Focus away from hospital care in plan to cut costs

Reducing hospital bed capacity, increasing private collaboration, and prescription criteria are among a raft of changes to health services in Manx Care's plan for 2025-26.

The health operator published its aims for the next financial year, following its mandate from the Department of Health and Social Care (DHSC).

Manx Care outlines how it aims to stay within its £361.8m budget, with a focus on reducing pressure at Noble's Hospital.

Health Minister Claire Christian said: "The most important part of this is changing the way we provide care, moving from the hospital to closer-to-home."

While Manx Care's budget has increased by £14.8m, Tynwald will be asked to approve an additional £20m to cover an overspend in 2024-25.

This year's budget is therefore £500,000 more than the 2025-26 allocation, something Manx Care called "an immediate cost pressure before inflation".

Manx Care's operating plan said "difficult decisions will need to be taken" to deliver within budget.

The health body said much of its spend was "largely demand-led, volatile and difficult to predict".

To generate income, Manx Care said it would work with the private sector to improve "the provision of diagnostics, testing and hiring of rooms and equipment when not in use outside of NHS time" to "unlock further income".

It also said there would be changes to prescription eligibility criteria, including potential rises in prescription charges, which would generate "significant" rising funds.

Increasing the financial share towards primary and community care, social care and mental health, are among ways the plan aims to move care "closer to home".

And Manx Care said hospital bed capacity would be reduced to encourage this move.

The health minister said the shift to community care would mean "hospital appointments are available for those who need them most".

Ms Christian added: "If we are to be sustainable, we need to make best use of all elements of our health and care services."

While emergency and cancer care services "will be protected", there was to be a reduction to funding for elective services, it said.

There would also be a focus on regional community-based hubs to provide services including "health and care advice, social support, early intervention and well-being activities".

Manx Care said it was currently "heavily reliant" on the north west of England for both non-elective and elective care, which came at an "extremely high cost".

The off-island, known as tertiary, care was currently costing more than £25m, and an review of services would seek to reduce these costs, it said.

The mandate and operating plan are due to be debated in Tynwald later this month.

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