Correspondence regarding cuts

Summary

The requester asked for correspondence between Manx Care and the DHSC regarding service cuts from October 2024 to February 2025. Manx Care released 14 documents but redacted personal names and email addresses under data protection exemptions.

Key Facts

• The request was received on 2025-01-28 and the outcome was issued on 2025-02-19.
• 14 documents totaling 30 pages were released to the requester.
• Personal data including names not in the public domain and email addresses were withheld.
• The withheld information was exempt under section 25(b)(i)&(ii) of the Freedom of Information Act 2015.
• The correspondence relates to urgent measures to address financial challenges and ensure service sustainability.

Data Disclosed

• 2025-01-28
• 2025-02-19
• 2025-02-18
• 2025-01-31
• 2025-01-17
• 2025-01-16
• 30
• 14
• 4402809
• s25(b)(i)&(ii)
• Article 5
• Article 6
• Article 9
• October 2024

Exemptions Cited

• Section 25(b)(i) of the Freedom of Information Act 2015 (Absolute exemption for personal information)
• Section 25(b)(ii) of the Freedom of Information Act 2015 (Absolute exemption for personal information)
• Article 5 of the General Data Protection Regulation (Data protection principles)
• Article 6 of the General Data Protection Regulation (Conditions for lawful processing)

Original Request

Please provide copies of any correspondence between Manx Care and the DHSC, relating to service cuts or reductions to services, or the cessation of services whether temporary or permanent. I am specifically interested in any correspondence relating to service cuts in the current financial year, and the next financial year. Please provide anything from the 31st October 2024 to date.

Data Tables (9)

Full Response Text

Manx Care Noble’s Hospital, Strang Braddan, Isle of Man IM4 4R (01624) 650 000

Our ref: 4402809 18 February 2025

Dear

We write further to your request, received 28 January 2025, which states:

"Please provide copies of any correspondence between Manx Care and the DHSC, relating to service cuts or reductions to services, or the cessation of services whether temporary or permanent. I am specifically interested in any correspondence relating to service cuts in the current financial year, and the next financial year.

Please provide anything from the 31st October 2024 to date."

Response:

Please find enclosed copies of the information that is being released to you.

While our aim is to provide information whenever possible, in this instance we are unable to provide the information you have requested in relation to names not in the public domain and also email addresses in the information you have requested because it is absolutely exempt under s25(b)(i)&(ii) of the Act (absolutely exempt personal information). The reasons why that exemption applies are that: · Manx Care is satisfied that the information amounts to personal data of which you are not the data subject; and · Manx Care is satisfied that disclosure of the information would contravene one of the data protection principles as set out at Article 5 of the General Data Protection Regulation as it applies in the Isle of Man pursuant to the Data Protection (Application of GDPR) Order 2018, namely that Manx Care can only disclose the information where it would be fair, lawful and meet one of the conditions for lawful processing in Article 6 [or if you are dealing with sensitive personal data “and one of the conditions in Article 9 of the GDPR and Schedule 2 of the Implementing Regulations is met”] and in this case, none of those conditions have been met, i.e. names not in the public domain and email addresses.

Please quote the reference number 4402809 in any future communications.

Your right to request a review

If you are unhappy with this response to your freedom of information request, you may ask us to carry out an internal review of the response, by completing a complaint form and submitting it electronically or by delivery/post.

An electronic version of our complaint form can be found by going to our website at https://services.gov.im/freedom-of-information/Review . If you would like a paper version of our complaint form to be sent to you by post, please contact me and I will be happy to arrange for this. Your review request should explain why you are dissatisfied with this response, and should be made as soon as practicable. We will respond as soon as the review has been concluded.

If you are not satisfied with the result of the review, you then have the right to appeal to the Information Commissioner for a decision on; 1. Whether we have responded to your request for information in accordance with Part 2 of the Freedom of Information Act 2015; or 2. Whether we are justified in refusing to give you the information requested.
In response to an application for review, the Information Commissioner may, at any time, attempt to resolve a matter by negotiation, conciliation, mediation or another form of alternative dispute resolution and will have regard to any outcome of this in making any subsequent decision. More detailed information on your right to a review can be found on the Information Commissioner’s website at www.inforights.im. Should you have any queries concerning this letter, please do not hesitate to contact me. Further information about freedom of information requests can be found at www.gov.im/foi.

I will now close your request as of this date.

