From: Susie Colley, Director, Save Torbay Hospital Ltd
To: Freedom of Information Team, Torbay and South Devon NHS FT (copied to the FOI team and others)
Subject: FOI TSD10612 - Request for internal review, clarification of Q4(f), and further questions

Good afternoon, Freedom of Information Team,

Thank you for your response of 5 October 2026 (ref TSD10612). I am writing to request an internal review of several answers, provide the clarification you asked for on question 4(f), and ask further questions arising from your response.

1. Internal review: Section 2(d), modelling of waiting times and delays in diagnosis. I asked what modelling had been done on increased waiting times and delays in diagnosis. Your answer did not say whether any modelling exists. Instead, it quoted the national standard of 90% of cancer-related results reported within 10 calendar days. For 2(d)(ii), you simply referred to that answer.

Based on information I have now received from the recent UKAS accreditation visit, they state that Torbay's Cellular Pathology service now reports 94% of cases within 10 days, which exceeds the national standard. They also say the service achieved this despite working in ageing facilities. Using the 90% national standard as the benchmark for the relocated service therefore allows performance to fall from its current level while still "meeting standards". For Torbay patients waiting for a cancer diagnosis, that would be a deterioration. Please confirm:

(a) whether any modelling of post-relocation turnaround times has been undertaken. If so, please provide it. If not, please state plainly that the information is not held, as section 1(1)(a) of the Act requires.
(b) whether the Trust will commit to maintaining at least the current 94% performance, rather than the 90% national minimum.
(c) what modelling accounts for the time added by transporting specimens from Torbay to Gadeon House. This includes collection schedules, batching, late-day specimens, weekends and bank holidays, and disruption on the A380/A38 corridor.

2. Internal review: Section 2(d)(iii), theatre utilisation. You stated that cellular pathology does not affect theatre utilisation. That answer contradicts your own answer at 2(b), which acknowledges that the service provides intraoperative support, including frozen sections. While a frozen section is being processed and reported, the patient remains under anaesthetic and the theatre remains occupied. Please explain how the Trust reached this conclusion, and provide any assessment of frozen section turnaround times under the new model.

3. Internal review: clinical concerns and the timing of the decision. At 2(b) you state that the clinical model "is still in development by the consultants and lab leads". At 4(a)(i) you confirm that the decision to relocate was taken on 26 March 2026. It was taken under urgent decision-making arrangements, driven by an NHS England capital deadline of 31 March. The decision was therefore made before the clinical model for time-critical work, including frozen sections and urgent cancer pathways, had been settled. I am aware that clinical colleagues have raised concerns about the proposal.

At 4(e) I asked what objections or concerns were raised. Your answer referred me back to 4(a)(i), which records dates and decision-makers but no concerns at all. That is not an answer to the question. Please provide:

(a) any record of concerns raised by consultant histopathologists, laboratory leads, biomedical scientists or staff side representatives, whether in meeting minutes, correspondence, or submissions to the options appraisal.
(b) the relevant entries from the cellular pathology and programme risk registers.
(c) confirmation of whether a clinical impact assessment existed at the time of the decision on 26 March 2026.

4. Internal review: Section 2(e), Section 22 exemption. Section 22 is a qualified exemption. Your response did not state when the full and final business case will be published, show that a settled intention to publish existed when my request was received, or set out any public interest test. The decision has already been taken and endorsed by the Board. The public interest in understanding its clinical impact before implementation is therefore substantial. Please reconsider the exemption, or provide the public interest assessment and the intended publication date.

5. Internal review: Section h(c) to (e), "the relevant Board papers". Your answers state that "the relevant Board papers" set out the financial rationale, the governance followed, and the opportunities for scrutiny. You did not identify which papers these are or where they can be found. Some of the papers concerned went to a Private Board meeting on 2 April 2026 and will not be publicly available. Under your duty to advise and assist (section 16), please identify each paper by meeting date, item and title, and provide a link or a copy.

6. Clarification of Question 4(f). My request at 4(f) relates to the Trust's own decision-making on the relocation of cellular pathology (histopathology) services to Gadeon House, Exeter. Specifically, I am requesting: the options appraisal and business case considered by the Executive Committee on 25 March 2026, including the financial appraisal; the record of the urgent decision taken by the Chief Executive and Chair on 26 March 2026; the Chief Executive's report to the Private Board on 2 April 2026, and the papers and minutes for the Board meeting of 7 May 2026, in so far as they relate to this decision; the Trust's bid to the NHS estates safety fund; any risk register entries and equality impact assessment relating to the programme.

7. Further questions: transport costs and estates.
(a) Has the Trust assessed the recurring revenue cost of transporting specimens from Torbay to Exeter, including courier contracts, vehicles, staffing, and out-of-hours runs? Please provide the annual cost estimate and say where it appears in the options appraisal.
(b) Did the options appraisal compare those ongoing transport costs, over the life of the arrangement, against the cost of upgrading the existing Torbay laboratory?
(c) What assessment has been made of specimen integrity, chain of custody and contingency arrangements for road disruption or adverse weather?
(d) Your response states that the move "directly addresses known safety risks in the current environment". Please specify those risks and provide the condition survey or estates report that identified them.

I look forward to your response within the statutory timescale.

Yours faithfully,

Susie Colley

From: Freedom of Information Team, Torbay and South Devon NHS Foundation Trust (tsdft.foirequests@nhs.net)
To: Susie Colley (chair@tqcc.co.uk)
Reference: TSD10612
Signed by: Alex Spooner

⇩  Download the Trust's full response (PDF)

Dear Ms Colley, Request for Information. We are writing to confirm that we have now completed our search for the information you requested. A copy of the information is below. The questions reflect concerns raised locally about the future of pathology services at Torbay Hospital and the consequences for patients requiring urgent histopathology support, alongside the £7.5 million loan agreed by Torbay Council to Royal Devon University Healthcare NHS Foundation Trust in connection with a centralised pathology hub at Gadeon House, Exeter.

1. Justification for the proposed £7.5 million loan. On the business case for the loan, the alternatives considered, any comparison of repairing or upgrading Torbay against relocating, and why capital investment in the existing Torbay estate was not pursued: the Trust stated that it is not party to the separate contractual arrangements between Torbay Council and Royal Devon University Healthcare NHS Foundation Trust and does not hold the requested information, directing the campaign to Torbay Council and to Royal Devon.

2. Impact on Histopathology and Frozen Section Services.

(a) Whether the hub would remove, reduce or relocate histopathology functions at Torbay: "Relocation. There are no plans that would reduce the availability of urgent or time-critical pathology support for care at Torbay Hospital."

(b) Assessment of impact on surgical procedures requiring frozen section analysis during operations: "There will be a modern laboratory for routine work with clearly defined pathways for any time-critical work, including intraoperative support such as frozen sections and urgent cancer requirements, to ensure safe and timely patient care. The clinical model is still in development by the consultants and lab leads and this is a key output."

(c) Whether patients would be redirected to Exeter or Plymouth: "There are no plans that would reduce the availability of urgent or time-critical pathology support for care at Torbay Hospital."

(d) What modelling has been undertaken regarding:

• (i) Increased waiting times: national standards reflect that most diagnostic work is not immediate, with 90% of cancer-related results expected within 10 calendar days; these standards will continue to be used as the benchmark; local turnaround times are already monitored and will be tracked through transition, with the explicit requirement that standards are maintained.
• (ii) Delays in diagnosis: see the answer to 2(d) above.
• (iii) Theatre utilisation: "Cellular Pathology does not impact theatre utilisation."
• (iv) Clinical risk: cellular pathology is a clinical support service rather than patient-facing; urgent and time-critical work will continue to be available at Torbay through clear and agreed clinical processes, including through the Acute Services Laboratory on site where required.
• (v) Patient travel burdens: "There is no change to where patients will receive care."
• (vi) Workforce retention and recruitment: the Trust recognised a difficult and uncertain period for pathology teams; there is ongoing engagement including meetings with the Chief Executive, other senior leaders, staff side representatives and HR; colleagues are involved in the design, fit-out and day-to-day planning of the new service; implementation planning includes retention and recruitment considerations, potential relocation linked to histopathology activity, and a formal equality impact assessment and mitigations. The Trust added that "the move also directly addresses known safety risks in the current environment."

