FOI Tracker

Freedom of Information Requests

This page tracks all Freedom of Information requests submitted as part of The Heart Campaign Torbay's investigation into cardiac services in Devon.

Update – 8 April 2026: NHS Devon has confirmed it will not progress the case for change programme "at this time", following a Joint Committee decision on 26 March 2026. The programme has been absorbed into the ICB's five-year commissioning plan. This is a significant development, but the language is carefully qualified throughout - "at this time" and "right now" are not permanent commitments. The campaign's FOI requests remain active and the evidence gathered continues to form part of the public record. The cath lab failure of 8-9 March 2026, the unanswered questions about the Teignmouth patient transfer, and the Trust's financial pressures have not gone away. We will continue to monitor and report.
Update – 21 April 2026: Torbay and South Devon NHS FT issued four FOI decisions on the same day. The Trust refused both cath lab outage requests in full under Section 40(2) (TSD10425 transfer handling and TSD10426 divert log), applying a blanket personal data exemption even to questions about decision-maker roles, escalation pathways, and which receiving hospitals were contacted. The Trust extended deadlines on the EPR Epic procurement requests (TSD10299 and TSD10421) under Section 43(2) (commercial interests) and on the Section 75 Adult Social Care request (TSD10396) under Section 12(1) (cost limit). Revised response date for all three extensions: 20 May 2026. The two refusals are candidates for internal review.
Update – 27 April 2026: The campaign has submitted a comprehensive forensic FOI to Torbay and South Devon NHS FT requesting the full evidence base behind the proposed pathology reconfiguration, including business cases, raw activity data, financial and operational modelling, clinical risk assessments, Carter-based efficiency claims, and the full governance trail from 2018 to present. The request follows NHS Devon ICB's confirmation on 14 April that the Trust Board has approved the relocation of routine histopathology services to a new laboratory at Gadeon House in Exeter, with confirmation due at the public Board of Directors meeting on 7 May 2026. The campaign has set a 7-working-day response deadline (6 May 2026) to obtain the underlying evidence before the public meeting. The statutory deadline is 26 May 2026.
Official Position vs. Reality: On 3 December 2025, NHS Devon published an open letter claiming the "case for change does not contain any proposals for 'change' or 'closure'" and that the programme is "not about reducing or closing local services." FOI requests revealed proposals were already being discussed to suspend emergency cardiology services on an "eight-week test and learn basis" - directly contradicting these public assurances. The ICB's internal review of FOINHSD25/1493, which challenged the lack of transparency about programme timelines, was never answered on its merits.

Click any request to view details and download documents where available.

Last updated: 28th April 2026

12
Documents Available
4
Overdue
4
Awaiting Response
3
Under Review/Challenge
2
Correspondence on Record

Overdue

Why This Matters: The Royal College of Physicians identified 29 concerns at Royal Devon in 2020. While RDE claims 25 cardiology recommendations were completed, questions remain about whether the broader concerns have been addressed.
Status: Response now overdue. Extension was granted to 15 December 2025. Exemptions claimed have been challenged.

This request seeks the Royal College of Physicians' recommendations and reviews of cardiology services at RDE, particularly any reviews conducted after the 2020 report that identified 29 concerns.

Why This Matters: If key decision-makers were aware of the Royal College of Physicians' findings about quality concerns at Royal Devon, yet still proceeded with plans to move services there, this raises serious questions about patient safety priorities.

This request asks whether relevant decision-makers were aware of the Royal College of Physicians review findings and the six critical issues identified.

Status: Submitted 28 November 2025. No acknowledgement or response received from either TSD or RDE. The statutory 20 working day deadline expired around 7 January 2026. See R4932-1 for the detailed follow-up request submitted 13 January 2026, which is also unanswered.

Why This Matters: This detailed follow-up seeks to establish precisely what information was known about the RCP investigation, when it was known, by whom, and whether it informed the Case for Change proposals - including the 8-week "test and learn" closure of emergency cardiology services.

Full request text covers five areas:

  1. Awareness of the RCP investigation - earliest date each of the following became aware: Royal Devon University Healthcare NHS Foundation Trust; Torbay and South Devon NHS Foundation Trust; the Chief Executive of Torbay and South Devon NHS Foundation Trust; Professor Briggs. If awareness was gained through correspondence or meetings, copies of relevant documents requested.
  2. Inter-trust information sharing - whether information relating to the RCP investigation was shared between Royal Devon and Torbay and South Devon prior to the development of the Case for Change, including dates, form of communication, and copies of any records where the RCP investigation was referenced.
  3. Case for Change formulation - the date the Case for Change was first drafted; the date the 8-week "test and learn" proposal was first discussed; copies of early draft papers, options appraisals, or briefing documents; and whether decision-makers were aware of the RCP investigation at the time of drafting.
  4. Governance, risk, and assurance - whether the RCP investigation was recorded as a risk or dependency within Case for Change programme documentation, risk registers, assurance frameworks, or board papers. If not recorded, the documented rationale for its exclusion.
  5. Completeness of information - if any information is stated to be "not held", confirmation of whether it was ever held and subsequently deleted, and the applicable retention schedule.

Status: Response due 10 February 2026. Now significantly overdue - no response received from either TSD or RDE. The ICB's decision on 26 March 2026 not to progress the case for change programme does not resolve this request, which is directed at TSD and RDE and asks specifically about what decision-makers knew about the RCP investigation and when.

Critical Challenge: Royal Devon University Healthcare NHS Foundation Trust has a publicly declared forecast deficit of over £40 million. This formal challenge demands the ICB explain how RDE can absorb additional cardiac workload from Torbay when it's already under severe financial pressure. The entire Case for Change assumes RDE has capacity - but does it?
Why This Matters: The proposed Case for Change relies on transferring cardiac services from Torbay to RDE. But if RDE is already struggling with a £40m deficit, how can it safely absorb more unfunded activity? This challenge exposes a fundamental flaw in the strategic planning - transferring risk from one struggling service to an already-failing trust doesn't strengthen the system, it risks catastrophic failure.

Distribution:

  • To: d-icb.involve@nhs.net (ICB INVOLVE team), Steven Clark (NHS Devon ICB), Steve Darling MP
  • CC: Caroline Voaden MP, Martin Wrigley MP
  • Formal request: Challenge to be recorded in governance framework with written response within 7 working days

Timeline:

  • 20 January 2026: Initial challenge to ICB about cath lab funding (see FOINHSD25/1415)
  • 9 February 2026: Chase-up email to Steven Clark requesting outstanding answers
  • 27 February 2026: Major escalation - Governance Failures Challenge sent to ICB INVOLVE team and MPs
  • ~10 March 2026: Deadline passed - no response received from NHS Devon ICB

To: Steven Clark (NHS Devon ICB)
Date: 9 February 2026

Good afternoon Steven

I'm writing to follow up on the questions I initially raised on 13 January 2026, as I'm still awaiting your response. Specifically, the concerns centred around the following issues regarding Royal Devon University Healthcare NHS Foundation Trust (RDUH).

Given RDUH's publicly declared forecast deficit of £40m+, I would like to understand:

  1. How has the ICB assured itself that RDUH has the financial capacity to absorb additional cardiac workload from Torbay without further compromising its financial position or the quality and safety of care?
  2. What financial modelling or assessment has been carried out to evaluate the impact of any proposed service transfer on RDUH's budget and operational resilience?
  3. Has the ICB considered the risk that additional activity could push RDUH further into deficit, and if so, what mitigation is in place?
  4. How does the ICB reconcile the proposed transfer with its statutory duty to ensure financial sustainability across the system?

I would be grateful for a substantive response at your earliest convenience. Given the significance of the ongoing Case for Change discussions, clarity on these financial governance questions is essential before any proposals are advanced further.

Kindest regards

Susie Colley
Chair of the Torquay Chamber of Commerce and The Heart Campaign

To: d-icb.involve@nhs.net, Steven Clark (NHS Devon ICB), Steve Darling MP
CC: Caroline Voaden MP, Martin Wrigley MP
Date: 27 February 2026

Dear Mr Govett,

Following my email of 9th February, I am writing as Chair of the Torquay Chamber of Commerce and Chair of the HEART Campaign to seek further clarity regarding the assumptions within the proposed draft Case for Change, particularly those relating to Royal Devon University Healthcare NHS Foundation Trust (RDUH) absorbing additional demand should services at Torbay Hospital be reduced.

Given RDUH's publicly declared forecast deficit of over £40 million, it is important for stakeholders to understand how the associated risks have been assessed and mitigated. To support constructive dialogue, I would be grateful for the ICB's assurance on the following points:

  1. Financial capacity - How has the ICB satisfied itself that RDUH can take on additional unfunded activity without compromising its financial stability?
  2. Operational capacity - What evidence demonstrates that RDUH has the beds, emergency resilience, and discharge performance to manage increased demand?
  3. Workforce - What modelling confirms that RDUH can safely staff any additional activity given current workforce pressures?
  4. Patient safety - How have the risks associated with longer travel times and ambulance delays been assessed for Torbay residents?
  5. System resilience - How does transferring risk from Torbay Hospital to a trust already under pressure strengthen the overall system?
  6. Governance - Has NHS England reviewed the Case for Change in light of RDUH's financial position, and is this risk captured in the programme risk register?
  7. Transparency - Why has RDUH's financial position not been clearly communicated in public engagement materials?

Given the significance of these issues, I request that this challenge is formally recorded within the governance framework and that written responses are provided within 7 working days of this email.

Thank you

Susie Colley
Chair of the Torquay Chamber of Commerce and the Heart Campaign

Status: Response deadline of ~10 March 2026 has passed with no formal response received from NHS Devon ICB. The ICB has not confirmed that this challenge has been recorded in the governance framework as requested. Note: the ICB's decision on 26 March 2026 not to progress the case for change programme does not constitute a response to the seven specific governance and financial questions raised here, which remain unanswered.

Awaiting Response

Deflection: Rather than answer these questions about their own services, RDE suggested contacting the ICB instead.
Why This Matters: Torbay publishes its cardiac cath lab waiting time openly (7 weeks, October 2023). When asked for equivalent data, RDE claimed it was "not available" - yet they want to take over Torbay's workload. If RDE won't answer basic questions about their efficiency, staffing, and costs, how can anyone assess whether they're capable of absorbing more patients?

Questions RDE refused to answer:

  • Why do 8 interventional cardiologists still require locum cover for sickness?
  • What are the costs of running weekend sessions?
  • Why are Torbay's waiting lists increasing due to RDE patient transfers - and why isn't this acknowledged?
  • Why can't RDE publish waiting time data that Torbay provides transparently?

Response: RDE suggested writing to the ICB instead of responding directly.

Download Original Request (PDF)
Trust Extension Notices (21 April 2026): Torbay and South Devon NHS FT has split the three EPR submissions into two separate FOIs and issued extension notices for both on the same day. TSD10299 covers the refined request of 25 March 2026 ("Cost and due diligence of EPIC"). TSD10421 covers the extended financial request of 29 March 2026. The Trust has confirmed it holds the requested information for both and has invoked the public interest test, citing Section 43(2) (commercial interests) as the potentially applicable exemption. Both deadlines have been extended to 20 May 2026. The campaign should expect the Trust to refuse disclosure on commercial grounds, particularly around contract value, payment profile, and supplier-specific terms, and may need to argue the public interest case in any internal review.
Why This Matters: The Trust confirmed in February 2026 that replacing both cardiac catheterisation labs costs £5.7m - equivalent to 40% of the Trust's entire annual capital budget of £14.3m, with a national funding bid having already failed. The Trust is simultaneously committing to an EPR contract costing between £36.7m and £55.4m. Understanding how the EPR was approved, what it will cost in full, and how it is funded is directly relevant to whether capital constraints on the cath lab replacement were genuinely unavoidable or a result of competing financial priorities. The 29 March submission draws directly on financial disclosures in the Trust's 2024/25 Annual Report and Accounts and asks whether EPR capital is ring-fenced, whether it counts against the Trust's CDEL allocation, and whether it benefits from central spending flexibility that was not available to the cath lab programme.

Organisation requested to respond:

  • Torbay and South Devon NHS Foundation Trust (refs: TSD10299 and TSD10421, extension notices issued 21 April 2026)

From: FOI (Torbay and South Devon NHS Foundation Trust) tsdft.foirequests@nhs.net
To: Susie Colley (chair@tqcc.co.uk)
Subject: RE: TSD10299 - FOI Extension of Time
Trust contact: foi.tsdft@nhs.net
Reference: TSD10299 (covers the refined request of 25 March 2026)

Dear Susie,

Request for Information

Thank you for your request for information which we received on 25/03/026. We can confirm that the Trust does hold the Cost and due diligence of EPIC falling within the terms of your request.

The Freedom of Information Act obliges us to respond to requests promptly and in any case no later than 20 working days after receiving your request.

When a qualified exemption is potentially applicable and the public interest test becomes relevant, the Act permits an extension of the response period beyond 20 working days. In such cases, a comprehensive reply must be issued within a timeframe that is considered reasonable given the specific circumstances.

We aim to make all decisions within 20 working days, including cases where we need to consider where the public interest lies in respect of a request for exempt information. In this case, however, we have not yet reached a decision on where the balance of public interest lies.

In your case, we estimate that it will take an additional 20 working days to take a decision on where the balance of public interest lies. We plan to let you have a response by 20/05/2026. If it appears that it may take longer to reach a conclusion, we will keep you informed.

The specific exemption(s) which apply in relation to your request is/are:

  • Under Section 43 (2) of the Act, a public authority may refuse to disclose information if it would, or would likely to, prejudice the commercial interests of any person, including the public authority holding it. Commercial interest can be defined as the ability of a party to successfully participate in a commercial activity, such securing contracts for the provision of goods or services.
  • Disclosure of information under the Freedom of Information Act has the effect of placing it in the public domain. I must therefore disregard who has asked for the information and am required to consider the effect of releasing the information to the public at large.

If you wish to discuss any of the above, please contact us, quoting the FOI reference number above.

Yours sincerely,

Sarah Goss
Data Protection Lead
Torbay and South Devon NHS Foundation Trust

From: FOI (Torbay and South Devon NHS Foundation Trust) tsdft.foirequests@nhs.net
To: Susie Colley (chair@tqcc.co.uk)
Subject: RE: TSD10421 - FOI Extension of Time
Trust contact: foi.tsdft@nhs.net
Reference: TSD10421 (covers the extended financial request of 29 March 2026)

Dear Susie,

Request for Information

Thank you for your request for information which we received on 29/03/2026. We can confirm that the Trust does hold Electronic Patient Record (EPR) programme falling within the terms of your request.

The Freedom of Information Act obliges us to respond to requests promptly and in any case no later than 20 working days after receiving your request.

When a qualified exemption is potentially applicable and the public interest test becomes relevant, the Act permits an extension of the response period beyond 20 working days. In such cases, a comprehensive reply must be issued within a timeframe that is considered reasonable given the specific circumstances.

We aim to make all decisions within 20 working days, including cases where we need to consider where the public interest lies in respect of a request for exempt information. In this case, however, we have not yet reached a decision on where the balance of public interest lies.

In your case, we estimate that it will take an additional 20 working days to take a decision on where the balance of public interest lies. We plan to let you have a response by 20/05/2026. If it appears that it may take longer to reach a conclusion, we will keep you informed.

