Residents can expect to see fewer hospital beds, longer waits for non-urgent care, and higher charges for dental services and prescriptions in the next year after the Isle of Man Government issued new instructions to Manx Care.

The health and care provider’s new Mandate for 25/26 outlining significant cost-saving measures for the organisation.

Manx Care has been told it must remain within its allocated £361.8 million budget, with a 2% efficiency savings target imposed by the Department of Health and Social Care (DHSC).

The Mandate, along with the Manx Care Operating Plan, sets out how services will be restructured to achieve financial sustainability, shifting resources from hospital care to community-based services and increasing reliance on self-management for chronic conditions.

Manx Care has been told to reduce spending on secondary care and shift around £6 million to primary and community care.

Waiting times for non-urgent care are expected to increase, as Manx Care implements a review of all outpatient waiting lists, ensuring only those with ongoing need remain.

Additionally, outpatient follow-up appointments will be reduced by 10%, requiring patients to initiate their own follow-ups rather than being automatically scheduled.

Manx Care has also acknowledged that some services will change or be reduced.

The previously mandated adult ADHD pathway is being reconsidered while plans for a new diabetic retinopathy screening programme have been postponed due to cost concerns.

The Mandate states that elective care waiting times may rise as clinical validation work continues.

However, it asks Manx Care to protect existing cancer waiting time targets and maintain investment in Urgent and Emergency Integrated Care (UEIC) to avoid further delays in A&E.

Hospital capacity will also be affected by financial limitations.

The Government expects improvements in productivity and efficiency within hospital services, while Manx Care has committed to reducing the use of additional funds for bank and agency staff cover.

Additionally, the Mandate highlights a focus on reducing patient transfers to off-island care where possible.

Manx Care will work with providers to ensure that only essential cases are referred off-island, with an emphasis on repatriating care when it can be safely provided locally.

The Mandate also suggests that charging policies for dental services and prescriptions will be reviewed, raising the possibility of increased costs for patients.

While the Government is working with Manx Care to assess where private services could be introduced, it has also stated that only services specified in the Mandate will be provided within the existing funding allocation.

The Government have also ordered Manx Care to reduce management and administration costs at Noble’s Hospital by £500,000 and instigate a review of its workforce allocation to ensure all staff are deployed effectively.

Manx Care will also move ahead with the development of a Manx Care Record, replacing outdated digital systems, though full implementation remains subject to Treasury approval.

Manx Care has stated that these changes aim to ‘maintain safe and sustainable services’ while ensuring value for money but acknowledges that service users may notice changes in how and where they receive care in the coming year.