Isle of Man News - POSTED Mon last week

Minister unveils plans to improve services and reduce health and social care costs

by LC

Kate Beecroft MHK, Minister for Health and Social Care, has today unveiled a package of measures aimed at improving two important areas of care on the Island while reducing costs.

Chemotherapy services and care services that bridge the gap between hospital and home are to receive a major boost under the initiative, whilst helping to generate an overall saving for the Department of Health and Social Care (DHSC).

The chemotherapy service is to move from its temporary home in the former Ward 20, which is close to but separate from Noble’s Hospital, and will relocate inside the main hospital building. 

Although Ward 20 is on the Noble’s Hospital estate, having the service located within the main hospital building will be in line with best practice and improve safety for patients, with medical support being immediately and rapidly available if required.  It will also be more convenient for patients and their families, with easier access to facilities such as the café, shop and the Macmillan Cancer Information Centre.

Other intravenous therapies currently provided at the Day Assessment and Treatment Unit, which is located next to Ward 20, will also move to the main hospital building.

The move comes at the same time Noble’s Hospital has received a generous legacy of £215,000, specifically earmarked for cancer equipment, with a number of uses for the bequest being considered.

Ward 5 within Noble’s Hospital, currently a medical ward, will be repurposed to accommodate the chemotherapy service.  It means that original plans being considered to extend the hospital at a cost of around £1 million can now be abandoned.

The intention is for care staff based on Ward 5 to redistribute throughout the hospital’s other medical wards, effectively filling vacancies, and therefore reducing the need to cover these with bank and agency staff, representing a potential saving of £480,000 a year.

The reconfiguration of the ward space and redistribution of staff will be made possible by the introduction of an expanded and all-Island intermediate care service, primarily for older people, which will be based at Ramsey and District Cottage Hospital.  It will see the number of beds there increase from 21 to 31 with patients able to ‘step-up’ and ‘step-down’ to the unit.

The redistribution of staff is expected to leave a small surplus of nurses and healthcare assistants.  These will transfer to Ramsey to support the 10 additional beds, with staff given the opportunity to request relocation.

The intermediate care service, based at Ramsey and District Cottage Hospital, will be led by a consultant doctor in older person’s medicine who will be supported by a speciality doctor.

It means that GPs from Ramsey Group Practice will no longer provide inpatient care, with the budget instead used to fund the two new full-time doctors.  The proposal is cost-neutral and will provide better value for money given the additional 10 beds in Ramsey.  The GP’s usual duties at their group practice will not be affected.

Having two consultant doctors in older person’s medicine will enable better on-Island peer support as it means that the need for a locum doctor to provide occasional cover for the current single post will be reduced, saving around £43,000.

The appointment of the new doctors will also enable a significant improvement in community care for older people.  The doctors will be available to provide specialist advice and support to colleagues who care for older people in the community.  This should help lower unnecessary admissions to Noble’s Hospital as well as reduce pressure on the Ambulance Service and the Emergency Department.

A final component of the package of care the doctors will provide is the introduction of a new outpatient clinic specifically for frail patients and older people with orthopaedic problems.

The Minister said: “I am pleased to be able to unveil this package of measures today, all of which are interdependent and need to be implemented simultaneously for our plans to succeed – there is a real domino effect.

“Colleagues within the DHSC have been working for several months on addressing two key objectives: improving care and reducing costs.  The two may seem at odds with each other, but I and my political colleagues within the Department have been very encouraged by the efforts and creative thinking of staff across the organisation.  They have demonstrated real team-work and have developed some bold and innovative proposals.  The focus now will turn to implementing these so that our community and the public purse can benefit from the improvements.

“Given the lead time to implement our plans and, crucially, recruit two new doctors, it is unlikely that savings can be realised this financial year, however it will mean we commence 2018/19 in a stronger position.  This work is only one of the options being explored to reduce the DHSC’s expenditure, but it is a positive step in the right direction.”

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