Yours sincerely

From: Cope, Teresa To: Subject: FW: Urgent Measures to Address Financial Challenges and Ensure Service Sustainability for Manx Care Date: 31 January 2025 09:08:05 Attachments: image002.png image003.png image004.png image007.png image005.jpg image006.jpg     From: Lawless, Kevin (Manx Care)

Sent: 17 January 2025 15:25 To: Cope, Teresa Subject: FW: Urgent Measures to Address Financial Challenges and Ensure Service Sustainability for Manx Care   Hi Teresa,   As discussed, for your information.   K     From:

Sent: 17 January 2025 13:58 To: Radcliffe, Katy ; Lawless, Kevin (Manx Care) Subject: FW: Urgent Measures to Address Financial Challenges and Ensure Service Sustainability for Manx Care            Shaun Stacey     Improvement Director   Manx Care • Noble’s Hospital • Strang Braddan • Isle of Man • IM4 4RJ                                             www.manxcare.im Privacy Notice: https://www.gov.im/about-the-government/statutory- boards/manx-care/manx-care-privacy-notice/     cid:image001.png@01DB2EB0.20CD7860     From: McCauley, Sam

Sent: 16 January 2025 11:55 To: Cc: Richardson, Paul (DHSC) ; Teare, Pam Subject: RE: Urgent Measures to Address Financial Challenges and Ensure Service Sustainability for Manx Care   Hi   Thanks for the time. As discussed in October Manx Care undertook extensive media communications on measures required to come into Financial Balance:https://www.gov.im/news/2024/oct/10/measures-to-bring-manx- care-into-financial-balance/   Then on the elective was open that the “cooling-off” had not had the expected impact on activity: https://www.gov.im/news/2024/oct/25/update-on-planned-activity-and-cost-saving-measures-from-manx-care/   Therefore we think that any communications need to be more reflective of what has previously been announced and clearly land on a simple narrative on the impacts for the remaining proportion of the financial year.   Suggest: In October 2024 Manx Care announced a series of measures required to come into Financial Balance. At that time those measures were expected to reduce the forecast overspend to circa £8m for 24/25 however Paul Richardson MA (Oxon) Yn Ard Oikagh | Chief Officer a: Rheynn Slaynt as Kiarail y Theay | Department of Health and Social Care       Belgravia House, Circular Road, Douglas, Isle of Man, IM1 1AE e: | w: www.gov.im/dhsc t:       despite implementation of these measures and concerted efforts to manage costs, current expenditure levels are unsustainable.   Further strengthening of these measures is required to ensure financial sustainability while maintaining the safety and quality of essential services. The Manx Care Board are seeking to optimise resources, control costs, and strengthen financial governance balanced with “no harm” to patients and continued prioritisation of the urgent and emergency needs of the community. In line with previous commitments Manx Care want to be clear about how these measures may impact patients and service users Operations -       Urgent and time-critical operations, as well as already scheduled procedures, will continue -       Non-urgent and non-time critical elective procedures will be further slowed down which will see an impact on total waiting times for patients -       To reflect a smaller number of elective procedures taking place selected wards will be stood down. This will allow maintenance and repairs to take place which have been outstanding and are required to enable those wards to be effectively utilised in the next financial year -       A freeze on new recruitment will remain in place until April 2025, alongside strict restrictions on the use of temporary staffing arrangements,   Manx Care is committed to maintaining patient safety and essential services while addressing its financial challenges. These measures are designed to ensure service sustainability, mitigate risks, and improve overall efficiency and we want to be clear on their impacts for the remainder of the financial year.   The below needs finessing and I am concerned about the line in red of the deficit as the previous PR talked about £14.7m – sorry will check but is this figure in latest financial accounts published by the Board?   Have briefed the Minister and said we were going to try and agree a revised PR and approach to the media and she has suggested concurrently we write to Tynwald Members as they are aware something has gone out but been held back.   – do you want to pick up with Manx Care colleagues and feed back?   Best Sam     From: Richardson, Paul (DHSC)

Sent: 15 January 2025 17:36 To:

Cc: Cope, Teresa McCauley, Sam Subject: RE: Urgent Measures to Address Financial Challenges and Ensure Service Sustainability for Manx Care   Thank you for sending this through I think/hope I’ve arranged a call tomorrow morning where we can run through this and the sequencing of any briefing and potential subsequent Comms.     All the best                                     From:

