Spiralling costs mean NHS is set to stand down plans for health and wellbeing centre in Teignmouth

The NHS in Devon has confirmed that plans for a new Health and Wellbeing Centre in Teignmouth are set to be stood down

The cost of the building has more than doubled due to spiralling construction prices and increases in the cost of borrowing since estimated costs were published in 2020.

When the NHS consulted on plans to relocate the most well-used services from Teignmouth Community Hospital to a new health and wellbeing centre in the middle of town in autumn 2020, the estimated cost was about £8 million. Current cost estimates for the building have risen to about £19 million, calling into question the scheme’s value for money.

Since 2020, the project has been beset by a series of challenges – including the NHS having to refocus efforts on the pandemic response, a complex planning process and the effect of statutory scrutiny work by a Devon County Council committee.

NHS Devon is due to publish agenda papers for the meeting of its Board on 25 July shortly. The papers will recommend that £9 million of limited capital resources designated for urgent remedial work across the NHS estate in Devon are not diverted to the Teignmouth Health and Wellbeing Centre. The capital pot is already inadequate to cover the cost of high priority schemes and essential remedial works across the ageing NHS estate in Devon.

On 26 July, agenda papers will be published ahead of the meeting of Torbay and South Devon NHS Foundation Trust’s Board which will seek to endorse the recommendation made to the NHS Devon Board.

If members of the Boards approve the recommendations, it will bring an end to the Teignmouth Health and Wellbeing Centre project in its current form. Importantly, it will also allow the NHS to fast-track work to support Channel View Medical Group, which was due to relocate from its two town centre bases into the new building. A solution is needed as the lease on one of Channel View’s sites – in the Den Crescent – ends on 31 March 2025.

Steve Moore, Chief Executive Officer of NHS Devon, who took on the role in February 2024, said: “I want to say sorry to people in Teignmouth and especially the patients and staff of Channel View Medical Group, who were looking forward to the opening of the new health and wellbeing centre.

“We have a legal duty to ensure local people have access to general practice services and I can reassure you that we are absolutely committed to finding a sustainable solution and creating a brighter future for primary care in Teignmouth.”

The plan was for Torbay and South Devon NHS Foundation Trust to take a head lease on the health and wellbeing centre from the developer and pay rent while sub-letting the majority of the building to the GP practice.

TSDFT Chief Executive Liz Davenport said: “We’re very sorry that the scheme now looks unlikely to proceed after so much work has gone into it. We were confident it could be delivered but the project has faced procedural and financial obstacles at every turn and, combined, they now look insurmountable.

“We will continue to provide local services in Teignmouth from our existing buildings until sustainable alternatives are found.”

In 2020, the partners in one of Teignmouth’s GP practices (Teignmouth Medical Practice (TMP)) wished to retire, and one of the other practices in the town, Channel View Medical Group, agreed to take over their contract and the lease on TMP’s Den Crescent premises. The practice, which retained the name Channel View Medical Group, agreed to take on the contract to protect continuity of care for the local population. This decision was made on the understanding that the practice would be able to move into the new health and wellbeing centre and that the financial and operational limitations arising from the outdated existing buildings would be short-term. 

At the time, it was made clear by the landlords that the practice would need to exit the premises when the lease ends in March 2025. The building itself would need significant investment to bring it up to the required standards for modern medical care.

With the health and wellbeing centre due to be stood down, a new solution needs to be found.

Dr Rebecca Chowdhury, Senior Partner at Channel View Medical Group, said: “We are extremely disappointed and saddened for both our patients and staff that the planned health and wellbeing centre is due to be stood down. Our two bases in the town centre are cramped and out-dated, and running two sites is inefficient and complicated. We do not have adequate space, which is impacting on our ability to recruit, retain and expand our team.

“As a training practice for GPs and other clinical roles – including paramedics, advanced clinical practitioners and nurses – it is imperative we have the room to provide a high-quality training experience to ensure we attract clinicians to work in Teignmouth. We need a sustainable base that will allow us to provide the best services for our patients now and in the future.

