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Population served by the multidisciplinary team
The combined Durham & Chester-le-Street multi-disciplinary team serves a population of around 30,000 people over 65. The team is based at the Bowes Lyon Unit on the western fringes of Durham City in Lanchester Road Hospital.
The Service operated by the Directorate consists of:
i) Roseberry Ward is a 15 bed unit at Bowes Lyon Unit. It is a mixed gender acute assessment and treatment ward for functional patients from North Durham.
ii) Oak ward, West Park Hospital is a 12 bed mixed gender acute assessment and treatment ward for functional patients from South Durham and Darlington.
iii) Acute assessment and treatment wards for older people with organic problems are situated at Auckland Park Hospital, Bishop Auckland. Hamsterley ward has 15 female beds and Ceddesfeld ward has 15 male beds.
iv) There are five Community Mental Health Teams serving the populations of:
a. Darlington and Teesdale
c. Durham and Chester le Street
e. Sedgefield and Dales
v) There is an established acute hospital liaison service that operates 24 hours a day, 7 days a week with bases at the two main hospital sites (University Hospital of North Durham and Darlington Memorial Hospital).
The Head of Service is responsible for operational management of the directorate and is supported by two Locality Managers (one for Durham, Derwentside and Easington and the other for Darlington and South Durham).
There is a Clinical Director. The Associate Clinical Director post is currently vacant.
Clinical governance is managed through a monthly Quality and Assurance Group (QuAG).
The Directorate operates using ‘Daily Lean Management’ with daily, weekly and monthly report-outs by ward and team managers.
Each ward and team has a Leadership Hub (‘supercell’) with responsibility for operational leadership, performance monitoring and quality improvement
The services for North Durham operate as multidisciplinary teams and there are good links with the University Hospital of North Durham (UHND) and local GPs. The CMHT is organised into 4 ‘Cells’ (two organic, one functional and one Care Home Liaison). New referrals are allocated daily. Monday to Friday the Team Manager and the Advanced Nurse Practitioner review and allocate all referrals. Referrals for patients under 65 years of age or complex referrals are discussed with the GP Aligned Consultant before allocation. In the absence of the Team Manager or Advanced Nurse Practitioner one of the Band 6 Nurses (Functional or Organic Cells) within the team will allocate and respond to urgent referrals. New assessments are discussed at the Cell’s ‘huddle’ on a daily basis and further team involvement is allocated then. All assessments are recorded on PARIS electronic record. There is a CPN service at weekends and Bank Holidays for non-routine work.
Patients are either seen in clinic at the Bowes Lyon Unit, or at their own home.
Following the introduction of Purposeful and Productive Community Services (PPCS) all administrative tasks associated with a clinical contact are expected to take place immediately after (or as close as possible to) the contact. Therefore, administrative time for dictating, writing clinical notes, phone calls is built into every clinical appointment, rather than appearing as a separate allocation of time in timetables.
The team typically receives around 75-80 referrals per month. The total team caseload is around 1,425. All patients are offered an initial appointment within 28 days of referral and many are seen earlier than this.