A Teesside hospital is showing others how it’s done in getting patients out of hospital while coping with fewer beds available because of Covid outbreaks.

Neil Atkinson, managing director of the North Tees and Hartlepool NHS Foundation Trust, told of hospital challenges, with 89 patients waiting over 12 hours in A&E in one month, but good performance on discharging them. Meanwhile, councillors heard how the University of North Tees was held up as a good example regionally and nationally as healthcare professionals get ready for the winter months.

Mr Atkinson told a trust board meeting: “Talking a little bit about emergency activity, we have seen an increase in bed occupancy in August. Our threshold is about 92%, we are pretty much operating at 92%.

“What has driven some of that is the increased incidence of Covid patients that we’ve had, which has resulted in a reduction in the number of beds we’ve got available. We’re also starting to see an increase in the number of stranded patients, a marginal increase.

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“These are patients that stay in the trust in excess of 21 days. I think it’s important to note the trust is working very hard with local authority colleagues to ensure that discharges are undertaken promptly.

“And we are one of the best performers on discharges. We recently had a visit from the national discharge team to look at what we are doing.”

A trust report says they have one of the lowest number of “stranded” patients in the country. Mr Atkinson said the trust saw 85% of patients within four hours in August, against a 76% target, and they were making improvements as they piloted an additional registrar and a “More Before 4” group.

He said of ambulances: “99.6% of our patients are dealt with within 59 minutes and our average handover time is around 26 minutes, which is one of the best in the region. On a bit of a negative, we did have 89 patients in August who waited over 12 hours in accident and emergency.

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“80% of those patients went on to EAU (emergency assessment unit), SDU (surgical decision unit) or a mental health facility. This is a reflection of how busy A&E is, some of the increased bed occupancy and the number of patients waiting for a bed.

“I think it’s really important that we continue to focus on this. We are ensuring there is no harm to patients as a result of that long wait.”

Hospital discharges were discussed at a separate Tees Valley joint health scrutiny committee meeting where Councillor Lynn Hall said: “North Tees do that particularly well I feel at the moment. It meant that last winter we had more ambulances going to North Tees because they knew they could leave their patients there and then get back out on the road. That needs to go right across the Tees Valley so we can improve that.”

Councillor Rachel Creevy from Hartlepool Council said: “That learning needs to not just be across James Cook and North Tees hospital but across to Durham, Newcastle and hospitals in Cumbria because it was really good and really positive.”

Peter Rooney, director of strategy and planning at the North-east and North Cumbria Integrated Care Board (ICB), replied: “It is true that North Tees do a number of things better than most other trusts in the patch, in fact on some occasions in England. There are some elements of the urgent care flow which are better. And we want to share that learning everywhere.”

Craig Blair, director of place-based delivery for the ICB, said the hospital had contributed to important work over the last year: “The urgent treatment centre at North Tees is a key reason why we have good urgent care performance in Stockton, in particular how that supports the flow of ambulances to and from the site. That spec is now being used to inform the regional specification.

“I think that’s a really good example of where we’ve taken learning and applied it across the North-east and North Cumbria. It’s an ideal opportunity to feed back good ideas, and areas of challenge and we can have a really robust debate around what’s working well and what’s not in terms of urgent care, how we change the system and learn from one another, to improve our responsiveness ahead of the next winter surge.

“The learning that we’ve taken from things in North Tees has been brilliant. So we’ve got similar approaches now right across the whole of the Tees Valley, and that should help as we travel through the winter and we’re expecting to undergo the pressures again.

“It may be at different times, different hospitals and different services need to support one another, but it’s a consistent offer everywhere. We can manage that pressure and make sure that all of our patients right across the Tees Valley get the best possible responses.”

They told the committee about a five-year “joint forward plan” for NHS services. Mr Rooney said: “Very simply, people in our region on average die younger and have a longer period of illness before they die. We want to do something about that.

“Our region has one of the deepest and most entrenched and long-lasting health inequalities in the country. We need to do something about that.”