(e) Will the Trust publish the full clinical impact assessment? "This information is exempt under Section 22 of the Freedom of Information Act, as it is intended for future publication as part of the full and final business case."

3. Substantial Change and Public Consultation.

(a) Whether the proposal constitutes a substantial development or variation in health services: the Trust confirmed it had considered the nature of the change, its position being that the programme relates to cellular pathology (a clinical support service rather than patient-facing) and to the future provision of laboratory facilities, rather than a change to where patients receive care.

(b)(i) Legal advice: no external legal advice was sought; the Trust referred to NHS England's "Planning, Assuring and Delivering Service Change for Patients" and considered the matter through its governance processes.
(b)(ii) Integrated Care Board: the ICB are aware of the significant estates and infrastructure risks associated with the Trust's existing cellular pathology laboratory and supported the bid for monies through the NHS estates safety fund; the ICB are aware of the target operating model under the Peninsula Pathology Network, described as an NHS England led strategy.
(b)(iii) Health Overview and Scrutiny Committee: No. The Trust attended the Torbay Council Adult Health and Social Care Overview Sub-Board on 16 July 2026 and a briefing was included in its update paper.
(b)(iv) Why no public consultation to date: see the answer to 3(a).

4. Governance and Accountability.

(a)(i) Service location: the proposal to relocate routine cellular pathology (histopathology) to Gadeon House, Exeter, was considered through an options appraisal and business case process by the Trust's Executive Committee on 25 March 2026. Due to the requirement to commit NHS England capital funding by 31 March 2026, the decision was taken on 26 March 2026 under the Trust's urgent decision-making arrangements by the Chief Executive and Chair, in accordance with the Trust's governance processes. The proposal was subsequently reported to the Trust Board through the Chief Executive's report to the Private Board meeting on 2 April 2026 and was formally and retrospectively endorsed by the Trust Board on 7 May 2026.
(a)(ii) Service delivery arrangements: formed part of the same options appraisal and business case, including the relocation of routine cellular pathology activity to Gadeon House while maintaining arrangements for urgent and time-critical work, through the same governance steps and dates.
(a)(iii) Provider responsibilities: no change to provider accountability; the Trust continues to provide the service.
(a)(iv) The £7.5 million loan: not party to the arrangements, information not held, redirected to Torbay Council.

(b) to (e) Which bodies considered the proposal, on what dates, what votes took place, and what objections or concerns were raised: the Trust cross-referred each of these to its answer at 4(a)(i) and 4(a)(ii), answered "Not Applicable" for provider responsibilities, and redirected the loan element to Torbay Council. The answer to 4(e), on objections or concerns, referred back to 4(a)(i), which records dates and decision-makers but no concerns.

(f) Copies of Board papers, committee reports, business cases, financial appraisals, clinical impact assessments, risk registers, equality impact assessments, and minutes: the Trust asked the campaign to clarify whether the request related to the £7.5m loan or to the Trust's own decision-making, stating that as worded this part was too broad for it to determine which records were being requested. (The campaign has since provided that clarification, reproduced in the internal review letter above.)

(g) Edginswell employment land: the Trust stated it does not hold this information and directed the campaign to Torbay Council.

h. Transparency and Public Confidence.

(a) Whether the proposals are definitive or still under consideration: the Trust considered these matters addressed in its responses above.
(b) The anticipated impact on local services: addressed under section 2; the full clinical impact assessment is intended for future publication as part of the full and final business case.
(c) The financial rationale: "The relevant Board papers set out the financial rationale for these decisions."
(d) The governance processes followed: "The relevant Board papers set out the governance processes followed."
(e) The opportunities available for public scrutiny and consultation: "The relevant Board papers address this matter, including whether any public scrutiny has taken place and whether further scrutiny or consultation is planned."

Signed: Alex Spooner, Freedom of Information Team, Torbay and South Devon NHS Foundation Trust.