The specific exemption(s) which apply in relation to your request is/are:

  • Under Section 43 (2) of the Act, a public authority may refuse to disclose information if it would, or would likely to, prejudice the commercial interests of any person, including the public authority holding it. Commercial interest can be defined as the ability of a party to successfully participate in a commercial activity, such securing contracts for the provision of goods or services.
  • Disclosure of information under the Freedom of Information Act has the effect of placing it in the public domain. I must therefore disregard who has asked for the information and am required to consider the effect of releasing the information to the public at large.

If you wish to discuss any of the above, please contact us, quoting the FOI reference number above.

Yours sincerely,

Kind regards,

Sarah Goss
Data Protection Lead
Torbay and South Devon NHS Foundation Trust

To: Joe Teape (Trust CEO), with Martin, Chris, Sally, Torre, Phil, Nicole
Date: 29 March 2026, 22:29

Good evening

I am writing to request information under the Freedom of Information Act 2000 regarding the Trust's Electronic Patient Record (EPR) programme, specifically the implementation of the Epic system.

This request relates to financial disclosures referenced in your 2024/25 Annual Report and Accounts.

Please provide the following:

1. Contract Value and Scope

  • a) The total contract value with Epic (including all contracted modules and services)
  • b) The contract start date and duration
  • c) A breakdown of total expected programme cost, including:
    • Software licensing
    • Implementation and configuration
    • Training and change management
    • Hardware and infrastructure
    • Third-party consultancy or system integration support
  • d) Any contract variations, change notices, or cost uplifts agreed since contract signature

2. Payment Profile and Commitments

  • a) The full payment schedule over the life of the contract
  • b) Total capital expenditure incurred to date on the EPR programme (by financial year)
  • c) Total revenue expenditure incurred to date (if applicable)
  • d) Total outstanding contractual commitments as of the most recent reporting date
  • e) Forecast remaining spend to programme completion

3. Funding Sources and Restrictions

  • a) A breakdown of funding sources for the EPR programme, including:
    • Public Dividend Capital (PDC)
    • Internal capital
    • System (ICS) allocations
    • National/NHSE programme funding
  • b) Confirmation of whether any of these funding streams are ring-fenced specifically for the EPR programme
  • c) If ring-fenced, details of the conditions attached to that funding
  • d) If not ring-fenced, confirmation of whether funds could be reallocated or withheld due to financial performance or capital regime constraints

4. Capital Regime and Constraints

  • a) Confirmation of whether EPR-related capital expenditure counts against:
    • The Trust's Capital Departmental Expenditure Limit (CDEL)
    • The Integrated Care System capital envelope
  • b) Details of any capital expenditure limits, controls, or penalties applied by NHS England that may affect the EPR programme
  • c) Any correspondence with NHS England or the Integrated Care Board regarding approval, restriction, or prioritisation of EPR capital spend

5. Programme Status and Risk

  • a) Current total approved budget for the EPR programme
  • b) Latest forecast outturn cost and variance against budget
  • c) Go-live date(s) and any changes to the delivery timeline
  • d) Any identified financial risks to programme delivery, including risks related to funding availability or capital constraints

6. Governance and Oversight

  • a) Copies of any business cases (outline, full, or updated) for the EPR programme
  • b) Board or committee papers (or extracts) discussing:
    • Programme affordability
    • Funding arrangements
    • Financial risks or mitigations
  • c) Details of any external approvals required (e.g. NHS England, DHSC)

If any of this information is exempt from disclosure, please specify the exemption(s) applied and provide partial disclosure where possible.

I would prefer to receive this information in electronic format.

Please also confirm whether any part of the EPR programme is classified as nationally mandated digital infrastructure and whether it benefits from central spending flexibility or exemption from capital controls.

Thank you

Susie Colley
Chair of the Torquay Chamber of Commerce and the Heart Campaign

To: tsdft.foi@nhs.net
Date: 25 March 2026, 09:17

Good morning Mr Teape,

I am writing to request information under the Freedom of Information Act 2000 regarding the procurement and approval of the Electronic Patient Record (EPR) system (Epic) by Torbay and South Devon NHS Foundation Trust.

To assist with cost limits under Section 12 of the Act, I have limited the scope of my request to specific documents, date ranges, and final approved materials.

Please provide the following:

1. Governance and decision-making

  • The exact date(s) on which the Trust Board approved:
    • a) The Outline Business Case (OBC)
    • b) The Full Business Case (FBC)
    • c) The selection of Epic as the preferred supplier
  • Copies of the relevant Trust Board minutes and papers only (excluding sub-committees), limited to meetings held between 1 January 2020 and 31 December 2025, where:
    • The OBC or FBC was approved, and/or
    • Epic was approved as the preferred supplier

2. Financial scrutiny

  • Trust Board papers and minutes only (not Finance or Audit Committees), within the same date range (2020-2025), where:
    • The total programme cost was presented for approval
    • Affordability was considered
  • Any final affordability assessment or summary included within the approved business case or Board papers

3. Total cost and payment profile

  • The total expected lifetime cost of the EPR programme, where this is already recorded in existing documents
  • The contract duration and high-level payment profile (e.g. annual or phased costs), where held
  • A high-level summary of funding sources (e.g. NHS England vs Trust funding), where already documented

4. Pilot / testing

  • Confirmation of whether a pilot, phased rollout, or formal evaluation was conducted prior to full approval
  • If no internal pilot was undertaken, a brief summary of the external evidence or deployments relied upon, where recorded in business case or Board papers

5. Risk and impact

  • Relevant risk summaries (not full risk registers) relating to:
    • Financial risk
    • Operational disruption
    • Workforce/training impact
  • Where these are included in:
    • The OBC/FBC, or
    • Trust Board papers within the specified date range

If any of this information is already publicly available, please provide direct links to the specific documents.

If any part of this request is considered likely to exceed the cost limit, I would be grateful if you could advise how it may be further refined, in accordance with your duty to provide advice and assistance under Section 16 of the Act.

If exemptions are applied, please provide the remaining information and explain the basis for any exemptions.

I look forward to your response within the statutory timeframe.

regards

Susie Colley
Chair of the Torquay Chamber of Commerce and the Heart Campaign
Elected Governor of Torbay Hospital

To: tsdft.foi@nhs.net
Date: 24 March 2026, 20:42

Good evening

I am writing to request information under the Freedom of Information Act 2000 regarding the procurement and approval of the Electronic Patient Record (EPR) system (Epic) by Torbay and South Devon NHS Foundation Trust.

Please provide the following:

1. Governance and decision-making

  • The exact date(s) on which the Trust Board approved:
    • a) The Outline Business Case (OBC) for the EPR
    • b) The Full Business Case (FBC) for the EPR
    • c) The selection of Epic as the preferred supplier
  • Copies of the relevant Board and/or Committee minutes and papers where these decisions were discussed and approved

2. Financial scrutiny

  • Any Board, Finance Committee, or Audit Committee papers or minutes where the cost of the EPR programme (including the £36.7m-£55.4m contract) was discussed, challenged, or approved
  • Documentation setting out the affordability assessment and impact on the Trust's financial position

3. Total cost and payment profile

  • The total expected lifetime cost of the EPR programme, including (but not limited to):
    • Software and licensing
    • Implementation and infrastructure
    • Staff training and backfill
    • Ongoing maintenance and support
  • The annual payment profile and duration of the contract (including any extension options)
  • Confirmation of what proportion of costs will be funded by:
    • a) Central/NHS England funding
    • b) The Trust's own budget

4. Pilot / testing

  • Whether any pilot, phased rollout, or formal evaluation of the Epic system was conducted by the Trust prior to full commitment
  • If not, what evidence or external deployments were relied upon to justify the decision

5. Risk and impact

  • Copies of the risk register entries, impact assessments, or business case sections relating to:
    • Financial risk
    • Operational disruption during implementation
    • Workforce/training impact

If any of this information is already publicly available, please provide direct links to the specific documents.

If parts of this request are considered exempt, please provide the remaining information and explain the basis for any exemptions applied.

I look forward to your response within the statutory 20 working days.

Thank you

Susie Colley
Chair of the Torquay Chamber of Commerce and the Heart Campaign
Elected Governor of Torbay Hospital

Status: Three submissions to Torbay and South Devon NHS FT, which the Trust has split into two separate FOIs. The refined request of 25 March (Section 16 advice and assistance, narrowed to Trust Board papers only, defined date range 2020-2025, risk summaries rather than full registers) has been logged as TSD10299. The extended financial request of 29 March (drawing directly on the 2024/25 Annual Report, asking specifically about CDEL treatment, ring-fenced funding conditions, PDC vs internal capital breakdown, payment profile by financial year, and central spending flexibility) has been logged as TSD10421. The initial request of 24 March is presumably absorbed into TSD10299. On 21 April 2026 the Trust issued separate extension notices for both references, confirming it holds the requested information and invoking the public interest test against Section 43(2) (commercial interests). Both deadlines are now 20 May 2026. The campaign should expect partial or full refusal on commercial grounds, particularly around contract value, payment profile, and supplier-specific terms, and may need to argue the public interest case in any internal review.

Trust Extension Notice (21 April 2026): Torbay and South Devon NHS FT has confirmed it holds the requested information but has invoked the public interest test to extend the response deadline by 20 working days to 20 May 2026. The exemption cited is Section 12(1) (cost of compliance exceeds the appropriate limit). However, Section 12 is a procedural cost-limit provision, not a qualified exemption, and is not subject to the public interest test. The Trust's reasoning that it needs additional time to consider "where the balance of public interest lies" is therefore inconsistent with the only exemption it has cited. If Section 12 is genuinely engaged, the Trust should be discharging its Section 16 duty (advice and assistance) by suggesting how the request could be refined to fall within the cost limit, rather than extending under public interest grounds that do not apply.
Why This Matters: The Trust's 2024/25 Annual Report and Accounts disclose significant financial pressures within the Section 75 partnership arrangements with Torbay Council for Adult Social Care. This request seeks to establish when those pressures were first recognised internally as requiring intervention, not merely routine monitoring. If the financial imbalance was identified materially earlier than it was disclosed publicly or escalated to the Board, that raises questions about governance, transparency, and whether the financial position influenced decisions about service configuration - including the proposed centralisation of cardiac services.

Organisation requested to respond:

  • Torbay and South Devon NHS Foundation Trust (ref: TSD10396, extension notice issued 21 April 2026)

Note on the Trust's prioritisation: The original request explicitly anticipated cost limit issues and prioritised two specific items if they applied: (1) the earliest report identifying the issue, and (2) the first presentation of the Section 75 Recovery Plan to the Business Development Committee. The Trust has not yet engaged with this prioritisation in its extension notice.

From: FOI (Torbay and South Devon NHS Foundation Trust) tsdft.foirequests@nhs.net
To: Susie Colley (chair@tqcc.co.uk)
Subject: RE: TSD10396 - FOI Extension of Time
Trust contact: foi.tsdft@nhs.net
Reference: TSD10396

Dear Susie,

Request for Information

Thank you for your request for information which we received on 29/03/2026. We can confirm that the Trust does hold Section 75 arrangements and associated financial pressures in Adult Social Care falling within the terms of your request.

The Freedom of Information Act obliges us to respond to requests promptly and in any case no later than 20 working days after receiving your request.

When a qualified exemption is potentially applicable and the public interest test becomes relevant, the Act permits an extension of the response period beyond 20 working days. In such cases, a comprehensive reply must be issued within a timeframe that is considered reasonable given the specific circumstances.

We aim to make all decisions within 20 working days, including cases where we need to consider where the public interest lies in respect of a request for exempt information. In this case, however, we have not yet reached a decision on where the balance of public interest lies.

In your case, we estimate that it will take an additional 20 working days to take a decision on where the balance of public interest lies. We plan to let you have a response by 20/05/2026. If it appears that it may take longer to reach a conclusion, we will keep you informed.

The specific exemption(s) which apply in relation to your request is/are:

  • Section 12(1) does not oblige a public authority to comply with a request for information if the authority estimates that the cost of complying with the request would exceed the appropriate limit.

If you wish to discuss any of the above, please contact us, quoting the FOI reference number above.

Yours sincerely,

Sarah Goss
Data Protection Lead
Torbay and South Devon NHS Foundation Trust

To: Joe Teape (Trust CEO), with Martin, Chris, Sally, Phil, Torre, Nicole, Cat, David, Anne-Marie, Jim
Date: 29 March 2026, 23:02

Good Evening

Having looked at the Accounts for the TBH it would appear necessary to obtain further information therefore under the Freedom of Information Act 2000, please provide the following information relating to the Section 75 arrangements and associated financial pressures in Adult Social Care:

1. Section 75 Recovery Plan

  • The date on which the Section 75 Recovery Plan was first presented to the Business Development Committee
  • Copies of the initial version of the Recovery Plan, and any subsequent revised versions presented during 2024/25

2. Committee Papers and Minutes

  • All agenda papers, reports, and minutes of the Business Development Committee where the Section 75 Recovery Plan was discussed, reviewed, or approved during 2023/24 and 2024/25

3. Earliest Identification of Financial Pressure

  • The earliest internal report, briefing, or risk register entry (including Board Assurance Framework entries) that identifies:
    • a material mismatch between income and expenditure within the Section 75 / Adult Social Care arrangements, or
    • a requirement for recovery, mitigation, or transformation action

4. Financial Monitoring Reports

  • Monthly or periodic budget monitoring reports for Adult Social Care / Section 75 arrangements from April 2023 to March 2025, including any exception reports highlighting overspends or cost pressures

5. Escalation and Risk Classification

  • The date on which the financial position was formally escalated to:
    • the Board, and/or
    • inclusion on the Board Assurance Framework as a financial sustainability risk
  • Copies of the relevant BAF entries and any supporting documentation

Please provide the information in electronic form. Where documents are withheld, please specify the exemption(s) relied upon and provide any reasonably severable material.

If the request exceeds cost limits, please prioritise: (1) the earliest report identifying the issue, and (2) the first presentation of the Section 75 Recovery Plan.

For the avoidance of doubt, this request seeks to identify the earliest point at which the financial imbalance was recognised internally as requiring intervention, rather than routine monitoring.

Thank you

Susie Colley
Chair of the Torquay Chamber of Commerce and the Heart Campaign
Elected Governor of Torbay Hospital

Status: Submitted 29 March 2026 to Torbay and South Devon NHS FT, directly to Trust CEO Joe Teape with a wider CC list than previous submissions. Triggered by financial disclosures in the Trust's 2024/25 Annual Report and Accounts. The Trust assigned reference TSD10396 and issued an extension notice on 21 April 2026 confirming it holds the requested information. The Trust has cited Section 12(1) (cost limit) as the applicable exemption and pushed the response date to 20 May 2026 ostensibly to consider the public interest balance, but Section 12 is not a qualified exemption and is not subject to the public interest test. If Section 12 is genuinely engaged, the Trust should be discharging its Section 16 duty (advice and assistance) and engaging with the campaign's stated prioritisation: (1) the earliest report identifying the issue, and (2) the first presentation of the Section 75 Recovery Plan to the Business Development Committee. Awaiting substantive response.

