Manx Care

[Apple]

5 minutes ago, code99 said:

I hazard a guess that these latest cancellations/postponements cannot be solely attributed to Covid. Or maybe they are?

The reduction in bed space at Nobles is a controversial issue and some managers and ministers have said over the years that we have not 'lost' any NHS beds since the new hospital was built. Of course, it is all about staff as well.

I think the current situation speaks for itself. 

[Apple]

On 7/20/2021 at 11:04 AM, code99 said:

What this place needs is a ‘code of best practice’ to replace the current complaints procedures, which are not fit for purpose, IMHO. The current process risks legitimate complaints being whitewashed. The prevailing ethos seems to be to defend the system no matter what, and try to make out that whatever happened was never due to negligence. When they do grudgingly admit that there was something wrong then there seem to be only two possible types of interpretation: a) it was somehow patient’s fault, or b) minor mistakes were made and lessons have been learnt.  

On this Island, one gets the impression that some medical practitioners view treating NHS patients as doing them favours, as opposed to doing their (well-paid) jobs. It goes without saying that the attitudes quickly improve if you are a private patient.  Whoever is going to be the next Health Minister must address this stark inequality in delivery of health service, and also the deficiency in accountability among the medical staff of all ranks.

In essence there isn't a lot I would disagree with in this. There is soon to be a public consultation on a new complaints process and this will be a unique opportunity for everyone to have their say. We should all not waste that opportunity.

Before we start a new system though we do need to ask for an up to date state on what has been happening over the last 5 years that lead to the agreed motion of the "broken system' in Tynwald in April. I have not seen personally the figures for 2020 /21 on the number and categories of complaints and which areas they are most raised. Again this would be useful to set a base line for future review (in view of what the Policy Reform Minister said about the apparent cultural organisational improvements in the last year or so. 

From what was said about whistleblowing (or actually was not said maybe) I got the impression that HR has been less than forthcoming in providing the data needed for the question that was asked and the annual reports for the Chief Secretaries office seem not to be happening from all areas and the data is wrong. 

He sounded as though he was getting a little angry with Mr Thomas and Ms Edge.  Sounded very evasive to me. ☹️

[The Voice of Reason]

1 hour ago, code99 said:

 

Who knew when Neil Kinnock made that speech “I warn you not to fall ill…” all these years ago he was right not only about the UK then, but that he was also prophesising about the IOM health system in 2021? 

I doubt it. The speech was made in 1993 and I think he was focusing on the UK. Not sure the IOM health system of 28 years later was in his thoughts

[Apple]

Credit where it is due as it is easy to overlook events that are not highlighted by a press release, for whatever reason.

This is a longish explanation from Teresa Cope about Manx Care not meeting the gold standard of the two week waiting time for Breast Care services, which we currently can not achieve for women on the island.

In short, when you strip out all the unnecessary jargon and repetition, patients can be referred off island to a Spire private hospital for their triple assessment clinic currently we have 60 places booked. There is also mention, funnily enough only in the last 30 seconds, that they are going to advertise for a new Consultant (hopefully a dedicated Breast Care Specialist) along with a Breast Care Specialist Nurse and an additional member of the team - just like we used to have.

According to Ms Cope everything should be back on track by mid to end September. Let's hope so. Anxious waits for ladies and families we can do without as a prelude to the illness / recovery involved.

https://www.manxradio.com/news/isle-of-man-news/new-choice-for-patients-waiting-for-breast-cancer-consultations/

 

Edited July 22, 2021 by Apple

[John Wright]

25 minutes ago, Apple said:

Credit where it is due as it is easy to overlook events that are not highlighted by a press release, for whatever reason.

This is a longish explanation from Teresa Cope about Manx Care not meeting the gold standard of the two week waiting time for Breast Care services, which we currently can not achieve for women on the island.

In short, when you strip out all the unnecessary jargon and repetition, patients can be referred off island to a Spire private hospital for their triple assessment clinic currently we have 60 places booked. There is also mention, funnily enough only in the last 30 seconds, that they are going to advertise for a new Consultant (hopefully a dedicated Breast Care Specialist) along with a Breast Care Specialist Nurse and an additional member of the team - just like we used to have.

