Freedom of Information Requests

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

1. Clinical consultation

The Trust states: "Clinical service leads were briefed" and "the pathology clinical service lead was engaged throughout."

This is not the same as formal consultation. What remains unclear is:

• Which consultant groups were consulted?
• On what dates?
• Were written responses sought?
• Were concerns recorded in meeting minutes?
• How many clinicians supported versus opposed the proposal?
• What specific objections were raised?

If a significant number of clinical leaders expressed concerns, the response appears to acknowledge that questions were raised but does not disclose the nature, extent or strength of those concerns.

2. Concerns raised by clinicians

This is probably the most evasive answer. The original questions asked whether concerns were raised regarding safety, workforce, logistics, transport, turnaround times, recruitment, resilience, and future service implications.

Rather than answering "yes" or "no", the Trust states "Our staff have raised many questions" and "The issues you raise are central to the work and are being addressed..."

That does not tell readers whether those risks were identified, how serious they were assessed to be, whether any were considered unacceptable, or whether any clinicians advised against relocation.

3. Options appraisal

The Trust confirms an options appraisal existed and was presented on 19 March 2026. However, the response does not explain:

• What options were considered
• The scoring methodology
• Who undertook the appraisal
• Whether retaining pathology at Torbay was fully costed
• Why refurbishment was rejected
• Whether temporary modular facilities were considered
• Whether clinicians participated in scoring

Merely saying an appraisal occurred does not demonstrate that the process was balanced.

4. Timing of the decision

The Trust's timeline suggests:

• Options appraisal: 19 March 2026
• CEO email to pathology staff: 20 March 2026
• Business case: 25 March 2026
• CEO and Chair approval under urgent decision-making arrangements: 26 March 2026
• All staff informed: 5 May 2026
• Board meeting in public: 7 May 2026

This raises a governance question: if staff were informed of a "preferred option" on 20 March, before the business case was considered on 25 March and before public Board discussion in May, at what point was the decision effectively made, and what opportunity existed for clinicians or staff to influence the outcome after 20 March?

5. "No proposals at this time"

The Trust states: "There are no further Board approved proposals for other service moves from Torbay Hospital at this time." But it also states: "We continue to work with partners through the Peninsula Pathology Network to explore options for a more resilient and sustainable regional pathology model."

In effect, the Trust is distinguishing between active strategic planning and formally approved proposals. That distinction may be technically correct, but it does not answer whether consolidation beyond cellular pathology is being actively explored.

6. Major service change

The Trust's argument is that because urgent and time-critical services remain on site, this is not a major service change. That is an assertion rather than an explanation. The unanswered questions are:

• What proportion of current pathology activity will move?
• What proportion of staff will move?
• What impact assessment has been undertaken on clinical pathways?
• What advice was sought regarding whether this constituted a substantial service variation?
• Were local authority scrutiny committees consulted?

These are legitimate governance questions that the Trust's response does not address.

To: Catherine Lissett
CC: Phil Keeling, Torre, Sally, Nicole, Andrew, Georgian, David, John
Date: 4 June 2026, 12:55

Good afternoon Ms Lissett,

Thank you for your response.

Having reviewed your answers, I remain unclear on several points because a number of the responses describe processes and ongoing work but do not address the substance of the questions asked.

In relation to clinical consultation, you state that clinical leaders and pathology colleagues were briefed and had opportunities to provide feedback. Please could you clarify:

• Which consultant groups and clinical leaders were consulted?
• On what dates did these discussions take place?
• Were concerns formally recorded in minutes, reports or consultation feedback?
• What specific concerns were raised regarding safety, workforce sustainability, transport and logistics, turnaround times, recruitment, resilience and future service implications?
• Were any clinicians opposed to the proposed relocation and, if so, how were those concerns considered within the decision-making process?

Regarding the options appraisal presented in March 2026, please could you provide further detail on:

• The options considered.
• The appraisal methodology and scoring criteria used.
• Whether refurbishment or redevelopment at Torbay Hospital was fully costed and assessed.
• Whether clinicians were involved in the appraisal and scoring process.
• The reasons why alternative options were discounted.

Your response confirms that an options appraisal was presented on 19 March 2026 and a business case considered on 25 March 2026, yet pathology staff were informed of a preferred option on 20 March 2026. Please explain what opportunity remained for staff and clinicians to influence the decision after the preferred option had been identified.

I would also be grateful if you could clarify the statement that there are "no further Board-approved proposals" beyond cellular pathology. While I appreciate the distinction you draw between strategy and formal proposals, you also state that work continues through the Peninsula Pathology Network to explore a more resilient and sustainable regional pathology model. Please therefore confirm what services are included within that work, what scenarios are being considered, and whether any modelling has been undertaken regarding future consolidation of pathology services beyond cellular pathology.

Finally, to assist understanding of the decision-making process, please advise whether the following documents can be provided:

• The March 2026 options appraisal.
• The March 2026 business case.
• Relevant risk assessments and risk registers.
• Clinical feedback summaries.
• Equality and Quality Impact Assessments.
• Minutes or reports recording consultant and clinical leader feedback.

I look forward to your response.

Kindest regards

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

From: Catherine Lissett, Chief Medical Officer, Torbay and South Devon NHS Foundation Trust (catherine.lissett@nhs.net)
To: Susie Colley (chair@tqcc.co.uk)
Subject: FW: Request for Clarification Regarding Gadeon House and Peninsula Pathology Network

Dear Mrs Colley

Further to your email of 19 May 2026 requesting clarification, I will answer the specific questions you asked in the order you set them out. You may also find it helpful to read the published papers for the Board meeting held in public on 07 May 2026: Board, governors and annual members meetings

For completeness and because this correspondence may be shared publicly, I have included at the end of this email the published extract from the papers for the Board meeting held in public on 07 May 2026.

1) The "time-limited opportunity": what it was and why decisions were taken at pace

The issue we were addressing was a defined estates safety risk affecting our cellular pathology (histopathology) accommodation at Torbay Hospital, including ventilation and formalin exposure risks that cannot be safely mitigated over the longer term. In January 2026, we were advised that ring-fenced NHS England Estates Safety Funding capital was available to address this, but only if an affordable, deliverable solution could be implemented within the financial year and all expenditure was completed by 31 March 2026.

Were consultants formally consulted prior to these decisions being made?

Our engagement focused on the clinical leaders and colleagues directly involved in, or impacted by, cellular pathology. Pathology colleagues were briefed on the options and had the opportunity to provide feedback. Clinical service leads (including consultant specialty leads for relevant areas) were briefed, and the pathology clinical service lead was engaged throughout.

Were any concerns raised by clinicians regarding safety, workforce impact, transport/logistics, turnaround times, recruitment, resilience, or future service implications?

Our staff have raised many questions. The issues you raise are central to the work and are being addressed through the design of the model and ongoing risk management. Maintaining service quality, turnaround times and clinical support for patients remains a core requirement. Work is now starting with cellular pathology colleagues to co-design the service model for the new laboratory.

Were any formal option appraisals undertaken comparing refurbishment/redevelopment at Torbay Hospital against relocation to Exeter?

Yes. An options appraisal was presented to the Executive Committee on 19 March 2026, and a detailed business case was considered on 25 March 2026. As outlined in the Chief Executive's report to the Board in May 2026, an earlier plan to address this through a new on-site asset linked to enabling works for the New Hospitals Programme did not progress in 2024, leaving an urgent requirement to secure a safe and sustainable solution.

At what point were the Board, clinicians, and staff informed that relocation to Gadeon House had become the preferred option?

