Published on: 9 September 2021

Healthcare leaders in South Tyneside and Sunderland are moving forward on work to create outstanding future hospital services as part of the ‘Path to Excellence’ clinical transformation programme.  

In March 2020, Phase Two of ‘Path to Excellence’ was officially paused to allow frontline NHS staff to focus on the response to the COVID-19 pandemic. 

In February this year work restarted and focused on developing ideas for the transformation of surgical services.

To help explain why the transformation of services it vital, the Path to Excellence programme has published a further updated draft case for change (September 2021). 

Surgical teams at South Tyneside and Sunderland NHS Foundation Trust have been discussing the best way to arrange future surgical services since 2016.

Most recently they have been busy fine tuning ‘working ideas’ to make sure any additional learning from COVID-19 is factored into the plans before a formal public consultation is launched later this year.

The ‘working ideas’ were initially published in February 2019 and outline a clear ambition to separate emergency operations from planned operations with multiple benefits for both patients and staff. 

This would mean South Tyneside District Hospital would provide only planned operations, with all emergency operations and some planned procedures taking place at Sunderland Royal Hospital.  Both hospitals would continue to provide outpatient services as well as diagnostic tests and scans.

The impact of the pandemic and need for stringent infection control measures and separate pathways of care for non-COVID-19 patients, has made the reasons for changing surgical services even more, not less, urgent.  The national decision to postpone all non-urgent operations at the start of the pandemic has also left the NHS with a backlog of patients waiting for surgery. 

Changing services would also help the NHS be better prepared for periods of ‘surge’. This is when lots of people arrive at the hospital and need to be admitted. There is always a surge in the winter months because the weather is colder and there are lots of viruses going around. Surges can happen for other reasons too and COVID-19 is a perfect example of this.

Local NHS leaders want to ensure surgical services are arranged in a way that minimises any such disruption in future and helps the NHS reduce waiting lists and avoid further delays or cancellations for people who need planned operations. 

Dr Shaz Wahid, Executive Medical Director at South Tyneside and Sunderland NHS Foundation Trust, said:  “There is no doubt that COVID-19 has increased the pressures on our surgical services and we cannot lose sight of the vital improvements we still need to make.

“We know that organising surgery with emergency operations at one hospital and planned operations at another is a tried and tested model with lots of national evidence to support it. Many other parts of the NHS have done it with great success.

“This would mean some patients would need to travel to a different hospital and we want to be upfront, open and honest about that. But we also believe there are many benefits that would outweigh the downside of this.

“Most importantly, all other appointments would still take place locally and it is only the surgical procedure that may take place at a different hospital in future, everything else would continue as it is now.”

Whilst efforts for Phase Two of the programme are now focussed solely on surgical services, the local NHS is very clear that pressures on emergency care and acute medicine have not gone away. 

Clinical teams do, however, need more time to debate and discuss the impact of COVID-19.  Any future planned changes to the Trust’s Emergency Departments and acute medical wards would be subject to the same rigorous process and a separate public consultation in due course. 

Dr Neil O’Brien, a local GP and Accountable Officer for Clinical Commissioning Groups (CCGs) across South Tyneside, Sunderland and County Durham said: “Now more than ever, it is important that we continue to focus on building strong and resilient services for the future and we cannot lose sight of the challenges facing the NHS and pressures on our workforce, which have only been exacerbated by the pandemic.

“The Path to Excellence clinical design teams are now busy fine tuning the working ideas for the future of surgical services and we will share the proposals for change during a formal public consultation later this year.  The aim is very simple – we want to provide the very highest quality of care and timely access to all patients who need an operation.

 “As we progress these plans, one of things we are making absolutely certain of is that any decisions around the future of surgical services do not negatively impact or influence how we deliver emergency care and medicine in the future – this is vital and really important.”

The ‘Updated Draft Case for Change (September 2021)’, is the fifth key document the programme has published which has shared the challenges being faced and how ideas have developed over time. They demonstrate how patient, staff and public feedback has influenced the development of working ideas that will eventually form part of a formal public consultation later in the year.

Over the next few months the NHS will prepare for public consultation including the normal NHS processes and assurances that are needed. The NHS will give advance notice of a public consultation starting and how people can get involved.

The programme continues to actively seek the views of staff, patients and stakeholders to gain their views on what is important to them to make hospital services better. 

Find out more about the updated Draft Case for Change (September 2021) and ways to get involved and give views.

Read the summary

Read the easy read – full version

Read the easy read – short version

Watch the updated Draft Case for Change animation

Visit for further information on the programme

Media contact: Nichola Taylor –