Trust organises additional consultation meetings in Axminster and Seaton

Axminster-new-main-entranceTHE Northern Devon Healthcare NHS Trust has organised additional consultation meetings so local people can have a say on whether it should temporarily transfer inpatient services at Axminster to Seaton.

The Trust is holding a four-week public consultation on options to resolve significant patient safety risks at both hospitals.

Its preferred option is to temporarily merge inpatient services at Seaton, giving one unit with 18 beds rather than 10 at each site.

Following feedback from the local community, the Trust is offering additional consultation meetings at Axminster on the evening of Monday 15 December.

There will also be additional meetings at Seaton on Monday 22 December.

Local people can have their say, find out more about the patient safety risks and make suggestions on how the issues could be addressed on the following dates:

Axminster Hospital

  • Monday 15 December (2pm to 7pm)
  • Monday 22 December (2pm to 4pm)
  • Monday 29 December (2pm to 4pm)

Seaton Hospital

  • Monday 22 December (4.30pm to 7.30pm)

Pre-booking is essential to ensure everyone has an opportunity to participate.

To book an appointment, lasting 45 minutes, please call 01271 322460 or e-mail

The consultation runs from Tuesday 2 December until Tuesday 30 December 2014.

The full consultation document is available on the Trust website at


Over the Christmas period there may be some delay in responding to messages. We commit to responding as soon as we are able. Sorry for any inconvenience.

Please leave any further comments on this page –

Posted in News.

Last updated: March 6, 2018


  1. Thank you for posting the terms of reference for the External Assessment regarding the safe working. During the consultation it was agreed that carrying this out purely at Axminster was neither fair nor equitable and that the assessment needed to be fulfilled at both Seaton and Axminster.
    Please assure the community that you are planning to carry out this assessment on both sites prior to the board meeting of January 5th, so that a true representation of the needs at Seaton and Axminster can be reached.

    • Dear Mr Holt
      The external review will consider whether the Trust has been objective in its decision-making regarding patient safety at Axminster Hospital, because this is the subject of the consultation. However, the external reviewer will look at the principles of safer staffing in 10 bed units in general, and there will be a limited comparison of Seaton and Axminster. The findings of this review will be equally applicable to Seaton, Axminster, Ottery St Mary, Crediton and lfracombe.
      Kind regards

  2. In the questions and answers section dated 15 Dec you state that the terms of reference for the review of safety include Axminster and Seaton Hospitals. This seems to imply they had been drawn up but not published .

    Is this true ? Or is it that they had not and indeed still have not been finalised ?

    Kind regards
    Martin King

    • Dear Mr King

      Please follow this link to read the Terms of Reference for the review.

      There was a small delay whilst they were agreed with the reviewer.

      Independent reviewer – Rhiannon Jones

      Rhiannon Jones has been a registered nurse for 29 years and has senior management, leadership and corporate experience in nursing and the NHS generally, spanning acute and community services. For the past five years she has been assistant director of nursing for a large integrated health board in Wales, which employs around 16,000 staff and has a one billion budget. She deputises for the executive director of nursing and has a delegated portfolio for quality, safety and patient experience. She is a clinical fellow for the Lean Enterprise Academy and has a postgraduate diploma in healthcare management, a diploma in nursing and a masters degree.

      Kind regards

  3. I do not accept your response to my question on Safe Staffing and CQC reports. At no point is Axminster named as being more vulnerable than anywhere else and no recent reports on Axminster are shown. Most questions on CCQ site come with either not yet inspected or this site is with another provider! Can you clarify this please?
    Ann Veit

  4. can you tell me why a question posted to this site on the 27th Dec approx. 11-30 am has not yet appeared above? Now 17.00
    Ann Veit

    • Dear Ann
      All messages are checked before posting. This is to ensure offensive messages are not published on an NHS website and is not a censure measure. Given the message was posted on a Saturday, there was a short delay in the message being approved.
      Kind regards
      Katherine Allen

  5. I have questions about the Board Meeting on the 7 th January.

    In the procedure for Board meetings it says that there will be 10 minutes for questioning at the end .

    With such a controversial matter as the Bed Consultation being discussed is
    it possible to have a longer period for questions as it is highly likely that if the Option to move beds to Seaton decision is recommended there will many questions.

    Does voting take place before or after public questions ?

    It also states that questions need to be registered 36 hrs beforehand – does this mean by 9pm on the 5th Jan ?

    Please confirm the email address to which the questions should be sent.

    Many thanks

    Martin King

      • Your reference does not provide answers to my specific questions unfortunately .

        Could you please let me have specific answers?

        Many thanks

        Martin King

        • 1) Please let me have the names of the person /persons who decided that Option 5 was the NDHT preferred option in the Consultation Document

          Kevin Marsh, Director of Nursing
          Robert Sainsbury, Director of Operations Dr George Thomson, Medical Director

          All three had the responsibility of exploring and evaluating all available options from their professional perspectives. The decision on the options under consultation was made by the Trust Board.

          2) Who will be the authors of the papers presented to the Board Meeting on the 7th January ?

          The three executive directors listed above.

          3) Who is responsible for preparing and signing off the Board meeting papers ?

          The relevant executive directors are responsible for their own Board papers and reports.

          4) What is the process for commenting or asking questions at the Board meeting on the 7th January ?

          We request that members of the public wishing to ask a question at the Board meeting submit it by 9pm on 5 January 2015. Please email the Trust Secretary if you would like to submit a comment or question.

          • One of my other questions was asking for confirmation that questions will be put to the Board and answered before any decision is taken ?
            Clearly this is extremely important otherwise the questioning will be ineffective.

            kind regards


        • Dear Mr King

          The Board meeting is one that is held in public but it is not a public meeting. We have requested all questions to be submitted to the Board in advance of the meeting and the Chair will review those received before considering how they will be addressed before, during or after the Board meeting.

          The purpose of allowing until 5 January for questions to be submitted is so that people can review the content of the Board papers before putting a question to the Board.

          Kind regards

  6. I have now looked at the CQC report and at no point can I find Axminster being pin pointed as an hospital with a specific ‘Lone Working’ problem. I agree that ‘Lone Working’ is not ideal it has been common practise for some time. Even in Seaton! Why has Axminster been singled out as ‘at risk’ when others have not? Your propaganda has frightened a lot of frail elderly people and should it be discovered that there is a more sinister reason to close Axminster and this is a cynical attempt to disguise it, as is strongly suspected. Can you reassure all concerned that this is not the case?

    • Dear Ann

      Thank you for your message and your continued interest in your local NHS services.

      The Care Quality Commission visited the majority of our community hospitals in their July 2014 inspection. There is an action plan that we have drawn up and sent to the CQC which sets out how we will address some of the issues they saw during their inspection. It does not matter that the inspectors did not visit Axminster, as there is the expectation that lone working will be eradicated in all our community hospitals.

      You are right that this situation has evolved over many years, but now that our regulator has joined the Board in requiring lone working to be eradicated, we must act.

      I hope my response provides sufficient reassurance of the rationale behind this very difficult decision.

      Kind regards

  7. Can you tell me when the Independent Review of Axminster Hospital is to take place? We are 13 days away from the Extraordinary General Meeting and no sign of review or it’s promised report.
    Is Seaton Hospital having a similar review? If not why not? Will they take into account the 26 additional services available at Axminster Hospital? These increase patient safety dramatically.

  8. Before I ask the question I navigated my way to this site to ask, I have just stumbled across a very worrying page heading on the previous page.
    What about safe staffing at Seaton hospital?
    This absolutely indicates the consultations are pure ‘lip service’ and the NDHT think they have made the decision and that is that.
    I have previous experiences indicating this is the case. One being when Tina Nardlett? Ass Director of Nursing, stated at a consultation that the DECISION HAD BEEN MADE TO CLOSE AXMINSTER BEDS. It was also stated at a drop in meeting by Iain Roy, Director of Facilities, THAT TO CLOSE SEATON BEDS WOULD TURN IT IN TO AN EMPTY SHELL. Is the decision on patient care and finance to be taken on the fact that keeping beds open at Seaton is taken by treating that hospital as a charity case? This is the most preposterous decision I have ever known be made by a public body and would like the reasoning. Patient care and safety does not really come into the reasoning I have so far heard.

    • Dear Ann

      Thank you for your message and we are happy to provide a response.

      The senior clinicians and managers that you have met at the consultation meetings are very clear that this is a genuine consultation with five options being considered.

      It is normal and common practice for the NHS to indicate which is its preferred option – we would have been asked through the consultation so we preferred being clear from the start.

      You refer to the conversations during the drop-ins that we held in October and November when we had announced a ‘decision’ to consolidate inpatient beds at Seaton. As you know, this engagement approach was criticised and restarted as a formal consultation approach. Therefore it is not surprising that you heard our senior managers refer to the decision before December and the consultation options during December.

      Both options 4 and 5 resolve the safe staffing issues. There are a variety of reasons, for and against, each location being chosen. The purpose of the consultation is to uncover these reasons and ensure a full and proper debate before the decision on a temporary move is made.

      Kind regards

  9. Ever since it was posted some weeks ago the Terms of Reference for the Independent enquiry into bed Safety in Axminster were promised when agreed. Subsequently we have been told the enquiry will include Seaton.

    When can we expect to see them and what is the timing of the enquiry?

    It does not seem it can be done in time to have any relevance to this Consultation and yet it may reveal interesting and important issues that are relevent to this Consultation.

  10. Fairness of Bed availability for both Axminster and Seaton communities.

    It has been agreed at consultation meetings and is stated in the Consultation options that the demand and need for inpatient beds is ‘ roughly equal .

    This demand has been running at circa 10 beds in both Axminster and Seaton and is not expected to lessen in the near future.

    When and if the beds are consolidated onto one site it is vital that fairness of allocation is maintained to ensure that one community is not disadvantaged by the consolidation.

    If this is not done there will be unfairness of choice in the system and serious distress caused to one or other of the communities.

    Can you please confirm that the management of the bed allocation when consolidation takes place will be such that half the beds will be generally available to meet the needs of patients in each community ?

    with kind regards

    Martin King

    • Dear Mr King

      Thank you for your message and continued interest in the consultation.

      In terms of admissions into community hospitals, we do not restrict access to patients from certain postcodes. If a community hospital inpatient stay is required to support the recovery or rehabilitation of a patient then we will do our best to accommodate them in the nearest hospital to their home. If this hospital is full, as sometimes happens, the patient will be offered a place at the next nearest hospital.

      We do not ringfence beds in hospitals for certain patients as our services are provided on the basis of need. We can assure you that we feel there is currently sufficient supply of beds to meet the health needs of Axminster and Seaton.

      Kind regards

  11. Please see emails below

    I have not receivd an answer to my question asked on 15th December regarding the numbers of people who are for closure of beds in Axminster and the numbers against ?

    From: Martin King
    Subject: Fwd: Axminster beds
    Date: 20 December 2014 08:33:55 GMT

    Dear Katherine

    Many thanks for arranging to get answers to my financial questions and staff advertising questions.

    This just leaves the question asked on the 15th December in my email copied below.

    I do not need perfect accuracy but confirmation for example that responses are overwhelmingly against closing beds in Axminster and Option 5 with approximate numbers of reponses would be fine . It is of course very important to know this as it will help to indicate the success or otherwise of the consultation process.

    many thanks and a Happy Christmas


    PS will your office be functioning as normal apart from Bank Holidays ?

    Begin forwarded message:

    From: Martin King
    Subject: Axminster beds
    Date: 15 December 2014 12:39:30 GMT

    Dear Katherine,

    Any news on the requests for information on advertising and further financial information ?

    I do have a further question which is – How many people have responded to date in favour of closing beds in Axminster and how many against ?

    Kind regards


    • Dear Martin

      Thank you for your message.

      You asked us for the number of people who were for and against the closure of beds in Axminster.

      The consultation on safer staffing will not assess numbers because this is not a public vote. The consultation asks for people’s views on the information we have set out and for your suggestions as to alternative ways we could resolve the current patient safety risks.

      However I can confirm that we have had a very good response to the consultation, full detail of which will be contained in the Board papers when they are published.

      Kind regards

  12. At yesterdays meeting Both Iain Roy and Steve Hudson denied knowing anything about the no Strings offer of £300,000 from Axminster Leaque of Fiends to cover nursing costs. What is wrong with communications in NDHT that such high fliers turn up at an important consultation without all the facts? This offer was emailed to Alison Diamond over 10 day ago.
    Steve Holt , Treasurer of LOF and Chairman of AHAG, has resent this to a number of parties to ensure they know the offer is genuine. I feel it questionable that the chief official did not pass the information to those concerned. Is there a reason?