The preferred option was considered through the Executive Committee in March 2026 (19 March options appraisal; 25 March business case). The Board were briefed regularly by the Chief Executive, including through formal meetings and governance. Clinical service leads were verbally briefed through their regular fortnightly meetings, as were the Medical Staffing Committee through their regular meetings. Pathology colleagues (cellular pathology, blood science and microbiology) received a personal email from Joe Teape, Chief Executive, on 20 March 2026, setting out the options appraisal and preferred option. Regular fortnightly meetings take place between cellular pathology colleagues, the Chief Executive, Chief Medical Officer and other leads to ensure we continue to listen and understand concerns, provide regular briefings and agree actions together. The most recent meeting was last Wednesday (20 May 2026), when discussions included arranging visits for colleagues to Gadeon House and a forthcoming service model design session. Confirmation to all staff was shared on 05 May 2026 through the Chief Executive, ahead of the Board meeting in public on 07 May 2026.

"No proposals at this time": clarifying what is (and is not) agreed

You have noted that lease arrangements, secured capital funding, governance approvals and planning activity indicate active development. In this case, those steps relate to a specific, agreed programme to address an estates safety risk in cellular pathology. As set out in the Chief Executive's report, the agreed programme comprises:

• an initial relocation of cytology services to release capacity on the Torbay site to enable immediate mitigation of safety risks
• a planned move of routine cellular pathology into fit-for-purpose laboratory accommodation at Gadeon House within an estimated 12-18 months.

It is important to be clear that urgent and time-critical pathology services will continue to be delivered safely from Torbay Hospital through an on-site Acute Service Laboratory while routine elements transition in a phased and managed way.

Royal Devon University Healthcare NHS Foundation Trust is separately progressing its own lease arrangements with Torbay Council (the freeholder) for other floors in Gadeon House for the relocation of some of its pathology services.

You asked whether we have developed medium or long-term strategic modelling, draft proposals or planning assumptions for the consolidation of pathology or diagnostic services beyond cellular pathology. In parallel with the specific cellular pathology programme above, we continue to work with partners through the Peninsula Pathology Network to explore options for a more resilient and sustainable regional pathology model, while maintaining appropriate local service delivery. However, beyond the cellular pathology programme described above, there are no further Board-approved proposals for other service moves from Torbay Hospital at this time.

I understand your concern about the language of proposals. Strategy describes direction and priorities; it is not, in itself, a set of agreed proposals. A proposal is only created when an option is developed to the point it can be formally decided through governance.

In this case, the agreed model is primarily an estates safety and workforce resilience intervention within a clinical support service, and it explicitly maintains urgent and time-critical provision locally from Torbay Hospital. National guidance on major service change focuses on proposals that materially alter how patients access services at the point they receive care; in this case, the model maintains local urgent and time-critical provision while routine work transitions in a managed way.

I hope this answers your questions. Should you have any further questions, please submit these through our Freedom of Information process: tsdft.foirequests@nhs.net

Yours sincerely,

Kate Lissett

The text below is taken from the published papers for the Board meeting held in public on 07 May 2026.

Development of Gadeon House for the long-term provision of Cellular Pathology Services

Cellular Pathology is one part of our wider pathology services, which also include Blood Sciences and Microbiology. While Blood Sciences and Microbiology focus on tests such as blood analysis and the identification of infections, Cellular Pathology involves the examination of tissue and cell samples to support diagnosis and treatment, including the diagnosis of cancer and other serious diseases. These services are safety-critical and rely on specialist laboratory facilities and workforce.

Over several years, we have sought national support to address significant estates safety risks associated with the life-expired temporary building at Torbay Hospital, from which Cellular Pathology services have been provided. These risks include ventilation and formalin exposure and cannot be safely mitigated over the longer term. Earlier plans to address this through the creation of a new on-site asset as part of enabling works linked to the New Hospitals Programme did not progress in 2024, leaving us with an urgent requirement to secure a safe and sustainable solution.

In parallel, we have worked with the Peninsula Pathology Network to explore options for a more resilient and sustainable regional pathology model, including the potential for consolidated laboratory provision across the peninsula, while maintaining appropriate local service delivery.

In January 2026, we were advised that capital funding from NHS England was available, subject to a requirement that an affordable and deliverable solution could be implemented within the financial year, with all expenditure completed by 31 March 2026. This created a time-limited opportunity to address the longstanding safety risks associated with the current accommodation.

An options appraisal was presented to Executive Committee on 19 March 2026, which identified a preferred option to establish a consolidated Cellular Pathology laboratory at Gadeon House, Exeter. This includes an initial relocation of Cytology services to Royal Devon University Healthcare NHS Foundation Trust to release capacity on the Torbay site, enabling immediate mitigation of safety risks, followed by a planned move into the fully fitted laboratory at Gadeon House within an estimated 12-18 months.

To deliver this option, it was necessary to agree a lease arrangement and commit funding for design and fit-out works within a short timescale. A detailed business case was therefore brought to Executive Committee on 25 March 2026. Given the time-critical nature of the funding opportunity, the Chief Executive and Chair approved the proposal under our urgent decision-making arrangements on 26 March 2026, in line with our governance arrangements and standing financial instructions.

Appropriate due diligence was undertaken alongside executive engagement with cellular pathology colleagues and the rationale for urgency, the financial arrangements and the expected benefits were fully documented. The approach, including the landlord paying fit-out invoices directly, was agreed as a proportionate and financially compliant route to delivery, with design and cost risk remaining with us.

Approval was given for £4.6m of national NHS England capital funding, secured through a time-limited estates safety funding programme, to support the development of Cellular Pathology services at Gadeon House, Exeter. This funding is ring-fenced capital and cannot be used for day-to-day operational or staffing costs. The investment covers lease costs, design development and professional fees, and the fit-out of the laboratory space to create fit-for-purpose facilities. We have entered into a 15-year lease with Torbay Council, who are the freeholder of the building, with a Trust break option at 10 years.

Throughout the transition, maintaining service quality, turnaround times and clinical support for patients remains a core requirement. Urgent and time-critical pathology services will continue to be delivered safely from Torbay Hospital through an Acute Service Laboratory, while routine elements of the service transition in a phased and managed way. Clinical leaders are closely involved in the design and implementation of the model and risks associated with transition are being actively managed.

The new accommodation will provide long-term, fit-for-purpose laboratory facilities, improving staff safety, wellbeing and retention and enhancing service resilience through standardised reporting, improved workforce productivity and the use of digital pathology.

Equality and workforce impacts will continue to be considered as part of detailed implementation planning, with mitigations developed where required. Progress and risk will be reported through our established governance arrangements, including to the Board of Directors in public.

Best wishes

Kate
Kate Lissett
Pronouns: She/Her
Chief Medical Officer
Torbay and South Devon NHS Foundation Trust

To: Joe Teape, Catherine Lissett
CC: Phil Keeling, Torre, Nicole, Sally
Date: 19 May 2026, 15:12

Good afternoon

Thank you for your detailed response.

I appreciate the clarification provided, however a number of important concerns remain unresolved.

Firstly, I would like clarification regarding the statement that:

"A time-limited opportunity arose earlier this year to secure national capital funding to address these risks."

Please can you clarify precisely what consultation took place with consultant pathologists, laboratory clinicians, service leads, and wider clinical teams before decisions were taken to:

• pursue the national capital funding opportunity,
• enter into lease arrangements for Gadeon House,
• and progress plans for relocation of services.