Sent: 15 January 2025 17:28 To: Richardson, Paul (DHSC) Cc: Cope, Teresa Subject: Urgent Measures to Address Financial Challenges and Ensure Service Sustainability for Manx Care Importance: High   Hi Paul,   As discussed see below for a modified but more detailed note for minsters;   Overview Manx Care is facing significant financial pressures, with a projected deficit of £14.7 million by the end of the financial year. Despite efforts to manage costs, current expenditure levels are unsustainable. Immediate action is required to ensure financial sustainability while maintaining the safety and quality of essential services.   The Manx Care Board has approved a series of urgent measures aimed at optimising resources, controlling costs, and strengthening financial governance. These actions are grounded in the principle of “no harm” to patients and prioritize the urgent and emergency needs of the community.   Key Measures Being Implemented 1. Temporary Suspension of Elective Operations • Non-urgent, non-time-critical elective procedures (including off-Island care) not yet scheduled will be paused until April 2025. • Urgent and time-critical operations, as well as already scheduled procedures, will continue. (it is important to stress here that those patients already scheduled will not be stood down)     2. Reduction in Inpatient Capacity • Selected wards will be temporarily closed in response to the suspension of elective procedures. • This will allow for environmental improvements and ensure long-term sustainability, preventing disruptions in the next financial year.                                (it is really important to point out the importance of getting this maintenance completed to prevent a fall over of this capacity later in this year impacting further on patient access and flow through the organisation)       (the next 3 items are a continuation of what is already in place but are essential we increase the oversight and supervision of at this time, the reason for indicating these in the briefing is to ensure that ministers and the public are aware of these tighter controls as they will ompact on the opportunity to flexibly deliver service) 3. Recruitment and Vacancy Freeze • A freeze on new recruitment will remain in place until April 2025, alongside strict restrictions on temporary staffing arrangements. • This aligns with the reduced elective capacity and addresses the reliance on temporary workforce solutions.   4. Centralised Oversight of Job Planning • Job planning for medical, nursing, and allied health professionals will be centrally coordinated. • This measure will maximise workforce efficiency, ensure resource optimisation, and support continued service delivery.   5. Strengthened Financial Controls • Enhanced financial governance will include stricter purchasing controls and increased accountability for financial decisions. • These measures will improve transparency and ensure the sustainability of financial resources.   Benefits of the Measures   Although these measures are challenging, they are essential for the long-term sustainability of Manx Care. Key benefits include: • Improved Patient Safety Management: Enhanced hospital flow and clinical validation of waiting lists will improve outcomes. • Optimised Workforce Efficiency: Reduced reliance on temporary staff will allow for more structured time for direct patient care. • Financial Sustainability: Strengthened governance will ensure resources are allocated effectively and transparently.   Conclusion   Manx Care is committed to maintaining patient safety and essential services while addressing its financial challenges. These urgent measures are designed to ensure service sustainability, mitigate risks, and improve overall efficiency. Continued collaboration with government partners will be essential to navigate this critical period.   Action Required: • Support and endorsement of the proposed measures         I hope the above provides a more comprehensive explanation of the measures that enable the Minister and Members to understand the approach Manx Care is taking at this difficult time. I understand that Teresa has provided you with the board paper inclusive of the risk assessment and the communication documents that support these actions so I haven’t copied them again.   Look forward to catching up in the morning.     Best wishes             Improvement Director   Manx Care • Noble’s Hospital • Strang Braddan • Isle of Man • IM4 4RJ                                             www.manxcare.im Privacy Notice: https://www.gov.im/about-the-government/statutory- boards/manx-care/manx-care-privacy-notice/

1

From the office of the Minister Hon. A Cannan, MHK 1 November 2024

Wendy Reid Manx Care Chair Nobles Management Suite Strang IM4 4RJ

Via email:

Dear Wendy

Manx Care Back to Balance Plan 2024/25

I am writing further to recent correspondence between Manx Care and the Department on proposed further measures to close the financial gap between this year’s budget and Manx Care’s forecast overspend.

As you know the Manx Care Board had proposed additional mitigations to further close the gap, on top of those actions that it is already taking as part of its existing and enhanced Cost Improvement Plan. These additional mitigations, in the form of detailed savings schemes with potential service impacts were considered by the DHSC Board on 28th October, and it was agreed that they should be presented to the Council of Ministers to seek a direction on whether some, all or none of these options should be pursued in the interests of closing the financial gap. Council considered these schemes very carefully at its meeting on 31st October and resolved very clearly that it could not support those plans in frontline areas which would have a direct impact on the public.

For clarity those proposed schemes which Council does not support are as follows: -

• Ceasing the Shingles vaccination programme • Ramsey MIU Closure • Close MEDS • Close Ward 4 • Close Ward 11 • Reduce Overnight Ambulance Provision • Do not transfer critically unwell patients overnigh

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