The Tees Valley Joint Health Scrutiny Committee met on Tuesday 2 June 2026 to discuss a range of significant health service matters. Key topics included an update on neonatal care across the North East and North Cumbria region, a review of the University Hospitals Tees Quality Account for 2025-2026, and planned workforce reductions at the Trust. The committee also received a presentation on the review of adult eating disorder services provided by Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV) and considered its work programme for the upcoming year.

Delivery of Neonatal Care across North East and North Cumbria Region

The committee received a presentation providing an update on neonatal services across the North East and North Cumbria region. Representatives from the Northern Neonatal Network, NHS England Specialised Commissioning, and the North East and North Cumbria Integrated Care Board explained that neonatal critical care services, encompassing intensive, high dependency, and special care for newborn babies, are delivered through a networked model. This model ensures care is provided based on clinical need and cot availability, which may necessitate families travelling to access specialist care. A dedicated neonatal transport service is in place for safe transfers between units.

The presentation highlighted background information on the Neonatal Critical Care Review published in 2019, which aimed to standardise services nationally. Regional reviews have been undertaken to ensure compliance with these standards. Proposed changes include increasing the admission threshold within Special Care Units from 30 to 32 weeks gestation and re-designating Sunderland Neonatal Intensive Care Unit to a Local Neonatal Unit with a corresponding change to its admission threshold. These changes are intended to ensure consistent standards of care and improve outcomes for babies.

While babies already move across the region for appropriate care, the proposed changes are expected to have a limited impact on additional transfers, with an estimated small number of babies from North Tees and Darlington areas requiring care at alternative sites annually, representing less than 1% of total births. Feedback from families emphasised the importance of clear communication, early information, and support for travel and accommodation. Assurances were given that appropriate facilities and support are in place, with ongoing engagement with families and patient representatives.

During the discussion, a member questioned the assertion regarding declining birth rates in the Tees Valley, suggesting it did not fully reflect the local position. Concerns were also raised about staffing levels and the reflection of findings from the Ockenden Review. Representatives assured the committee that staffing remains a key consideration, and while pressures exist, cot closures due to shortages are rare. The re-designation of services at North Tees was noted, with appropriate staffing arrangements in place and under review.

Engagement with voluntary organisations, specifically Neo Angels, was queried, with members highlighting the positive support such groups provide. Representatives confirmed no direct consultation with individual charities had occurred but noted no adverse feedback had been received. The value of these groups was acknowledged, and care coordinators play a role in signposting families to appropriate support.

Concerns were raised about neonatal capacity pressures and the potential impact of proposed changes, particularly regarding transfers between units, the number of moves a baby might experience, and the impact on families in areas with limited public transport. Representatives acknowledged these challenges, emphasising improved communication with families as a key focus. Special care units will continue to care for babies from 33 weeks gestation and above, with transfers for higher levels of care.

The specialised nature of neonatal intensive care was explained, with fewer specialist centres operating in line with national standards. The regional model aims to keep babies as close to home as possible, with care provided at centres like Newcastle and James Cook, rather than transfers outside the region. Cot capacity is considered sufficient regionally, with transfers outside the region now occurring very rarely.

Regarding accommodation for families, representatives advised that arrangements are discussed regularly with providers, and work is ongoing to improve facilities. Accommodation in Newcastle is used around 70% of the time, with consistent availability. Challenges such as financial support, parking, and food access were acknowledged, and families are signposted to relevant charities and voluntary organisations.

The committee resolved to note the update on neonatal services.

University Hospitals Tees - Quality Account 2025-2026

The committee received a presentation on the University Hospitals Tees NHS Foundation Trust's Quality Account for 2025/2026. This was the second Quality Account produced since the formal establishment of University Hospitals Tees as a hospital group, aiming for shared quality priorities, performance, and achievements across both the South Tees and North Tees and Hartlepool NHS Foundation Trusts, while maintaining local accountability and site-specific transparency. Residents will continue to access services at their local hospitals, but service delivery will increasingly take place across all University Hospitals Tees sites.