Specifically:

• Were consultants formally consulted prior to these decisions being made?
• Were any concerns raised by clinicians regarding safety, workforce impact, transport/logistics, turnaround times, recruitment, resilience, or future service implications?
• Were any formal option appraisals undertaken comparing refurbishment/redevelopment at Torbay Hospital against relocation to Exeter?
• At what point were the Board, clinicians, and staff informed that relocation to Gadeon House had become the preferred option?

Secondly, I remain concerned about the repeated use throughout your email of phrases such as:

"There are no proposals at this time..."

while simultaneously confirming:

• lease agreements,
• secured capital funding,
• governance approvals,
• workforce planning,
• operational planning,
• and active scoping work around microbiology and blood sciences consolidation.

To many readers, these activities appear to constitute active strategic development rather than merely exploratory discussion.

I would therefore welcome clarification as to whether:

• the Trust has developed any medium or long-term strategic modelling regarding consolidation of pathology or diagnostic services beyond cellular pathology;
• any proposals, draft business cases, strategic outlines, or planning assumptions exist concerning further transfer, merger, or network consolidation of services over the next 5-10 years;
• and how this position aligns with the wider One Devon strategy documents, which reference increasing integration and merger of services across Devon.

At present there appears to be a significant difference between the public reassurance that there are "no proposals" and the strategic direction implied by both the Peninsula Pathology Network arrangements and wider One Devon planning documentation.

Given the degree of public interest and concern, transparency on these points is extremely important.

I would be grateful for a clear response.

Kindest regards

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

From: Catherine Lissett, Chief Medical Officer, Torbay and South Devon NHS Foundation Trust (catherine.lissett@nhs.net)
To: Susie Colley (chair@tqcc.co.uk)
CC: Joe Teape, Chief Executive, Torbay and South Devon NHS Foundation Trust (joe.teape@nhs.net)
Signed jointly by: "Joe and Kate"
Subject: RE: Request for Clarification Regarding Gadeon House and Peninsula Pathology Network

Dear Ms Colley

Thank you for your email of 09 May 2026 and for taking the time to set out your questions so clearly. We are very aware of the strength of local interest in these matters and welcome the opportunity to clarify our position.

First, we would like to address the comment you reference from the Board meeting held in public on 07 May. The discussion around Gadeon House and histopathology services took place as part of the Chief Executive's report. The remark that there were "no proposals to move any services" was made by Dr Lissett during discussion of our organisational strategy, which was a later agenda item. Our new organisational strategy sets out our overall direction and priorities; it does not contain specific proposals for service change. We can understand how, taken out of context, that comment may have caused confusion, and we hope the clarification is helpful.

Turning to your specific questions:

Is Torbay and South Devon NHS Foundation Trust formally participating in the Peninsula Pathology Network arrangements connected to Gadeon House?

Yes, we are a partner in the Peninsula Pathology Network, working alongside other NHS organisations in Devon and the wider southwest peninsula. This collaboration supports shared standards, resilience and sustainability across pathology services, which are essential to patient care.

More broadly, pathology services across the NHS are increasingly delivered through networked arrangements. This approach supports quality, resilience, and the ability to provide specialist services, while ensuring that urgent and clinically essential elements of care continue to be delivered locally.

Gadeon House is a building on the outskirts of Exeter which is owned by Torbay Council.

Are any pathology, laboratory, diagnostic, administrative, or support services currently planned to be transferred, consolidated, relocated, or shared through the Gadeon House facility, either fully or partially?

As set out in the Chief Executive's report considered by our Board in public, there is a specific programme of work relating to cellular pathology (histopathology). The Board papers are available on our website.

This specific programme of work follows longstanding concerns about the safety and suitability of our current facilities at Torbay Hospital, including significant estates risks that cannot be mitigated in the longer term.

A time-limited opportunity arose earlier this year to secure national capital funding to address these risks. As a result, a decision was taken, under our established governance arrangements, to develop a new, fit-for-purpose cellular pathology laboratory at Gadeon House in Exeter. We have entered into a lease agreement with Torbay Council in order to deliver this. Separately, Royal Devon University Healthcare NHS Foundation Trust are also entering a lease agreement with Torbay Council for space on other floors in Gadeon House to relocate some of their pathology services.

Our programme involves:

• an initial relocation of cytology services to create capacity on the Torbay site, and
• a planned move of routine cellular pathology work into the new laboratory once it is completed.

It is important to be clear that:

• urgent and time-critical pathology services will continue to be delivered safely from Torbay Hospital through an on-site acute service laboratory, and
• this programme relates specifically to cellular pathology, which is one specialism within our pathology services.

If no service moves are currently proposed, does this statement apply only to immediate operational changes, or also to future strategic plans under the Peninsula Pathology Network programme?

There are no proposals at this time to move other services beyond what is described above.

We continue to work with partners through the Peninsula Pathology Network to consider how services can be made as safe, resilient and sustainable as possible over the long term. As with any NHS organisation, any future changes would be subject to appropriate planning, governance and engagement with staff, patients and communities where appropriate.

Has the Trust entered into any agreements, governance arrangements, financial commitments, workforce planning, or service development discussions relating to Gadeon House?

As part of the Gadeon House development for cellular pathology:

• we have entered into a lease arrangement for the facility (with Torbay Council as the freeholder),
• secured £4.6m of ringfenced national capital funding to support the development, and
• progressed this through our formal governance processes, including executive and Chair approval in line with our standing financial instructions.

Clinical, workforce and operational planning in regards to which other pathology services, notably microbiology and blood sciences, is being scoped with the clinical teams with a view to determining which services can be safely provided from a consolidated laboratory, however, this is at a very early stage and is being developed by the clinical teams with patient safety as a key focus. This is being undertaken in a phased and managed way, with ongoing oversight through our established governance arrangements and continued reporting to the Board in public.

We hope this provides helpful clarity.

We recognise that these are important issues for local people and we remain committed to being open and transparent as our plans develop.

Joe and Kate

Best wishes

Kate
Kate Lissett
Pronouns: She/Her
Chief Medical Officer
Torbay and South Devon NHS Foundation Trust

To: Catherine Lissett
Date: 12 May 2026, 17:22

Good afternoon, Ms Lissett

Thank you for your reply and for taking the time to review the matters we have raised.

We appreciate your willingness to look carefully at both the comments made during the Board meeting on 7 May and the wider programme position before responding substantively. We recognise the importance of ensuring the context and accuracy are properly understood.

Our hope is that this can lead to a constructive and open dialogue, as we genuinely believe a shared understanding of the issues is in everyone's best interests. We would very much welcome the opportunity to meet with you in person at an appropriate stage, as we feel a face-to-face discussion may help provide clarity and avoid any unintended misunderstandings that can sometimes arise through correspondence alone.

Thank you again for your consideration, and we look forward to hearing from you further.

Kindest regards

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

From: Catherine Lissett, Chief Medical Officer, Torbay and South Devon NHS Foundation Trust (catherine.lissett@nhs.net)
To: Susie Colley (chair@tqcc.co.uk)
Subject: RE: Request for Clarification Regarding Gadeon House and Peninsula Pathology Network

Dear Mrs Colley

Thank you for your email.

I am reviewing the points you raise, including the comments made at the Board meeting in public on 7 May. I will respond fully once I have had the opportunity to confirm the precise context and accuracy of the Board discussion and the current programme position.

I will come back to you with a substantive response

Best wishes
Kate
Kate Lissett
Pronouns: She/Her
Chief Medical Officer
Torbay and South Devon NHS Foundation Trust

To: Catherine Lissett
Date: 9 May 2026, 15:57

Good afternoon Ms Lissett,

I am writing to seek clarification regarding the relationship between Torbay and South Devon NHS Foundation Trust and the pathology consolidation programme associated with Gadeon House in Exeter.

