ICB challenged over plans to shift patients to trust facing £40m deficit

I have written to NHS Devon's Integrated Care Board demanding answers about plans that would see Torbay patients sent to Royal Devon University Healthcare NHS Foundation Trust - a trust that has publicly declared it will miss its financial targets this year by more than £40 million.

In a formal letter to the ICB, I asked Chair Steve Govett, seven direct questions about how the proposed "Case for Change" can be considered safe or sustainable when the receiving trust is already in financial and operational difficulty.

The key questions:

• How can a trust forecasting a £40m+ deficit absorb additional unfunded demand from Torbay?

• What evidence shows Royal Devon has the bed capacity, staffing, and discharge capability to handle more patients?

• How have the clinical risks of increased travel times been quantified - particularly for time-critical conditions like heart attacks?

• Why is Royal Devon's financial fragility not mentioned in public engagement materials?

The letter requests formal written responses and asks that the challenge be recorded within the Case for Change governance framework.

"Without credible, evidence-based answers, it is difficult to see how proposals involving the downgrading of Torbay Hospital could be considered safe, sustainable, or in the best interests of the population," the letter concludes.

13 January 2026

Dear Mr Govett and Board Members,

I am writing in my capacity as Chair of the Torquay Chamber of Commerce and Chair of the Heart Campaign to formally challenge the assumptions underpinning the Case for Change, specifically where these rely on Royal Devon University Healthcare NHS Foundation Trust (RDUH) absorbing additional demand arising from any downgrading of services at Torbay Hospital.

RDUH has publicly declared that it will fail to meet its financial plan this year and is forecasting a deficit in excess of £40 million. In this context, I am seeking formal assurance from the Integrated Care Board on the following matters, which I consider to be material governance, safety, and sustainability risks.

1. Financial viability
   What assurance has the ICB received that a trust forecasting a £40m+ deficit has the financial capacity to absorb additional unfunded demand from the Torbay Hospital catchment without further destabilising its financial position or requiring emergency system intervention?
2. Capacity and flow
   What evidence demonstrates that RDUH has sufficient bed capacity, emergency department resilience, and discharge capability to safely accommodate increased activity resulting from a downgrade of Torbay services, given existing pressures on flow and occupancy?
3. Workforce sustainability
   What workforce modelling has been undertaken to demonstrate that RDUH can staff any additional activity safely, particularly in acute and specialist services, in light of existing vacancy rates, rota fragility, and reliance on temporary staffing?
4. Ambulance and patient safety impact
   How have the clinical risks associated with increased travel times, ambulance conveyance delays, and reduced local access to urgent and emergency care been quantified and mitigated, particularly for time-critical conditions affecting Torbay's population?
5. Risk transfer and system resilience
   How does the ICB justify transferring clinical and operational risk from Torbay Hospital to a provider that is already in financial and operational difficulty, and how does this improve overall system resilience rather than concentrate failure?
6. Governance and assurance
   Can the ICB confirm whether NHS England has reviewed and assured the Case for Change in light of RDUH's declared financial position, and whether this risk has been formally recorded and mitigated within the programme risk register?
7. Transparency and stakeholder confidence
   Why has the financial fragility of RDUH not been clearly set out in public engagement materials, and how does the ICB consider this consistent with its duties of transparency, accountability, and adherence to the Nolan Principles of Public Life?

Given the scale of risk involved, I request that written responses to these questions are provided and that this challenge is formally recorded within the Case for Change governance framework. Without credible, evidence-based answers, it is difficult to see how proposals involving the downgrading of Torbay Hospital could be considered safe, sustainable, or in the best interests of the population.

I would welcome confirmation of how and when the Board intends to address these concerns.

Kindest regards,

Susie Colley

Chair, Torquay Chamber of Commerce

Chair, The Heart Campaign Torbay