Why This Matters: NHS Devon ICB confirmed in its 14 April 2026 correspondence that the Trust Board has approved the relocation of routine histopathology services to a bespoke new laboratory at Gadeon House in Exeter, with time-critical and urgent pathology work remaining at Torbay through a permanent Acute Services Laboratory. The decision is to be confirmed at the TSD Board of Directors public meeting on 7 May 2026. This FOI seeks the underlying evidence base behind that decision: business cases, options appraisals, raw activity data, financial and operational modelling, clinical risk assessments, and the full governance trail. The request is deliberately structured to test the Carter-based efficiency claims that typically underpin pathology consolidation decisions, and to expose any assumptions or sensitivities that have not been publicly disclosed.
Strategic Significance: This is the largest-scope FOI submitted by the campaign to date. It explicitly asks for raw datasets and underlying spreadsheets, not summaries, and addresses the full governance chain from 2018 to present. The submission anticipates Section 43 (commercial) and Section 36 (effective conduct) refusals and instructs that any exemptions be applied narrowly with full public interest justification. The 7-day response window set by the campaign is timed to fall before the 7 May Board of Directors public meeting where the relocation is to be confirmed.

Organisation requested to respond:

  • Torbay and South Devon NHS Foundation Trust (awaiting acknowledgement and reference number)

Distribution:

  • To: Joe Teape (Trust CEO), Chris (Chair), Martin, Phil Keeling, Torre, Nicole, Sally, Mark

Ten areas covered by the request:

  1. Formal programme and business case documentation - SOC, OBC, FBC; One Devon Programme references; options appraisals with scoring matrices, weighting criteria, and ranking outputs
  2. Explicit plans for service relocation or consolidation - all recorded information confirming, discussing, or modelling transfer of pathology activity to UHP Plymouth (Derriford), RDUH (Exeter), or any "hub" laboratory designation; the proposed role of Torbay as an Essential Service Laboratory; scenario modelling where Torbay activity is split across multiple receiving sites
  3. Underlying activity and demand data - actual datasets (not summaries) for test volumes by discipline, hot vs cold workload classification, time-stamped diurnal demand data, referral patterns, inter-site sample flows
  4. Modelling, assumptions, and outputs - all financial models including spreadsheets (cost per test, workforce changes, capital investment, NPV/IRR); operational models (turnaround time, transport/logistics, capacity); explicit assumptions; sensitivity and scenario analyses
  5. Clinical risk and impact evidence - clinical risk assessments for on-site service loss; impact assessments for A&E, ICU, maternity, surgical pathways; turnaround delay clinical risk modelling; EqIAs and QIAs
  6. Carter-based efficiency claims - all local analyses of efficiency savings from pathology networking; post-implementation reviews; benefits realisation reports; variance analyses; evidence on whether projected savings have materialised
  7. Governance, decision-making, and assurance - full minutes, board papers, and appendices (not summaries) from Trust Board, Finance and Investment Committees, Quality/Clinical Governance Committees, Pathology Programme Boards, Network Boards from 2018 to present; decision logs, highlight reports, risk registers
  8. External direction, correspondence, and challenge - correspondence with NHS England and NHS Devon ICB; Carter implementation directives; independent reviews, gateway reviews, external assurance reports
  9. Commercial sensitivity and public interest - explicit instruction that Section 43 and Section 36 exemptions be applied narrowly to specific redacted elements rather than whole documents, with full public interest test justification
  10. Format of response - data and models in original electronic formats (Excel rather than PDF); appendices and embedded data; Section 44 transfer where another organisation holds the information

To: Joe Teape (Trust CEO), Chris (Chair), Martin, Phil Keeling, Torre, Nicole, Sally, Mark
Subject: Freedom of Information Act 2000 Request - Pathology Reconfiguration - Torbay and South Devon (Forensic Request)
Date: 27 April 2026, 21:37

Good evening

I am writing to request detailed information under the Freedom of Information Act 2000 regarding any actual or proposed reconfiguration of pathology services affecting Torbay Hospital and the wider Torbay and South Devon system.

This request specifically seeks recorded information, underlying datasets, modelling outputs, and formal governance materials, not summaries.

1. Formal Programme and Business Case Documentation

Please provide:

  • a) Any Strategic Outline Case (SOC), Outline Business Case (OBC), or Full Business Case (FBC) relating to pathology service reconfiguration, consolidation, or networking involving Torbay.
  • b) Any programme documentation produced under or aligned with the One Devon Programme that references pathology services.
  • c) Any options appraisal documents (including longlists/shortlists), including scoring matrices, weighting criteria, and ranking outputs.

2. Explicit Plans for Service Relocation or Consolidation

Please provide all recorded information that confirms, discusses, or models:

  • The potential or planned transfer of pathology activity from Torbay to:
    • University Hospitals Plymouth NHS Trust (Derriford)
    • Royal Devon University Healthcare NHS Foundation Trust (Exeter)
    • Any "hub" laboratory designation(s) within Devon
  • The proposed or assumed role of Torbay as an Essential Service Laboratory (ESL) or otherwise

This should include scenario modelling where Torbay activity is split across more than one receiving site.

3. Underlying Activity and Demand Data (Raw Where Held)

Please provide the actual datasets (not summaries) used in planning and modelling, including:

  • Test volumes by discipline (biochemistry, haematology, microbiology, histopathology, etc.)
  • Classification of workload into "hot" (urgent) vs "cold" (routine) activity
  • Time-stamped demand data sufficient to understand diurnal variation and peak demand
  • Referral patterns and inter-site sample flows

If full datasets cannot be disclosed due to size, please provide extracts sufficient to demonstrate structure and analytical use.

4. Modelling, Assumptions, and Outputs

Please provide:

  • a) All financial models (including spreadsheets) used to estimate:
    • Cost per test before and after reconfiguration
    • Workforce changes and skill-mix assumptions
    • Capital investment requirements (automation, estate, logistics)
    • Net present value (NPV), internal rate of return (IRR), or equivalent metrics
  • b) All operational models, including:
    • Turnaround time modelling (baseline vs proposed)
    • Sample transport/logistics modelling (including assumed transit times and failure rates)
    • Capacity modelling for any proposed hub site(s)
  • c) The explicit assumptions underpinning these models (e.g. % automation, staffing ratios, courier frequency, failure tolerances).
  • d) Sensitivity analyses, scenario testing, or downside risk modelling.

5. Clinical Risk and Impact Evidence

Please provide:

  • Clinical risk assessments relating to loss or reduction of on-site services at Torbay
  • Impact assessments for A&E, ICU, maternity, and surgical pathways
  • Any modelling of delayed turnaround times and associated clinical risk
  • Equality Impact Assessments (EqIA) and Quality Impact Assessments (QIA)

6. Carter-Based Efficiency Claims

In relation to the Carter recommendations and the "hub and spoke" model:

  • All local analyses estimating efficiency savings attributable to pathology networking
  • Any post-implementation reviews, benefits realisation reports, or variance analyses
  • Evidence demonstrating whether projected savings have been achieved, are on track, or have not materialised

7. Governance, Decision-Making, and Assurance

Please provide full minutes, board papers, and appendices (not summaries) from:

  • Trust Board meetings
  • Finance and Investment Committees
  • Quality / Clinical Governance Committees
  • Any Pathology Programme Boards or Network Boards

where pathology reconfiguration has been discussed (from 2018 to present).

Please include:

  • Decision logs
  • Highlight reports
  • Risk registers (including programme risks relating to pathology reconfiguration)

8. External Direction, Correspondence, and Challenge

Please provide:

  • Correspondence with NHS England and NHS Devon Integrated Care Board relating to pathology consolidation
  • Any instructions, targets, or directives tied to Carter implementation
  • Any independent reviews, gateway reviews, or external assurance reports

9. Commercial Sensitivity and Public Interest

If you consider any information exempt under Section 43 (commercial interests) or Section 36 (prejudice to effective conduct), please:

  • Apply exemptions narrowly to specific redacted elements rather than whole documents
  • Provide the remainder of the material
  • Include the full public interest test justification

Given the significant implications for patient safety, access to urgent diagnostics, and public expenditure, there is a strong public interest in disclosure of the underlying evidence base.

10. Format of Response

I request that:

  • Data and models are provided in their original electronic formats (e.g. Excel rather than PDF where held)
  • Documents include appendices and embedded data where available

If any part of this request is held by another organisation, please transfer it as appropriate under Section 44 or advise accordingly.

Thank you please respond within 7 working days.

regards

Susie Colley
Chair of the Torquay Chamber of Commerce and the Heart Campaign
(Declined) Governor of Torbay Hospital

Status: Submitted 27 April 2026 to Trust CEO Joe Teape and Chair Chris Balch, with a wide CC list. The campaign has set a 7 working day response deadline (6 May 2026) timed to fall before the 7 May 2026 Board of Directors public meeting where the histopathology relocation decision is to be confirmed. The statutory FOIA response deadline is 26 May 2026 (20 working days). Awaiting acknowledgement and Trust reference number. Given the scope of the request and the Trust's recent pattern of issuing extensions under Section 12 (cost limit), Section 43 (commercial interests), and Section 36 (effective conduct), the campaign should expect a likely extension notice. The request explicitly anticipates this and instructs the Trust to apply any exemptions narrowly to specific redacted elements rather than whole documents, with full public interest test justification.

Under Review or Challenge

Why This Matters: This request asked fundamental questions about RDE's capacity and reliance on Torbay. The incomplete responses and failed internal review suggest RDE doesn't want to reveal the full picture of their dependency on Torbay's cardiac services.
ICO Investigation: The Information Commissioner's Office has formally confirmed that our complaint regarding RDE's handling of this FOI request is eligible for investigation. Awaiting findings.
32.9
Average weeks wait
for angiogram
72.86
Maximum weeks wait
for angiogram
£7,080
Average cost
of angioplasty

What we asked for:

  • Waiting times for angiogram, angioplasty, pacemaker insertion
  • Weekend angiograms in private hospitals
  • Cases referred from RDE to Torbay - and whether Torbay was paid
  • How often Torbay locum cardiologists covered RDE staff shortages

Status: Internal review failed to address deficiencies. ICO investigation now formally confirmed and underway.

Download Original Request (PDF) Download Initial Response (PDF) Download Follow-up Response (PDF) Download Internal Review (PDF) Download ICO Complaint (PDF)
Major Reversal: NHS Devon initially claimed "we do not hold this information." After Internal Review challenge, they now admit they DO hold the information but are withholding it using Section 22 (future publication - with no publication date) AND Section 36 (prejudice to effective conduct of public affairs - need for "safe space"). This is the Edge Health modelling that underpins the entire cardiac services reconfiguration.
Why This Matters: Edge Health was commissioned to model demand and capacity across all 5 Peninsula hospitals including cardiology. This modelling is being used to justify service changes, yet the public cannot see the data, methodology, or findings. NHS Devon claims publishing it would be "detrimental" and that they need "safe space" for "free and frank conversations" - essentially arguing the public should not see evidence used to make decisions about their healthcare.

What Was Requested:

Information about Edge Health Ltd's commission to undertake demand and capacity modelling across Devon's acute hospitals, referenced in the Peninsula Acute Sustainability Programme (PASP). Specifically:

  1. Commissioning authority - Who commissioned the work
  2. Scope and purpose - Which hospitals and specialties were included (explicitly asking if cardiology was modelled)
  3. Timescales - When work was conducted and forecast period
  4. Outputs and deliverables - Reports, presentations, findings
  5. Contract and costs - Contract value, date, procurement method
  6. Governance and oversight - Which boards reviewed findings, meeting papers/minutes

What NHS Devon Revealed (16 February 2026):

  • Commissioned via: NHS England's Recovery Support Programme (RSP) on behalf of Peninsula Acute Provider Collaborative (PASP)
  • Process: NHS Devon requested support from NHS England Southwest to identify Edge Health as existing provider
  • Joint arrangement: Edge Health commissioned via joint working arrangement through NHS England's RSP
  • Specification provided: "PASP - Scenario modelling 15.3.2024 v0.2" - 20-week project covering all 5 acute hospitals
  • Contract costs: Still claims doesn't hold this information (contradicts NHS England's response)

What They're Still Withholding:

  • Actual modelling outputs and findings
  • Whether cardiology was explicitly included in scope
  • Timescales and forecast periods used
  • Reports, presentations, executive summaries
  • Contract value and procurement details
  • Board papers, minutes, governance documents

NHS Devon's Justification for Withholding:

Section 22 (Information intended for future publication):

  • Report being incorporated into draft 5-year ICB Commissioning Intentions and Strategic Commissioning Plan
  • "Would be detrimental to publish this report in isolation without wider context"
  • No publication date provided - "NHS Devon is unable to provide a date/format when this report will be published"

Section 36 (Prejudice to effective conduct of public affairs):

  • "ICB must be assured it has a safe space where it can conduct robust free and frank conversations"
  • Need to "explore all possible scenarios with partners and clinicians"
  • Claim that disclosure "will inhibit and hinder these conversations"
The Problem with Section 22: ICO guidance is explicit: "a general intention to publish at some point in the future is insufficient; there must be a clear and specific intent to publish the information within a reasonable timeframe." NHS Devon has provided no publication date, making this exemption legally questionable.
The "Safe Space" Argument: Section 36 is being used to hide evidence that underpins major service changes affecting public healthcare. The argument that the public cannot see modelling used to justify closing their local cardiac services because officials need "safe space" for "free and frank conversations" fundamentally contradicts transparency and democratic accountability.

PASP Specification (Disclosed):

The specification document reveals the modelling project was:

  • 20-week timeline (started March 2024)
  • Covered: All 5 acute hospitals across Devon, Cornwall & Isles of Scilly
  • Included: Demand and activity modelling, workforce modelling, travel modelling
  • Deliverables: Static report, interactive model, workshop materials
  • Used GIRFT expertise - Getting It Right First Time programme data and case studies
  • Purpose: "Developing a sustainable model for acute services" - described as "exit criteria for Devon"

Good afternoon

Thank you for your response to my Freedom of Information request (FOINHSD25/1474).

I am writing to request an internal review of the decision, for the following reasons:

1. Incorrect application of Section 22 ("information intended for future publication")

Section 22 can only be applied when:

  1. There is a settled intention to publish, and
  2. Publication is planned for a specific or at least reasonably identifiable date, and
  3. The public interest in withholding outweighs the public interest in disclosure.

Your response states: "The information held by NHS Devon is intended for future publication… The publication date is still to be confirmed."

A publication date that is not set does not meet the legal test for a "settled intention" under Section 22. ICO guidance is explicit on this point: "a general intention to publish at some point in the future is insufficient; there must be a clear and specific intent to publish the information within a reasonable timeframe."

Therefore, the exemption is incorrectly applied unless NHS Devon can: identify what will be published, identify where, provide an approximate publication timeframe, and demonstrate a public interest test explaining why withholding is in the public interest.

2. NHS Devon's statement that NHS England holds Q1 and Q5 contradicts NHS England's own FOI decision

NHS Devon stated: "NHS Devon does not hold the information in response to questions 1 and 5… you may wish to have direct communication with NHS England."

However, NHS England has already responded under FOI-2510-2272157, stating clearly that: "NHS England does not hold this information."

This creates a clear contradiction. Under Section 1(1)(a) FOIA, the authority has a duty to confirm whether it does or does not hold information. Authorities cannot redirect applicants back and forth where each denies holding the data.

Given that commissioning and contracting of local modelling for PASP would logically fall within the remit of NHS Devon (the statutory system commissioner), the assertion that the ICB holds none of this information requires proper clarification.

3. The decision does not address each question individually

Even where Section 22 may apply to some outputs, it cannot logically apply to: dates of commission, procurement method, contract value, governance structures, oversight boards, the scope of modelling (e.g., whether cardiology was included). These are factual details describing process, not unpublished documents.

