A review of Manx Care’s governance has laid bare failures in strategic planning, risk management, and accountability.
The report reveals a governance structure struggling with “significant gaps” in oversight, poor coordination with the DHSC and a lack of long-term planning.
Despite being operational since 2021, the report found that Manx Care remains overly focused on short-term mandates rather than sustainable strategy, a flaw the review warns is undermining its effectiveness.
Clarity
The report says: “Previously, there has been a lack of clarity as to what the mandate represented and this has significantly impacted upon the development within Manx Care of a longer term vision and strategic plans, as the focus has been on the operational delivery of the mandate each year.”
It goes on to highlight a “disconnect between the mandate and the financial settlement”.
Dr. Wendy Reid, Chair of Manx Care, acknowledged the issues in the report’s foreword, saying the review was necessary to “identify opportunities to strengthen our governance framework”.
Committees
The review also exposes inefficiencies in Manx Care’s committee system.
Meetings are described as overly frequent, poorly attended, and plagued by last-minute cancellations.
Board papers are routinely submitted late, sometimes just hours before meetings and often lack clear summaries of risks or required actions.
One particularly scathing observation notes that at a People Committee meeting, a staff member discussing an ongoing investigation was allowed to speak unchecked, potentially compromising the case.
Holding Manx Care Back
A major flashpoint is the strained relationship with government shared services, which provides HR, IT, and finance support.
The report reveals there are no key performance indicators to assess these services and there are difficulties around holding people and systems to account.
One stakeholder survey respondent warned: “Shared Service Agreements are a risk to Manx Care,” while another lamented “capacity challenges within Shared Services which subsequently impact upon the services provided”.
Leadership
The review also casts doubt on leadership effectiveness.
While some respondents praised Manx Care’s “compassionate” leadership, others highlighted inconsistencies, with one remarking: “There are definitely pockets of excellence, some leaders really strive to build relationships and engage.
“There are others who do not.”
Non-Executive Directors (NEDs) were found to contribute unevenly, with some offering little input during meetings.
The report calls for a succession plan to address skills gaps and ensure board members are held accountable through annual appraisals.
Manx Care has pledged to implement an action plan, including a reset of its risk management framework and clearer strategic objectives.
As one stakeholder survey respondent put it: “Culture change is a major challenge. I see willingness at Board level, but evidence of lack of communication and openness at operational levels.”
The full report is available on the government website.
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