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: NHS Devon ICB INVOLVE team, 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