Summary of Requested Actions

  1. Conduct a full internal review
  2. Reassess the decision to apply Section 22 without a publication date
  3. Reassess the claim that NHS Devon does not hold Q1 and Q5
  4. Provide all information that is not legitimately covered by Section 22
  5. Provide a lawful public interest test if you maintain the exemption

Kindest regards

Susie Colley
Chair of the Torquay Chamber of Commerce and The Heart Campaign

Status: Initial response claimed "does not hold information" - challenged 25 November 2025. Internal Review received 16 February 2026 partially reversed decision - NHS Devon now admits it DOES hold information about commissioning authority and provided specification document, but is withholding modelling outputs, findings, contract costs, and governance documents using Section 22 (no publication date given) and Section 36 ("safe space" argument). The specification reveals this was a major 20-week project covering all Peninsula hospitals. Campaign successfully forced NHS Devon to admit holding information and disclose specification, but core modelling data remains hidden.

Download Internal Review Response (PDF) Download PASP Specification (PDF)
ICO Investigation: Formal complaint submitted 23 December 2025 citing serious concerns about NHS Devon's handling of this request. The response was inadequate, incomplete, and appears to fall below the standards required under the Freedom of Information Act 2000.
Why This Matters: NHS England says NHS Devon commissioned Edge Health, but NHS Devon claims it holds no documentation. The public cannot access basic procurement information about modelling that underpins major service changes affecting their healthcare.

Background:

After NHS England confirmed it "does not hold information about who authorised Edge Health" and directed the request to NHS Devon ICB as the commissioning authority, this FOI requested:

  1. Authorising individuals - Names and job titles who approved commissioning
  2. Dates of approval - When authorisation was given
  3. Contractual documentation - Contract, purchase order, business case, approval papers, procurement route
  4. Correspondence - Internal NHS Devon correspondence about decision; correspondence with Edge Health about scope
  5. Costs - Total cost, invoices, payment records

NHS Devon's Response (16 February 2026) - What They Revealed:

  • Process: NHS Devon requested support from NHS England Southwest to identify suitable provider
  • Selection: Edge Health identified as existing NHS England provider
  • Arrangement: Commissioned via "joint working arrangement" through NHS England's Recovery Support Programme (RSP)
  • Approval date: "Resource confirmed in place July 2024"
  • Cost to NHS Devon: Nil - "covered by RSP"
  • Specification: PASP Scenario modelling document (same as FOINHSD25/1474)

NHS Devon's Claims of "Information Not Held":

  • No contract, agreement, purchase order, or call-off documentation
  • No business case, approval papers, or decision reports
  • No procurement route documentation
  • No internal correspondence about decision to appoint Edge Health
  • No invoices or payment records
The Implausibility Problem: NHS Devon acknowledges it was involved in the Peninsula Acute Sustainability Programme, it knows who authorised the commission, it knows the timeline, it knows the funding source — yet claims to hold no documentation whatsoever. It is highly unlikely that a public body could be involved in a programme of this nature without generating or receiving any emails, meeting notes, briefings, reports, or communications.

ICO Complaint - Grounds for Investigation:

  1. Implausible "information not held" claims
    NHS Devon asserts it holds no procurement documentation, contractual records, internal correspondence, decision-making material, or funding arrangement documentation. The ICO has repeatedly ruled that blanket assertions of "information not held" require clear justification. NHS Devon provided none.
  2. Failure to demonstrate adequate searches (Section 1 breach)
    The authority did not describe searches undertaken, identify systems checked, explain search terms used, or confirm whether relevant staff were consulted. The response gives the impression that no meaningful search was conducted at all.
  3. Breach of duty to advise and assist (Section 16 breach)
    NHS Devon did not explain why it holds some information but not other related records, clarify its governance responsibilities, or provide meaningful assistance in understanding the division of responsibilities between NHS Devon and NHS England. Simply redirecting to NHS England is not sufficient to discharge the Section 16 duty.
  4. Lack of transparency around commissioning and governance
    NHS Devon provides no explanation of why it retains no documentation, whether it received deliverables from Edge Health, whether it participated in meetings or oversight, or whether it was consulted during commissioning.
  5. Evasive response inconsistent with normal public-sector practice
    It is not standard practice for a public body to be involved in a programme, know who authorised it, know when it commenced, know the funding source — yet hold no documentation, correspondence, or records. This raises concerns about inadequate record-keeping, failure to retain information, potential non-compliance with statutory obligations, and reluctance to disclose information.
  6. ICO Action Requested:
    • Investigate the adequacy of NHS Devon's searches
    • Require NHS Devon to conduct fresh, properly documented searches
    • Require NHS Devon to provide a compliant response
    • Assess whether NHS Devon breached Sections 1 and 16 of the FOI Act
    • Consider whether NHS Devon's record-keeping practices comply with public-sector standards

The Circular Redirection Pattern:

Question NHS England Says NHS Devon Says
Who authorised Edge Health? "Contact NHS Devon" "We don't hold internal correspondence - contact NHS England"
Contract documentation? "We don't hold this" "We don't hold this - contact NHS England"
Business case/approval papers? "We don't hold this" "We don't hold this - contact NHS England"

Status: Response received 16 February 2026. NHS Devon claims it doesn't hold contracts, business case, approval papers, or internal correspondence despite being the commissioning authority. Formal complaint submitted to ICO 23 December 2025 on six grounds: implausible "information not held" claims, failure to demonstrate adequate searches, breach of duty to advise and assist, lack of governance transparency, evasive response inconsistent with normal practice, and inadequate record-keeping. Awaiting ICO determination.

Download Response (PDF) Download PASP Specification (PDF)

Responses Received

KEY DECISION: At its Joint Committee on 26 March 2026, NHS Devon decided to bring the case for change for cardiology and cardiovascular services into its wider health and care planning as part of its five-year commissioning plan and the neighbourhood health model. The ICB states it "will not progress the case for change programme at this time."
Critical qualification: The decision not to progress is explicitly time-limited. The ICB uses "at this time" in its key statement and "right now" in its assurance that there are no plans to change where services are delivered. This is not a permanent withdrawal. The case for change has been absorbed into broader planning, not abandoned. The campaign must continue to monitor how the five-year commissioning plan and neighbourhood health model develop, as these are now the vehicles through which any future service reconfiguration may be pursued.

What the ICB has confirmed:

  • The Joint Committee on 26 March 2026 decided to bring the cardiology case for change into the five-year commissioning plan and neighbourhood health model
  • The case for change programme will not be progressed as a standalone programme at this time
  • There are no plans to change where cardiology services are delivered "right now"
  • The ICB states it will keep local people, staff and stakeholders informed as plans develop
  • A new "lived experience group" is being created for people with long-term conditions including heart conditions

What the ICB has not confirmed:

  • That the threat to Torbay's cardiac services is permanently withdrawn
  • Any commitment to maintain emergency cardiac services at Torbay Hospital beyond the immediate term
  • How the five-year commissioning plan will treat cardiology service configuration across Devon
  • What triggered the decision to absorb the programme rather than progress it - whether this was a response to campaign pressure, financial pressures, or other factors

From: NHS Devon Integrated Care Board, Freedom of Information Office
To: Susie Colley, Chair
Date: 8 April 2026
Re: FOINHSD26/1566 and FOINHSD25/1493

Thank you for your request under the Freedom of Information Act 2000.

NHS Devon Integrated Care Board (ICB) is confirming in accordance with Section (1)(a) of the Act, whether it holds the information requested and (b) is supplying it unless otherwise specified.

Please see below the most up to date information held in response to your Freedom of Information requests, FOINHSD26/1566 and FOINHSD25/1493.

At our Joint Committee on 26 March 2026, we decided to bring the case for change for cardiology and cardiovascular services into our wider health and care planning as part of our five-year commissioning plan and the neighbourhood health model.

We will not progress the case for change programme at this time.

Over the past year we have seen real improvements in access, performance and prevention. With the NHS Long Term Plan, the Devon health and care strategy and our commissioning five-year plan now in place, our focus is on delivering these system-wide priorities.

This allows us to look at the whole picture - how we prevent heart and wider health problems, diagnose them earlier, and support people closer to home.

Taking this joined-up approach will help ensure services continue to meet the needs of our communities in the future.

We know people care deeply about their local heart services. There are no plans to change where cardiology services are delivered right now.

We are committed to keeping local people, staff and stakeholders informed and involved as our plans develop.

Yours sincerely,
Libby Ryan-Davies
Chief Strategic Planning and Commissioning Officer
NHS Devon

This statement, included by the ICB in the response as context, was made six days before the Joint Committee decision of 26 March 2026.

"Next week, our board will be asked to consider a recommendation to bring the case for change for cardiology and cardiovascular services into our wider health and care planning, including our five-year commissioning plan and the neighbourhood health model we are beginning to implement.

"This would allow us to look at the whole picture - how we prevent heart and wider health problems, diagnose them earlier, and support people closer to home, alongside the care provided in hospital.

"Taking this joined-up approach will help ensure services are sustainable for the future and continue to meet the needs of our communities.

"We know people care deeply about their local heart services, so we want to be clear about what's being proposed. No decisions have been made at this stage, and there are no plans to change where cardiology services are delivered right now.

"We are committed to keeping local people, staff and stakeholders informed and involved as our plans develop."

Also included by the ICB in the response. Signed by Libby Ryan-Davies as Chief Strategic Planning and Commissioning Officer.

The letter confirmed the ICB was finalising plans to develop future pathways for cardiovascular disease, cardiology and cardiac surgery services across Devon, with a draft case for change planned for wider patient and public engagement between January and March 2026. That engagement did not proceed on the originally stated timetable.

The letter stated explicitly: "The draft case for change does not contain any proposals for 'change' or 'closure', and a case for change doesn't automatically lead to service changes for NHS services." The campaign noted at the time that this framing was not consistent with the content of the proposals that had already been shared with clinicians and MPs.

The letter committed to sharing the updated case for change with local authority Overview and Scrutiny Committees, the Heart Campaign and wider stakeholders before a clinical validation exercise led by the NHS Devon Chief Medical Officer. Neither the wider sharing nor the clinical validation exercise had taken place before the programme was absorbed into the five-year plan.

Status: Response received 8 April 2026. The ICB has formally confirmed it will not progress the case for change as a standalone programme, following a Joint Committee decision on 26 March 2026. The programme has been absorbed into the five-year commissioning plan and neighbourhood health model. However, the response uses qualified language throughout ("at this time", "right now") and does not provide any long-term assurance about Torbay's cardiac services. This response also covers FOINHSD25/1493 (Case for Change timeline and SRO absence) - see that card for background. The Internal Review challenge submitted 9 December 2025 on FOINHSD25/1493 was never answered on its merits.

Download ICB Response Letter (PDF)
Why This Matters: NHS Devon's consistent response of "we do not hold this information" is part of a pattern that fragments accountability. The ICB should have oversight of waiting times if they're making decisions about service configuration.

Requested waiting times for cardiac procedures carried out at RDE from 1 July 2025.

Outcome: NHS Devon does not hold this information. Request referred to RDE (see RDF3688-25).

Download Document (PDF)
EQUIPMENT FAILURE OCCURRED (8-10 March 2026): Both cardiac catheterisation labs at Torbay Hospital failed over the weekend of 8-9 March. Specific patient case documented: Patient from Teignmouth requiring urgent cardiac intervention - Torbay cardiology staff requested transfer to RDE, RDE declined despite regularly receiving help from Torbay, patient sent to Derriford Plymouth instead. Campaign escalated immediately to Trust CEO (7 March) and Medical Director (10 March) with five urgent questions about contingency arrangements and transfer protocols. The warnings about equipment failure and lack of system resilience have been proven correct with concrete evidence of patient harm from longer travel times. Trust CEO responded 16 February 2026 confirming £5.7m replacement programme, but manufacturer support ends June 2026 - creating 15-month uncertainty window before replacement completed September 2027.
Why This Matters: If Torbay's cath labs generate income for cardiac services, where does that money go? Understanding the financial flows helps explain whether underinvestment in Torbay is strategic rather than necessary.

Asked where cardiac services finances go and whether there is money available to refurbish catheterization laboratories.

Key finding: Funds held in central budget. Expenditure budgets aim to cover costs of activity less any agreed efficiency targets.

Escalation Timeline:
  • October 2025: Trust CEO stated funding was "earmarked" pending approval in January, implying ICB involvement
  • September-October 2025: NHS Devon ICB confirmed they received no request from Torbay
  • 20 January 2026: Formal challenges submitted to both organisations
  • Before 26 Jan 2026: Trust confirmed business case being updated, but no timescales provided
  • 26 January 2026: Campaign responded highlighting staff retention crisis - delay risks clinician exodus and de facto closure by attrition
  • 26 January 2026: Partnership offer made offering fundraising support
  • 29 January 2026: HVAC failure risk escalated - immediate threat to cath lab capacity
  • 3 February 2026: Formal structured request sent with 7-day deadline for funding position, timeline, and costs
  • 16 February 2026: Trust CEO responded confirming funding and timeline
  • 8-9 March 2026: CRITICAL - Both cath labs failed over the weekend
  • 7 March 2026: Escalated to Trust CEO requesting incident details
  • 10 March 2026: Escalated to Medical Director (CEO on leave) - Specific patient case documented: Patient from Teignmouth requiring urgent cardiac intervention - Torbay requested RDE transfer, RDE declined, patient sent to Derriford Plymouth instead
  • 10 March 2026: Five urgent questions raised about contingency arrangements, transfer protocols, and incident review
  • 12 March 2026: Trust Deputy CEO responded via Comms - confirmed both labs failed, admitted SOPs for diverts were inadequate, committed to strengthening cross-site protocols. Did not address the specific patient case or RDE refusal allegation.

The Contradiction:

  • Trust CEO (17 October 2025): Provisional sum earmarked in draft capital programme, approval expected January. Implied ICB involvement in funding.
  • ICB Acting CEO: "NHS Devon is not aware of a request received from Torbay and South Devon NHS Foundation Trust to approve funding to refurbish two cath labs"
  • Trust CEO (before 26 Jan 2026): Confirmed business case being updated for capital funding
  • Trust CEO (16 Feb 2026): Funding confirmed through Trust capital programme. National bid unsuccessful. 18-month timeline to completion.
  • ACTUAL OUTCOME (8-10 March 2026): Both cath labs failed over weekend. Patient from Teignmouth requiring urgent cardiac intervention - Torbay requested RDE transfer, RDE declined, patient sent to Derriford Plymouth instead. All warnings proven correct. Concrete evidence of patient harm from longer travel times.
  • Trust incident response (12 March 2026): Trust states RDE "offered support" - directly contradicting the documented patient case. Two formal FOIs now submitted to establish the factual record (RDF4139-26 and divert log request).

Critical Risks Identified:

  • Staff retention: Prolonged uncertainty risks exodus of experienced cardiologists. Once lost, expertise cannot be replaced - predetermining service closure by attrition. "ICB may win by default."
  • HVAC failure: Shared air-conditioning system at risk of near-term failure. Would cause sudden total loss of cath lab capacity affecting both Torbay and RDE patients, with >£600k annual income loss. UPDATE 7 MARCH 2026: BOTH CATH LABS HAVE FAILED.
  • Manufacturer support ends June 2026: Cannot guarantee repairs from June 2026. Creates 15-month uncertainty window before replacement completed September 2027.
  • System resilience breakdown: RDE allegedly declined to provide support during Torbay's cath lab failure despite regularly receiving assistance from Torbay when RDE labs are over capacity.

Good evening Mr Teape

I am writing to formally challenge the current lack of clarity regarding the funding position for the cardiac catheter laboratory refurbishment.

