St Teresa's loses 'vital' rapid response service contract

St Teresa’s Hospice has delivered essential pain and symptom management and crisis intervention 24/7, 365 days a year, since launching its rapid response service in 2011. 

Staffed by specialist nurses and healthcare assistants, the service gives patients the choice to die at home with their loved ones, rather than in hospital.

However, the charity has been left "devastated" after its contract was awarded to the County Durham and Darlington NHS Foundation Trust (CDDFT) following a new tendering process. 

Chief executive Nicola Myers said she "passionately believes" the hospice is best placed to provide the service, arguing that losing the contract could reduce the "quality and timelessness" of care for patients in the town. 

St Teresa's Hospice, on Woodland Road in Darlington (Image: STAN SEATON)

More than 40 past and present GPs and professionals have signed a letter calling on the CDDFT to either return the contract or at least sub-contract it, saying they "do not believe the decision made is in the best interests of patients and the community". 

On Monday (September 16), the CDDFT, which was awarded the contract by the integrated care board, noted how the hospice had previously "raised that the current service was not sustainable".

In response, a hospice spokesperson said it was a "historic" sustainability issue that occurred under a previous leadership nearly two years ago, and was resolved "within less than a month".

David Gallagher, chief contracting and procurement officer for NHS North East and North Cumbria Integrated Care Board (ICB), said it carried out a "competitive tendering process" that was "in line with healthcare procurement regulations", with CDDFT being the successful bidder.

‘Please think again – and work with us’

St Teresa’s Hospice - which has provided a community service in the town for 40 years - developed the rapid response service for three years before it was put out to tender by NHS commissioners in 2015. 

The hospice was the chosen provider in Darlington, and Marie Curie in County Durham, with funding split 50-50 between the NHS and the charities.

There are fears that loss of the contract could destabilise St Teresa's Hospice (Image: STAN SEATON)

The new contract, which comes into effect on December 1, means that, in Darlington, NHS commissioners will contribute £250,000-a-year towards the service.

St Teresa’s said it would supplement the service financially from its own funds - "significantly more" than the £250,000 figure - if it was awarded the contract.

This week, clinicians and practice managers said in a letter they were "deeply disappointed and concerned" over the news in a letter to CDDFT. 

The letter raised concerns over whether the "amazing quality of care" would be lost at the trust, which was ranked "requires improvement" at a 2019 inspection. 

The letter also voices fears that the loss of the contract could "destabilise the hospice", which runs largely on charitable donations. 

Ms Myers said: "Every day, I hear how this service has proven invaluable to the people of Darlington and their loved ones, often making the crucial difference between a dignified, supported end-of-life experience and an unnecessary, distressing hospital admission."

She added that, while national reports highlight "widespread dissatisfaction with end-of-life care", the service at St Teresa's "continues to provide immediate, high-quality support". 

She added: "Our dedicated team consistently upholds the highest standards, offering expert, compassionate support to patients, carers, and families, exemplifying our commitment to being there when it matters most.

“We are immensely proud that 99 per cent of our patients receive care within an hour of their call for help.

"Our rapid response service also offers seamless access to other hospice services, including specialist counselling, social work and complementary therapies, precisely when it’s needed.

“This service embodies our mission and our values, providing our patients with choice and compassionate holistic care when they need it most."

Carol Charlton, chair of trustees, backed calls to review the decision. 

She said: "We know from the very clear feedback we have received over more than a decade that the service is highly valued by patients and their loved ones. That’s because it provides expert care when it is called upon – and choice at the most difficult time any family can face.

“It is a matter of public record that all hospices are facing unprecedented financial challenges, and St Teresa’s is no exception. 

“However, despite running at a budget deficit, we have made it clear that we will use our charitable funds to maintain the outstanding levels of care we have established.

“A strategy is in place to address the budget deficit, including the launch of a lottery, and we are confident service levels can be sustained for years to come."

Ms Charlton said she wants to trust to work alongside the hospice "rather than risk it being diluted or lost altogether" amid the "huge difficulties" facing the NHS. 

She said: "Please think again – and work with us in providing the best possible Rapid Response service for the people of Darlington.”

Trust 'committed' to ensuring 'smooth and safe transition'

The CDDFT said it was awarded the contract following a "full and open procurement process undertaken by the two ICBs when St Teresa’s raised that the current service was not sustainable."

The trust has already reached out to "offer support for a review of [St Teresa's] wider needs" and is "committed" to ensuring a "smooth and safe transition". 

However, in response, the hospice has branded the trust's comments on the historic sustainability issue as "disingenuous", noting how the service was continued for years after being resolved. 

Darlington Memorial Hospital, which is run by the County Durham and Darlington NHS Foundation Trust (Image: Sarah Caldecott)

"Our standards of care have not faltered at any time", a spokesperson said.

"Whilst we acknowledge that the Trust was awarded the contract through a formal procurement process, it is important to clarify that St Teresa’s raised concerns about the procurement process itself. These concerns remain."

St Teresa's noted "overwhelmingly positive" feedback and is continuing to urge the trust to reconsider, saying: "We look forward to continuing the collaborative working that takes place between us to put the needs of patients first."

The CDDFT already provides the majority of palliative care rapid response across Darlington and County Durham via the local district nurse teams.

They are supported by specialist palliative care nursing and consultant team, who provide a 24 hour advice line to health professionals - with one of those consultants also providing the expert clinical care into St Teresa’s Hospice.

It also provides the single point of access service for rapid response care in Darlington, meaning there will be "no disruption for patients and their families". The trust confirmed that patients can continue to use the same contact numbers. 

The full statement from Mr Gallagher said: "As commissioners of the Rapid Response Palliative and End of Life Care Pathway in Darlington, following a detailed service review, the ICB in line with healthcare procurement regulations carried out a competitive tendering process where interested providers, including the existing provider, were able to submit a tender to deliver the service.

"Following an evaluation process, the successful bidder was County Durham and Darlington NHS Foundation Trust (CDDFT).

"CDDFT will work closely with St Teresa's Hospice as the current provider during the transition to ensure continuity of service for patients, with the changes due to take place in December 2024."

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Lola McEvoy, Labour MP for Darlington, said: "St Teresa’s provide an excellent service that has touched the lives of many families in Darlington, including my own.

"Their care towards patients and their loved ones under the most difficult circumstances imaginable is remarkable and that is reflected in the excellent feedback they have received.

"I recently met with the Hospice chief executive and Chair of Trustees and heard their concerns. I have since written to the CEO of County Durham and Darlington NHS Hospital Trust requesting an urgent meeting to discuss this issue."