Watchdog finds 'toxic' culture in Manx hospital A&E

The report found issues at the understaffed Noble's Hospital emergency department

There is a "toxic" culture of bullying and blame in the Isle of Man's emergency department at Noble's Hospital, an inspection has found.

The Care Quality Commission's report said it was a "significant concern" along with "ineffective" staff training and medicine storage systems.

Manx Care's director of nursing Paul Moore said the understaffed department had been "really struggling" at times.

He warned efforts to change governance and culture would take time.

Mr Moore said on average the emergency department had about 50% of the required staff over a given month, and recruitment was the "number one priority" to help make lasting changes.

"The bottom line is I have to put staff in front of patients before other considerations, especially when we're short", he added.

'Feral behaviour'

The CQC is a UK government agency which was commissioned to inspect the department to highlight areas for improvement, but does not have any enforcement powers on the island.

It found a "significant disconnect" between nursing and medical staff had the potential to "cause or contribute to patient harm".

During inspectors' four-day visit in June, some staff said the attitude and behaviour of senior medics was "feral".

These issues of culture and leadership have been raised by the CQC with the Department of Health and Social Care, which regulates Manx Care.

Inconsistent approaches to safeguarding, a "weaponised" incident reporting system and ineffective systems to manage medicines as well as an overall lack of oversight were also highlighted as areas of concern.

Overall the inspection found the service was not always "safe, effective, responsive or well-led", but praised the "compassion and kindness" with which patients were treated.

Health Minister Lawrie Hooper said the findings were "not surprising, but concerning" and he hoped to see improvements when the CQC returned for a full inspection of Manx Care in October.