Presentations or Briefings from Manx Care to the DHSC

Summary

The requester sought presentations and briefing documents shared between Manx Care and the DHSC regarding service reductions in January-February 2025. Manx Care released a public communication detailing urgent financial measures and service suspensions but withheld specific briefing materials citing exemptions for personal data.

Key Facts

• Manx Care faces a projected deficit of £35 million by the end of the financial year.
• Non-urgent elective operations and off-island care are suspended until March/April 2025.
• A recruitment and vacancy freeze is in effect until April 2025.
• Some requested briefing documents were withheld as they contain personal data.
• The response included 13 documents totaling 23 pages.

Data Disclosed

• £35 million
• 1st January 2025
• 1st February 2025
• March/April 2025
• April 2025
• FY 2024/25
• 23 pages
• 13 documents
• 2025-03-31
• 2025-06-10

Exemptions Cited

• Section 25(b)(i) & (ii) of the Act (Absolutely exempt personal information)

Original Request

Please provide copies of any presentations or documents used at briefings between Manx Care and the DHSC - from the 1st January 2025 to the 1st February 2025 I'm looking for any presentations / briefing documents that were presented to the DHSC by Manx Care, I believe that there must have been briefings and information shared in respect of the Mandate and proposals to reduce services in year (being the FY 2024/25). I assume these briefings / presentations would have been led by (or produced by) the Improvement Directors. There may also have been minutes taken of these briefings / presentations which I would also be grateful for copies of.

Data Tables (6)

Full Response Text

Manx Care Communication Release

Manx Care Announces Urgent Measures to Address Financial Challenges and Ensure Service Sustainability

Manx Care is currently facing significant financial pressures due to ongoing expenditure challenges. Despite extensive efforts to manage costs, our current expenditure levels are unsustainable, with projections indicating a potential deficit of £35 million by the end of the financial year.

These challenges, combined with external factors, are impacting our ability to maintain services without compromise. Our immediate priority must remain on safely responding to the urgent and emergency needs of our community. To address these pressures and ensure financial sustainability, the Manx Care Board has proposed and agreed upon a series of urgent measures.

The measures are focused on optimizing resources, controlling costs, and improving financial governance while maintaining our core commitment to patient safety and essential services. Central to all our actions is the principle of “no harm” as we navigate these necessary changes.

Key Measures Being Implemented 1. Temporary Suspension of Elective Operations : Non urgent and non time critical Elective procedures, including off-island care, not already scheduled, will be paused until March/April 2025. Urgent and time critical planned operations will continue
2. Inpatient Ward Closures: Select wards will be temporarily closed to in response to the temporary suspension of elective operations . This will enable environmental improvements to ensure the long-term sustainability of inpatient facilities and prevent unplanned disruptions. 3. Recruitment and Vacancy Freeze: A freeze on new recruitment and continued strict restrictions the use of temporary workforce arrangements will be in effect until April 2025. 4. Centralised Oversight of Job Planning: Job planning for medical, nursing, and allied health professional staff will be centrally coordinated to maximize efficiency and ensure optimal resource utilisation. 5. Strengthened Financial Controls: Enhanced financial governance will include tighter purchasing controls and increased accountability for financial decisions to ensure transparency and sustainability. Benefits of These Measures

While these measures are challenging, they are critical to ensuring the long-term sustainability of our services. They also provide opportunities to: • Improve patient safety management through better hospital flow and the clinical validation of waiting lists • Create more structured time for direct patient care by reducing reliance on additional or temporary workforce. • Align with our strategic intent to deliver more care closer to home, reduce unnecessary hospital stays, and eliminate duplication in diagnostics. Acknowledging the Impact

We understand the difficulties these changes will bring for our workforce and the community. These decisions have not been made lightly, and we are committed to minimizing disruption wherever possible. However, ensuring the sustainability of our services is a vital objective at this critical time.

Manx Care remains steadfast in its commitment to the health and safety of our community, and we thank you for your understanding and continued support as we navigate these challenges together.

For further updates or queries, please contact

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

Our ref: 4552181 10 June 2025

Dear

We write further to your request, received 31 March 2025, which states:

"Please provide copies of any presentations or documents used at briefings between Manx Care and the DHSC - from the 1st January 2025 to the 1st February 2025

I'm looking for any presentations / briefing documents that were presented to the DHSC by Manx Care, I believe that there must have been briefings and information shared in respect of the Mandate and proposals to reduce services in year (being the FY 2024/25). I assume these briefings / presentations would have been led by (or produced by) the Improvement Directors. There may also have been minutes taken of these briefings / presentations which I would also be grateful for copies of."

Response

Please see attached documentation.
s25(b)(i)&(ii) While our aim is to provide information whenever possible, in this instance we are unable to provide some of the information you have requested because it is absolutely exempt under section 25 of the Act (absolutely exempt personal information). The reasons why that exemption applies are that: • The Manx Care is satisfied that the information amounts to personal data of which you are not the data subject; and • The 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 the 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. Names and email addresses have been redacted

Please quote the reference number 4552181 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

Manx Care • Noble’s Hospital • Strang • Braddan • Isle of Man • IM4 4RJ

+44 (0) 1624 650000
enquiries@manxcare.im
www.manxcare.im Manx Care - delivering health and statutory social care services on the Isle of Man

31 January 2025

Dear

Re : Additional savings in Manx Care planned for February and March 2025 in order to achieve financial ‘control total’ of £15M.

I wish to clarify the communication that took place from myself regarding the above matter, following the decision of the Manx Care board on 7th January, to progress with the implementation of additional actions to control expenditure in the final two months of this financial year.

These additional measures were recommended to the Manx Care Board by the Improvement Directors, who are currently working across both the DHSC and Manx Care. The measures built upon the actions that had been previously agreed by the Manx Care Board and DHSC in September 2024, and Implemented from October. Essentially, these actions went deeper with the intention of mitigating further financial risk of circa £2.3M. I am aware that, in advance of these recommendations being formally brought to the Manx Care Board, they had been subject to discussions within the DHSC, such was the ongoing and very regular discussions, regarding the in-year financial position and necessary work being undertaken to plan for 25/26.

The day following the Boards’ decision (the 8th January 2025) I had a regular scheduled meeting with at 0900, where I intended to discuss the decision of the Manx Care Board. I therefore contacted via Teams, and we caught up later that day when I briefed her on the matter. No papers were shared at that point with DHSC – it was what I would consider a high-level, verbal briefing.

and I were together the following day (9th January) as part of the BMA pay negotiations, and I also recall briefly discussing this then. had confirmed that the Minister was aware but that there hadn’t been opportunity to discuss in very much detail.
Chief Executives Office
Management Suite Noble’s Hospital Strang Braddan Isle of Man IM4 4RJ

Manx Care • Noble’s Hospital • Strang • Braddan • Isle of Man • IM4 4RJ

+44 (0) 1624 650000
enquiries@manxcare.im
www.manxcare.im Manx Care - delivering health and statutory social care services on the Isle of Man At this point I was progressing on the basis of the DHSC being informed of the actions being taken by Manx Care and not seeking permission to proceed.

On Friday 10th January, communications had been drafted by the Manx Care team with the intention of announcing the plan formally, both internally and externally on Monday 13th.
However, given the ongoing negotiations with the BMA, my suggestion back to our Communications team and was to defer until Wednesday 15th January, which was agreed. At that point I confirmed with Communications and with that DHSC was aware.

I sent all documents to him at 11.55am on 14th January. We were due to meet that afternoon with the BMA and so were together after that meeting. We met in my office and discussed this, although recognised that had still to read the documentation sent through. All Manx Care communication was finalised and scheduled for Thursday 16th January, as I was satisfied all DHSC officers were fully aware of the plans. The communication involved an all organisation wide ‘Lets Connect’, a separate briefing for Clinical teams, as well as public facing communications and media interviews.

On 15th January I was copied into further communication between and Minister Christian and at 15.55pm a meeting was scheduled by the DHSC at short notice, involving myself,

and Minister Claire Christian. At that meeting, Minister Christian stated that she was not aware of the planned actions and expressed disappointment with me that I, or yourself as Chair, had not briefed her personally on this matter. During that meeting I did express to Minister Christian that I had communicated with DHSC officers and it would not be usual for myself to take direct responsibility for briefing a Minister unless specifically asked by a DHSC officer.

Further meetings to discuss the financial mitigation were held as follows:

• 21st January involving both DHSC and Manx Care Comms Team,

and myself.
• 22nd January involving the above, plus the Minister Christian nd DHSC department members • 23rd January the matter was discussed with the Council of Ministers, attended by and myself We were advised at the end of last week (week ending 24th January 2025) that this would be discussed at the Treasury Board Meeting on 29th January 2025.

At all opportunities, we have expressed that operational planning for such matters has had to continue in the background to ensure mobilisation from 1st February and the risks associated with holding off communicating these actions. It has been incredibly difficult for me personally to hold such a line as this clearly reflects poorly on Manx Care as an organisation. Additionally, it is obviously greatly concerning for the public not to receive timely communication.

Manx Care • Noble’s Hospital • Strang • Braddan • Isle of Man • IM4 4RJ

+44 (0) 1624 650000
enquiries@manxcare.im
www.manxcare.im Manx Care - delivering health and statutory social care services on the Isle of Man

I do understand and appreciate that some additional funding was attempting to be secured. However, even as recent as the Treasury Board on 29th January which I attended, it was made clear that the £15m financial control total could not be breached.

In such matters I always reflect on what more I could have done to mitigate the situation that has arisen. In the week following the decision by the Manx Care Board, I was personally leading the negotiations with the BMA whilst preparing the organisation for responding to Industrial action, along with leading operational delivery in the absence of the Executive Director

Up until 15th January I was clear that we were informing DHSC of our plans and not seeking permission for those plans to be implemented. That changed following conversations with the DHSC on 15th January and, in order to demonstrate an aligned and colligate approach on this matter, I continued to instruct formal communications to be paused to enable a fully aligned approach with DHSC and government to be communicated, despite the inevitable leaks of information. I ultimately feel that has backfired and ultimately placed us parties in an incredibly difficult position.

I attach relevant emails and documents, as evidence, to support the points raised my letter.

Yours sincerely,

Teresa Cope Chief Executive Officer

From: on behalf of To: Cc: Subject: Additional savings in Manx Care planned for February and March 2025 Date: 31 January 2025 13:05:33 Attachments: image001.png Additional Savings (002).docx FW Let"s Connect at 10am today - slides.msg FW Financial mitigations comms plan and query RE medical colleague briefing.msg FW Manx Care Communication Release.docx.msg Good afternoon,   Please find attached a letter from Teresa regarding additional savings, along with relevant emails in support.   Kind regards,       Business Support Officer CEO Office     Manx Care

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