In the email dated the 17th October 2025, you stated that a provisional sum had been earmarked within the Trust's draft capital programme and that approval was expected in January. We are now well beyond that point, yet no definitive confirmation has been provided.

Furthermore, in an email from the Acting CEO/Chief Strategic Commissioning and Planning Officer (the Integrated Care Board) Ms Ryan-Davies confirming "that NHS Devon is not aware of a request received from Torbay and South Devon NHS Foundation Trust to approve funding to refurbish two cath labs". This directly contradicts the implication that external approval or funding was required. In the absence of any such request, it is reasonable to conclude that either the Trust has not pursued the refurbishment despite having funding available, or that the position previously set out was inaccurate.

This situation is unacceptable, particularly given the clinical significance of the cardiac catheter laboratory and the need for transparency in capital decision-making.

I therefore require a clear and unequivocal response to the following:

  1. Has the Trust's capital programme been formally approved, and if so, on what date?
  2. Is funding for the cardiac catheter laboratory refurbishment approved within that programme?
  3. If funding is not approved, please explain precisely why, and confirm whether any request has been made to the ICB.
  4. If no request has been made, please explain the rationale for that decision.
  5. If funding is approved, what is the confirmed allocation and delivery timetable?

If a clear position cannot be provided, please advise what steps are now being taken to resolve the discrepancy between the Trust's statements and the ICB's position, and when a definitive decision will be communicated.

Given the seriousness of this matter, I would expect a direct and timely response addressing each point above.

Kindest regards

Susie Colley
Chair of the Torquay Chamber of Commerce and The Heart Campaign

Hi Steven

Sorry to bother you again but would it be possible for you to get back to me re the answers from LRD before our next meeting on Monday 26th.

As discussed on the 12th January we are seeking urgent clarification regarding the funding position for the cardiac catheter laboratory refurbishment at Torbay Hospital.

I understood from Mr Teape in October 2025 that the ICB may be involved in funding the refurbishment. However, I have now been advised that the ICB is not aware of any capital funding request from the Trust in relation to this scheme. This sits in direct contrast to the position communicated by the Trust, which stated in October that a provisional sum had been earmarked within its draft capital programme, with approval expected in January.

As matters stand, there is no clear or consistent account of where responsibility for this decision lies, nor whether funding is available, requested, or withheld. This lack of transparency has led to significant concern locally.

I should also make you aware that a major public demonstration is now being planned as part of a campaign to obtain clear answers from the ICB and the Trust. A meeting is scheduled with the Police to plan how this can be done in a peaceful and safe manner. The purpose of this campaign is not to generate conflict, but to bring common sense and transparency to the table and to avoid further unnecessary and damaging publicity for the NHS locally.

Before matters escalate further, I am therefore requesting a clear and definitive response from the ICB addressing the following:

  1. Has the ICB received any formal or informal request from Torbay Hospital NHS Trust for capital funding for the cardiac catheter laboratory refurbishment?
  2. If no request has been received, does the ICB consider that the Trust has the ability to fund this scheme from its own approved capital resources?
  3. If a request is required, what specific information is outstanding and what steps are necessary to enable a decision to be made?
  4. What action is the ICB now taking to resolve the conflicting positions being communicated publicly?

A clear response at this stage would be a constructive step towards resolving this issue and could help prevent further escalation and reputational damage.

Given the circumstances, I would appreciate a prompt and direct reply.

Kindest regards

Susie Colley
Chair of the Torquay Chamber of Commerce and The Heart Campaign

Good evening Mr Teape

Thank you for your response confirming that teams are updating the business case in relation to capital funding for the cardiac catheter laboratories.

While we appreciate that this work is ongoing, I am writing to express serious concern about the impact that continued uncertainty is having on staff morale and retention within the cardiology service.

There is a growing and very real risk that prolonged delay, without clear timescales or reassurance about the Trust's commitment to maintaining cardiology services at Torbay, will result in the loss of experienced cardiologists and specialist staff. Once lost, this expertise will be extremely difficult to replace and would, in effect, predetermine the outcome of any future decision-making — regardless of the eventual conclusions of the business case.

In other words, if clinicians leave due to uncertainty and deteriorating morale, the ICB may "win" by default, not through a considered, evidence-based process, but through attrition. That outcome would be deeply damaging for staff, patients, and public confidence.

In this context, may I ask:

  • When the updated business case for capital funding is expected to be completed and reviewed;
  • Whether interim assurances can be given to cardiology staff regarding the Trust's intention to retain and support the service at Torbay; and
  • What steps are being taken now to stabilise morale and prevent the loss of key clinical personnel while system-level decisions remain unresolved.

The Heart Campaign remains keen to work constructively with the Trust, but time is now a critical factor. Delay carries tangible risks that cannot be remedied retrospectively.

I would welcome an early update and, if possible, a meeting to discuss how these risks can be mitigated in the immediate term.

Kindest regards

Susie Colley
Chair of the Torquay Chamber of Commerce and The Heart Campaign

Dear Mr Teape,

I am writing on behalf of the Heart Campaign to follow up on an issue that is central to the future of cardiology services at Torbay Hospital.

We have not yet received an update on whether the Trust has secured, or identified, the necessary capital funding to refurbish the cardiac catheter laboratories. As you will appreciate, the condition and viability of the cath labs are clearly integral to the continuation of local cardiology services and to maintaining safe, effective patient care.

In the interests of transparency and mutual collaboration, we would welcome clarity on:

  • Whether funding for cath lab refurbishment has been identified within the Trust or wider system; and
  • If not, whether alternative options are being actively explored.

The Heart Campaign is keen to work constructively with the Trust. If the primary barrier to refurbishment is access to capital funding, we would be willing to explore whether the campaign could play a role in supporting or contributing to fundraising efforts, subject of course to understanding the scale, scope, and feasibility of what would be required.

We raise this not as a challenge, but in a genuine spirit of partnership, recognising the shared objective of safeguarding high-quality cardiology services for the Torbay population.

We would appreciate an update at your convenience and would welcome the opportunity for further discussion if helpful.

Kindest regards

Susie Colley
Chair of the Torquay Chamber of Commerce and The Heart Campaign

To: Joe Teape (Trust CEO), Libby Ryan-Davies (ICB Deputy CEO)
CC: Martin Wrigley MP
Importance: High

Good Afternoon

Thank you for confirming the intention to proceed with refurbishment of the cath labs.

I need to formally flag that the current condition of the Cath labs represents an immediate and escalating clinical risk.

While the Cath labs can be refurbished independently, the air-conditioning system is shared across the Hetherington block. A safe and sustainable solution requires a single, coordinated HVAC refurbishment to support both cath labs.

Senior cardiologists advise that failure of the existing HVAC system is a realistic near-term risk. If this occurs, there is a credible risk of sudden loss of cath lab capacity, rather than a controlled or phased degradation. This would have significant impact on urgent and elective cardiac services.

In this context, a two-year delivery timeframe is not clinically viable without either accelerated delivery of the shared HVAC works or robust interim mitigation.

For assurance on patient safety and service continuity, clarity is urgently required on:

  • Interim mitigation or contingency arrangements should the shared HVAC system fail
  • Whether the Hetherington block HVAC works can be prioritised or fast-tracked
  • Confirmation of approved capital funding, scope, and senior responsible ownership
  • How this risk is being formally recorded and reviewed through executive and Board governance

Lastly, if the Cath labs fail then neither NDD Hospital patients or RDE could be treated and hence the Trust could lose a significant income (currently >£600k).

Consequently there is substantial evidence to support both a clinical and economic argument to refurbish now.

Given the potential for unplanned service failure, I recommend this is reviewed as a matter of urgency at executive and Board level.

I am available to discuss at short notice.

Kindest regards

Susie Colley
Chair of the Torquay Chamber of Commerce and The Heart Campaign

To: Joe Teape (Trust CEO), Libby Ryan-Davies (ICB Deputy CEO), J. Govett
Subject: Urgent: Cath Lab Replacement - Funding Position, Timeline and System Risk
Deadline: 16 February 2026 (7 working days)

Good evening Mr Teape, Ms Ryan-Davies, Mr J.Govett.

Further to my email of 29 January and my discussion with Mr J Teape yesterday, the 4th Feb, I am writing in my capacity as Chair of the Heart Campaign and on behalf of the Torbay business community through the Chamber of Commerce.

The purpose of this email is to request clarity on the replacement of the Torbay Hospital cardiac catheter laboratories, and specifically:

  1. Whether a funded replacement programme is in place
  2. The timescale for delivery
  3. The level of clinical and system risk should the current labs fail or become unavailable

As you will appreciate, this is not simply an internal equipment issue. If Torbay were to lose cath lab capacity, the wider catchment would face increased time-to-definitive treatment for acute cardiac events, with inevitable impact on outcomes. This is a system resilience and patient safety issue, not just a local operational concern.

To enable constructive support locally, could you please provide the following in writing within the next 7 working days (16th February):

A) Replacement plan and timeline

  • Confirmation of the Trust's intended plan for cath lab replacement (one lab / both labs)
  • The current timeline and key milestones
  • Any contingency plan should one lab fail before replacement is completed

B) Capital requirement

  • The total estimated capital cost for the replacement programme (headline figure)
  • Whether this includes enabling works, installation, commissioning and any associated estates works

C) Funding position

  • The amount of funding already secured
  • The current funding gap (if any)
  • Whether this scheme is in the ICB capital programme and/or submitted for national capital funding

If the Trust and ICB are not currently able to confirm the above, then I would be grateful for a clear statement of what information is outstanding and when it will be available.

Given the potential patient safety implications, I would appreciate a response by 16th February 2026. [7 working days from today].

Once we have the confirmed position and the headline figures, we can consider what support the local community and business sector may be able to offer in terms of advocacy and assistance in unlocking the appropriate funding routes.

regards

Susie Colley
Chair of the Torquay Chamber of Commerce and The Heart Campaign

From: Joe Teape (Chief Executive)
Date: 16 February 2026

£5.7m
Total capital cost
for replacement
Sept 2027
Target completion
date
HIGH
Trust-confirmed
risk level
June 2026
Manufacturer stops
guaranteed repairs

Funding Confirmed:

  • Programme funded through Trust core capital programme for 2026/27 and 2027/28
  • Total cost: Approximately £5.7m (includes new air handling, installation, commissioning, estates works)
  • Budget context: £14.3m total capital for entire organisation - cath labs represent 40% of Trust's capital budget
  • National funding bid FAILED: Estates Safety Fund 2026-2031 bid unsuccessful "due to high demand"
  • Other priorities competing for capital: Cancer aseptic pharmacy (essential for chemotherapy), LINACs (radiotherapy), diagnostic equipment

Timeline:

  • Design phase: Starting shortly, minimum 6 months legally and clinically required for safety-critical facilities
  • Design completion: September 2026
  • Full replacement: September 2027 (18 months from now)
  • Subject to: Ratification through internal governance process

Risk Level - Trust Confirms HIGH:

"The level of risk is high, which is why replacing both cardiac catheter labs has been prioritised within our capital programme."

Critical Warning - Manufacturer Support Ends June 2026:

  • Manufacturer has notified Trust they cannot guarantee repair support from June 2026
  • Equipment will not automatically "stop working or become unsafe" at that point
  • But repairs "may still be possible but cannot be guaranteed"
  • This "increases the level of uncertainty over time"

Contingency Plans:

  • Trust has experienced failures in past - team acted quickly to rectify and maintain service
  • Developing strengthened mitigations through governance routes
  • Working with manufacturer to understand different fixes for different failure scenarios
  • Reviewing internal escalation plans
  • Assessing how to maintain safe service if one lab unavailable
  • Mobile unit under consideration if both labs fail simultaneously (though unlikely)
  • Financial contingency built into capital programme

System-Wide Impact Acknowledged:

"We fully recognise the important role the labs play in supporting the wider system. Any sustained loss of capacity would have a direct impact on patient flows, pathways and system performance."

Key Constraint - National CDEL Cap:

Trust explains Capital Departmental Expenditure Limit (CDEL) is the national cap on NHS capital spending. Every capital pound counts towards this single national limit. "The NHS is legally required not to exceed this limit." Even if a trust has cash or can borrow, spending still counts towards CDEL and may not be permitted if national limit is close to being breached.

To: Joe Teape (Trust CEO), Libby Ryan-Davies (ICB Deputy CEO)
Date: 7 March 2026

CRITICAL INCIDENT: Both cardiac catheterisation labs at Torbay Hospital failed. RDE allegedly declined to provide support despite regularly receiving assistance from Torbay when their own cath labs are over capacity. The warnings about equipment failure and lack of system resilience have been proven correct.

Good evening Mr Teape,

I am writing to request immediate clarification regarding a serious matter that has been brought to my attention concerning the recent failure of both cardiac catheterisation labs at Torbay Hospital.

I have been informed that, during this incident, the Royal Devon and Exeter Hospital declined to provide support to Torbay's cardiology service. This is particularly troubling given that RDE reportedly requests - and receives - regular assistance from Torbay when their own cath labs are over capacity and patients require urgent treatment.

If accurate, this raises significant concerns about patient safety, inter-hospital cooperation, and the wider operational resilience of cardiology services across our region - especially since Torbay's cath labs are considered "terminal" and in need of replacement.

To understand the gravity and implications of this situation, I request confirmation of the following:

  • Whether this event occurred as described
  • The date and time of the incident
  • How many patients were affected
  • What actions were taken to manage patient care
  • The clinical outcomes for those patients
  • The reasoning provided by RDE for declining assistance, if applicable

This information is essential for reassurance that appropriate protocols were followed and that patient welfare was not compromised. I would appreciate a prompt and transparent response.

Kindest regards

Susie Colley
Chair of the Torquay Chamber of Commerce and The Heart Campaign
Governor of Torbay Hospital

To: Chris Balch (Medical Director), Joe Teape (Trust CEO)
CC: Steve Darling MP, David Thomas (Torbay Council), Steve Race MP, Steven Clark (NHS Devon ICB)
Date: 10 March 2026 18:21

SPECIFIC PATIENT CASE: Patient from Teignmouth requiring urgent cardiac intervention over the weekend (8-9 March). Both cath labs non-operational. Torbay cardiology staff requested transfer to RDE. RDE declined. Patient sent to Derriford Plymouth instead. This is concrete evidence of system resilience failure and patient harm from longer travel times.

Good evening Mr Balch

I am writing to you as a matter of urgency regarding concerns raised over the weekend about the availability of emergency cardiology services at Torbay Hospital.

I wrote to the Chief Executive on Saturday but understand he is currently on annual leave and given the seriousness of the situation I felt it appropriate to bring this directly to your attention.

We have received reports that a patient from Teignmouth requiring urgent cardiac intervention was to be taken to Torbay Hospital over the weekend by ambulance, but this was not undertaken as both "cath" laboratories were not operational at the time. Allegedly, it has further been suggested that cardiology staff at Torbay sought to transfer the patient to the Royal Devon and Exeter Hospital but that this request was declined, resulting in the patient being transferred to Derriford Hospital in Plymouth.

As you will appreciate, this raises significant concerns regarding resilience in emergency cardiac services and the contingency arrangements in place when the catheter laboratories at Torbay are unavailable.

The HEART campaign has already highlighted ongoing concerns that the current cath lab equipment at Torbay is ageing and increasingly unreliable. We understand the laboratories have been described as effectively "terminal" and prone to breakdowns, which is why discussions have been taking place about the urgent need for replacement facilities.