From publicly available information, it appears that Gadeon House is being developed as part of the Royal Devon-led NHS pathology consolidation facility for the wider Peninsula Pathology Network, and that Torbay and South Devon NHS Foundation Trust may be a participating member of that network. However, during the Board Meeting held in public on Thursday 7 May 2026, it is my understanding that you stated there were "no proposals to move any services."

In light of this, I would be grateful if you could clarify the following:

1. Is Torbay and South Devon NHS Foundation Trust formally participating in the Peninsula Pathology Network arrangements connected to Gadeon House?
2. Are any pathology, laboratory, diagnostic, administrative, or support services currently planned to be transferred, consolidated, relocated, or shared through the Gadeon House facility, either fully or partially?
3. If no service moves are currently proposed, does this statement apply only to immediate operational changes, or also to future strategic plans under the Peninsula Pathology Network programme?
4. Has the Trust entered into any agreements, governance arrangements, financial commitments, workforce planning, or service development discussions relating to Gadeon House?

Given the level of public interest and the comments made at the Board Meeting, I believe clarification would help avoid misunderstanding regarding the Trust's current position and future intentions.

I would appreciate any information you are able to provide. Perhaps it would be helpful if you had time in your busy schedule to meet with us so we could help allay the fears of the public?

Kindest regards

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

From: Susie Colley (chair@tqcc.co.uk)
To: Joe Teape, Martin Beaman
CC: Cat Johns (Torbay Council), David Thomas (Torbay Council), David Simmonds MP, Steve Darling MP, Steve Race MP, Martin Wrigley MP, Mark Hawkins (Rowcroft Hospice), Caroline Voaden MP, Phil Keeling, Torre, Sally, Nicole
Subject: RE: NHF and Trust

Good afternoon Mr Teape,

Thank you for your further response.

Having reviewed your reply carefully, I remain concerned that a significant aspect of my original question has not been addressed.

Throughout your correspondence, the assurances provided are framed almost entirely in the present tense. For example, you state that:

• there are currently no requirements arising from the NHF;
• there are currently no service changes proposed as a consequence of the NHF;
• the NHF does not currently mandate service reconfiguration.

While those statements clarify the Trust's present position, my question was directed specifically at the future implications of the Neighbourhood Health Framework once finalised and implemented.

The distinction is important.

I am not seeking confirmation of whether the NHF currently imposes obligations on the Trust. Rather, I am seeking clarification as to whether the Trust has received any indication, advice, expectation, guidance, or assurance regarding the future application of the NHF through NHS England, the Devon Integrated Care Board, or any associated planning and commissioning mechanisms.

Accordingly, I would be grateful if you could provide a direct response to the following questions:

1. Has the Trust received any indication from NHS England, the Devon Integrated Care Board, or any other NHS body that future planning guidance, commissioning arrangements, funding mechanisms, contractual requirements, performance frameworks, delivery expectations, or regulatory requirements arising from the NHF may be expected of NHS providers?
2. Has the Trust received any indication that compliance with future NHF-related requirements could influence, encourage, incentivise, or necessitate service redesign, service relocation, workforce redistribution, outpatient reform, pathway redesign, or any other service changes at provider level?
3. Has the Trust received any assurance from NHS England or the Devon Integrated Care Board that future NHF implementation will not be used, directly or indirectly, to support business cases, commissioning decisions, service reviews, or proposals affecting acute, emergency, inpatient, specialist, tertiary, or cardiac services?
4. If no such assurances have been received, will the Trust acknowledge that it is presently unable to rule out the possibility that future NHF-related planning, commissioning, funding, contractual, or performance requirements could influence future service change proposals?

I appreciate that the Trust is not the owner of the NHF and that responsibility for national policy rests with NHS England and the Integrated Care Board. However, as a provider organisation aligning its strategy with the NHF and related national policy, it is reasonable to ask whether the Trust has been given any indication of how those policies may be operationalised in future.

At present, your responses appear to describe only the current position and do not address whether future obligations, expectations, incentives, or requirements may arise through the mechanisms you have identified, namely commissioning decisions, planning requirements, contractual arrangements, funding frameworks, or performance management processes.

I would therefore be grateful for a clear and unambiguous response to the specific future-facing questions set out above.

Thank you for your assistance, and I look forward to your reply.

Kindest regards

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

From: Joe Teape, Chief Executive, Torbay and South Devon NHS Foundation Trust (joe.teape@nhs.net)
To: Susie Colley (chair@tqcc.co.uk)
CC: Martin Beaman, Cat Johns (Torbay Council), David Thomas (Torbay Council), Phil Keeling, Torre and Upton, Sally Allen Gerard, Nicole Amil, David Simmonds MP, Steve Darling MP, Steve Race MP, Martin Wrigley MP, Mark Hawkins (Rowcroft Hospice), Caroline Voaden MP
Subject: FW: NHF and Trust

Dear Mrs Colley

Thank you for your further email.

It may be helpful to distinguish clearly between ownership of national policy and the assurances that we, as an NHS provider, can properly give in relation to the Neighbourhood Health Framework (NHF).

Ownership of the NHF

The NHF is a national policy framework developed and owned by NHS England, working with Integrated Care Boards. It is not authored or determined by this Trust. As an NHS provider, our role is to understand national policy direction and to respond through local planning and governance processes; we do not set the framework or determine its national application.

Questions about the intent, status, and future use of the NHF as a policy instrument are therefore most appropriately directed to NHS England and the Devon Integrated Care Board, as policy owners and commissioners for local services respectively.

Position from the Trust's perspective

Within that context, we can provide assurance about what the NHF does and does not mean for us as a provider.

The NHF is a strategic framework setting out national ambitions for neighbourhood-based care. It does not impose statutory, mandatory, or binding requirements on us, nor does it in itself direct service reconfiguration.

Any obligations placed on us as an NHS provider arise only through formal commissioning decisions or nationally mandated planning, contractual, or performance requirements. There are currently no such requirements in place arising from the NHF.

There are no service changes proposed by us as a consequence of the NHF. Should any changes ever be developed locally, they would be subject to appropriate clinical scrutiny, commissioner agreement, governance approval, and where required, statutory engagement and consultation.

The NHF does not mandate, prescribe, or provide justification for changes to acute, emergency, inpatient, specialist, or cardiac services.

Engagement and consultation

The Trust's duties in respect of public involvement are set out in section 242 of the NHS Act 2006 (as amended), which requires NHS bodies to make arrangements to involve patients and the public in the planning of services and in decisions that may affect how services are delivered.

Formal public consultation is required where proposals constitute a substantial variation in service, assessed against recognised criteria including scale, impact on patients and access, clinical risk, and public interest, informed by relevant case law and guidance. Where the legal threshold for formal consultation is not met, we undertakes proportionate engagement appropriate to the nature and impact of the issue, with assurance provided through our clinical, executive and Board governance arrangements.

Workforce matters

We take issues relating to staffing, morale, and remuneration seriously. These matters are subject to established internal governance and are kept under active review. Importantly, this includes constructive and consistent engagement with our staff-side representatives, working in partnership to raise, consider and resolve concerns, with appropriate executive oversight to ensure impacts on workforce sustainability and patient safety are addressed.

We hope this clarifies both our position as an NHS provider and where responsibility properly sits for matters of national NHF policy. For definitive responses regarding the framework itself, we would recommend contacting NHS England or the Devon Integrated Care Board as outlined above.