“All our services are continuing as normal at all sites and our patients will continue to receive the same warm welcome and high standards of care from our wonderful team.

“We’re working closely with NHS Devon on accommodation solutions and will share more details as soon as we can.”

NHS Devon, which is responsible for commissioning primary care in the county, has been working with the practice to explore alternative arrangements to ensure the continued availability of GP care in the town, in line with NHS Devon’s legal duty. It is likely a short-term solution will be put in place while options for longer-term arrangements are confirmed. For now, NHS Devon is not intending to share details of the short-term options as they are commercial in confidence but will share further information as soon as possible.

For further information, see below and click here.

Background information

Multiple challenges have delayed development of the health and wellbeing centre, alongside spiralling construction prices and increases in the cost of borrowing since estimated costs were published in 2020. The delays in the project mainly stem from the following:

NHS pandemic response

The pandemic response had an impact on progress as resources were focussed towards responding to the pandemic within the NHS.

Planning process and pre-election period at Teignbridge District Council

As a district council, Teignbridge District Council (TDC) has a statutory responsibility as the local planning authority.

• Plans for the building on the original plot in Brunswick Street were developed by Torbay and South Devon NHS Foundation Trust through a long engagement process with the planning authority and landowner – TDC – in 2020. A conservation and heritage report effectively ended the scheme in April 2021 by saying the planned building was too big for the site.
• In September 2022, following a further period of extensive engagement with TDC, new plans were submitted for a centre on a different plot on the same site in Brunswick Street after the hotel that was originally due to develop it scrapped its plans due to the pandemic. The design process was restarted and negotiations on the application were complex.
• A planning committee decision on the application had to be delayed due to the pre-election period for Teignbridge District Council in spring 2023. The authority’s planning committee approved the application in the summer of 2023.

The design development period was protracted partly due to the complex and constrained town centre sites, which are situated within a flood plain. It effectively means that essential services could not be provided on the ground floor.

Statutory scrutiny work by Devon County Council’s Health and Adult Care Scrutiny Committee (OSC)

In December 2020, following full public consultation, Devon CCG approved the relocation of the most-used outpatient clinics from Teignmouth Community Hospital to the new Health and Wellbeing Centre. The CCG also decided to continue with the community-based model of care in the area and relocate other services from the hospital to the modern Dawlish Community Hospital.

During any change project, the NHS works with the local Health Overview and Scrutiny Committee. The committee is made up of elected Devon County Councillors, who represent local people and their views.

The primary aim of health scrutiny as stated in Government guidance is to strengthen the voice of local people, ensuring that their needs and experiences are considered as an integral part of the commissioning and delivery of services and that those services are effective and safe.

As part of its statutory scrutiny role, Devon County Council’s Health and Adult Care Scrutiny Committee (OSC) has considered the issue at a number of its meetings. A summary of OSC activity in connection with the project is set out below:

• In January 2021, members of Devon County Council’s Health and Adult Care Scrutiny Committee (OSC) first voted on a proposal to refer Devon CCG’s decision on service changes to the Secretary of State – the motion was not passed.
• In March 2021, OSC members held another vote and a motion to refer the CCG’s decision to the Secretary of State was passed. Between March and November, the OSC clarified aspects of its referral to the Independent Reconfiguration Panel (IRP), who, in November 2021, announced they would investigate the OSC’s referral.
• In March 2022, the IRP and Secretary of State found that the CCG had consulted adequately and made a series of recommendations – see Appendix 2.
• In June 2022, the OSC held another vote on re-referring the CCG’s 2020 decision, which was not passed.
• In March 2023, members started a process to look at re-referring the decision to the Secretary of State. This process continued through to January 2024, when a proposal to re-refer was not passed.

Uncertainty always makes delivering projects more difficult with developers and funders and TSDFT was unable to proceed with building the centre while a potential re-referral to the Secretary of State hung over the project. This is because, if the decision had been referred by the committee and the Secretary of State had overturned the CCG’s decision, TSDFT would not have been able to relocate services from the hospital and would potentially be risking spending money on a building it might not be able to use for its services.