An external report into the Island's health service has raised concerns about standards in three key areas of patient care at Noble's Hospital.
The first report in a wide-ranging review has been published today, covering the hospital's emergency department, critical care and theatres and anaesthetics.
The review highlights the commitment and dedication of staff and good levels of satisfaction among patients.
But it has found shortcomings in all three areas, from the management of trauma care to the number of medics available to deal with emergencies at certain times.
Issues which present 'immediate risk' are identified in two of the areas reviewed.
The report is the first of 13 to be carried out across the health service. It has been greeted as 'very helpful' by Minister for Health and Social Care Howard Quayle in progressing 'change and improvement' at the hospital and in the health service generally.
Jane Emison from the West Midlands Quality Review Service says her team also found staff shortages in two areas: