More patients will be cared for and monitored in their own homes and in GP-led centres to ease pressure on hospitals, councillors were told.

And more people will be seen and dealt with on the day in an "A&E but not A&E" system at hospitals, say NHS chiefs.

David Gallagher, executive director of place-based delivery for the Central and Tees Valley, North East and North Cumbria Integrated Care Board, outlined winter plans including more use of "same day emergency care".

He said some people in hospital would "bypass A&E" to get them seen quicker in the right places.

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"Where patients present usually through A&E and they don't really need hospital care but they do need some clinical care, it streams the patients off, usually in an adjacent part of the hospital," said Mr Gallagher.

"They're seen by clinicians, mointored, assessed, and hopefully the plan is to discharge them straight away. It's kind of A&E but not A&E."

Communications manager Jill Foggin said: "They do need emergency care but they're triaged... where there are services such as X-ray and consultants in specialisms where those patients can get the care on the same day.

"It might be a complication of diabetes, for example.

"They can have those investigations done properly on the day they attend and a decision made so that their ongoing care is at home rather than as an inpatient."

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Mr Gallagher told Darlington Borough Council's health and well-being board of work on urgent community responses to avoid people going into hospital, increased use of "virtual wards" where patients are monitored at home, and working with social services on patients discharged to care homes.

This winter, the trust is looking at increasing access to general practice, "making sure we've got additional capacity in urgent treatment centres which avoids patients going into hospital", and supporting GPs at times of pressure.

It is expanding discharge teams which support people leaving hospital and Home First, which prevents unnecessary hospital admissions and helps hospital discharges and support in the community.

Mr Gallagher spoke of plans by NHS England covering A&E, improvements in hospital discharges, managing peaks in demand and the ambulance service.

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He added: "One of the key things is getting that steady drip-drip communication to the public to try and make them aware of services that are available, how you access them."

He said 111, run by the ambulance service, was the first point of contact and "signposter" to tell people where they needed to go and give support on self-care.

Board chair Councillor Kevin Nicholson said: "I was impressed to see some of the planning that's been undertaken."

He referred to concerns over ambulance queues, saying: "I was pleased to hear that Darlington Memorial Hospital doesn't seem to be as impacted as severely as those other hospitals around the region.

"A whole new ward's been created to support those handovers. There are practical things that residents can see.

"It's about sharing information with the public to make sure they're accessing the right services at the right time."

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