The local population
Community health and social care services
Community specialist services
What We Do
How we are organised
Trust at a glance
Northern Devon Healthcare NHS Trust operates across 1,300 square miles, providing care for people from Axminster to Bude and from Exmouth to Lynton.
The Trust offers both acute services, centred on North Devon District Hospital (NDDH) and adult community services, across a network of 17 community hospitals and nine integrated health and social care community clusters, spanning Torridge, North Devon, East Devon, Exeter, Mid Devon, Teignbridge and West Devon.
Community-based and specialist staff also work from GP surgeries, other local bases and, increasingly, in people’s own homes.
Integration – a ‘joined up’ approach – is essential to this way of working. The Trust was one of the first in England to integrate acute and community healthcare services, in 2006, adding adult community health and social care services in 2008.
Northern Devon includes the key urban areas of Barnstaple and Bideford. The balance is drawn from the highly rural population in a network of small hamlets and villages across the area.
Eastern Devon includes the major urban area of Exeter, along with other urban areas of Exmouth, Crediton, Tiverton, Cullompton, Honiton and Sidmouth. The remaining population lives in rural areas.
The acquisition of the eastern Devon community services has substantially increased the community catchment population for the Trust as shown in the table above (Table 1).
The community catchment population has therefore more than trebled as a result of this acquisition. Whilst this increase is significant the ways of working, the culture is eminently transferable and work is already underway to understand the particular needs of the local population of eastern Devon by engaging with the local GPs.
The demographies of northern and eastern Devon are broadly similar. However, Exeter has a significantly higher proportion of working age people, and East Devon has significantly more older people, with more than a quarter aged 65 or older. This will present particular challenges and the Trust will work closely with GPs and commissioners to identify how best to meet their respective needs.
By 2030 the Office of National Statistics projects that the population for northern Devon will increase by 19% to 186,800, and eastern Devon will increase by the same percentage to 388,700. More significantly, the proportion of the population that will be aged 65 or older will increase to 31% in northern Devon and 28% in eastern Devon, meaning that nearly three in ten people across the whole of northern and eastern Devon will be 65 or older.
Although Devon has below average levels of deprivation nationally, northern Devon has significant levels of rural deprivation along with pockets of severe deprivation in urban areas such as Ilfracombe, Barnstaple and Bideford. The area covered by adult services in eastern Devon also includes area of deprivations in parts of Exeter (particularly Wonford, Whipton, city centre and Mincinglake) and Tiverton. The lowest levels of deprivation are seen around Sidmouth, Ottery St Mary, Woodbury and Budleigh Salterton. The following maps illustrate the extent of deprivation across northern and eastern Devon.
Life expectancy in Devon is above the national average, standing at 79.6 for males and 83.6 for females compared with 77.8 and 82.0 nationally. While Devon has longer life expectancy overall, there are some significant differences on a local level. For example within northern Devon, there is a difference of 13.5 years between the ward with the longest life expectancy (Greater Torrington) and the shortest (Ilfracombe). There are also significant differences in life expectancy within eastern Devon with a 10.3 year gap in Exeter e.g. Newtown at 74.4 to Pennsyilvania at 84.7.
The eastern Devon and specialist services elements of Devon Provider Services (DPS) has been transferred and integrated into the Northern Devon Healthcare NHS Trust in a process very similar to the one taken in 2006 with the northern Devon Vertical Integration. The services have been integrated into the existing Health and Social Care Directorate, which will be expanded to have northern, eastern and mid-Devon divisions. The full description of the services under acute, community health and social care and specialist services can be found in Appendix 2, however
summaries are shown below.
We offer a full range of acute services at the North Devon District Hospital and have a strategy to repatriate appropriate services to northern Devon to meet the needs of our local community, e.g. WAMD. Where it is not clinically or financially viable to directly manage a service, we work with neighbouring acute trusts to establish clinical networks. We work with Taunton on a vascular network, Derriford on a neonatal network and Royal Devon & Exeter on a cancer network.
Other recent initiatives include haematology and specialist ENT provision.
In between our acute and our community services, we have a range of intermediary services which aim to control and facilitate the flow of patients to and from the acute. These include the Pathfinder team and the complex discharge coordinators.
Community services can be divided into inpatient nursing and therapies at the five community hospitals run by this Trust and the five complex care teams, which consist of multidisciplinary teams with district nursing and social workers. In addition to inpatient care, some of the community hospitals offer a Minor Injury Unit and stroke rehabilitation.
Working across acute and community settings are the specialist services such as podiatry, musculoskeletal, audiology and ophthalmology. These services are organised in discrete pathways and are commissioned separately.
The North Devon District Hospital provides a full complement of secondary care services including diagnostics, treatment and follow-up care, along with A&E, cancer care, orthopaedic surgery, paediatric care and maternity services. The A&E department has recently been refurbished.
The seventeen community hospitals, offer services ranging from minor injury, rehabilitation and inpatient bed facilities.
- Barnstaple Health Centre
- Budleigh Salterton
- Exeter Community Hospital
- Ottery St Mary
- South Molton
- Tiverton & District
The Trust continually reviews the services to ensure that they meet the latest guidelines in clinical best practice and policy. It is committed to involving service users, patients, carers and the public in planning, developing, delivering and improving healthcare services.
To meet local healthcare needs we work closely with the NHS South West Strategic Health Authority; the Devon Primary Care Trust; the Devon Partnership Trust (mental health and learning disabilities); the South Western Ambulance Service NHS Trust (SWAST); Torridge and North Devon District Councils and Devon County Council adult and community (social) services.
With just over 4000 staff, Northern Devon Healthcare Trust is the largest employer in the area. In terms of the pay bill alone, the Trust contributes nearly £150,000 each day to the local economy.
The Northern Devon Healthcare Trust has its headquarters in Barnstaple. It is directed by the Trust Board, which meets monthly to determine strategy and receive information from the executive director team responsible for managing day-to-day operations.
The Trust Board is led by a Chairman (appointed by the Secretary of State for Health) with a team of five Non-Executive, five Executive and two Associate Directors. The Non-Executive Directors have a part-time role, providing experience and expertise, usually gained from working in organisations outside the NHS.
The Executive and Associate Directors are led by the Chief Executive and combine their role as board members with management responsibility.
The Board has adopted Codes of Conduct and Accountability recommended by the NHS Executive. Audit, Risk, Clinical Governance and Remuneration and Terms of Service Committees are well established.
Devon is a popular retirement and tourist area. More than 20% of the population are over 65 years old and nearly 10% are over 75 (UK averages are 16% and 7.5%, respectively). The total local population that the Trust serves is 483,900.