Kind regards

Joe
Joe Teape
Chief Executive

From: Susie Colley (chair@tqcc.co.uk)
To: Joe Teape, Martin Beaman
CC: Cat Johns (Torbay Council), David Thomas (Torbay Council), Phil Keeling, Torre and Upton, Sally Allen Gerard, Nicole Amil, David Simmonds MP, Steve Darling MP, Steve Race MP, Martin Wrigley MP, Caroline Voaden MP, Mark Hawkins (Rowcroft Hospice)

Good evening,

Thank you for your response.

For clarity and to avoid any further ambiguity, we require a direct answer to the following:

Will the Neighbourhood Health Framework (NHF), once finalised, impose any mandatory, binding, or otherwise enforceable requirements on the Trust that could lead, either directly or indirectly, to changes in acute, emergency, inpatient, or specialist services, including cardiac provision?

Your reply refers to the NHF as a "framework" and states it does not currently mandate reconfiguration. However, it does not address whether the NHF will carry obligations, targets, or expectations that the Trust is required to implement, whether formally or in practice.

Accordingly, please confirm:

• Whether the NHF is purely advisory, or whether it creates obligations (including through NHS England performance, planning, or funding mechanisms) with which the Trust must comply;
• Whether compliance with the NHF, now or in future, could reasonably be expected to necessitate service change of any kind;
• Whether the NHF or related national policy could be relied upon, in whole or in part, to justify future changes to cardiac or other acute services.

In relation to engagement and consultation, you state that not all service changes require formal public consultation. Given the Trust's statutory duties in respect of public involvement, please specify the criteria that will be applied in determining when consultation is required, and how the Trust will ensure those duties are demonstrably met.

Finally, we remain concerned that issues relating to staffing, morale, and the alleged non-payment for additional hours worked have not been substantively addressed. These matters have potential implications for workforce sustainability and patient safety, and we would expect confirmation that they are subject to formal review and appropriate governance oversight.

We would be grateful for a clear and specific response to each of the above points.

Thank you

Kindest regards

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

From: Joe Teape, Chief Executive, Torbay and South Devon NHS Foundation Trust (joe.teape@nhs.net)
To: Susie Colley (chair@tqcc.co.uk), Martin Beaman
CC: Cat Johns (Torbay Council), David Thomas (Torbay Council), Phil Keeling, Torre and Upton, Sally Allen Gerard, Nicole Amil, David Simmonds MP, Steve Darling MP, Steve Race MP, Martin Wrigley MP, Caroline Voaden MP
Subject: RE: NHF and Trust

Dear Mrs Colley

Thank you for your email and for setting out your questions so clearly ahead of the Board meeting on 07 May.

We recognise the level of public interest in both the draft Trust strategy and the Neighbourhood Health Framework (NHF) and the importance of clarity about what is, and is not, being proposed at this stage.

Purpose and status of our draft organisational strategy

Our draft strategy is a principles-based document. Its purpose is to set out the overall direction and values that guide how the organisation plans, prioritises, and makes decisions. It does not contain service-specific proposals, decisions or reconfiguration plans and should not be read as doing so.

The strategy has been developed in the context of national policy direction, including the 10 Year Health Plan for England and the Neighbourhood Health Framework (NHF), both of which apply nationally across the NHS. The strategy seeks to align with this national direction while recognising the need for local clinical judgement and decision-making.

Relationship with the Neighbourhood Health Framework

The NHF is a national framework, issued by NHS England, and is reflected in the strategy through its emphasis on neighbourhood-based care, community services, and outpatient reform. This aligns with the NHF's focus on improving access, coordination, and experience of care closer to home where appropriate.

The NHF does not mandate or imply reconfiguration of acute, emergency, inpatient or tertiary services and our draft organisational strategy does not state or suggest that it does. Where the strategy refers to services potentially being delivered differently in future, this is framed at a high-level and principle-based, rather than as a set of predetermined changes.

Cardiac services

The draft strategy does not include proposals relating to cardiac services. No clinical services or specialisms are named, singled out, or implied anywhere in the draft strategy. Cardiac services are not named or referred to, and no element of the NHF, or any other national policy, is being relied upon to justify changes to urgent, emergency, inpatient, or tertiary cardiac provision.

Where the strategy refers in general terms to specialist or acute services being delivered in networked ways, this is explicitly framed as a matter of local clinical safety, workforce sustainability, and affordability, not as a requirement flowing from national policy. Any consideration of change to specific services would require separate, explicit proposals, supported by clinical evidence and subject to appropriate governance and engagement.

National policy and local discretion

In response to your specific questions:

• The draft organisational strategy reflects national policy direction, including the 10 Year Health Plan for England and the NHF, where this relates to neighbourhood care, outpatient reform, and integration with community services.
• Decisions about whether, how or when services may change locally sit outside the strategy itself and would be matters of local clinical judgement, evidence and governance, not automatic consequences of national frameworks.

Engagement, involvement, and consultation

We recognise that wider engagement on our draft strategy has not yet commenced. We are undertaking focused engagement with key stakeholders including governors, our colleagues, primary care colleagues, MPs, Healthwatch and others ahead of the Board meeting in public on 07 May. This reflects the distinction between setting strategic direction and developing specific service proposals.

Subject to Board approval, we intend to undertake a series of community conversations in each of our five neighbourhoods over the summer as the strategy is taken forward.

It is important to be clear that not all service changes require formal public consultation. If and when any specific service proposals are developed in future, the appropriate form of engagement or consultation will depend on the nature, scale, and impact of the proposal, in line with statutory duties and best practice.

Any proposal that would constitute a significant service change would require separate governance, supporting evidence and engagement or consultation as appropriate.

Summary

In summary, the draft strategy sets direction and principles within the context of national NHS policy. It does not mandate or presuppose changes to cardiac services or any other specific area of care, nor does it rely on the NHF to do so. Any future service proposals would be considered on their own merits, with appropriate clinical evidence, governance, and stakeholder involvement.

We hope this provides clarity and supports informed and constructive scrutiny of the draft strategy at this stage.

Kind regards

Joe Teape
Chief Executive

From: Susie Colley (chair@tqcc.co.uk)
To: Joe Teape (Trust CEO), Chris Balch (Trust Chair)
Subject: NHF and Trust
Stated deadline: 30 April 2026

Good afternoon, Gentlemen

I am writing ahead of the Board meeting scheduled for 7 May to request formal clarification regarding the relationship between your draft strategy and the Neighbourhood Health Framework (NHF) issued in March 2026.

As you will be aware, the NHF should be informed by the Joint Strategic Needs Assessment (JSNA) and explicitly requires thorough and transparent community involvement. It also sets out specific service directions, including the development of single points of access and the shifting of certain outpatient follow-up care into neighbourhood settings.

The NHS England National Health Framework does reference cardiology, but only in the context of improving elective and outpatient pathways.

It does not authorise or imply the reconfiguration, relocation, or consolidation of acute, emergency, or inpatient cardiac services.

Any suggestion that the NHF provides a mandate for changes to tertiary or urgent cardiac provision therefore goes beyond its stated scope.

In this context, it is important to distinguish between national policy and locally developed strategy: the Trust's own engagement materials introduce the concept of specialist services operating in networked models for reasons of safety and viability, but do not specify which services this applies to.

Clarification is therefore needed as to whether cardiac services are included within that principle, and if so, on what policy basis and evidential grounds.

In addition please provide an impact assessment of call-to-balloon times for South Devon patients, including any changes over time and comparisons with national benchmarks. This metric is critical, as it directly reflects time to reperfusion within the "golden hour" and offers a clear, measurable indicator of patient outcomes. A transparent analysis of this data will help assess whether current pathways are meeting expected standards and where delays may be occurring.

Given this, I request that you clearly and explicitly set out:

1. Which specific elements of the draft Trust strategy are directly required by, or flow from, the NHF; and
2. Which elements represent local policy discretion, interpretation, or independent strategic choice.

In particular, if any proposals relating to cardiac services (including but not limited to tertiary provision, interventional services, or structural reconfiguration) are being justified by reference to the NHF, please provide:

• The exact NHF provisions being relied upon.
• A clear explanation of how those provisions support the proposed changes; and
• Any supporting clinical or policy rationale demonstrating that such changes are mandated rather than discretionary.

If no such explicit policy basis exists, this should be clearly stated.

Please confirm how the requirement for "thorough and transparent community involvement" has been met in relation to any proposed service changes of this scale, including details of engagement undertaken to date and any planned consultation.

To be clear, this request seeks to establish a transparent distinction between policy requirements set at a national level and decisions about service reconfiguration made locally. Maintaining this distinction is important to enable effective scrutiny and ensure public accountability.

The request includes internal correspondence that references the NHF in relation to the strategy, records that identify which aspects are mandated nationally versus those determined locally, and any documentation concerning the configuration of cardiac services under the strategy.

I would be grateful for a written response by 30th April.

Kindest regards

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

For the attention of: Chair and Board Members of Torbay and South Devon NHS Foundation Trust, and RDE Trust; Leader of Torbay Council
CC: John Govett, Mark Hackett, FOI teams, NHS Devon Involve, James Murray MP, Phil Keeling, Torre, Sally, Nicole, Cat Johns
Date: 6 June 2026, 15:27

I am writing to seek urgent clarification regarding recent decisions that appear to have significant implications for healthcare provision across Torbay and South Devon, and to request disclosure of the documentation, assessments, business cases, minutes, and decision-making records that informed those decisions.

I understand that Torbay Council has agreed to provide a loan of £7.5 million to the Royal Devon University Healthcare NHS Foundation Trust in connection with proposals for a centralised pathology hub at Gadeon House, Exeter. At the same time, concerns have been raised locally regarding the future of pathology services at Torbay Hospital and the potential consequences for patients requiring urgent histopathology support.

As members of the public, clinicians, patients, and elected representatives seek to understand the rationale behind these decisions, a number of important questions arise.

Justification for the proposed £7.5 Million Loan

• What was the specific business case supporting the decision to provide a £7.5 million loan to another NHS Trust?
• What alternatives were considered?
• Was any assessment undertaken comparing the cost of repairing, upgrading, or modernising existing pathology facilities at Torbay Hospital against relocating services to Exeter?
• If concerns relate primarily to the condition of the pathology building, why was capital investment in the existing Torbay Hospital estate not pursued as the preferred option?

Impact on Histopathology and Frozen Section Services

The histopathology department at Torbay Hospital has long been regarded as a highly efficient and clinically important service.

• Can the Trust confirm whether the proposed pathology hub would result in the removal, reduction, or relocation of histopathology functions currently undertaken at Torbay Hospital?
• Specifically, what assessment has been made of the impact on surgical procedures requiring frozen section analysis during operations?
• If frozen section services are no longer available locally, will patients requiring procedures dependent upon those services be redirected to Exeter or Plymouth?
• What modelling has been undertaken regarding: increased waiting times; delays in diagnosis; theatre utilisation; clinical risk; patient travel burdens; workforce retention and recruitment?
• Will the Trust publish the full clinical impact assessment?

Substantial Change and Public Consultation

The proposed changes appear capable of materially affecting the availability and accessibility of diagnostic and surgical services for residents throughout the Torbay and South Devon catchment area.

• Can the Trust explain whether it has considered whether the proposal constitutes a substantial development of, or substantial variation in, health services?
• What legal advice was obtained?
• Was the Integrated Care Board consulted?
• Was the Health Overview and Scrutiny Committee consulted?
• Why has there been no public consultation to date?

Governance and Accountability

• Who authorised the proposal in principle?
• Which committees, boards, executive groups, or governing bodies considered the proposal?
• On what dates were discussions held?
• What votes took place?
• What objections or concerns were raised?

Please provide copies of: Board papers; Committee reports; Business cases; Financial appraisals; Clinical impact assessments; Risk registers; Equality impact assessments; Minutes of all meetings where these matters were discussed or approved.

Edginswell Employment Land

I also seek clarification regarding the recent disposal of employment-designated land at Edginswell to Torbay and South Devon NHS Foundation Trust.

Public reports indicate that governance processes may have been accelerated and that the intended use of the site is as a car park for a period of at least five years.

Can the Council explain: why employment land was released for this purpose; what alternative sites were considered; what economic impact assessment was undertaken; what governance process was followed; which officers and members approved the transaction? Please provide the relevant reports, delegated decision notices, committee papers, and minutes.

Transparency and Public Confidence

These decisions have the potential to affect healthcare provision for hundreds of thousands of residents across South Devon for many years. The public is therefore entitled to understand whether these proposals are definitive or still under consideration; the anticipated impact on local services; the financial rationale underpinning the decisions; the governance processes followed; and the opportunities available for public scrutiny and consultation.

I would be grateful if the requested documentation could be published or released at the earliest opportunity so that residents may be fully informed of the potential consequences of these proposals.

I look forward to your response.

Kindest regards

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

From: Susie Colley (chair@tqcc.co.uk)
To: NHS Devon ICB Involve team
CC: Phil Keeling, Sally, Torre, Nicole, Cat Johns, Andrew, David, John, Georgian

Good afternoon NHS Devon communications and engagement team.

As Chair of the Heart Campaign I have read the reply sent to Dr Phil Keeling, who is part of the Heart Campaign Committee, and it is my opinion that the majority of the responses to the questions contain a number of assertions, references to engagement, and statements of intent, but relatively little evidence.

In my role as Chair from a scrutiny perspective, it leaves several important gaps which are entirely reasonable for the Chair of a campaign or scrutiny group to pursue.

I am concerned that throughout the responses there are repeated references to "significant engagement", "co-development", "opportunities to get involved", and "working with communities", but almost no detail about: who was engaged; when they were engaged; how they were selected; how many people participated; what data was collected; how the findings influenced the final strategy; and why no specific Devon-wide public meetings appear to have taken place before publication.

1. "We undertook significant engagement"

The ICB states it undertook significant engagement as part of the 10 Year Plan development. However no dates, locations, methodology, numbers, or demographic breakdown are given, and no evidence is provided that the engagement specifically addressed the One Plan for Devon or that Torbay residents participated. The phrase "significant engagement" is therefore unsupported.

Please provide a schedule of all engagement activities, with for each: date, location, format, number of participants, organisation responsible, and whether attendance was open to the public. Please provide the full engagement dataset including number of responses, geographic distribution, demographic breakdown, copies of questionnaires, and analysis reports. Please identify which events informed the Devon Health and Care Strategy and the One Plan for Devon, and provide the evidence trail showing how public feedback altered the final documents.

2. Reliance upon NHS England's 10-Year Plan Engagement

This appears to be a conflation. The response states that engagement undertaken for the national NHS 10-Year Plan shaped the Devon strategy and One Plan. Were people consulted on the national NHS plan or on Devon service changes? These are not the same thing. A respondent discussing NHS priorities nationally is not necessarily commenting on Torbay Hospital, Derriford, RDE, service relocation, elective care provision, emergency pathways, or local hospital roles. Please explain how national engagement can be regarded as engagement regarding service transformation in Devon, what specific local engagement was undertaken solely on the One Plan, and, if none, how the ICB satisfied its Section 14Z45 duty.

