Alder Hey Children’s Hospital queried whether Manx Care knew what it was asking when it imposed cuts on off-island care.
Details of communications between Manx Care and hospitals in the UK have been released following an FoI request apparently by Lawrie Hooper MHK.
The emails show exchanges about cancelling appointments, the implications of doing so and appears to show some confusion among Manx Care staff.
One such exchange is between Manx Care’s service development manager and Alder Hey’s associate director of income, costing and commissioning Gary Wadeson.
Another exchange saw the deputy CEO of a NHS trust appearing to offer to continue treatment even though it knew it would not get the money.
The full FoI is too large for us to publish, however it can be found using the number 4416389 or title Health cuts correspondence with the UK on the FoI website.
Can’t Pay
In his email dated January 20 2025, Kurt De Freitas said: “Due to our current financial situation, please do not carry out any activity on Isle of Man patients between now and 31st March 2025 that is not classified as P1.
“If you do, we will not be in a position to pay the corresponding invoice.”
In his response, Mr Wadeson replied: “With respect, are you understanding of the implications of this?
“There will be tens and tens of Isle of Man children (many here already), expecting surgery, dialysis, chemotherapy or outpatient attendances in the next few days. P1 patients are emergency admissions.”
Defer
Further along the exchange, Manx Care’s Executive Director of Health Services Oliver Radford informed Alder Hey that it was formally requesting to “defer routine new and non-time critical follow up outpatient appointments that are scheduled to occur between 1st February and 31st March”.
He added: “Please could follow up appointments be reviewed to see whether the patient could be discharged back to GP or provided with an option for patient initiated follow up.
“Ongoing treatments such as patients on cancer pathways or receiving regular treatment (such as Dialysis) should not be affected.”
Mr Radford also told the hospital that patients were to be told the decision was taken by Manx Care.
Concerns
When the same email about deferring care to the new financial year was sent to Liverpool Heart and Chest Hospital, it too raised concerns.
Deputy CEO and COO Jonathan Mathews said: “As you can imagine this causes the Trust significant concern, as this will disrupt and increase pressure on services and more significantly disadvantage patients.
“We will need to review the impact and data associated with any planned activity and look at a process of standing down activity appropriately led by our clinical teams.”
On January 29 205, Mr Mathews wrote to Manx Care to set out the trust’s decision on out patient appointments.
He said: “For OPA appointments 163 patients are currently scheduled and although we understand these will not be paid for, we have taken the decision as a Board to support continuing this activity if possible.
“We understand that travel may not be supported/funded from the IOM and will try and support virtual appointments where appropriate.”
Mr Radford confirmed that Manx Care would honour appointments that were “already booked and cannot be converted to virtual”.
Confusion?
The email exchange also appears to show moments of confusion around what was being communicated internally and externally at Manx Care.
In an email to Michael Hulme, the income & contracts manager at Liverpool Women’s NHS Foundation Trust on January 21 2025, Mr Radford noted that he had received receiving feedback from the Maternity Team that referrals into Foetal Management were not being accepted.
He said: “I just wanted to reiterate from my email below that our request to pause activity does not include high risk maternity referrals.”
Adding: “Also just to clarify that our request does not encompass emergency treatment such as urgent transfer of high risk pregnant women or neonates.”
Tertiary
In a later email, also dated January 21, Mr Radford told several figures in Manx Care, included CEO Teresa Cope, that he was “personally still unclear what we are asking tertiary providers to do”.
He added that the decision to curtail some elective/daycase activity would likely save about £750,000, excluding travel costs.
The email continued to say: “I appreciate the finances have worsened however we at risk of becoming disjointed in our decision making around tertiary with different members of the exec/improvement team with different ideas of what is going on and uncoordinated messages going to tertiary providers.
“Let’s not forget that we have gone a long way in developing the relationships with these providers over the past three years and as the person leading these relationships I don’t want to be the person picking up the pieces from April onwards.
“I think we need an urgent meeting (today) with the relevant execs and contracting/strategic partnerships team so that we are all on the same page before communicating further with providers.”
As stated above, the full FoI is too large for us to publish, however it can be found using the number 4416389 or title Health cuts correspondence with the UK on the FoI website.
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