On the 1 April 2011, County Durham and Darlington NHS Foundation Trust came together with Community Services to form a new integrated health care organisation delivering integrated acute and community health services to patients committed to providing quality care along the whole pathway; at home, in the community and in hospital. We provide services from three main hospital sites, six community hospitals, and around 80 locations across the area plus the care delivered at home. Our range of services includes hospital based emergency and planned care, including surgery, medical treatment for serious and life-threatening conditions, paediatrics and women services, community based services for long term conditions like diabetes or respiratory illness; and health and well-being services to improve health and prevent illness, such as smoking cessation and alcohol reduction. So now, whatever the health care needs of our community, and wherever they need them in County Durham, our commitment is to provide these to the best standard and quality. We provide acute services, for the most seriously ill or injured patients through our Accident & Emergency departments at Darlington Memorial and University Hospital of North Durham. Planned patient care, rehabilitation and recovery, and an urgent care centre are provided at Bishop Auckland Hospital. Outpatient and diagnostic facilities are provided at all these sites. We aim to treat patients as close to home as possible so provideoutpatient and community facilities, including inpatients and day care at six community hospitals. The Trust in its aim to continue to drive the quality of service provided to the community is to develop greater interdependence between our hospitals by creating centres of excellence in a range of specialties on each site, and greater integration between hospital and community services. Recent developments in this area includes the approval to centralise hyper-acute stroke services on a single site, at University Hospital of North Durham allowing us to improve emergency stroke care during the first 72 hours and the development of a specialist bariatric service at Darlington. University Hospital of North Durham has 366 beds and provides a wide range of acute specialties including Accident & Emergency, Anaesthetics and ITU, General Medicine, General and Vascular Surgery, Urology (Day case only), Orthopaedics, Obstetrics & Gynaecology, Paediatrics, Plastic Surgery, Rheumatology, Dermatology and Genito-Urinary Medicine. Additional out-patient facilities exist for ENT, Nephrology, Neurology, Radiotherapy/Oncology, Ophthalmology, Oral Surgery and Plastic Surgery. Clinical support departments of Imaging (including PACS digital radiology, CT, MRI and ultrasound), Coronary Angiography, Medical Physics, Pathology, Pharmacy and Allied Health Professions are all on site. Recent approval will see Durham provide a hyper-acute stroke unit, supporting 24/7 emergency stroke care, including administration of thrombolysis where appropriate, on a sustainable basis The Hospital was built under the Private Finance Initiative and opened in 2001, replacing the former Dryburn Hospital that has been demolished. It serves a population of c250, 000. For Plastic Surgery and Dermatology the population served is c750, 000, covering Sunderland and South Tyneside as well. The Department of Medicine is part of the acute and long-term conditions care group and provides all major medical specialties. There are 220 beds in the University Hospital for medical specialities, with a further 68 rehabilitation beds in satellite hospitals. There is a full range of diagnostic support with access to CT, MRI and Ultrasound including carotid imaging. There is a 40 bed acute medical unit receiving over 40 admissions/24 hours plus a co-located ambulatory care service. The AMU is supported by acute care physicians. There is a dedicated 24 bedded hyper acute stroke unit with support from Stroke consultants with direct admissions 24/7 for all acute stroke admissions.