3. The Timing Issue

Phil asked how we can be 12 months into this plan before it has been published and undergone any public engagement. The central issue remains unanswered: when did implementation begin? Please supply the formal commencement date of the One Plan for Devon, what actions have already been undertaken, what actions have already been funded, which actions commenced prior to publication, and what public engagement took place before those actions commenced.

4. Cancellation of the Public Meeting

Chris Reid had been invited and the ICB had confirmed he would attend a public meeting on 13 April. The meeting was cancelled by the ICB shortly before the event, citing pre-election restrictions. However, Torbay had no local elections. Please provide the specific NHS pre-election guidance relied upon, identify the clause that prevented attendance at a public information meeting, explain why attendance was agreed and then cancelled only two days before the event, explain why no replacement date was offered at the time, and provide copies of internal correspondence relating to the cancellation decision.

5. The Consultant Recruitment Issue

The response sidesteps the question. Phil did not ask who manages consultants. The question was whether the ICB would investigate concerns that consultants are advising trainees not to apply to Torbay Hospital because of perceived future downgrading. The issue is whether uncertainty created by strategic planning is affecting recruitment. Has the ICB assessed whether workforce recruitment is being affected by uncertainty regarding future service configuration? Has it received any reports from Torbay and South Devon NHS FT, University Hospitals Plymouth, or Royal Devon University Healthcare regarding recruitment concerns linked to transformation proposals? Has any workforce impact assessment been undertaken, and if so please provide it.

6. "No Specific Decisions About Individual Hospital Services"

If no decisions have been made, what options are currently under consideration? Has the ICB undertaken any modelling of future service distribution across Devon hospitals? Have any options appraisals been completed? Have any clinical working groups considered relocation, consolidation or reconfiguration of services? If so, please provide the papers. Which hospital services are currently under review?

7. The "People and Communities Framework"

The reply references a framework but provides no evidence of compliance. Merely citing legislation is not evidence that the duty has been fulfilled. Please provide Equality Impact Assessments, Public Involvement Impact Assessments, engagement plans, stakeholder maps, participation reports, and Governing Body papers discussing engagement.

8. The Missing Data

The entire response requires written evidence to support the answers. Without it, terms such as significant engagement, co-developed, public involvement, working with communities, and stakeholder engagement remain assertions rather than demonstrable facts. Please provide a complete schedule of all engagement activities, dates, locations and attendance figures, copies of surveys and consultation materials, the raw and analysed engagement data, evidence showing how feedback influenced the final plans, details of any engagement with Torbay residents, clinicians, patients, voluntary organisations and elected representatives, and copies of any public involvement, equality impact or stakeholder engagement assessments used to demonstrate compliance with Section 14Z45.

Kindest regards

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

From: INVOLVE (NHS Devon ICB) d-icb.involve@nhs.net
To: Phil Keeling
CC: Susie Colley (chair@tqcc.co.uk)
Subject: RE: Meeting - 13 April 2026

Dear Phil,

Thank you for your emails dated 14 April 2026 and 22 April 2026. To ensure each of your questions are responded to directly, your questions are highlighted in bold below followed by our response.

1. Has the ICB got a plan to get the management's AND CLINICIANS together to work on the practicalities of improving healthcare over the next 2 decades? If so can we have a timeline?

Yes, we have recently published our Health and Care Strategy and One Plan for Devon, our Five-year commissioning plan. Our future plans align fully with the published NHS 10 year plan.

2. Has the ICB got a timeline to explain the 5y plan to the public and expand on the above? How can we be 12m into this plan before it has been published and undergone ANY public engagement?

We undertook significant engagement as part of the 10 Year Plan development. This helped to shape the development of the health and care strategy and the One Plan for Devon, our five year commissioning plan. The findings from the 10 Year Plan engagement are referenced in both documents.

We remain fully committed to public engagement. In line with national NHS pre-election guidance, we were limited in attending public meetings up until 7 May 2026. However, we will be engaging openly with local communities over the summer in collaboration with Healthwatch to support the implementation and embedding of the Devon Health and Care Strategy and the One Plan for Devon.

3. Can the ICB comment and investigate what is being said by consultant staff at both RDE and Derriford with advising trainee doctors NOT TO APPLY for jobs at TBH as it won't "be a proper hospital soon" given relocation of services?

Operational matters, including recruitment, supervision and advice given to trainee doctors, are led by individual NHS Trusts and managed through their own clinical, workforce and governance arrangements.

We recognise that some people are worried about the future of local hospitals and services. Our published One Plan for Devon sets out how health and care services will need to evolve over the next five years. Our local hospitals play a vital role in our communities and will continue to do so.

We take concerns about workforce confidence and recruitment seriously. While this would be a matter for the relevant Trusts to address directly, we will share this feedback with the ICB workforce team. If you have any specific details, this would help ensure the issue is followed up appropriately.

The questions we received from the Heart Campaign were responded to prior to the public meeting on Monday 13 April 2026. These questions have formed part of the published One Plan for Devon FAQs page.

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, outlined in the One Devon People and Communities Framework which was co-developed with partners across Devon. The main duties are set out in the National Health Service Act 2006, as amended by the Health and Care Act 2022: section 13Q for NHS England, section 14Z45 for integrated care boards, and section 242(1B) for NHS trusts and NHS foundation trusts. These duties require substantial service change to have transparent public involvement.

We would like to offer you a meeting on MS Teams with Chris Reid, Chief Place and Transformation / Chief Medical Officer for NHS Cornwall, Isles of Scilly and Devon ICB, supported by the Director of experience and engagement. Convenient dates offered: 12 June 9.00-10.00; 19 June 12.15-1.00; 26 June 9.00-10.00.

Kind regards
NHS Devon communications and engagement team

From: Susie Colley (chair@tqcc.co.uk)
To: James Murray MP
CC: Sally, Phil Keeling, Torre, Nicole
Date: 6 June 2026, 14:46

Dear James Murray MP,

I am writing to request your urgent assistance regarding a series of decisions being taken by Torbay and South Devon NHS Foundation Trust, NHS Devon Integrated Care Board, and Torbay Council that appear to be contributing to the progressive transfer of acute and diagnostic services away from Torbay Hospital and towards Exeter.

Local residents are increasingly concerned that decisions are being made incrementally, without adequate public scrutiny, consultation, or transparency, resulting in the gradual erosion of services relied upon by communities across Torbay, South Devon and the wider catchment area.

Of particular concern are proposals relating to the centralisation of pathology services in Exeter, supported by a reported £7.5 million loan from Torbay Council to Royal Devon University Healthcare NHS Foundation Trust. Serious questions remain unanswered regarding the financial rationale, clinical impact, governance processes, consultation requirements, and consequences for urgent histopathology and frozen section services that support cancer surgery and other time-critical procedures.

The attached correspondence sets out a number of specific questions that have yet to receive satisfactory answers.

Given the significance of these changes and their potential impact on access to healthcare for hundreds of thousands of residents, I respectfully ask that you:

1. Seek an explanation from NHS Devon Integrated Care Board, Torbay and South Devon NHS Foundation Trust, and Torbay Council regarding the proposals.
2. Request publication of the business cases, clinical impact assessments, equality impact assessments, risk assessments and governance documentation underpinning these decisions.
3. Establish whether the proposals constitute a substantial variation of health services requiring formal public consultation.
4. Ensure that any reconfiguration of services complies fully with statutory duties relating to public involvement, transparency and accountability.
5. Consider whether independent review or ministerial scrutiny is warranted before any irreversible decisions are implemented.

