Manx Care had outlined a series of cost saving schemes which it hopes will reduce this year’s overspend by around £5m.

Chief executive Teresa Cope said the savings would reduce the organisation’s deficit to £8m and there had been discussions with the Council of Ministers about how the remaining financial gap can be bridged.

Measures to be taken include putting off non-urgent off-island procedures for potentially up to 200 Manx patients until the next financial year, keeping Ramsey’s Minor Injuries Unit closed at weekends, and changing out-of-hours on-call arrangements in adult social work.

Ms Cope told a media briefing: ’Ultimately these actions should get us down to £8m.

‘No one wants to be halfway through the year having to do the almost salami slicing schemes which is ultimately just delaying something. But we have made that commitment to reduce our deficit and these are the schemes we feel we can implement with the least impact on frontline services.’

‘I want to reiterate that none of this is easy. Taking this level of savings out of any organisation is incredibly challenging.’

Manx Care has an operating budget of £347m and the board knew at the start of the financial year that it needed to make £19m of cost improvement savings in order to balance its financial plan.

But Ms Cope said it became clear that the total that could achieved was more like £12m than £19m. September’s board meeting was told that the overspend was forecast to be £16.8m by the end of the financial year.

It signed off on an number of additional cost saving schemes totalling £5m.

These measures including additional scrutiny and sign-off for all bank and agency staff spend and a pause on all non-essential recruitment.

Some NHS rusts have been requested to delay some procedures into the new financial year where clinically safe and appropriate to do so. These do not include Alder Hey or Clatterbridge.

Additional focus is being placed on appointments and procedures to see whether they could be undertaken via video or if investigations (such as scans or blood tests) could be done at Noble’s and the results sent to the UK hospital.

Elective theatre in specific areas is being reduced by 18% to immediately reduce bank and agency spend. The number of theatre lists have been cut by 5.5 per week in three specialties with the shortest waiting lists.

Oliver Radford, director of health services, said the spend on agency staff had been ‘incredibly high’ and it was hoped that measures put in place would reduce that spend by £3.9m by the end of the financial year.

He said this year they were planning to spend £25.6m on sending patients to the UK for treatment, which is £2.9m overspent, largely the result of unplanned activity including £0.5m on patients in intensive care unit at Aintree and Walton, and higher than expected expenditure on cancer drugs.

Mr Radford said discussions had been held with the trust that runs Aintree, Broad Green and Liverpool Royal hospitals, Liverpool Heart and Chest Hospital and Wrightington Hospital to reduce the number of elective procedures they were planning to carry out.

He said there were just over 200 Isle of Man patients on the waiting list whose cases would be clinically assessed to see if they could be delayed until the next financial year.

Professor O’Neill, director of integrated mental health, social care and safeguarding, said there would be a pause and temporary closure of the mental health recovery college and a slowing down some other early intervention work.

The rota of out of hours on-call adult social workers will be withdrawn and the senior manager on call will manage queries instead.

But he added: ‘It’s very important to say we will still have on-call arrangement but we are moving those into our executive set-up. At the moment we ask members of staff to be on-call for a certain period outside normal business hours. There aren’t many calls. We will continue to review very closely this arrangement.’