North Devon and RD&E Hospitals prepare to merge

Staff and patients should see little difference

An end to operating theatres so small “it’s like playing musical chairs” and more efficient services are just some of the benefits on the way for North Devon District Hospital Trust (NDDHT).

Senior NHS members held a meeting recently with members of North Devon Council (NDC) to discuss the future of North Devon’s hospital.

Top of the agenda was looming plans to merge the Royal Devon and Exeter (RD&E) NHS Trust with North Devon Healthcare NHS Trust. The two have been collaborating since 2018 but will be formally combining to form a new trust in April. 

Speaking at a Torridge District Council external overview and scrutiny committee, Katherine Allen, director of strategy at the current RD&E Trust, said: “North Devon will benefit from the strengths of a bigger trust – whether that’s access to resources, to research, resilience of small teams joining together to make more resilient services – but equally RD&E will benefit from a small hospital, being really agile, getting things done quickly.” 

Ms Allen said the merger would help to address the problems with staff shortages at North Devon District Hospital and save money for both organisations. 

She added: “The most important thing is that staff and patients see very little difference. This is a corporate merger. The services will stay the same. North Devon patients will still access services in North Devon.

“That is the whole aim of this merger: to make sure that local access is maintained.”

One of the early plans of the new trust is to collate patient records between the RD&E and North Devon on a new digital platform. This is expected to go ahead in July.

The name of the new organisation has not yet been announced but has been decided. It will reflect the “history and provenance of both trusts,” Ms Allen assured the meeting.

A merger between North Devon District Hospital and the RD&E was proposed in 2003 but fell through. “What’s different about this time”, said Ms Allen, “is the clinicians are 100 per cent behind this, they understand the benefits, they can see the benefits of this merger for the patients.”

She warned that if the merger didn’t happen “we would lose momentum” and that NDDHT would be back in the same situation it was in 2017 with a worsening financial position and deteriorating quality of care.

RD&E have run some services in North Devon for decades, providing treatments for cancer as well as ear nose, throat and dental services.

In 2018 North Devon was struggling to provide some key services and asked for help. RD&E stepped up its role and the two trusts have shared many of the leadership positions with each other since then. “That has really stabilised local service provision and started the resolution of quite a number of our challenges”, said the strategy director. 

At several points in the meeting between councillors and health bosses, the  NHS representatives referred to the challenges posed by North Devon being relatively ‘“remote”, something that irked one councillor.

Councillor Christ Leather (Independent, Northam) said: “To me it’s been a managed decline of that [North Devon Healthcare] Trust over the years and I do hear about the remoteness of the hospital in North Devon. It’s not remote to the 180,000 people who live in the area. It might be a bit distant from Exeter but then the RD&E is remote for us in North Devon, so don’t keep on about how remote we are as if we’re at the end of the world.”

Cllr Leather also raised questions over just how much services would improve under the new trust given that the two organisations had been working together since 2018 yet North Devon District Hospital still received a critical report from the Care Quality Commission in November last year. The report said the hospital ‘requires improvement.’

Ms Allen argued the biggest problem is staff supply, which would be helped by the new merger.

She added: “The essence of our plan is we need support. North Devon needs the support of a larger partner and all the resources that brings and sharing of expertise to start to address some of the risks that are so publicly recognised in the CQC report.”

Another problem facing North Devon District Hospital is its ageing buildings, constructed in the 1970s. Zahara Hyde, a programme director at the NHS, told councillors of staff struggling with surgical theatres 40 per cent smaller than their modern equivalents.

Ms Hyde said: “It’s like playing musical chairs in there – not good and certainly not what we want.”

These theatres are due to be replaced as part of multi-million-pound redevelopments to North Devon District Hospital over the coming years. Works are set to take place between 2025 and 2027. 

The NHS boss described the redevelopment as “a big chunk of new coupled with a lot of refurbishment of the old.”

“We’re adding to the hospital is the best way to describe it. What we’re adding is new build but we’re using some of the investment to redesign some of what we’ve got left behind. 

“So it won’t have a whole new hospital, we’ll have a redeveloped site and the site will look very different.”