    • Dear Ann
      The offer of £300,000 over three years was made to the CCG from the League of Friends and not directly to the Trust. You are correct that it is a very generous offer.

      Should we receive written confirmation that the money could be a donation to the Northern Devon Healthcare Trust, we would consider it as part of the consultation. There are rules on how charitable donations can be spent and – rightly – our ability to use them to subsidise core NHS services is very limited.

      Kind regards

  13. I have searched and searched the internet and can find no report by CQC on Axminster Hospital. This is despite the fact that you have constantly quoted that the concerns over lone nurses is because of because of the CQC report. Can you direct me to the Website where I find this report.
    Lone nurses is a misnomer, from personal experience I know the quality and skills if HCAs at Axminster hospital are second to none. These should be taken into account.

  14. Should you move Axminster patients to Seaton you are incurring both Clinical and financial costs.
    As all the X-ray, scanning, testing, treatment and therapy facilities are at Axminster patients will have to ferried to and fro. There is the financial cost of ambulances, and attending staff. Also, more importantly, there is the cost to the patient in terms of pain and suffering and not least risk of injury. A patient with a joint replacement needing X-ray would need to be ferried to Axminster for x-rays, then returned to Seaton. The moving of the patient from bed to ambulance to trolley to x-ray table and then back through all these moves to return them to Seaton. This is massively increasing the risk which would be virtually non-existent if the patient bed was in Axminster. It is not just X-ray but all the other 26 facilities available in Axminster but not in Seaton.
    I would like to know how you justify this.

    • Dear Ann
      Thank you for your message. You raise some important points which are very relevant to the consultation. You can expect to see our assessment of these considerations in our consultation report when it is presented to the Board.
      We have also published data (here) on how many Seaton and Axminster inpatients are referred to the Axminster xray service and the numbers are very low, however we acknowledge that it is an inconvenience for those patients who have to travel to receive an xray.

      Kind regards

  15. thank you for your response. however I do not accept your comments firstly a number of people from NDHT have emphasised that the previous meeting were not a consultation and therefore have no bearing on this consultation.
    This is a never ending Temporary Closure. As has been stated previously the interpretation of temporary is when CCG make up their minds. which could be sometime never. A cynical use of temporary.
    The consultation document was not made readily in the area till the 8th Dec. and posters the 13th. They were only distributed locally because of the persistence of a local councillor and a local doctor.
    No matter how many responses you have already received you are still denying the people attending the meetings on the 29th the right to have their response included. We are only asking for a couple of extra working days to ensure as many responses are included as is right and proper
    Ann Veit

    • Dear Ann

      Whilst the months prior to December were not a formal period of consultation, we still conducted several events and meetings with the local community, the feedback from which directly influenced the consultation options and questions.

      We are very clear that this is a temporary closure. We have to provide services which are safe. Safe today, tomorrow and next year. We have made the commitment to NEW Devon CCG that this is a temporary move to ensure safe services. Anything the Board agrees to put in place in January can and will be undone in response to the CCG’s commissioning intentions, due in early 2015.

      Whilst I can understand the strength of your feelings about why we are consulting, I wish to reassure you that it is not as a result of any ulterior motive on our part. By far the easiest option would have been for us to wait until the outcome of the CCG’s consultation. However, our safe staffing concerns cannot wait until the outcome of this process which is why temporary action is required now.

      In response to your feedback we have amended our approach to the final consultation meeting on 29th December. We are extending the window for submissions until the 5th January. This is in order to give the people who are only able to attend the meeting on the 29th December time to submit their responses.

      Please note that a first iteration of the board papers will be published on the 2nd January, in advance of the board meeting on the 7th. If we receive any significant input between 2nd January and the 5th January, we will amend the board papers accordingly.

      Kind regards

  16. Can we please have the comments from 15th December. I know that many questions were asked and wish to ensure that you’ve captured them all.



    • No, there will be staff working over the Christmas break, although the communications team will not be working on Christmas Day, Boxing Day and New Year’s Day.

