"We're going to have to get better at our transport and travel arrangements for people leaving the Isle of Wight for health services - be it patients, relatives or staff.

"At the moment, they are not good enough. They take too long, they're not convenient and they're costly," Isle of Wight NHS Trust chief executive Darren Cattell has told the County Press.

He has been speaking after last week's announcement that the leadership of acute services across the Island, Portsmouth and south east Hampshire (covering around 800,000 people) will eventually fall under one single umbrella - with joint leadership and clinical teams. 

It raised a host of questions about mainland travel for treatment (which already sees Islanders dedicating often unnecessary hours to Hampshire appointments, out of pocket (with support services under threat in the proposed 2023/2024 budget) and feeling anxious).  

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Mr Cattell said: "We're not talking about huge numbers of services and people going off the Island.

"We know there will be one or two questions we'll need to ask, where services are really, really small and where patient numbers are small.

"It might mean a service is delivered by more people and we might rotate that through our organisations."

The organisations behind the three regions' acute services will remain independent and ultimately responsible for the services they provide.

Mr Cattell added new technology, with the right training and skills, could be among the advantages of closer working, helping cut the need for travel.

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"Our primary aim is to provide care as close to people's homes as we can. Where we're not able to do that, we're going to have to look to move those services. 

"It's going to be at the very edges, as opposed to mass service transfers."

So, what will be different this time around? After all, patients have been recounting stories of travel problems for years.

Darren insists many are actually an easy fix and talks are starting now on changes like ensuring appointment times are realistic, working around ferry timetables.

He promises more focus on the challenges faced by Islanders - with concerns heard.

"Travelling across a stretch of water is not without its challenges.

"When travel is necessary for treatment, we will do our utmost to ensure that travel is as smooth and efficient and low-cost as it can be, working with operators and providers.

"Islanders' time is just as valuable as that of mainlanders and to us, it's even more valuable.

"It's going to be different. We're going to be working together rather than working apart or potentially, at worst, blaming each other."

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Among the repercussions of last week's announcement were claims the new approach had not been properly considered

"This is something we've been working on, with Portsmouth colleagues, for a long time. There's nothing new here, from a service collaboration perspective.

"What we're talking about is a management arrangement and single accountability, to ensure decisions are made in the best interests of the population," said Mr Cattell.

"It wasn't necessary to consult - this was a management decision. We did have briefings with local authority colleagues, with information passed on to the relevant people.

"I can only apologise if that system didn't work as efficiently and effectively as possible."

Meanwhile, a closer relationship between the Isle of Wight's CQC-rated 'good' ambulance service and South Central's 'inadequate' one is also on the cards.

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"We have been working closely for a number of years and we have seen some significant benefits. There's a learning opportunity for South Central in the things that we've done. 

"We have a lot of common systems and processes but fundamentally our issue remains one of scale.

"We're fantastic at what we do but we can't do everything and that's why we have to partner with a bigger organisations.

"South Central are going through the same improvement journey as we did and I am absolutely sure they will come out the other side with a 'good' rating too."

For patients, care should be seamless - patients won't even know who's looking after them, said Mr Cattell.

He promised services would be based 'where it's best for them', with consultation with patients and staff on both sides of the Solent.

For their part, staff responded 'incredibly well' when they were told last week, he said.