According to Ms Cope everything should be back mon track by mid to end September. Let's hope so. Anxious waits for ladies and families we can do without as a prelude to the illness / recovery involved.

https://www.manxradio.com/news/isle-of-man-news/new-choice-for-patients-waiting-for-breast-cancer-consultations/

 

I thought there had been a public statement? It’s been all over the media for 48 hours. MR may have only decided to cover it. 

Good on Mrs Cope. She’s getting her teeth into things. Remember she’s only been in a position to do so for 3 1/2 months.

MC have identified the numbers, the delay, and negotiated a temporary solution plus put in place the route to permanent resolution. And in a pandemic.

I just hope this is a taste of things to come. With improved referral deadline targets and improved treatment delivery for all requirements across all specialities. 

There are some, especially community mental health, referral lags that are appalling. Community Psychologists take 18 months from referral to being seen. Obviously need  half a dozen more psychologists.

[Roger Mexico]

On 7/17/2021 at 9:25 PM, Apple said:

There are questions about this, bullying and non-disclosure agreements in next weeks Tynwald. So is the Health Service Consultative Committee report with it usual sycophantic "how great the services are" rhetoric. CoMIN get sucked into this rubbish every time though. Can't keep members I hear. Expensive committee that achieves little in my view. 

Looking at the latest HSCC Annual Report, apart from the usual compliments over handling Covid (whether it's true or not, genuflections have to made to prevent alienating people) it's actually fairly critical over most areas of the NHS.  Only Public Health gets a green rating and that wasn't even in DHSC.

The Preface (which I suspect is the only bit the politicians read - if that) gets in quite a few digs:

The Minister, Interim CEO, COO, DCEO and Medical Director [...] have demonstrated dedication (albeit with 2 notable undignified lapses regarding genomic testing, and the SPC inquiry)

[...]Sadly, the HSCC is again disappointed to be reporting limited progress in the majority of its members’ areas of health scrutiny. The strong common themes in members’ annual reports and key recommendations: slow progress in clearly identified actions (Cancer, Comms, Legislation, HR, P4G), insufficient strategic and admin support (Cancer, Care Quality and Informatics), and single point of failure staffing (Cancer, Nobles Patient Safety, and Community).

Treasury decision-making in business cases in general and asset replacement in particular leads to unnecessary duplication of effort, additional expense and intense frustration amongst many frontline staff who already have a difficult time juggling patient care and organisational functions, e.g. Integrated Care funding, and hospital pager replacement taking over 5 years.

[...]The largely unachieved specific P4G Actions and failed Cost Improvement Plans now transfer to Manx Care who are set a 1% CIP in its first year.

[...]The last WMQRS update report to Tynwald in January 2019 identified 579 achievable quality standards were still unmet. The P4G reporting action was removed in April 2019. The HSCC disagreed with this decision and suggested that ongoing reviews are vital to ensure that compliance with achieved standards remains monitored. We understand that Manx Care now has plans to employ CQC to do this, but this had been a DHSC action since April 2019 and CQC recommendations have no legal enforcement route in any event.

I thought this was particularly telling:

The remaining DHSC structure numbers just 20 but nevertheless there is earnest recruitment to add another 16 DHSC posts, with concerning duplications at Senior executive levels between the DHSC and Manx Care structures.

[...]The Mandate between DHSC and Manx Care was completed just weeks prior to Manx Care’s formal inception. There are concerns about day-to-day protocols between the 2 structures and role duplication, particularly in Patient Engagement and Commissioning. Plans to double the DHSC structure are in place.

And there was a kick at the departing Quayle:

The period between Health services establishing what should be done in 2016 and any significant progress on transforming those services in a meaningful way for the patient, has been too long and remains so far from the promised road map laid out by the then Health Minister, and now outgoing Chief Minister.

The main problem with the HSCC is I suspect constitutional - it's a body which is supposed to monitor the governance of the Health Service rather than its operation.  So criticism has to be about process rather than outcomes and mostly written in bureaucratese.