  17. The closing date for the Consultations is the 30th Dec. 24 hours after the last consultation meeting. This really does not give sufficient time for options to be absorbed, the questions answered and the document mailed to the NDHT. With the back log of Christmas post due to the bank holidays etc. I feel the Consultation period should be extended until at least the 5th January. This still only gives 3 working days between the last consultation meeting and the closing date for the consultation. This is an absolute minimum of time that is fair to allow the final responses to be included. I look forward to your answer.

    • Dear Ann

      Thank you for your latest comment.

      We are very aware of the tight timescales of the consultation. On balance, given the engagement we did prior to December with the six weekly drop-ins and the additional month of consultation, we feel we have conducted an appropriate consultation given the temporary nature of any proposal.

      The document has been available since 1 December, which will give people sufficient time to digest and respond to the consultation questions. Indeed, we have received a great many responses to the consultation already.

      We also had no choice because we continue holding the risks of two unresilient inpatient services and the toll this is taking on our staff. The percentage of agency staff we are using is unsustainable and unaffordable and we have been really clear that not acting is not an option open to us. Therefore we are unable to extend the consultation.

      I acknowledge that this, and our other, responses to you are difficult. We too are finding this a really difficult situation to manage.

      Kind regards

    • Dear Ann

      In response to your feedback we have amended our approach to the final consultation meeting on 29th December. We are extending the window for submissions until the 5th January. This is in order to give the people who are only able to attend the meeting on the 29th December time to submit their responses.

      Please note that a first iteration of the board papers will be published on the 2nd January, in advance of the board meeting on the 7th. If we receive any significant input between 2nd January and the 5th January, we will amend the board papers accordingly.

      Kind regards

  18. Has Seaton the same so Called Safety issues as Axminster and the “lone” working?
    I understand that Axminster has “wet rooms” Seaton does not. So more expense!

    I understand that you have concerns re cover Staff sickness and it is difficult as there is little notice.
    Why is there no plan to put into action. All business have the same problems they usually plan ahead to put into place cover.

    I find it difficult understand why you are so fixed in moving to Seaton. In listing all the points I still cannot get it ! With all the services that Axminster has and the layout. You keep hiding behind this safety issue . It cannot be serious, as you have had almost 4 months to correct it. Any business would have fixed there and then !
    The other point is that Seaton will be empty! You told me this at the end of October. Surely the hospital could be rented to various medical practices or a care home. I do not think you should sell it,

    Look at the cost of these 4 months meetings and so on !!!

    • Dear Mr Baulch

      Thank you for your message and I can well understand the reason you are raising these important points.

      As the provider of 17 community hospitals, we are very experienced in planning our community workforce and ensuring that we maintain the clinical rotas for all our services. However, what we are seeing in some of our services is a culmination of issues which are out of our control.

      We plan to cover any gaps in the rota with agency staff but this is an incredibly vulnerable way to staff our hospitals. Agency staff are ideally used to fill short-term vacancies and shifts. They tend not to be as reliable as our own staff (i.e accept ‘better’ offers for shifts in bigger hospitals) but we also consider filling more than 20% of shifts with agency staff to be unsafe because they don’t know the Trust, our policies, the area or the hospital as well as permanent staff.

      These factors are all described in the consultation document and we are discussing our perspectives on safer staffing at the consultation meetings.

      Both options 4 and 5 address our safer staffing concerns and, weighing up all the known factors, we expressed our preference for option 5. The purpose of the consultation, which is happening quite effectively on this message board, is to explore that with the public to get your opinions too.

      Kind regards

  19. At the first meeting I asked for the numbers of staff at each location, Seaton and Axminster. Alison Diamond told me she would send the details to me . As of this day, I have not received any response.

    Why is Aminster having a staff review and not Seaton? Will we get the results sent to us?

  20. Please can you ensure that I am booked in to the Axminster consultations on the 22nd and 29th December previously I was booked in for 2.30. Also do I need to book in/ register for places at the board meeting on the 7th January? If so please reserve place for myself and Mervyn Symes at this meeting.

    • Dear Ann

      I am happy to confirmed you are booked into both the consultation meetings and the Board meeting on 7 January.

      Kind regards

  21. I am looking to find the publication of the notes taken at the consultation events. Can someone direct me to where I may find them please.
    Thank you.
    Steve H

  22. have just looked at the trust attendees for the next 2 meetings at Axmi nster. Cold we have job titles along with names – we could be talking from any on from an IT boffin to a carpark attendant.

