Save Our Hospital Services (SOHS) has published an open letter expressing fears for 'the continuing threat' to North Devon District Hospital services. It says it is concerned Northern Devon Healthcare NHS Trust (NDHT) has identified the following services as 'vulnerable': care of the elderly, stroke, oncology, maternity, radiology, trauma and orthopaedics, acute medicine and paediatrics. The Gazette put some of the points raised in the letter to the trust. It said with A&E as the foundation of the hospital, the review of 11 services was to understand their strengths and where challenges were being experienced, to see whether support was needed from 'NHS neighbours'. It said: "Some of them were chosen because they are critical to support a 24\/7 A&E in North Devon and some were chosen because there were clear indicators showing signs of challenge, mostly due to workforce shortages or our remoteness. "The conclusions from this review will help us make a decision about what organisational form would best support the clinical arrangements we need to meet local health need." SOHS cited a decline in performance on waiting times, including that the 'aggregate' total of patients waiting more than a year for treatment was 933. However, the trust said it 'did not recognise' the numbers quoted and that as of a year ago, 108 people had been waiting more than 52 weeks and this was now down to six. SOHS says the trust quotes a workforce shortfall as of April 2019 of 27 senior doctors, 86 nurses and midwives and 15 therapists and specialists. It also said North Devon and Torridge patients were disadvantaged with the imbalance in senior staffing when compared with the Royal Devon and Exeter Hospital. The trust said nationally one in 11 NHS posts were vacant and it was not alone in managing shortfalls. It said the RD&E catchment population was three times the size of North Devon, so there would 'inevitably' be differences in staff numbers. SOHS has reminded the trust and NEW Devon CCG of their pledge in the NHS Constitution 'to provide convenient, easy access to services'. It says for patients in North Devon and Torridge, that must mean access to services at NDDH. NDHT said: "We have always pursued a strategy of ensuring as much local access to health services as possible. "What hasn't changed is that if you need specialist care, you will be advised to access this from a larger hospital - usually Plymouth, RD&E or Bristol. For example, patients with rare cancers or those who need radiotherapy will always need to travel to the RD&E for this specialist care to ensure the best possible outcome."