Considering the reported incident this weekend, I would be grateful if the Trust could urgently clarify:

  • whether both catheter laboratories at Torbay Hospital were unavailable at the time
  • what contingency arrangements are in place when the labs are not operational
  • whether a request was made to transfer the patient to the Royal Devon and Exeter Hospital
  • who is responsible for accepting or declining such transfers within the regional cardiac network
  • whether any review of the incident is now taking place

While we fully respect patient confidentiality, reassurance regarding the resilience of emergency cardiac services at Torbay Hospital is clearly in the public interest.

Given the level of concern locally, I would appreciate a response at the earliest opportunity.

regards,

Susie Colley
Chair of the Torquay Chamber of Commerce and The Heart Campaign
Elected Governor of Torbay Hospital

From: Jane Harris, Associate Director of Communications and Partnerships (on behalf of Adel Jones, Deputy CEO and Chief Operating Officer)
To: Susie Colley (Heart Campaign Chair)
CC: Steve Darling MP, Martin Wrigley MP, Steve Race MP
Date: 12 March 2026, 17:17

CONFIRMED BY TRUST: Both cardiac catheterisation labs at Torbay Hospital simultaneously failed due to unplanned technical issues. The Trust has admitted that existing standard operating procedures for managing this scenario were not adequate and has committed to strengthening cross-site protocols. The failure mode the Heart Campaign warned about has now occurred - and the Trust's own response confirms the system was not prepared for it.

Dear Ms Colley

Thank you for taking the time to write and for setting out your concerns so clearly. I recognise the important role you play in advocating for people with heart conditions and I understand why any suggestion of disruption to local cardiology services would be concerning.

Both of Torbay Hospital's cardiac catheterisation labs did experience a short, unplanned outage recently due to technical issues. These issues have since been resolved and services are currently operating as normal.

During the period of disruption, cardiology clinical teams worked together across Devon to agree appropriate support arrangements, in line with established clinical protocols. However having reviewed the incident carefully, we have identified a need to strengthen the standard operating procedures for cardiology diverts with the senior management teams to ensure that cross-site support across Devon is improved and I have agreed with Chief Executives across Devon that I will take this forward at pace.

Both University Hospitals Plymouth NHS Trust and Royal Devon University Healthcare NHS Foundation Trust offered support as part of these arrangements over the weekend period. I can confirm that no patient was left without appropriate clinical oversight or escalation.

Thank you again for raising these concerns. We value constructive engagement with patient representatives and campaign groups, and we remain committed to working closely with partners to ensure safe, resilient cardiology services for our population.

Yours sincerely
Adel Jones
Deputy Chief Executive and Chief Operating Officer
Torbay and South Devon NHS Trust

What this response does not answer:
  • How long "short" actually was - the duration of the outage is not stated
  • Whether PPCI was available to Torbay catchment patients during the outage window
  • What happened to the specific patient from Teignmouth documented in accordion 9 - the response does not address the alleged RDE refusal or the Plymouth transfer
  • "Appropriate clinical oversight or escalation" is not confirmation that emergency cardiac intervention was accessible
  • Why the Comms Director responded on behalf of the Deputy CEO, to emails addressed to the CEO and Chair - neither Joe Teape nor Prof Chris Balch responded directly

Status: Trust Deputy CEO (Adel Jones) responded 12 March 2026, confirming both cath labs simultaneously failed over the weekend of 8-9 March due to unplanned technical issues and are now restored. Trust acknowledged existing SOPs for managing cath lab diverts were inadequate and has committed to strengthening cross-site protocols "at pace." However, the response does not confirm the duration of the outage, whether PPCI was available to Torbay catchment patients during the window, or the clinical outcome for the patient documented in accordion 9 (transferred to Plymouth after RDE declined). Response sent by Comms Director Jane Harris on behalf of Adel Jones - neither Trust CEO Joe Teape nor Chair Prof Chris Balch responded directly to emails addressed to them. Two formal FOIs now submitted to establish the factual record: RDF4139-26 (transfer handling, four organisations) and a divert log request (three organisations), both due 14 April 2026. £5.7m replacement programme confirmed (16 Feb) but completion not until September 2027. Manufacturer support ends June 2026.

Download Original FOI Response (PDF)
Internal Review not substantively answered: The ICB's Internal Review response (due approximately 7 January 2026) was never received. Instead, the ICB bundled this request into its 8 April 2026 response to FOINHSD26/1566, stating the case for change programme will not be progressed at this time. The specific questions about documented timelines and the SRO's absence were never answered - the programme withdrawal has made them procedurally moot. The campaign should note that the ICB has not confirmed whether documented timelines existed, nor addressed the Internal Review challenge.
Why This Matters: The "Case for Change" is the foundational document justifying the proposed relocation of cardiac services. NHS Devon initially refused to confirm whether they even hold documented timelines, then admitted they hold "part" of the requested information but provided minimal detail. The Internal Review challenging that position was never answered on its merits.
29 Jan
2026 Board meeting
for "next steps"
s40(2)
Exemption claimed
for SRO details
0
Timelines provided
(original or revised)

What we asked for:

  • Information about the SRO's "temporary unplanned absence"
  • Original and revised timelines for the Case for Change
  • Internal risk assessments mentioning delays
  • Confirmation of interim SRO arrangements

What NHS Devon revealed (8 December 2025):

  • NHS Devon confirmed it holds part of the requested information
  • Next steps to be considered at 29 January 2026 Board meeting
  • Refused to provide SRO absence details citing Section 40(2) (personal information)
  • Did not confirm whether documented timelines exist
Internal Review Challenge (9 December 2025): Response failed to confirm whether documented timelines exist or provide any substantive information about programme delays. Internal Review response due approximately 7 January 2026. No response was ever received to the Internal Review challenge itself.

Status: Initial response received 5 December 2025 (clarified 8 December). Internal Review submitted 9 December 2025. The Internal Review was never answered on its merits. On 8 April 2026, the ICB issued a combined response to FOINHSD25/1493 and FOINHSD26/1566 confirming the case for change programme will not be progressed at this time, following a Joint Committee decision on 26 March 2026. The specific questions about programme timelines and the SRO absence remain unanswered. See FOINHSD26/1566 for the full text of the ICB's 8 April response.

Download Original Response (PDF) Download Internal Review Request (PDF)
Why This Matters: NHS Devon ICB claims Royal Devon can absorb Torbay's cardiac workload, yet this data reveals their cath labs are already "fully utilised during weekdays." If RDE is at full capacity and already transferring 284 patients TO Torbay, how can they take on Torbay's cases?
2,674
Weekend procedures
Jan 2023 - Oct 2025
20.29
WTE consultant
cardiologists
284
Inpatient transfers
to Torbay since Oct 2023

This request sought information about cath lab capacity and utilization rates, weekend elective cardiology procedures, consultant staffing levels, and patient transfers between RDE and other hospitals.

Key finding: RDE cath labs are "fully utilised during weekdays" - they are running weekend sessions to manage demand.

Download Document (PDF)
Why This Matters: This was the first attempt to get information about Edge Health's commission to model demand and capacity across Devon's hospitals - the modelling that underpins proposed cardiac service changes. NHS England's response: "We don't hold this information. Contact Devon ICB."

What Was Requested:

  1. Commissioning Authority - Which NHS organisation commissioned Edge Health; who initiated or requested the modelling
  2. Scope and Purpose - Which hospitals and specialties were included; explicit confirmation whether cardiology was modelled
  3. Timescales - When work was conducted; forecast period covered
  4. Outputs and Deliverables - Reports, forecasts, capacity models, presentations produced
  5. Contract and Costs - Contract date, value, reference number, procurement method
  6. Governance and Oversight - Which boards reviewed findings; minutes, papers, summaries

NHS England's Response (17 November 2025):

"NHS England does not hold this information."

NHS England explicitly directed the request to:

NHS Devon Integrated Care Board - "responsible for the majority of NHS budget and services in Devon"
The Critical Statement: NHS England explicitly identifies NHS Devon ICB as "responsible for the majority of NHS budget and services in Devon" - positioning them as the authority that should hold this information. This makes Devon ICB's subsequent claims that they hold no contracts, business cases, approval papers, or internal correspondence fundamentally implausible.

Status: Response received 17 November 2025. NHS England confirmed it does not hold information and explicitly directed request to NHS Devon ICB as the organisation "responsible for the majority of NHS budget and services in Devon." This triggered subsequent FOI requests to Devon ICB (FOINHSD25/1474, FOINHSD25/1520, and FOI-2510-2272157 NHSE:0679333).

Critical Finding: SWASFT confirmed prehospital thrombolysis is NOT provided in South Devon (only Portland and Isles of Scilly). Paramedics haven't been trained in thrombolysis for over 10 years. No specialist ECG interpretation service exists. Moving cardiac services from Torbay to Exeter would extend diagnostic uncertainty from 15 to 43+ minutes - directly contradicting NICE guidance that requires thrombolysis when PCI cannot be delivered within 120 minutes.
Why This Matters: If ambulances don't carry clot-busting drugs and paramedics aren't trained to administer them, then every extra minute travelling to a cath lab increases heart damage and death risk. NICE guidelines are unequivocal: if timely PCI cannot be achieved, prehospital thrombolysis MUST be available to prevent avoidable harm and excess mortality.

Key Findings from SWASFT Response (26 January 2026):

  • Zero thrombolysis capability in South Devon - medication only carried in Portland and Isles of Scilly
  • No paramedic training for over 10 years - not part of current education programmes
  • Zero administrations 2022-2025 - no crews have carried medication in South Devon
  • No dedicated specialist ECG interpretation service - crews cannot routinely access cardiology advice
  • RD&E has no advice line - only PPCI activation function available
  • 75-minute threshold - SWASFT guidelines require critical care support if PPCI cannot be reached within 75 minutes (not 120)

The NICE Compliance Trap:

NICE guidelines (CG167 and NG185) are unequivocal: where primary PCI cannot be delivered within 120 minutes, prehospital thrombolysis MUST be available to prevent avoidable delays to reperfusion and reduce avoidable harm. Moving emergency cardiology from Torbay to Exeter creates a choice:

  1. Option 1: Expose patients to call-to-balloon times exceeding NICE thresholds = foreseeable and avoidable harm
  2. Option 2: Reintroduce prehospital thrombolysis = paramedic retraining, clinical governance, competency assessment, audit, significant cost and risk
HSSIB Report (October 2025): National investigation found ambulance crews struggle to identify borderline STEMI cases, ECG auto-interpretation fails when needed most, and clinical support hubs lack specialist ECG expertise. In 9 ambulance trust investigations into missed STEMIs, only ONE had auto-interpretation correctly identifying "STEMI" - the others showed only "abnormality of some description."

The Diagnostic Uncertainty Problem:

Being taken to Torbay means borderline cases get expert cardiology eyes within ~15 minutes. Extending travel time to Exeter means diagnostic uncertainty persists for 43+ minutes. This directly contradicts the HSSIB findings that crews already struggle with borderline STEMI diagnosis.

For the attention of Ms Libby Ryan-Davies

Good evening Ms Ryan-Davies

I am writing further to confirmation from the ambulance service, in response to a query raised via the heart campaign, that pre-hospital thrombolysis is no longer provided by paramedics in this region, with the exception of the Isles of Scilly and Portland.

NICE guidance on acute coronary syndromes (including CG167 and NG185) is unequivocal that patients with ST-elevation myocardial infarction (STEMI) must receive reperfusion therapy within defined national time standards. NICE is also clear that where timely access to primary PCI cannot be achieved, pre-hospital thrombolysis should be available in order to prevent avoidable delays to reperfusion and reduce avoidable harm, including excess mortality and long-term cardiac damage.

Against this backdrop, I am seeking clarification on how the ICB has assured itself that the proposed merger of cardiology services between Torbay and Exeter would not result in foreseeable and avoidable harm to patients.

If service reconfiguration leads to call-to-balloon times that exceed NICE-recommended thresholds for patients in the Torbay catchment area, and no effective pre-hospital thrombolysis pathway is in place, this would represent a known and predictable failure to meet national standards of care. The clinical consequences of delayed reperfusion in STEMI are well established, and any resulting increase in morbidity or mortality would be both foreseeable and avoidable.

Can you therefore confirm:

  • How the ICB has assured itself that the proposed service changes would not expose patients to increased risk of avoidable harm due to delayed reperfusion;
  • Whether the absence of a pre-hospital thrombolysis pathway has been formally risk-assessed against NICE standards;
  • Whether the potential need to reintroduce pre-hospital thrombolysis has been explicitly considered, costed, and incorporated into planning; and
  • How accountability for any failure to meet NICE-recommended time standards has been addressed within the ICB's governance framework.

Kindest regards

Susie Colley
Chair of the Torquay Chamber of Commerce and The Heart Campaign

FAO the Information Governance Team

Good evening

Thank you for clarifying that thrombolysis is no longer routinely practised, following the successful transition to PPCI.

In light of ongoing discussions about future cardiology provision at Torbay, I wanted to ask whether SWAST has had any engagement with the ICB regarding the potential implications for reperfusion pathways, including whether re-introduction of thrombolysis has been considered should access to timely PPCI change.

I would also be grateful to understand whether any preliminary consideration has been given to the training, clinical governance, and operational arrangements that would be required to support thrombolysis safely, noting NICE guidance on acute coronary syndromes (CG167 and NG185), which emphasises the importance of timely reperfusion via primary PCI, or thrombolysis where PPCI cannot be delivered within recommended timeframes.

Kindest regards

Susie Colley
Chair of the Torquay Chamber of Commerce and The Heart Campaign

To: SWASFT Information Governance
CC: Joe Teape (Trust CEO), Libby Ryan-Davies (ICB Deputy CEO), Steven Clark (ICB), ICB Executive Office, Steve Darling MP
Subject: Query re thrombolysis provision and ambulance crew training (Torbay pathway resilience)

Dear Nicole

Further to your concise answers in your email of the 26.01.2026 would you be able to furnish us with additional information please?

My understanding is that ambulance crews are no longer licensed/authorised to administer thrombolysis to patients in Torbay Hospital catchment area. Given the time-critical nature of acute coronary syndromes, I would be grateful if you could confirm whether this is correct and, if so, the rationale and timeline for that change.

Current position

Can you confirm whether any ambulance clinicians in your service are currently able to administer thrombolysis in the prehospital setting within the Torbay Hospital catchment area?

Impact on heart attack care

  • What is the current pathway for patients with suspected STEMI / time-critical heart attack when catheter lab access is delayed or unavailable?
  • What mitigations are in place for patients in rural or remote areas where transport times are longer?

Planning and resilience

  • Has the service, or the local ICB, considered the option of retraining crews (or a defined cohort of clinicians) to administer thrombolysis if required for system resilience?
  • Has the ICB asked the ambulance service to explore this option as part of contingency planning?

Training, timeline, and cost

  • How long it would take to retrain and sign off clinicians (or specialist teams)?
  • How many staff would realistically need training to provide safe coverage?
  • Who would be responsible for funding training, governance, and ongoing competency?

Kindest regards

Susie Colley
Chair of the Torquay Chamber of Commerce and The Heart Campaign

Status: SWASFT response received 26 January. ICB challenged same day on NICE compliance and patient safety implications. Initial follow-up sent to SWASFT 27 January asking about ICB consultation. Comprehensive follow-up sent 5 February with detailed questions on current licensing/authorisation, rationale for change, STEMI pathways when cath lab delayed, rural area mitigations, whether ICB requested contingency planning, and retraining costs/timelines. Awaiting responses on whether contingency planning for thrombolysis reintroduction has been explored and what system resilience options exist if cardiac services change.

