Hospital and community services getting it together
Newsround talked to Medical Director Robin Mitchell about the Trust's plans for the future.
County Durham and Darlington NHS Foundation Trust now runs community health services, as well as hospital services.
Robin Mitchell says: "Our aim is to offer more "joined up" services which are easier for patients to use and understand and - as far as possible - provide more of our services outside hospital, and closer to all of our homes."
The Trust has been focusing on a number of key areas
"In developed countries, long term conditions account for around two thirds of health spending," Robin explains. "As people get older they are more likely to have at least one and often more conditions, like diabetes, or heart disease.
"A lot of care for these conditions continues to be offered only in hospital, when much more could be offered near to, or in a patient's own home. Key developments over the next 2-3 years will include more community services or new ways of managing care for people with diabetes, heart disease, multiple sclerosis, epilepsy and chronic respiratory disease.
"We know that we are living longer, so we need to provide more care and better care for older people. Our aim will be to provide alternatives to admission to an acute hospital, so that frail older people can be better supported in the community, and early intervention can maintain their independence for longer."
The NHS also needs to improve end of life care - as was highlighted in a recent national report. "Most people do not want to spend their last days or hours in hospital," says Robin. "But despite their plans, this still happens. Our end of life team are working to ensure that more people pass away peacefully, in a place of their choice, with loved ones around them."
Other plans include moving the urgent care centres at UHND and at Dr Piper House in Darlington so that they are next door to A&E, and providing better A&E and urgent care for children, integrating children's health and social care more closely, and reducing hospital visits and lengths of stay for surgical patients.
If all this more routine care is being provided closer to home, what about the more specialist care we still need from our hospitals?
"Over the last few years, we have taken some important steps to make sure we provide high quality hospital care for patients in an emergency - including centralising our services for acutely ill people in Durham and Darlington, and making Bishop Auckland a centre for more planned services.
"Compared to city centre hospitals - like RVI and James Cook - Bishop Auckland, Darlington and Durham hospitals are relatively small. However, taken together, we are a one of the largest Trusts in England. So although we may not be able to offer all aspects of all services on each site, we do think that we have the "critical mass" in terms of patient numbers and expert staff so that each of our main sites can be home to different specialist services. We need to work out which services will sit best at which sites."
Robin refers to the current consultation being run by NHS County Durham and Darlington, looking at hyper-acute stroke: "There is wide agreement that emergency care immediately following a stroke should be provided from one site, not two, because that way we can provide better, faster 24 hour care. The discussion is now around whether this should be Durham or Darlington."
If stroke is centralised at Durham, what service will replace it at Darlington? "Thanks to surgeon Andy Gilliam and his team we will soon be launching a bariatric surgery service (for people with serious weight problems) at Darlington Memorial Hospital," says Robin. "This is a new service not previously offered in the Trust, and we can only do this be having the expertise in one place."
There has also been speculation recently about the future of maternity services. "We believe we can continue offering consultant led maternity at Durham and Darlington for at least the next three years, but there are some issues around quality standards which we will need to plan carefully to address. For example, is it right that there are fewer doctors available for a mother delivering her baby at 3am, than for a mother delivering at 3pm? These are challenges for all hospitals in the NHS, and we need to find ways of addressing them."
And what about the midwife led unit at Bishop Auckland? "We have been successful in recruiting more staff to fill vacancies, so that the unit can reopen in September as planned." We are committed to midwife led care, and would like to make it more widely available to new mums."