The Quality Account's purpose is to provide assurance on quality, safety, and patient experience, summarise performance, and highlight progress, challenges, and next steps. Shared Quality Priorities for 2025/2026 were structured around patient safety, clinical effectiveness, and patient experience, with some priorities carried forward from the previous year and new ones focusing on reducing healthcare-associated infections and embedding infection prevention and control practices.

Information was provided on patient safety, including the implementation of the Patient Safety Incident Response Framework, improvements in incident reporting, and progress in medication safety, including reductions in medication omissions and the roll-out of electronic prescribing. Updates were also given on infection prevention and control, learning from deaths, clinical effectiveness, and patient experience, including improvements in Friends and Family Test scores and complaint handling. The committee heard about work related to mental health and vulnerable groups, and urgent and emergency care performance.

Proposed changes to Quality Priorities for 2026/2027 were outlined, with some priorities to be discontinued and others revised and continued. Patient safety, patient experience, and clinical effectiveness will remain central to the Trust's quality improvement work.

During the discussion, a member queried whether recent and planned investment represented value for money. Representatives advised that capital investment is integral to the Trust's strategy, particularly given the North Tees estate's age. While a new hospital build could take up to ten years, interim investment in the existing estate is important. A Strategic Outline Case for estate options had been presented to the Trust Board.

A member congratulated the Trust on awards received, particularly for dementia services, and welcomed the positive Freedom to Speak Up culture. Queries were raised regarding the scope of electronic prescribing and ensuring a full picture of patients' medications, including those from GPs and dentists. Representatives explained the focus on medicines reconciliation and discussions with patients at admission and discharge.

Concerns were raised about high A&E waiting times, with representatives explaining prioritisation based on clinical need and ongoing work to eliminate corridor care. A member raised concerns regarding performance against the 62-day cancer pathway at North Tees, which was significantly below target. The Integrated Care Board representative noted increased demand across the Durham and Darlington patch as a contributing factor.

Concerns regarding staff morale and declining Staff Friends and Family Test scores were also raised. Representatives acknowledged staff morale as a complex issue, influenced by factors including the COVID-19 pandemic and cost-of-living challenges. Efforts are being focused on areas where meaningful improvements can be made.

A member referred to previous patient and carer feedback mechanisms and queried how current engagement feedback could be reported to support scrutiny and be reflected in future Quality Accounts. Representatives confirmed this feedback would be considered. Comments were also made regarding the length of the Quality Account following the merger of the Trusts, with a call for clearer and more specific targets.

The committee resolved to note the Quality Account 2025/2026 for University Hospitals Tees NHS Foundation Trust and to draft a formal response to be submitted to the Trust, with the draft to be circulated to members for information and final approval delegated to the Chair.

University Hospitals Tees - Planned Workforce Reductions

The committee received a presentation on University Hospitals Tees NHS Foundation Trust's planned workforce reductions for 2026/2027. Members were informed of national and strategic challenges facing the NHS, including economic pressures, rising costs, and workforce growth since 2019/20, necessitating a financial and productivity reset. Despite activity levels being comparable to pre-pandemic levels, workforce expansion and declining productivity have contributed to significant financial pressures.

University Hospitals Tees has experienced workforce growth of 2,833 whole-time equivalent (WTE) posts since 2019/20. The Trust's Medium-Term Financial Plan requires significant cost improvement savings, including a £90m cost improvement programme in 2026/27, with staffing costs representing approximately 65% of overall expenditure. Consequently, the Trust plans to reduce its workforce by 558 WTE posts during 2026/27, representing approximately 3.7% of the workforce. These reductions are aligned with service redesign, vacancy assumptions, and voluntary exits, with guiding principles prioritising patient safety and aiming for reductions through voluntary means where possible. A voluntary redundancy scheme was launched in May 2026.

The committee heard about the Trust's approach to workforce productivity, including reducing reliance on bank and agency staffing, improving sickness absence rates, and delivering service redesign for more efficient care models. While both Trusts benchmark as highly productive, further improvements are required. Workforce turnover rates remain relatively low and are being used in workforce planning to minimise compulsory redundancies. Sickness absence was acknowledged as an area for improvement, with actions in place to reduce absence levels.