Download Original Request (PDF) Download SWASFT Response (PDF)
Context: Submitted alongside the transfer handling FOI (RDF4139-26). Where that request asks what happened and why, this one requests the raw documented evidence - the actual divert log, SWAST triage notes, and cross-trust communications. Together the two requests cover both the decision-making record and the operational record. NHS Devon ICB is not included in this request as they would not hold operational divert documentation.
Why This Matters: The Trust's incident response (12 March, 17:17) gave a narrative account of what happened during the outage. Divert logs and SWAST records are the contemporaneous documented evidence against which that narrative can be tested. If the logs show a transfer request was made and declined, that contradicts the Trust's account that RDE "offered support." If they show no transfer was requested, that contradicts the patient case reported to the campaign.

Organisations requested to respond:

  • Royal Devon University Healthcare NHS Foundation Trust (ref: RDF4140-26, acknowledged 13 March 2026, no substantive response yet)
  • Torbay and South Devon NHS Foundation Trust (ref: TSD10426, response received 21 April 2026 - see below)
  • South Western Ambulance Service NHS Foundation Trust (responsible for transport and clinical handover decisions, awaiting response)

Information requested:

  1. The full site-to-site divert log for the date of the outage, including:
    • Timestamp of divert activation
    • Units placed on divert
    • Time the divert was lifted
    • All attempted transfer requests
    • Responses from each receiving hospital
    • Notes or escalation actions
  2. Any SWAST clinical triage notes relating to the Teignmouth patient transfer on the same date, with personal identifiers removed
  3. Any cross-trust communications relating specifically to the acceptance or refusal of that patient

All answers requested with reference to official documented records, not narrative accounts.

TSD Refused Disclosure on Section 40(2) Grounds (21 April 2026): Torbay and South Devon NHS Foundation Trust has applied Section 40(2) of the Freedom of Information Act 2000, citing the first data protection principle. The Trust states that disclosure would be "likely to identify the individual concerned." This is treated by the Trust as an absolute exemption not subject to the public interest test. The Trust has applied a single blanket refusal across the whole request, including the divert log timestamps and operational records that contain no personal data, and has not addressed each of the three items separately.

Trust response details:

  • Trust reference: TSD10426
  • Response date: 21 April 2026, 12:53
  • Signed by: Sarah Goss, Data Protection Lead
  • Exemption applied: Section 40(2) FOIA, by virtue of Section 40(3)(a)(i)
  • Reason given: "Disclosure would be likely to identify the individual concerned, breaching the first data protection principle"
  • Public interest test: Not applied (Trust treats Section 40(2) as an absolute exemption)

Grounds for potential internal review challenge:

  • The original request was specifically structured to separate operational records (divert log, transfer requests and responses, escalation actions) from any potentially identifying clinical information
  • SWAST clinical triage notes were explicitly requested with personal identifiers removed, which is a redaction request rather than a request for identifiable data
  • Section 40(2) cannot reasonably apply to timestamps of divert activation, units placed on divert, time the divert was lifted, or escalation pathway records that contain no personal data
  • The Trust has not addressed each of the three items separately and has not provided a reasoned explanation of why partial disclosure is not possible
  • The Trust has not engaged the duty under Section 16 (advice and assistance) to suggest how the request might be refined to enable partial disclosure

From: FOI (Torbay and South Devon NHS Foundation Trust) tsdft.foirequests@nhs.net
To: Susie Colley (chair@tqcc.co.uk)
Subject: RE: TSD10426 - FOI Final Response
Trust contact: foi.tsdft@nhs.net
Reference: TSD10426

Dear Susie,

Request for Information

We are writing to confirm that we have now completed our search for the information you requested.

A copy of the information is below:

REQUEST

I am requesting the full divert log relating to the unplanned outage of Torbay Hospital's cardiac catheterisation laboratories.

Please provide:

  • Torbay and South Devon FT (originating site)
  • RD&E (potential receiving site)
  • SWAST (responsible for transport and clinical handover decisions)
  • The Site-to-Site Divert Log for the date of the outage, including:
    • Timestamp of divert activation
    • Units placed on divert
    • Time the divert was lifted
    • All attempted transfer requests
    • Responses from each receiving hospital
    • Notes or escalation actions
  • Any SWAST clinical triage notes relating to the Teignmouth patient transfer on the same date, with personal identifiers removed
  • Any cross-trust communications relating specifically to the acceptance or refusal of that patient

This information is vital to understanding the operational processes followed and ensuring transparency regarding emergency cardiac service provision.

Trust response:

We have carefully considered your request and have concluded that to disclose this information would be likely to identify the individual concerned, breaching the first data protection principle. We believe that it is likely that the information may exempt under section 40(2) of the Freedom of Information Act by virtue of section 40(3)(a)(i).

S40(2) is described as "Any information to which a request for information relates is also exempt information if -

(a) it constitutes personal data which do not fall within subsection (1) and

(b) either the first or the second condition below is satisfied

S40(3) provides that -

"The first condition is -

(a) in a case where the information falls within any of paragraphs (a) to (d) of the definition of "data" in section 1(1) of the Data Protection Act 1998, that the disclosure of the information to a member of the public otherwise than under this Act would contravene -

(i) any of the data protection principles, or

(ii) Section 10 of that Act (right to prevent processing likely to cause damage and distress)

Section 1 of the Data Protection Act 1998 defines personal data as information which relates to a living individual who can be identified (a) from that data

This exemption is an absolute exemption that is not subject to the public interest test.

The information supplied to you continues to be protected by the Copyright, Designs and Patents Act 1988. You are free to use it for your own purposes, including any non-commercial research you are doing and for the purposes of news reporting.

If you wish to discuss any of the above, please contact us, quoting the FOI reference number above.

If you are unhappy with the way in which we have handled your request, please contact the Data Protection and Freedom of Information Lead in the first instance. If you wish to make a formal complaint, you should write to our Complaints Manager at Torbay and South Devon NHS Foundation Trust, First Floor Bowyer Building, Torbay Hospital, Torquay TQ2 7AA.

If you are not content with the outcome of your complaint or the internal review, you may apply directly to the Information Commissioner for a decision. Generally, the Information Commissioner will only make a decision once you have exhausted the complaints and/or internal review process provided by us. The Information Commissioner can be contacted at: The Information Commissioner's Office, Wycliffe House, Water Lane, Wilmslow, Cheshire, SK9 5AF or through this link https://ico.org.uk/global/contact-us/

Yours sincerely,

Sarah Goss
Data Protection Lead
Torbay and South Devon NHS Foundation Trust
Belmont Court, Torbay Hospital, TQ2 7AA

Status: Torbay and South Devon NHS FT response received 21 April 2026 from Sarah Goss, Data Protection Lead, under reference TSD10426. The Trust has refused disclosure in full on Section 40(2) grounds, treating the entire request as personal data without distinguishing between the operational divert log and the clinical triage notes. The Trust's blanket exemption is a candidate for internal review on the grounds set out above. Substantive responses from RDE (under reference RDF4140-26) and SWASFT remain awaited as separate organisations not bound by this Trust response. SWASFT's response is likely to be particularly significant as the ambulance service holds dispatch and handover records that are independent of either hospital's account.

Why This Matters: Virtual wards allow patients to be monitored and treated at home rather than as inpatients, with different specialties operating distinct virtual ward models. The Trust runs a frailty virtual ward service. This request asked for comparative information between the frailty virtual ward and any cardiac virtual ward provision, to establish whether there is parity of investment and capacity between specialties at Torbay.

Organisation requested to respond:

  • Torbay and South Devon NHS Foundation Trust (ref: TSD10012)

Subject as logged by the Trust: "Frailty versus Cardiac Virtual wards comparison issues"

Status: Submitted 3 November 2025 to tsdft.foirequests@nhs.net. The Trust requested an extension on 2 November 2025, with a revised response date of 9 December 2025. Substantive response received 9 December 2025. Full response content to be added to this card when available.

Context: Submitted the same evening the Trust issued its incident response (12 March, 17:17). That response confirmed both labs failed but failed to address the core allegation - that RDE declined a transfer request for a patient from Teignmouth who was subsequently sent to Derriford Plymouth instead. This FOI asks all four organisations directly to provide the documented record of what happened, who made the decisions, and why.
Why This Matters: The Trust's incident response stated that RDE "offered support" - directly contradicting the allegation that a transfer was declined. One of these accounts is wrong. This FOI requests the official incident log, divert records, and internal communications so the documented facts can be established, not just competing narratives.

Organisations requested to respond:

  • Royal Devon University Healthcare NHS Foundation Trust (ref: RDF4139-26, acknowledged 13 March 2026, no substantive response yet)
  • Torbay and South Devon NHS Foundation Trust (ref: TSD10425, response received 21 April 2026 - see below)
  • South Western Ambulance Service NHS Foundation Trust (awaiting response)
  • NHS Devon Integrated Care Board (awaiting response)

Information requested:

  1. Whether a transfer request was made for a patient from Teignmouth requiring emergency cardiology intervention during the outage, including the date and time of the request
  2. Whether that transfer request was declined by RDE, and if so the role (not name) of the individual who made the decision
  3. The clinical or operational rationale recorded for accepting or declining the transfer
  4. The escalation pathway followed, including internal clinical discussions, cross-trust communications, ICB involvement, and application of SOPs for emergency cardiology diverts
  5. Whether alternative receiving centres were contacted and the responses given by each

All answers requested with reference to the official incident log, divert record, and internal communications. No personal data requested.

TSD Refused Disclosure on Section 40(2) Grounds (21 April 2026): Torbay and South Devon NHS Foundation Trust has applied Section 40(2) of the Freedom of Information Act 2000, citing the first data protection principle. The Trust states that disclosure would be "likely to identify the individual concerned." This is treated by the Trust as an absolute exemption not subject to the public interest test. The Trust has applied a single blanket refusal across the whole request, including questions about the role (not name) of the decision-maker, escalation pathways, SOP application, and which alternative receiving centres were contacted - none of which inherently identify a patient. The Trust has not addressed each of the five questions separately and has not offered partial disclosure. This response mirrors the Trust's refusal under TSD10426 for the divert log request submitted at the same time.

Trust response details:

  • Trust reference: TSD10425
  • Response date: 21 April 2026, 12:48
  • Signed by: Sarah Goss, Data Protection Lead
  • Exemption applied: Section 40(2) FOIA, by virtue of Section 40(3)(a)(i)
  • Reason given: "Disclosure would be likely to identify the individual concerned, breaching the first data protection principle"
  • Public interest test: Not applied (Trust treats Section 40(2) as an absolute exemption)

Grounds for potential internal review challenge:

  • Question 2 explicitly asked for the role of the decision-maker, not the name. Roles such as "on-call cardiologist", "executive on-call", or "bed manager" are organisational positions, not personal data. Section 40(2) cannot reasonably apply to position titles.
  • Question 4 asked about escalation pathways, application of SOPs, and ICB involvement. These are organisational and procedural records, not personal data about an individual patient.
  • Question 5 asked which alternative receiving centres were contacted and what responses were given. The names and responses of NHS Trusts are not personal data.
  • The Trust has applied a blanket refusal across all five questions without distinguishing between elements that may engage Section 40(2) and elements that clearly do not.
  • The Trust has not engaged the duty under Section 16 (advice and assistance) to suggest how the request might be refined to enable partial disclosure.
  • This is the second blanket Section 40(2) refusal from the Trust on the same day for related requests (TSD10425 and TSD10426), suggesting a pattern rather than a request-by-request analysis.

From: FOI (Torbay and South Devon NHS Foundation Trust) tsdft.foirequests@nhs.net
To: Susie Colley (chair@tqcc.co.uk)
Subject: RE: TSD10425 - FOI - Final Response
Trust contact: foi.tsdft@nhs.net
Reference: TSD10425

Dear Susie,

Request for Information

We are writing to confirm that we have now completed our search for the information you requested.

A copy of the information is below:

REQUEST

I am submitting this Freedom of Information request regarding the recent unplanned outage of the cardiac catheterisation laboratories at Torbay Hospital and the subsequent handling of emergency cardiology transfers.

Please provide the following information:

  • Was a transfer request made for a patient from Teignmouth requiring emergency cardiology intervention during the outage? Please confirm the date and time of the request.
  • Was this transfer request declined by the Royal Devon and Exeter Hospital (RD&E)? If yes, please specify the role not the name of the individual who made the decision, such as:
    • On-call cardiologist
    • On-call operational/flow manager
    • Executive on-call
    • Bed manager
    • Any other relevant role
  • Please provide the clinical or operational rationale recorded for accepting or declining the transfer.
  • Please provide the escalation pathway followed, including any:
    • internal clinical discussions
    • cross-trust communications
    • involvement of the ICB
    • application of standard operating procedures for emergency cardiology diverts
  • Please confirm whether any alternative receiving centres were contacted, and the responses given by each.

I request that all answers reference the official incident log, divert record, and internal communications.

Trust response:

We have carefully considered your request and have concluded that to disclose this information would be likely to identify the individual concerned, breaching the first data protection principle. We believe that it is likely that the information may exempt under section 40(2) of the Freedom of Information Act by virtue of section 40(3)(a)(i).

S40(2) is described as "Any information to which a request for information relates is also exempt information if -

(a) it constitutes personal data which do not fall within subsection (1) and

(b) either the first or the second condition below is satisfied

S40(3) provides that -

"The first condition is -

(a) in a case where the information falls within any of paragraphs (a) to (d) of the definition of "data" in section 1(1) of the Data Protection Act 1998, that the disclosure of the information to a member of the public otherwise than under this Act would contravene -

(i) any of the data protection principles, or

(ii) Section 10 of that Act (right to prevent processing likely to cause damage and distress)

Section 1 of the Data Protection Act 1998 defines personal data as information which relates to a living individual who can be identified (a) from that data

This exemption is an absolute exemption that is not subject to the public interest test.

The information supplied to you continues to be protected by the Copyright, Designs and Patents Act 1988. You are free to use it for your own purposes, including any non-commercial research you are doing and for the purposes of news reporting.

If you wish to discuss any of the above, please contact us, quoting the FOI reference number above.

If you are unhappy with the way in which we have handled your request, please contact the Data Protection and Freedom of Information Lead in the first instance.

If you are not content with the outcome of your complaint or the internal review, you may apply directly to the Information Commissioner for a decision. Generally, the Information Commissioner will only make a decision once you have exhausted the complaints and/or internal review process provided by us. The Information Commissioner can be contacted at: The Information Commissioner's Office, Wycliffe House, Water Lane, Wilmslow, Cheshire, SK9 5AF or through this link https://ico.org.uk/global/contact-us/

Yours sincerely,

Sarah Goss
Data Protection Lead
Torbay and South Devon NHS Foundation Trust
Belmont Court, Torbay Hospital, TQ2 7AA

Status: This request directly tests the contradiction between the Trust's claim that RDE "offered support" and the documented patient case in which a transfer to RDE was allegedly declined and the patient sent to Plymouth. The four organisations' responses, or failure to respond consistently, will establish the factual record. To date, only Torbay and South Devon NHS FT has issued a substantive response, received 21 April 2026 from Sarah Goss, Data Protection Lead, under reference TSD10425. The Trust has refused disclosure in full on Section 40(2) grounds, including questions about decision-maker roles, escalation pathways, SOP application, and alternative receiving centres, none of which inherently constitute personal data. This is the second blanket Section 40(2) refusal from the Trust on the same day for related requests (the divert log under TSD10426 was refused on identical grounds), suggesting a pattern rather than a request-by-request analysis. The Trust's blanket exemption is a candidate for internal review on the grounds set out above. Substantive responses from RDE (under reference RDF4139-26), SWASFT, and NHS Devon ICB remain awaited as separate organisations not bound by this Trust response.

