Secondary · Islands Observatory

06 · Secondary care — clinical & operational performance, six islands

Public lensThese are the dials every health system watches: how long you wait in A&E, for a first appointment, for a cancer diagnosis, for a scan. Each card explains what the number means and shows every island that publishes it — and names the ones that don't.

Politician lensTwo questions per card: why is our number worse than the comparable island's, and if we don't publish this number, why not? Missed-target rows are your agenda; the "not published" chips are your information requests. Note each row's basis before quoting across islands.

Management lensGuernsey's MSG contract KPI set is the most complete single published dashboard of the six — 40 indicators with targets. IoM's Annex C is the most honest about misses. If you run a board: publishing a KPI set like these costs little and pre-empts every FOI on this page.

Cross-island comparison lives here; Isle of Man monthly depth (IPR modality tables, trend charts) lives in the Healthcare Explorer →

Activity — how much work these systems do

The dials — one row per KPI, one card per jurisdiction

Workforce & flow — the operational undercurrents

Isle of Man — Manx Care workforce composition, Apr 2021 → Feb 2026 DERIVED

Isle of Man — waiting list by specialty (the only island publishing this depth) · snapshot 1 May 2026

Median wait in weeks for a first consultant-led outpatient appointment, by specialty. Bars = median weeks; counts = patients waiting. Worth borrowing: no other island publishes specialty-level waits — Manx Care does, monthly.

What the numbers point to — analysis & open questions

Methodology & data governance notes

Sources. Every displayed figure carries a source string (document + date) reachable by hover, tap or inline chip. The consolidated data layer (observatory_data.js) is generated by script from extraction CSVs in the observatory library; nothing is hand-typed into pages. Primary sources: government/board annual reports and accounts, Audit Scotland/KPMG annual audits, HIS inspection reports, C&AG/JAO reports, DHSC Assessments of Manx Care, Tynwald Hansard and written answers, ONS/NRS/PHS statistics, CAA punctuality statistics, and FOI responses held in the library.

Comparability. Jurisdictions differ in definitions, targets, reporting windows and population bases. Basis lines are mandatory on comparison rows; 3-year rolling averages (small populations) are marked and never silently mixed with single-year rates; derived figures (per-capita, per-1,000, inversions) are labelled derived; DERIVED Sankey nodes state their derivation.

Gaps. Missing data is displayed, not hidden: red chips = no comparable public figure exists; blue chips = published somewhere we have not yet extracted (each maps to a roadmap item). Gaps are findings.

Views. The Public view uses plain language and does not draft formal requests; Politician and Management views expose question/FOI wording and benchmark framing. The view switch changes emphasis, never the underlying numbers.

Corrections. Errors: observatory@coalfinch.com. Build log and change history: see the Roadmap page.