Manx Care has outlined a year of mixed fortunes in its third annual report.

Its performance during 2023-24 will be the subject of a debate during this month’s Tynwald sitting.

The healthcare provider ended the 2023-24 with a total operational deficit of £31.1m - the result of inflationary pressures, pay awards and investments in new services.

It secured an extra £43.8m in this year’s Budget, paid for in part with a 2p rise in the higher rate of income tax.

Waiting times for cancer diagnosis and treatment began to decrease towards the end of the year but waiting lists in other areas including dentistry continued to grow, the report shows.

‘We made significant progress during our third year, however we do acknowledge that 2023-24 was a challenging year financially,’ the foreword to the report states.

Manx Care said that over the three years since its inception, it has significantly reduced surgical waiting list volumes, with the total number of patients waiting for elective surgery reducing from 4,624 in April 2021 to 2,409 in March 2024.

But the report notes that ‘significant and sustained increase in demand’, combined with the operational challenges, has impaired its ability to provide timely access to consultant-led outpatient services and elective services.

Demand for consultant-led services has increased significantly over the three years, with the annual number of referrals being received from all sources increasing by 6.2% - from 31,226 in 2021-22 to 33,161 in 2023-24.

Referrals received from GPs, dentists and opticians for consultant-led services increased by around 8.8%, rising from 18,047 in 2021-22 to 19,633 in 2023-24. The main increase in demand within Primary Care has been the volume of referrals from GPs, up 10.2% to 16,398.

Over the last three years, the waiting list volume for patients waiting for their first outpatient attendance with a consultant has increased by around 26%, with 13,230 patients waiting at the end of 2021-22, and 16,619 waiting at the end of 2023-24.

As a result, only around 54% of urgent referrals from a GP to a consultant were being seen within the required six weeks last year.

The year saw a significant increase in demand for emergency care at both the emergency department at Noble’s and the Minor Injuries Unit at Ramsey Cottage Hospital – a combined increase in activity of 6%. Attendance increased by 2,656 (6%) from 44,054 in 2022-23 to 46,710 in 2023-24.

Manx Care was awarded £1.86m of Treasury funding to deliver a programme to reduce waiting lists, with a further £18.3m of funding agreed by Tynwald in 2022-23.

Phase 2 of the programme continued during 2023-24, with 3,745 patients either being seen or receiving treatment under the initiative within the year. A total of 404 orthopaedic surgical procedures were delivered across day-case and inpatient settings during 2023-24, predominantly for hip and knee replacements.

Demand for cancer services rose slightly in 2023/24, with an increase of 158 (2.6%) referrals on the 6,049 received in 2022/23 to 6,207 in 2023/24.

Manx Care has continued to fall a long way short in meeting the targets of 28 days from referral to diagnosis and 62 days from referral to first treatment, but the figures showed improvement over the year.

The number of patients awaiting allocation to an NHS dental practice has continued to rise and has reached more than 5,000 by March this year.

In 2023-24, 283 people were allocated to an NHS dental practice, but 2,261 were added to the waiting list.