Correspondence on Record

This section captures substantive email correspondence that is not yet a formal numbered FOI but where the campaign has put matters on record. Items here may graduate to a numbered FOI, or move to "Responses Received" if a substantive response arrives.

Why This Matters: The ICB has formalised a practice of issuing correspondence from a generic d-icb.involve@nhs.net inbox without named authors, making it impossible to determine who is responsible for the content, decisions, or advice being provided. This connects to the broader transparency concerns running through FOINHSD25/1474, FOINHSD25/1520 and FOINHSD25/1493. The 14 April email also makes a series of specific factual claims that are now testable via future FOI requests.

Testable claims made by NHS Devon in the 14 April email:

  • PPCI relocation: "There are no proposals to move PPCI" set out in the One Plan for Devon, the ICB's five-year commissioning intentions, or the Devon Health and Care Strategy. Worth FOI request for any internal papers, board discussions, options appraisals or clinical reviews referencing PPCI relocation.
  • Lead Provider model: Not in the One Plan for Devon but included in the Devon Health and Care Strategy. Testable via the Strategy text and any implementation papers, particularly any application to cardiology pathways.
  • Torbay Hospital NHP scheme: Wave 2, construction 2033 to 2035, cost "above £500 million", final scope pending full business case. Testable via FOI for current business case status and correspondence with DHSC on the timetable.
  • Histopathology relocation to Gadeon House Exeter: Trust Board has approved relocation of routine histopathology, with time-critical and urgent work remaining at Torbay through a permanent Acute Services Laboratory. To be confirmed at TSD Board of Directors public meeting on 7 May 2026.
  • "No underwritten guarantee": ICB has refused on the record to provide a guarantee that Torbay Hospital will not be downgraded, citing that the NHS cannot provide guarantees of that nature.
  • £14.2 million ED redevelopment: Stated completion 2026.
  • Cath lab refurbishment: Listed by ICB as a Trust capital priority. Directly relevant to FOINHSD25/1415.
  • Pre-election engagement pause: ICB stated they cannot attend public meetings during the pre-election period but will engage local communities fully and openly after the 7 May local elections. Worth tracking whether engagement actually happens.

From: INVOLVE (NHS DEVON ICB - 15N) d-icb.involve@nhs.net
To: Susie Colley (chair@tqcc.co.uk), Steve Darling MP, INVOLVE (NHS Devon ICB)
CC: Kevin Dixon, David Thomas (Torbay Council), Cat Johns (Torbay Council), Torre and Upton, Nicole Amil, phil.keeling1961
Importance: High

Dear Susie,

Following the meeting last night, I thought it would be helpful to resend the specific responses to your pre-meeting questions that you asked us to provide, please see below. We also want to signpost you to where our One plan for Devon details and useful documents, including our Frequently Answered Question (FAQs) sections, are online.

We understand personal contact details for NHS Devon colleagues are going to be shared following the meeting, please can we ask that you publish our Involve inbox (d-icb.involve@nhs.net) as the main contact email address for the ICB, as previously agreed.

This will ensure emails are directed to the most appropriate colleague for response. I note from your email dated 9 April 2026 you included a Joseph Govett and used the wrong email address for Mark Hackett, this highlights the importance of using the Involve Inbox as a single point of contact.

Any emails received personally by colleagues will be directed to this inbox with a co-ordinated response provided.

Kind regards
NHS Devon

The email then quoted the earlier ICB response of 13 April 2026 (15:11) which contained the substantive answers to the campaign's pre-meeting questions:

We welcome the opportunity to respond, as we are concerned that some of the information currently circulating does not reflect the content of the One Plan for Devon.

We would also like to clarify the role of the NHS Devon Integrated Care Board (ICB) and the Torbay and South Devon NHS Foundation Trust.

The NHS works as a partnership locally, with the ICB planning and commissioning services across Devon, and NHS Trusts run hospital services day-to-day. We work closely together to make sure services are safe, sustainable and meet local needs.

The One Plan for Devon sets out the overall direction for health and care over the next five years. It does not include specific decisions about individual hospital services but does recognise that delivering sustainable services across Devon will not be possible without transformation.

Where any future changes are proposed, these would be led by clinical teams and involve local people before any decisions are made.

ICBs and trusts all have legal duties to involve the public in their decision-making, these are outlined in the One Devon People and Communities Framework which was co-developed with partners across Devon.

The main duties on NHS bodies are set out in the National Health Services Act 2006, as amended by the Health and Care Act 2022:

  • section 13Q for NHS England
  • section 14Z45 for integrated care boards
  • section 242(1B) for NHS trusts and NHS foundation trusts

Q1. What is meant by the "Lead Provider model" in the five-year plan?

The Lead Provider model is not mentioned in the One Plan for Devon but is included in the Devon Health and Care Strategy.

The Lead Provider model is a commissioning and contracting approach, not a service change.

It means one NHS organisation may be asked to take overall responsibility for coordinating a pathway of care (for example, elective care or community services), working with other providers as partners.

This is intended to:

  • Improve coordination of care
  • Reduce fragmentation
  • Improve outcomes and patient experience

It does not predetermine:

  • Which services are delivered and where
  • The closure, relocation or reduction of services

Any changes to services would require separate proposals and public involvement.

Q2. Can the ICB confirm there are no relocation plans to move Primary Percutaneous Coronary Intervention (PPCI) to Exeter?

There are no proposals to move PPCI set out in:

  • The One Plan for Devon
  • The ICB's five-year commissioning intentions
  • The Devon Health and Care Strategy

If any such proposal were ever to be developed, it would require formal clinical review and full public involvement.

Q3. What does "New Hospital" mean in the Devon New Hospital Programme (NHP) appendix?

The reference to a "New Hospital" relates to the national New Hospital Programme, which is focused on:

  • Replacing or refurbishing unsafe or ageing hospital buildings
  • Addressing issues such as reinforced autoclaved aerated concrete (RAAC)
  • Improving the physical condition of hospitals

Torbay Hospital is in wave two of the national New Hospital Programme. Following a national review of the programme in early 2025, the timetable for main construction associated with the Torbay scheme moved to between 2033 and 2035.

The scheme is expected to involve a significant redevelopment of the existing hospital site. Current estimates suggest a total cost above £500 million, but the final scope, cost and funding position will only be confirmed once the full business case process has been completed and approved nationally.

While work continues nationally on the longer-term programme, Torbay and South Devon NHS Foundation Trust is exploring all other funding avenues available to manage estates risks and invest in the site. This includes the £14.2 million redevelopment of the Emergency Department, which is due to be completed this year.

Alongside this, the Trust is progressing other capital schemes on the Torbay Hospital site through national funding, including the refurbishment of day theatres, expansion of Oral and Maxillofacial Surgery services as well as several priority schemes through its own capital allocation such as the refurbishment of the cardiac catheterisation laboratories and aseptic pharmacy (chemotherapy).

In addition, essential infrastructure works are being taken forward to address known issues associated with the ageing estate and to keep services safe and operational while longer-term plans are developed.

North Devon District Hospital (Royal Devon University Healthcare NHS Foundation Trust) is in wave three of the New Hospital Programme. Construction is due to begin between 2035 and 2038 and involves a major site modernisation.

Derriford Hospital (University Hospitals Plymouth NHS Trust) is wave one of the New Hospital Programme for a specific project, a new Emergency Care Building. Construction has begun on this project and is due to be completed in 2028/29.

Q4. Can the ICB provide an underwritten guarantee that the hospital will not be downgraded?

The NHS cannot provide an "underwritten guarantee" of this nature, however, we can be clear that our One Plan for Devon does not include proposals to downgrade hospitals, remove services, or make specific changes to individual hospital services.

Any substantial service change would require transparent public involvement.

Local people can sign up for official NHS Devon updates, to receive the latest information and invites to engagement opportunities.

Q5. Are histopathology services being moved?

NHS England Estates Safety funding has been awarded to Torbay and South Devon NHS Foundation NHS Trust to address long-standing infrastructure risks in histopathology at Torbay Hospital. Histopathology is a clinical support service which is central to high-quality patient care.

As a result, the Trust Board has approved a long-term solution for routine histopathology to move to a bespoke new laboratory at Gadeon House in Exeter, once the new facility is ready. Time critical and urgent pathology work will remain on the Torbay Hospital site through a permanent Acute Services Laboratory.

This will be confirmed at the Board of Directors meeting in public on 07 May 2026 where further detail, including how turnaround times, service quality and clinical support will be maintained, will be shared.

Q6. Are there plans to reduce A&E opening hours to Monday-Friday?

Changes to A&E times are not included in the One Plan for Devon.

Torbay Hospital is currently undergoing a significant £14.2 million redevelopment of its Emergency Department (A&E) to increase capacity, improve patient care environments, and reduce waiting times. The project is designed to address challenges posed by an aging infrastructure, with the full redevelopment scheduled for completion in 2026.

Q7. Is maternity being moved to Exeter?

There are no proposals in the One Plan for Devon to re-locate maternity services.

Closing statement from the ICB:

As you would expect, the NHS routinely reviews services as part of future planning to ensure safety, quality and sustainability.

The NHS is founded on values of respect and open communication, and NHS Devon ICB has a statutory responsibility to involve and engage the public in decisions about healthcare planning. Any proposals for service change would require:

  • Formal clinical development
  • Public involvement and engagement
  • Clear decision-making processes

Operational matters are led by individual NHS Trusts and are considered through their own governance and public processes.

Thank you for providing these questions to us to answer and we would respectfully ask you to help us in countering unsubstantiated claims or information. If there are additional specific concerns you are aware of, we would welcome the opportunity to respond clearly and transparently.

As previously stated, we remain fully committed to public engagement, and while we cannot attend public meetings during the pre-election period, we will be engaging local communities fully and openly (after 7 May local elections).

Local people can sign up for official NHS Devon updates, to receive the latest information and invites to engagement opportunities, which includes the recruitment into a new lived experience group.

We look forward to continuing constructive engagement.

Yours sincerely,
NHS Devon Integrated Care Board (ICB)
Aperture House, Pynes Hill, Rydon Lane, Exeter, EX2 5AZ

The email was unsigned beyond the corporate name "NHS Devon Integrated Care Board (ICB)".

From: Susie Colley (chair@tqcc.co.uk)
To: NHS Devon ICB

Dear Sir/Madam,

I am writing in response to your recent communication.

While I note your explanation that a generalised email inbox is used for outgoing correspondence, it is not acceptable that emails are issued without any form of identification or signature. This approach lacks transparency and makes it impossible to determine who is responsible for the content, decisions, or advice being provided.

For matters of accountability, professionalism, and effective communication, it is essential that all correspondence clearly identifies the sender, at a minimum including a name, role, and department. Without this, it creates unnecessary confusion and undermines confidence in the process.

I would therefore ask that:

  • Future emails include a named contact and appropriate signature; and
  • You clarify who authored the previous correspondence so that I can address any follow-up appropriately.

I look forward to your prompt response and to improved clarity in future communications.

Kindest regards

Susie Colley
Chair of the Torquay Chamber of Commerce and the Heart Campaign
(Declined) Governor of Torbay Hospital

Status: ICB email of 14 April 2026 received and on file. Campaign reply of 25 April 2026 challenges the practice of unsigned correspondence and requests identification of the author of the previous email. No response received from NHS Devon ICB. The ICB's substantive Q&A answers contain eight specific factual claims that are now on the public record and testable via future FOI requests if required.

Why This Matters: Local people have observed a gradual erosion of services at Torbay Hospital over the past decade, often without clear communication or accessible public records. This request seeks a complete documented account of every service decision affecting Torbay Hospital since 2016, with the corresponding Board approval dates, rationales, and relocation details. The pattern that emerges from the answer will provide essential context for assessing the current cardiology and histopathology proposals.

Distribution:

  • To: Chris (Trust Chair), Martin, Joe Teape (Trust CEO), Catherine, Sally, Nicole, Torre, Anna
  • CC: Andrew, Mark, David Simmonds MP, David Thomas (Torbay Council), Cat Johns (Torbay Council), Jim, John, Julia, Julie, Jenny, Guy
  • Press CC: Emma Ruminski (BBC), Jake Wallace (BBC), Sam Blackledge (ITV), Zoe (Totnes Pulse), Rachel Tapper

Five items requested:

  1. A complete list of all services that have ceased to operate at Torbay Hospital, whether fully removed or significantly reduced in scope, since 2016.
  2. For each service, the date the decision was formally approved.
  3. The corresponding Board meeting at which each decision was discussed and/or ratified, including minutes or publicly available records.
  4. The stated rationale for each change, including any financial, clinical, or staffing considerations.
  5. Details of where these services have been relocated or how patients are now expected to access equivalent care.

The campaign also asks the Board to clarify what measures are in place to ensure that future service changes are communicated more transparently and with meaningful public engagement.

Good afternoon Chair and Members of the Board,

I am writing to formally request a clear and comprehensive account of all clinical and support services that have been reduced, relocated, outsourced, or withdrawn from Torbay Hospital over the past ten years.

This request is not made lightly. Over the past decade, many in the community have perceived a gradual erosion of services, often without clear communication or accessible public records explaining when and why these decisions were taken. For a publicly funded institution, this lack of transparency raises serious concerns about accountability and public trust.

Specifically, I ask that the Board provide:

  1. A complete list of all services that have ceased to operate at Torbay Hospital, whether fully removed or significantly reduced in scope, since 2016.
  2. For each service, the date the decision was formally approved.
  3. The corresponding Board meeting at which each decision was discussed and/or ratified, including minutes or publicly available records.
  4. The stated rationale for each change, including any financial, clinical, or staffing considerations.
  5. Details of where these services have been relocated or how patients are now expected to access equivalent care.

It is essential that this information is presented in a clear and accessible format. Patients and residents rely on Torbay Hospital as a cornerstone of local healthcare provision, and they deserve to understand how and why its services have evolved.

If this information is already available in the public domain, I ask that you provide direct links or references. If not, I request that this letter be treated as a formal request for disclosure and responded to within the appropriate statutory timeframe.

I would also ask the Board to clarify what measures are in place to ensure that future service changes are communicated more transparently and with meaningful public engagement.

I look forward to your response and would ask that all efforts are made to supply the information within 7 working days please.

Kindest regards

Susie Colley
Chair of the Torquay Chamber of Commerce and the Heart Campaign

Status: Sent 26 April 2026 to Trust Chair and Members of the Board, with wide distribution including local MPs, Torbay Council, and regional press (BBC, ITV, Totnes Pulse). The campaign has requested response within 7 working days, which sets a deadline of 7 May 2026. The letter explicitly invites the Board to treat it as a formal request for disclosure if the information is not already publicly available, which means it could escalate to a numbered FOI if the deadline passes without response.

FOI Contact Information

To submit Freedom of Information requests to the relevant organisations:

  • Royal Devon University Healthcare NHS Foundation Trust:
    Email: rduh.foi@nhs.net
  • Torbay and South Devon NHS Foundation Trust:
    Visit: Freedom of Information page
  • NHS Devon ICB:
    Email: d-icb.foi@nhs.net

All documents obtained through legitimate Freedom of Information requests.
Documents are provided for transparency and public interest in cardiac healthcare services across Devon.