In October 2017 the Care Quality Commission rated the trust, which runs North Devon District Hospital, as requires improvement, raising concerns in maternity services, end of life care, A and E and outpatients. Councillors at Devon County Councils health and adult care scrutiny committee have been told progress has been made in tackling the issues, but it has come at a cost. Trust chief executive Suzanne Tracey told them the improvements could not be achieved within a balanced budget. She said the board had already decided to set a deficit budget for the year of £12m, but the current forecast was that would be a £17m overspend. Councillors were told a new leadership structure in the maternity department had been established, with a new head of midwifery in post and three obstetricians in the team have been appointed. Mrs Tracey said an organisational development specialist is working with the team to change the culture, a joint specialist is working across North Devon to help with challenges in end of life care, increased cleanliness spot checks are taking place and a substantive leadership team had been put in place in the outpatients department. Cllr Sara Randall-Johnson, chairman of the committee, asked what was being done to make it more attractive to potential employees to come and work at the hospital. Mrs Tracey added: We are trying to ensure that once we recruit people, we can retain them. We have been able to make the posts more attractive if we combine them across North Devon and Exeter, and we are looking to enrich the jobs by providing more training and development. There is more we can do to sell Devon as more of a place to live and there is lots that we are doing to recruit people, but we cant do all of this and maintain a balanced financial budget. Our board already decided it would set a deficit budget this year of £12m. All the things we are doing come with a price tag and we are looking at a deficit of £17m. We will need to get that back in balance, but we are taking account of how we can get that back and it may take a few years to achieve. A report outlining the actions that the NDHT has taken to improve since the CQC report was provided to the committee. A follow-up inspection in July after last Octobers inspection showed there had been some progress, but Professor Ted Baker, chief inspector of Englands hospitals, said further work needed to be completed.