What forced Manx hospital to issue its highest alert?
BBCMounting pressures at the accident and emergency department at the Isle of Man's main hospital forced Manx Care to cancel 19 operations and declare the highest level of alert.
The healthcare provider declared an Operational Pressures Escalation Level Four (Opel) alert for Nobles Hospital on Monday.
The status reflected severe pressure on urgent and emergency care, raising concerns about patient safety.
Manx Care chair Wendy Reid said the problems stemmed from escalating congestion in the "flow" of patients through A&E and into wards.
She said the pressures had been building over several days before the alert was declared.
The alert was reduced to Opel level three on Thursday morning.
Why did it become unmanageable?
Reid said fewer patients than usual had been discharged from hospital on Monday, leaving beds occupied for longer.
This created a backlog that spread through the hospital as emergency admissions continued to rise.
"We do not want patients cared for in corridors. That's not an appropriate way of delivering care," she said.
In response, managers reviewed discharges across wards, brought in additional staff and increased capacity where possible to ease pressure.
Manx Care also cancelled 19 non-urgent procedures, while retaining services for cancer patients and children.
An apology
Reid said people affected by cancellations were being contacted to reschedule their appointments, aiming to complete all missed surgeries by the end of June.
She also apologised to patients and said cancelling treatments was always a last resort.
"Personally I'd like to apologise to those 19 people. I was a gynaecological surgeon, I know how awful it is to cancel anyone," she said.
She said Manx Care would "always protect cancer operations and acute surgical needs", but added that demand for beds and emergency care sometimes meant "the pressure hits on the elective surgical activity".
Could it happen again?
Now the alert level has been reduced, Reid said Manx Care would examine every stage of the incident, including discharges, ambulance pressures, theatre activity and A&E demand.
This would identify any lessons and reduce the likelihood of similar escalation in the future, she said.
It comes days after Manx Care chief executive Teresa Cope announced she would step down after five-and-a-half years in the role.
Reid said the departure was "her decision" and "the right time for her professionally and personally".
She credited her with building Manx Care "from scratch" into "an integrated health and social care organisation that is successful".
Reid added that Cope will remain in the position until the summer and insisted there would be "no leadership gap" during the transition.
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