An integrated NHS trust which has twice delayed its foundation trust application has launched a service review that is likely to result in the closure of community hospital beds.

Northern Devon Healthcare Trust was originally due to submit its foundation trust application in May this year but failed to hit this target after experiencing difficulties reaching agreement with commissioners on activity levels and service provision.

The trust now anticipates submitting its application to the DH by December.

It is hoped the review will allow the £193m turnover trust - which has balanced its books since 2006-07 - to cut costs by £60m over five years.

Northern Devon chief executive Jac Kelly told HSJ the trust’s 300 community beds cost on average three times more than its acute beds. The trust was therefore anticipating a “very different balance in terms of community infrastructure and bed provision” in future.

About half of the trust’s business is its district general hospital and half is community services across the north, east, and centre of the county.

Demographic change is expected to lead to annual acute growth of between 1 and 2 per cent in the county. Devon’s proportion of over 85s is about six years ahead of that projected nationwide, with some areas reporting a proportion of older residents not predicted nationally until 2076.

Ms Kelly said the FT application had been a “catalyst” to work with the North, East and West Devon clinical commissioning group on service configuration. This has included exploring new ways of delivering care in people’s homes.

“What is very clear working with the CCG is what one group of GPs think will work for them may not be the same in a different part of the patch,” she said.

An event earlier this month bought together representatives from the trust, commissioners, Devon County Council and residents to look at options for service provision examining the physical and skills assets available in the county.

This could see space at community hospitals used to provide other community services such as day centres for older people.

Tim Burke, chair of the NEW Devon CCG, told HSJ the CCG accepted this could mean less beds.

“Community hospitals have to demonstrate for the future they are playing the most useful role they can,” he said.