The cumulative effect of service transfers from Torbay to Exeter has generated considerable concern locally. Public confidence depends upon full transparency and meaningful engagement before decisions of this magnitude are finalised.

I would be grateful for any assistance you can provide and look forward to your response.

Kindest regards

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

From: Susie Colley (chair@tqcc.co.uk)
To: Keir Starmer MP (Prime Minister), James Murray MP, Matthew Pennycook MP
CC: Joe Teape, John Govett, Andrew, Georgian, David, John, Phil Keeling, Nicole, Torre, Sally, Steve Darling MP
Subject: Letter to Keir Starmer and Health and Housing Ministers

Dear Prime Minister,

I am writing on behalf of The Heart Campaign and many residents, patients, carers and clinicians across South Devon who are increasingly concerned about the future of acute healthcare services at Torbay Hospital.

Our campaign is not opposed to NHS modernisation, service improvement or the development of more efficient ways of working. We fully recognise the significant financial and workforce pressures facing the NHS. However, we believe that any reconfiguration of services must be transparent, clinically justified, properly consulted upon and demonstrably improve patient access and outcomes.

We are deeply concerned that a series of proposals affecting key services at Torbay Hospital, including previous plans relating to cardiac services and more recent concerns regarding pathology and histopathology provision, may represent a gradual reduction in the role of the principal acute hospital serving South Devon.

This appears difficult to reconcile with the stated objectives of providing healthcare closer to people's homes. We ask how moving services further away from the communities they serve can improve access for elderly residents, vulnerable patients, carers and those without private transport.

The Heart Campaign is concerned that the cumulative effect of the proposed changes to acute services at Torbay Hospital may constitute a substantial variation in the provision of NHS services. If so, questions arise as to whether the public involvement, consultation and scrutiny requirements contained within the National Health Service Act 2006, as amended, and related regulations have been fully complied with. We therefore seek assurance that all statutory duties relating to patient and public involvement, local authority scrutiny and consultation have been properly discharged before any further significant service changes are implemented.

We are acutely aware of the legislation, and hopefully cite correctly, the relevant Acts below:

National Health Service Act 2006, section 242 (for NHS trusts and foundation trusts) requires involvement of patients and the public in: planning services; developing proposals for service changes; and decisions affecting service operation where those changes affect how services are delivered or the range of services available.

National Health Service Act 2006, section 14Z45 (inserted through the Health and Care Act 2022 for Integrated Care Boards) imposes a similar duty on ICBs to involve patients, carers and representatives when developing proposals for changes to commissioning arrangements that affect service delivery or service availability.

National Health Service Act 2006, section 244 and the associated Local Authority (Public Health, Health and Wellbeing Boards and Health Scrutiny) Regulations 2013 require consultation with the local authority's health scrutiny function where there is a "substantial development" or "substantial variation" of NHS services. From our understanding this is the provision most often cited when major service reconfigurations are proposed.

Torbay Hospital serves a large and geographically dispersed population across South Devon. The area experiences substantial seasonal increases in demand due to tourism, while extensive housing development continues across the region. Residents are entitled to understand how future healthcare needs will be met and how neighbouring hospitals in Exeter and Plymouth could absorb additional demand when they already face significant pressures.

Our campaign has engaged extensively with local processes. We have submitted more than forty Freedom of Information requests, attended scrutiny meetings, organised numerous public meetings involving patients and clinicians, and sought constructive dialogue with decision-makers. Despite these efforts, many fundamental questions regarding the future of acute services remain unanswered.

We are therefore requesting ministerial intervention to ensure:

• Full transparency regarding the long-term future of acute services at Torbay Hospital.
• Publication of the evidence supporting any proposed service transfers or reductions.
• Assurance that all consultation and public engagement requirements have been properly fulfilled.
• An independent assessment of the impact on patient access, cancer pathways, emergency care and healthcare outcomes across South Devon.
• Confirmation that healthcare infrastructure planning is keeping pace with population growth and increasing demand.

The people of South Devon are not seeking special treatment. They are seeking reassurance that they will continue to have reasonable access to safe, timely and effective acute healthcare close to the communities they live in.

We respectfully ask for your urgent attention to this matter before any further significant changes are made.

Kindest regards

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

From: Susie Colley (chair@tqcc.co.uk)
To: Layla Moran MP, Andrew George MP, Danny Beales MP, Beccy Cooper MP, Josh Fenton-Glynn MP, Paulette Hamilton MP, Joe Robertson MP, Greg Stafford MP, Alex McIntyre MP
CC: Steve Darling MP, Andrew, David, Georgian, John, Phil Keeling, Sally, Torre, Nicole
Subject: Urgent Parliamentary Scrutiny Required Regarding Acute Services at Torbay Hospital

For ease of reference, I have reproduced below in full the correspondence submitted to the Prime Minister on behalf of The Heart Campaign and concerned residents across South Devon.

Dear Members of the Health and Social Care Committee,

I am writing as Chair of The Heart Campaign in Torquay, South Devon to seek your assistance and scrutiny regarding growing concerns over the future of acute healthcare services at Torbay Hospital.

I attach below a detailed letter that was sent to the Prime Minister outlining concerns shared by patients, carers, clinicians and residents across South Devon regarding a series of proposed and potential service changes affecting Torbay Hospital.

This is not a party-political issue. Access to safe, timely and effective healthcare is a matter that affects every constituent regardless of political affiliation. We therefore ask Members of the Committee from all parties to consider the issues raised and to support transparency, accountability and proper public engagement before any further significant changes are made.

Torbay Hospital serves a large, ageing and geographically dispersed population. South Devon also experiences substantial seasonal demand through tourism and continuing population growth through major housing development. Against this backdrop, there is increasing public concern regarding the cumulative impact of service transfers and reductions affecting the area's principal acute hospital.

Our campaign fully recognises the financial and workforce pressures facing the NHS and supports service improvements where these are clinically justified and demonstrably beneficial to patients. However, we believe that any significant reconfiguration of services must be supported by clear evidence, full transparency and compliance with all statutory duties relating to consultation and public involvement.

We are particularly concerned that the cumulative effect of recent and proposed changes may amount to a substantial variation in NHS services, raising important questions regarding public consultation, scrutiny and patient engagement requirements under the National Health Service Act 2006 and subsequent legislation.

Over recent years, The Heart Campaign has worked constructively with local NHS organisations, attended public meetings and scrutiny committees, organised community engagement events, and submitted more than forty Freedom of Information requests. Despite these efforts, many questions about the long-term future of acute services at Torbay Hospital remain unanswered.

We therefore respectfully ask members of the Health and Social Care Committee to:

• Review the concerns outlined in the attached correspondence.
• Seek assurances that all statutory consultation and public engagement requirements have been fully met.
• Support full transparency regarding the future of acute services at Torbay Hospital.
• Encourage independent assessment of the impact that service changes may have on patient access, emergency care, cancer pathways and healthcare outcomes across South Devon.
• Consider whether current healthcare infrastructure planning adequately reflects the area's growing and ageing population.

The residents of South Devon are not seeking preferential treatment. They are seeking reassurance that essential acute healthcare services will remain accessible to the communities that depend upon them and that any significant changes will be subject to proper scrutiny and public accountability.

I would be grateful if Committee members could give this matter their urgent consideration and advise whether any further information would assist.

Thank you

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