Doctors claim 'critical shortfall' in hospital beds is posing 'direct risk' to life

But Manx Care refutes shortage figures saying work continues to ease pressure

Efforts to reconfigure wards at Noble’s Hospital have been taking place at the ‘worst possible time’.

That’s the admission from Manx Care, which says it’s been an ‘incredibly difficult winter’.

It follows concerns raised by the Medical Staff Committee over what it says is a ‘critical shortfall’ in inpatient beds; something it claims is risking patient safety.

You can find out more HERE.

The group - made up of 75 senior doctors and consultants - has passed a formal resolution calling for immediate government intervention.

It says the hospital’s current capacity is insufficient to safely support the simultaneous demands of emergency admissions and planned surgical procedures.

It’s also highlighted what it says is ‘profound moral injury’ being experienced by physicians.

Bed Numbers

The MSC claims that prior to the formation of Manx Care Noble’s Hospital operated with 314 beds but the current operating model has reduced that to 168 beds.

This, it says, represents a 46 percent decrease in capacity.

These figures have been challenged by Manx Care which says the current number of hospital beds is 233.

When it was formed in 2021 it says the number was 279; this, the health body says, represents a reduction of 46 beds or 16.5 percent.

Bed spaces have been lost across a number of service areas as models of care delivery have changed.

Moral Triage and Cancelled Operations

The MSC says the restricted number of inpatient beds is severely limiting post-operative recovery space forcing the frequent postponement of planned operations.

“Doctors are frequently forced into a state of moral triage where unsafe staffing levels and a chronic shortage of beds dictate clinical priorities rather than the actual needs of the patient.” 

Medical Staff Committee

Emergency Department

Delays within the Emergency Department are being driven, the MSC says, by a lack of available ward beds for onward admission which results in prolonged patient ‘boarding’.

It adds that senior clinicians have noted an increasing volume of attendances placing substantial strain on systems responsible for timely reassessment of patients, continuity of clinical review and effective communication.

“In a busy and overstretched environment these limitations severely affect patient flow, compromise the overall patient experience and pose a direct risk to patient lives.” 

Medical Staff Committee

Emotional Burden

The MSC says surgeons and clinicians are having to ‘bear the emotional burden’ of failing those people who trust them for healing when operating theatres are cancelled due to lack of post-operative space or personnel.

It adds that a persistent inability to provide the high-standard care they were trained for transforms the workplace into a site of ‘ethical conflict’ leading to a ‘sense of betrayal and exhaustion that goes far beyond traditional burnout’.

Mitigation

As an ‘immediate first step’ the MSC has called for the prompt provision of 50 additional inpatient beds; this is something Manx Care says isn't possible. 

It also wants stronger clinical coordination, adequate staffing and a more medically led approach to organisational decision-making.

Bed Occupancy

The bed occupancy rate for this financial year is 86.9 percent and therefore at a safe level although Manx Care says it has been higher on some days.

Anything above 90 percent indicates severe pressure.

The health body says no more ward space can be opened on the Noble’s Hospital site but the Day Procedure Suite has on occasions remained open overnight.

Additional beds in nursing homes have also been purchased to accommodate patients who are deemed medically fit to leave hospital.

Since the establishment in 2024 of Intermediate Care – which enables more care to take place in the community – the number of medically fit patients occupying hospital beds has reduced from an average of 23 to 5.

Work is ongoing to formalise the commissioning of nursing home beds and home care placements to enable a ‘discharge to assess’ model to be introduced.

Manx Care says this will help patients to be transferred out of the hospital pending the completion of financial and other care-based assessments which do not need to be undertaken while a patient is in hospital.

“We are responding to some real pressures. We need a bigger Emergency Department. We do need a clear pathway in the Clinical Decision Unit to be available as quickly as possible.”

Teresa Cope

Resolution

Further meetings between Manx Care, the MSC and the Department of Health and Social Care are scheduled this week.

Manx Care’s Chief Executive Teresa Cope has acknowledged the concerns about the substantial strain being felt but says she’s confident safe care is being delivered:

You can listen to her interview, in full, in this episode of Newscast: