The Department of Health and Social Care's published its assessment of how Manx Care performed this year.
It shows the health service ended the 2024-25 financial year with a £15.6m deficit, said to be caused by inflationary rises in contracts and drug spending.
Among the positives listed are improved emergency care, school nursing and better mental health support for children and young people.
However other issues identified include delays in dental care, and concerning waiting times for hospital appointments and tests.