment to the mandate and Manx Care’s strategic priorities,’ it states.

The report noted, however, there has been significant progress with mandate planning and the design of the governance structure is ‘reasonable’.

It highlights the potential duplication of roles across Manx Care and the DSHC, citing the shared service finance team while Manx Care also has its own small team headed by an executive director of finance.

MIAA noted that committee meetings were often cancelled at short notice and re-arranged, or regularly overran, meaning individuals had to leave due to other commitments.

The review highlighted that the quality, consistency and brevity of reports could be improved across the board and its committees.

Observations and review of papers highlighted a ‘general lack of ownership of actions’, the review found.

At board meetings responsibility for updating the action log was delegated to the company secretary and the deputy company secretary, which supported ‘a lack of ownership and accountability’.