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Other issues which the visiting team recommend should be given further consideration include: a.
A review of the systems by which the limit on the headcount of government employees is achieved, with particular emphasis on achieving speedy decision-making at an appropriate level, an appropriate number and skill mix of healthcare staff, and the impact of bank and agency staff and other mechanisms for circumventing the headcount limit.5
b.
An information strategy with clear plans for achieving appropriate data collection on hospital services.
c.
Introducing systems for ensuring and monitoring implementation of NICE and other published evidence of effectiveness or for formally agreeing if guidance is not applicable to the Isle of Man. If this is within the remit of the Clinical Recommendations Committee then this should be made explicit and the Committee should actively take on this role.
d.
Clarifying what services Noble’s Hospital is expected to provide and for what services patients should be referred elsewhere. As part of this work, the tension between providing services locally and meeting expected standards for the quality of services will need to be openly debated and discussed.
e.
Arrangements for funding off-Island referrals and treatment, in particular, to make sure that these arrangements ensure appropriate robust, timely pathways of care. Return to Index
5
“Since 2002 the number of professionally qualified clinical staff within the NHS [in England] has risen by 20.14 per cent. This rise includes an increase in doctors of 40 per cent; a rise in the number of nurses of 10 per cent; and 19 per cent more qualified ambulance staff.� http://www.nhsconfed.org/priorities/political-engagement/Pages/NHS-statistics.aspx#staff (accessed 27.11.13) WMQRS Iom ED TA CC Report V2.1 20140408
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