NDHT and RD&E agree to explore joining together on a more formal basis

19 Dec 2019

The Boards of Northern Devon Healthcare NHS Trust and the Royal Devon and Exeter NHS Foundation Trust have agreed that the two organisations will explore joining together on a more formal basis. Both Boards have agreed that this process must be based on the premise that any new arrangement is beneficial to people in all the communities served by both Trusts and this premise is supported by NHS regulators.

Suzanne Tracey, joint chief executive of NDHT and the RD&E, said: “The starting point for both organisations is the clear view that wherever you live – whether that is in rural Northern Devon, in the centre of Exeter, or on the borders of Somerset and Cornwall - we have a shared duty, as part of the National Health Service, to ensure that people have good access to high quality care and, in particular, A&E and supporting services when they need them.

“We recognise that both organisations face some significant challenges. We both need to transform with the use of technology and recruit and retain the workforce needed to deliver high quality services to our patients. We both need to improve our performance against some of the key targets on accessing health services. We need to do this in a clinically and financially sustainable way.

“That is why we now need to explore whether working together on a more formal basis provides us with a better opportunity to address these challenges, making the best use of our collective resources to meet the health needs of the local population. Clearly, any new arrangement between the two organisations must be appropriately supported by NHS Improvement/NHS England.”

The Boards of both organisations will now work together to determine the next steps. The organisations have agreed that a Collaborative Agreement should be extended beyond June 2020 to allow the appropriate processes, including conversations with NHS regulators, to be completed. The Trusts have emphasised their commitment to keeping staff and the community informed and engaged as this process develops.


The move towards joining together is the next step in a long-standing partnership between the two organisations. The RD&E has supported the delivery of acute services in Northern Devon for a number of years through clinical networking arrangements to ensure patients in Northern Devon have local access to specialist care. In June 2018, this arrangement was strengthened as part of a Collaborative Agreement which supported NDHT to address some of the challenges faced in providing acute services from the most remote hospital in mainland England.

The Collaborative Agreement included a commitment to undertake an appraisal of the best way of structuring the relationship to ensure the continued delivery of clinically and financially sustainable services. The agreement has reinforced the already positive partnership between the two organisations with both benefitting from sharing expertise and economies of scale as we have begun to bring together support services.

In November 2019, the NDHT Board met to consider the challenges facing some of its core acute services and how best they could be supported on a sustainable basis given the issues it has faced in relation to workforce shortages, its remoteness and the pressure on its finances. The NDHT Board took account of the outcomes from the Review of Hospital Services in Northern Devon conducted during 2019. The NDHT Board reached the view that joining with another provider was the best option to secure the long-term sustainability of hospital services for the population of Northern Devon. Given the history of collaboration between the two organisations, the Board further agreed that the best partner to explore a formal arrangement with would be the RD&E.

Throughout 2019, NDHT carried out a targeted and inclusive engagement exercise, speaking to more than 2000 staff, patients and members of the public about what was important to them about hospital services. Commenting on the conversations, Ms Tracey said, “I want to thank everybody who shared their views with us. It is really clear how important our services are to people and how much people value their local NHS staff. During our dialogue with people, we heard about the transport and access difficulties people face in Northern Devon and we are really clear that this must be a priority as we develop our services. The decision to explore joining together is the beginning of the conversation about how we make sure our services are sustainable and meet the needs of local people. I look forward to continuing this conversation with the local community.”

In December 2019, the RD&E Board considered the recommendation from NDHT and agreed to work with NDHT to explore joining together with the proviso that any new arrangement must be of benefit to people in all communities served by both Trusts, has a robust and fully funded business case (including the resource required to transform services) and the support of the regulatory bodies.



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