Published on: 27 August 2025
A new programme called Guiding You Home is working to help patients in South Tyneside and Sunderland leave hospital sooner – and recover better once they're at home.
The collaborative programme, led by South Tyneside Council; Sunderland City Council; South Tyneside and Sunderland NHS Foundation Trust; and North East and North Cumbria Integrated Care Board, aims to improve health outcomes for residents across both areas.
Anna Hargrave is the jointly appointed director for the programme.
She said:
"At times, people are having to wait longer in hospital than we would like, or staying when they don’t need to, waiting for their discharge arrangements.
"Others are going into care homes or receiving long-term support at home, when the right short-term help provided earlier might have enabled them to return to being more independent at home.
"This isn't ideal for patients, and it puts extra strain on busy staff teams.
"We want to improve the way we support people to recover and return home – or in some cases, help them avoid admission to hospital in the first place."
The programme sees multi-agency teams working collaboratively with ward staff, care homes and domiciliary (home based) care services to find more effective ways of working – with the focus on helping patients get discharged faster, or stay out of hospital altogether, with more help provided at home.
The partners are hoping that this approach will help 40% more people recover better after leaving hospital and remain independent, while supporting more than 700 people each year with short-term help at home.
Anna added:
"Our review showed that we can make real improvements by working more closely together. All four organisations agreed to launch a joint programme to make these changes happen.
"Together, we are committed to getting people the right care, in the right place, at the right time.
"When you need to be in hospital, that support will always be there.
"But once you are ready, we want to support you to live as independently as possible.
"This could be through a range of options including hospital discharge, reablement at home, or returning-to-independence beds.
"With all our organisations working as one system, we will maximise opportunities for recovery, reduce unnecessary hospital admissions, and promote a ‘home first’ approach wherever it is safe and appropriate."
The programme will run until next spring and will be tested across key sites in both boroughs, aiming for the new approach to become normal practice by April 2026.