[Non-Believer]

So the DHSC that was supposed to have largely morphed into Manx Care still remains as a separate entity and is now engaged in recruitment to almost double its remaining numbers with duplication of some roles now under Manx Care? WTF? Who is supposed to be in charge of this?

Maybe we'll end up with competing Health Care providers with competition to drive down costs and drive up services.

Yeah, right.

[Apple]

2 hours ago, John Wright said:

Good on Mrs Cope. She’s getting her teeth into things. Remember she’s only been in a position to do so for 3 1/2 months.

I agree. Apparently she has done more to improve things more in her time so far than was achieved in the last 5 years, if you know what I mean. !! 

Re the Breast service, the hardest part will be the recruitment of the staff needed. We are not quite there yet.

It is important to maintain confidence of the public in some of the services for treatment benefits if nothing else.  

[quilp]

Just now, Apple said:

Re the Breast service, the hardest part will be the recruitment of the staff needed. We are not quite there yet.

Not quite is right, I just hope her efforts don't go tits up... 

[Apple]

13 minutes ago, Non-Believer said:

Who is supposed to be in charge of this?

Well, we pay for it so they must know what they are doing....

or as DA said repeatedly, it was a unanimous decision to vote to bring in Manx Care so the NHKs must have known we were going to be doubling up surely. They wouldn't have sanctioned anything they did not know about surely.

Burt seriously, there are significant changes and developments, including legal and off island issues connected to Manx Care that have not yet been announced or developed. We are still waiting to hear about the Private services provider in Nobles that won the contract!

We need to maintain scrutiny of what they do, how they meet the Mandate requirements, what the impact of changes are on the public. That is why a lot of attention is now being poured over the process and procedures for scrutiny and will be in the public domain soon. 

If the last 5 / 6 years and Covid have resulted in anything positive it is now about the priorities of providing a health service and (statutory to note) social services to meet the islands ongoing needs.

 

Edited July 22, 2021 by Apple

[Non-Believer]

It reads to me like persons have been relieved of their empire so have decided to start constructing a replacement.....

[John Wright]

1 hour ago, Apple said:

I agree. Apparently she has done more to improve things more in her time so far than was achieved in the last 5 years, if you know what I mean. !! 

Re the Breast service, the hardest part will be the recruitment of the staff needed. We are not quite there yet.

It is important to maintain confidence of the public in some of the services for treatment benefits if nothing else.  

 

1 hour ago, quilp said:

Not quite is right, I just hope her efforts don't go tits up... 

At least they’ve got a back up plan to ensure meeting service targets. It’ll be so much more expensive to use private services or locums, so hopefully they’ll put together the right package to attract permanent staff, and, of course, no one should have to go off Island for treatment that can be done safely and well here. It’s a daunting struggle for many.

I’m speaking as someone who did 50+ day trips for chemo over a 6 month period, twice a week. 

[Non-Believer]

1 minute ago, John Wright said:

How do you make that out. New broom. Going places. Hopefully the first initiative of many.

But why then, as the report that Roger M has been good enough to post indicates, do roles duplicating what Manx Care is (should) be now doing need to be created in an organisation that Manx Care is supposed to be superceding?

These parts of DHSC should now be redundant, not a vehicle to increase their staffing by @ 100%?

[Andy Onchan]

1 hour ago, quilp said:

Not quite is right, I just hope her efforts don't go tits up... 

I see what you did there....

[John Wright]

44 minutes ago, Non-Believer said:

But why then, as the report that Roger M has been good enough to post indicates, do roles duplicating what Manx Care is (should) be now doing need to be created in an organisation that Manx Care is supposed to be superceding?

These parts of DHSC should now be redundant, not a vehicle to increase their staffing by @ 100%?

That’s to misunderstand the roles of DHSC and MC. The DHSC roles will not be clinical or medical or nursing or care, or management of those services. So no duplication.

Its a problem of this sort of commissioning system that it’s wasteful of management on both sides agreeing what is to be done, setting the budget, reviewing etc. It’s a duff system which England is rowing back from just as IOM launches.

It has one, well two, possibly, advantages.

Immunity from political interference and ability of politicians to plausibly deny any responsibility for service delivery