MANAGER Margaret Jefferson has worked at St Cuthbert's Hospice since it opened in 1988 and has no doubts that the extension will make an enormous difference to the lives of the patients who rely on it.

"I think it's something that has been the aim of the hospice ever since it started but, for all sort of reasons, we have had to wait this long," she said.

"I can think of any number of patients who have asked: 'Why haven't you got a bed for me?' Hopefully, I will never be asked that again."

This year, the hospice celebrates its 18th anniversary and, as it comes of age, has launched an appeal to give it the key to the door of a £3.2m extension.

More than half the money has already been raised, but the hospice needs help to find the remaining £1.3m that will allow the unit to be built.

"The new unit will make a major contribution to caring for those with a life-threatening illness locally," said Margaret.

"It will enable us to expand and enhance our current work, provide the more intensive treatments that some illnesses demand, as well as allowing us to provide greater help and support to patients, families and carers."

Set in its own grounds off Park House Road, St Cuthbert's is an oasis of tranquillity close to the centre of Durham City.

The building dates back to 1839 and had previously been a mining agent's house, National Coal Board offices and, in the 1960s, was home to BBC Radio Durham, where a young Kate Adie cut her journalistic teeth.

Since it became a hospice, more than 4,000 people from North Durham have received free palliative care there - last year alone there were 340 referrals.

Many have been suffering from cancer, others from debilitating neurological conditions, such as multiple sclerosis and motor neurone disease and, in a reflection of the area's industrial past, others suffer from conditions such as chronic emphysema.

Staff offer everything from pain relief and specialist medical help to advice on benefits and mortgages for families whose main bread-winner may be unable to continue working.

At St Cuthbert's, the emotional well-being of those facing the possibility of death is as important as the control of symptoms.

However, when the doors close at night, the staff go home. Patients who need round-the-clock care, as many do in their final days, will need to travel if they need to be in a hospice.

If the money comes in to build it, the unit would "more or less guarantee" that a bed was there for those who needed it, when they needed it, on their doorstep.

Margaret said: "If patients need in-patient care of any complexity, they need to go to Sunderland or Newcastle, which is quite a trek - particularly if you are really unwell and you are leaving your family and friends here.

"Distance is important when you are facing an end-of-life situation. It is particularly difficult for families with young children.

"If a parent has to travel 20 miles or so, it does make it very hard for the family to feel part of what is going on and it is just as important for the elderly, for whom travelling may be difficult."

The extension will include ten individual en-suite bedrooms. Four will be for respite care and the remaining six for the specialist care needed by the most severely affected patients, including two beds earmarked for patients from Derwentside.

There will also be room for other services, beds for families to stay the night, space for physiotherapy, a library, educational rooms for health professionals and a ground-floor chapel. Staff will work closely with GPs and district nurses.

Margaret said the hospice was more than a place where people could die with dignity.

"People can live years with cancer - and sometimes being in a hospice allows them to cope better when they get home.

"It is about lifting their spirits, having a break and some physical rehabilitation. We do a lot of work with patients' psychological and emotional needs.

"The hospice is more than just a place for people to die with dignity. Many people are living longer with cancer, due to improved treatment and early diagnosis. We have to try to ensure those extra years are good years with some happy memories.

"We can help people find their own personal resources to get the best out of life, however long or short that may prove to be.

"When death does come, the hospice can provide the care, skill, sensitivity and compassion that is so essential when we reach the final milestone of life."