  23. Initially I was told by Katherine Allen the 30 minute slot were available and I, along with others, booked 2-30 appointments for all four consultation days. Turned up on Monday for 2-30 appointment only to find there was no such thing. Two of us had to hang around until 3 pm. When we were squeezed in with the 3 pm people. Bad manners and bad organisation to say the least.

    • Dear Ann

      I am really sorry that you were not seen at the time we confirmed on 15th December. We changed the timings of the sessions to make them longer, so people could have more time to discuss their issues. We are trying our hardest to be fair and give everyone the opportunity to participate fully in the consultation but obviously that didn’t work well for you.

      Perhaps, if you plan to book into a third session, we can make plans to avoid this in future.

      I will also be emailing again shortly as we have prepared all of the information required to respond to the questions you raised at the meeting on 8 December.

      Kind regards

  24. Please could you publicise on the website who from NDHT is attending the next 3 meetings?
    Thank You
    James Vann

  25. This week with the second consultation meeting the format appears to have altered. Last week you advised us that anyone could attend, with or without an appointment but if time was limited only those with booked appointments could ask their questions. This week you seem to be stressing “pre-booking essential”. Please clarify – again on the website so that everyone can be clear.
    Thank You
    James Vann

    • We have always requested that people make an appointment. As stated on our website, having reviewed the way the drop-ins worked in October and November, we are asking people to make appointments to ensure we can offer everyone the opportunity to have in-depth and detailed conversations with us. We request that people book a 45-minute appointment to ensure everyone has the opportunity to participate. Of course, if someone arrives without having made a booking, we would not turn them away. However, we would request that people make a booking in order for us to ensure that we have staff and facilities to accommodate them.

  26. I attended your consultation meeting last Monday the 8th December at Axminster Hospital and was promised answers to questions I had asked and had also emailed in to NDHT a few days before. I have not received any answers as yet:
    This is a copy of my previous email:

    I would like to book to come to this meeting on Monday 8th.
    I would like to ask
    1)More information and detail about the £250,000 invested in extra staff for the 6 selected hospitals in June 2014. We have been led to believe increasing staff to stop lone nursing would cost a lot more.
    2) External assessment of quality of care at Axminster and not Seaton – why
    3) West Dorset patients not included in your Dr Foster acuity figures ? why
    4) Why can the Lyme Medical Centre GPs no longer be paid for admitting patients to Axminster?

    Thank You

    Dr James Vann

    We were promised complete minutes and answers to questions asked at the Axminster meeting, which were to be posted on your website. Please can you advise me where I could see this.

    I will telephone again tomorrow to try and attend tomorrows extended meeting at Axminster. We were also promised details of who from NDHT would be attending each meeting so questions could be targeted at the most suitable people. Please could that also be put on the NDHT website.

    Thank You

    Dr James A Vann

    • Dear James

      Please find enclosed our response to your questions below.

      1)More information and detail about the £250,000 invested in extra staff for the 6 selected hospitals in June 2014. We have been led to believe increasing staff to stop lone nursing would cost a lot more.

      In June 2014 the Trust invested £250,000 in increasing the number of nurses at six hospitals. There were some hospitals which could not be increased, either because we were experiencing recruitment difficulties or because there was insufficient health need (i.e. only 10 beds).

      The cost of an additional nurse on duty on every shift at both Axminster and Seaton would be an additional 5.5 nurses = £300,000 which presents relatively poor value for money when assessed against the number of patients that would benefit from this investment.

      2) External assessment of quality of care at Axminster and not Seaton – why

      The external review looks at safer staffing and lone working in a 10-bed hospital and therefore will equally apply to Axminster as it does Seaton.

      3) West Dorset patients not included in your Dr Foster acuity figures ? why The acuity data comes from previous inpatients. If a resident of West Dorset was admitted to one of our hospitals, their acuity will be included in our data.

      4) Why can the Lyme Medical Centre GPs no longer be paid for admitting patients to Axminster?

      Lyme GPs are able to admit patients to Axminster. There was a brief hiatus when the services transferred to Virgin but both Lyme practices have admitting rights to Axminster and Seaton community hospital.

      Kind regards

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