The teams at County Durham and Darlington NHS Foundation Trust have been on the front line of caring for people with Covid-19 for more than a year. They’ve experienced first-hand the impact the pandemic has on patients and their families and, indeed, their colleagues. Noel Scanlon, executive director of nursing, is part of the leadership team that’s ensured the trust was prepared to care for increasing numbers of Covid-19 patients while supporting and keeping safe around 8,000 members of staff. As we marked the anniversary of the first lockdown this week, he reflects on some of what he and his colleagues have experienced and learnt.

“In February 2020, we were all watching with growing unease the images from northern Italy where cases of patients seriously unwell with Covid-19 were overwhelming hospitals. Of course, we had a sense of what that could potentially mean for the UK but, while we had been preparing for a pandemic for years, the impending sense of what was coming was quite difficult to believe and certainly a cause for tremendous concern.

“It’s important to remember that at that stage only a handful of cases had been identified in the UK and we had no patients with Covid-19 in our care until mid-March, however, we recognised that to mitigate against the situation in Italy repeating itself here, we’d have to make some assumptions, instigate enormous changes and act incredibly fast.

Darlington Memorial Hospital

Darlington Memorial Hospital

“We redesigned our emergency departments at University Hospital of North Durham and Darlington Memorial Hospital, bringing in the builders to the latter, creating completely separate pathways for Covid and non-Covid patients. Reluctantly, we also had to pause many of our valued services, so those staff could, following refresher training, be redeployed to the front line – including wards caring for Covid patients, our emergency departments and ITU. This impacted almost 1,000 nurses, but also doctors, and allied health professionals such as radiographers, physiotherapists and many others such cleaners and porters. We also welcomed back colleagues who had retired, some in their 70s.

“Staff were redeployed within their skill set, but it was still a daunting prospect for many of them and it was heart-warming to hear how welcome people were made to feel. I am so proud to say that, without exception, they responded with enthusiasm and a ‘can do’ attitude. In such a stressful situation, you might reasonably expect conflict, disagreement on the best way to do things – there was none of that – only commitment to patients and a calm, measured approach. My view that people working for the NHS have a strong sense of public service – which they put way above personal gain or expectation – has been proven day after day.

County Durham and Darlington leading medical director reflects on a Covid year like no other

“Our staff adjusted to having to wearing scrubs and onerous PPE, including aprons, hats, gloves and masks, for long shifts. Our infection control team tested thousands of colleagues to ensure they could safely wear FFP3 face masks, used in very high risk areas. Our amazing procurement team ensured that we never ran out of PPE, even taking deliveries in the middle of the night. Indeed all our corporate teams rose to the challenge, working long hours, taking on new roles in some cases – in solidarity with their clinical colleagues.

“We also realised that the fear felt by the general public was hugely magnified amongst our staff who were, after all, going to be on the front line. They were scared about caring for large numbers of very ill patients and also about their own safety and that of their families. Keeping our staff informed became a top priority and we introduced a daily Covid-19 bulletin, issued by email to every member of staff, detailing changes, the reasons behind them and giving an opportunity for discussion and engagement.


“Of course, some staff became ill with Covid themselves, putting pressure on already stretched services, but they returned as soon as they were able. A number of colleagues lived separately from their families for months, in order to protect them. The sacrifices people have willingly made in order to undertake their professional duties, to ‘play their part’, have been enormous – Team CDDFT stepped up in a way that surpassed all expectations.

“One area under intense pressure has been our ITUs at Durham and Darlington. In 2019/20, we had a total of 22 ITU beds, used mainly for patients after major surgery, serious illness or following an accident. At the height of the first wave and then again in January 2021, we had significantly more patients requiring ITU care than we would usually have had capacity for, however we’d anticipated this increase and expanded our ITUs.

As intensive care of Covid patients requires aerosol generating procedures, they have to be nursed in isolation, meaning our ITUs tripled in size, expanding into adjacent wards, operating theatres and treatment rooms. Caring for these patients took the expertise and skill of all our critical care, operating theatre, surgical and anaesthetic teams, who worked long, very tiring shifts sometimes in unfamiliar settings. Learning new techniques and developing new treatments, proving beneficial to patients across the NHS, became essential; including turning patients regularly, known as proning and the various ways of safely delivering oxygen – so much oxygen in fact that we had to start monitoring our supply to ensure we had sufficient. Thankfully, almost 85 per cent of our Covid patients have survived. Many of those who have died were young and our hearts go out to their families who may have been unable to be with their loved one until the very end, due to national visitor restrictions.

County Durham man spent seven months in hospital after contracting Covid-19

“We’re also all too aware of the toll the loss of so many patients has taken on our staff who, in many cases, replaced family members by holding a patient’s hand, offering comfort, listening to and talking with them. If we have one regret from the first wave, it’s that we had to pause our urgent and elective surgery programme, to keep those patients safely away from the infection risk, to create space and free up essential staff to care for Covid patients. We’re very sorry for the impact this had on those waiting for surgery and are grateful to them for their patience and remarkable tolerance. We reintroduced theatre lists as soon as we were able to and continued with all cancer treatment throughout the pandemic, moving our chemotherapy service away from our acute sites, to Shotley Bridge and Bishop Auckland Hospitals.

Darlington Memorial Hospital staff clapping for 72 years of the NHS

Darlington Memorial Hospital staff clapping for 72 years of the NHS

“Crisis can speed up innovation and the pandemic has accelerated the launch of some new ways of working, such as the successful introduction of popular virtual clinics. Patients are able to have a face to face consultation with their clinician, online, from the safety of home – if the patient’s happy to do so and is considered appropriate for virtual consultation. We were already using digital technology but that’s extended significantly in the last year.

“The last year has been an incredibly sad time and not one we would want to repeat, however, experiencing the wave of goodwill and appreciation that came our way was incredible. In addition to the Thursday night ‘clap for carers’, we’d like to thank our local communities – businesses, organisations and individuals for their generosity. They donated toiletries for patients whose families couldn’t bring them, made scrubs and thousands of washing bags, children painted rainbows which we now display on our Wellbeing Walls – and we continue taking delivery of pizzas, cream cakes, freshly grown vegetables and much more.

“It’s important to remember that we’ve had a second and third wave – indeed for much of January, we were caring for many more patients with Covid than during the first wave. It’s important everyone continues doing all they can to keep transmission down, whilst the vaccine programme continues and the effectiveness of vaccines is assessed. We’re still caring for patients very sick with Covid-19, some of whom will very sadly die, and while we’re optimistic, it’s important to remember that we’re still in a pandemic. Nevertheless, reflecting on the last 12 months, I know I speak for my director colleagues in saying that our overall feeling is one of incredible pride.”