During discussion, a member queried the ambition to achieve a 30% reduction in agency staffing and sought clarification on current agency spend. Representatives advised that the majority of agency staff are sourced through NHS Professionals, employed on Trust terms, and overall agency spend is relatively low. Further reductions are challenging due to the limited use of agency staff primarily for specialist medical roles.

Concerns were raised that student nurses were being advised of no substantive nursing posts available, with some encouraged to delay registration and work on the bank. Representatives stated the Trust has a strong relationship with Teesside University and that guaranteed employment was offered to newly qualified nurses in the previous year, though not mandated nationally this year. Vacancies are managed to support future recruitment.

A member queried plans for a more proactive care model and whether the workforce had the necessary experience. Representatives acknowledged that while some staff have community-based experience, future workforces will require broader, multi-skilled roles, influencing role development and potentially nursing education and training. Discussions with Teesside University will align workforce development with future service needs.

Concerns were highlighted regarding the potential impact of workforce reductions on waiting times and the future of the Rowan Suite and emergency care provision in Hartlepool. Representatives assured the committee that Hartlepool remains an integral part of the Trust's strategic plans.

The committee resolved to note the update on planned workforce reductions at University Hospitals Tees NHS Foundation Trust.

Adult Eating Disorder Services Review – Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV)

The committee received a presentation from the Director of Operations and Transformation at Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV) regarding a review of adult eating disorder services across the North East and North Cumbria. Adult eating disorder services are delivered through a Provider Collaborative arrangement between TEWV and Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust (CNTW). Recent service data indicates a sustained reduction in demand for inpatient care, alongside increased use of community-based and intensive alternatives.

A formal engagement process has commenced to review the existing pathway and service model, aiming to identify what is working well, opportunities for improvement, and to ensure an appropriate balance between inpatient, day, and community-based care. Engagement involves individuals with lived experience, families, carers, staff, and system partners through surveys, workshops, events, and data review.

Information was provided on the current service configuration, including inpatient provision and the operation of intensive day services and outreach models. Commissioned inpatient capacity stands at 20 beds across the region, with the planned closure of Ward 31A at the RVI creating an opportunity to review the balance between inpatient and community services. Investment in intensive day services has coincided with a reduction in inpatient bed occupancy.

Key areas under consideration include rebalancing inpatient and community provision, strengthening community and home-based services, exploring seven-day service models, expanding intensive day services as alternatives to admission, and addressing variations in service provision across the region. No decisions have been made at this stage, with patient safety, access to inpatient care when clinically required, and equitable provision across the region remaining core principles.

During the discussion, a member queried travel times and transport links from Skinningrove to Darlington, and highlighted the importance of engaging with elected members in areas served by Brotton Hospital, which also serves residents in North Yorkshire. These factors were noted as important considerations for expanding day services. The Director of Operations and Transformation thanked the member for the feedback, confirming that geographical access, transport considerations, and engagement with local elected members would be taken into account.

The engagement with the voluntary sector was confirmed as central to the review process. Queries regarding transitions between children's and adult eating disorder services were addressed, with representatives confirming close collaboration and a clear transition pathway in place, aiming for early intervention and recovery within children's services.

The committee resolved to note the update on the review of adult eating disorder services.

Work Programme 2026/27

The committee considered its draft Work Programme for the 2026/2027 municipal year. Members reviewed the current programme, which included standing items and those previously agreed. Members were invited to suggest additional items of interest. A member requested that 'Accessing Specialist Community Perinatal Mental Health Services' be included as an agenda item for the next meeting.

The committee resolved to note the Work Programme for the Tees Valley Joint Health Scrutiny Committee for the 2026/2027 municipal year and to include 'Accessing Specialist Community Perinatal Mental Health Services' as an agenda item for the meeting scheduled for 23 July 2026.

There were no urgent items considered by the Chair.