We are starting a process to review some of our inpatient wards for older adults. (These are wards mainly for people aged 65+.)

This work is part of our Service Change Plan 2026-27: Delivering tomorrow, with you in mind. It supports our strategy.

Our current services

We provide several older adult inpatient services across Cumbria, Northumberland, Tyne and Wear. These fall into two ‘pathways’, which provide support and treatment to people with:

  • Organic mental health needs. These are issues caused by physical changes in the brain. (For example, dementia, Alzheimer’s, and delirium.)
  • Functional mental health needs. These are problems caused by functional disorders. (For example, depression, anxiety or psychosis.)

We currently provide five inpatient organic wards:

  • Roker (male) at Monkwearmouth, Sunderland, with 12 beds 
  • Mowbray (female) at Monkwearmouth, Sunderland, with 12 beds
  • Woodhorn (mixed) at St Georges Park, Northumberland, with 10 beds
  • Castleside (mixed) at St Nicholas Hospital, Newcastle, with 10 beds
  • Ruskin (mixed) at Carleton Clinic, Cumbria, with 15 beds

We are starting by reviewing our organic inpatient wards. (However, there are close links between our organic and functional pathways. There will be some close working and potential cross-over.)

This review will have two phases:

  • Phase 1: temporary changes. We are reviewing how many organic inpatient beds we currently have, compared with current demand. We propose to reduce the number of beds across Roker, Mowbray and Woodhorn to 7 beds each. This means there are 13 fewer beds in total available in our region. However, this reflects the current level of demand for these beds.
  • Phase 2: longer-term model. Engaging with people to shape inpatient services that meet people’s needs, now and in the future. 

Why we need to change

To meet the needs of our local population, we need to modernise the way we work.

We must align the way we work to national and local frameworks. We also need to make best use of our physical ward environments and the resources available to us.

The number of people needing to be admitted to organic inpatient wards has fallen for a long time. This gives us an opportunity to review how many inpatient organic beds we need, now and in the future.

Our current services always strive to provide effective, high quality, compassionate care. However, they regularly face new challenges. New national objectives also present new opportunities. 

We will work together to change the way we provide care. By making the best use of services at the right time, we can help people recover and be part of their community.

Which wards we are reviewing, and why

The main focus of this review will be how we use Roker, Mowbray and Woodhorn wards in future.

  • Roker and Mowbray at Monkwearmouth Hospital in Sunderland, opened in 2013. They have a modern, award-winning dementia-friendly design.
  • However, Woodhorn, at St Georges Park in Northumberland, is much older and its environmental design is now outdated.

Two of our five organic wards are not being included in this review:

  • Castleside Unit recently transferred from the Centre for Aging and Vitality to St Nicholas Hospital, in Newcastle. We have developed its new environment using the latest dementia-friendly design principles. As this redesign and move is current, we are not reviewing this unit as part of this work.
  • To ensure we have beds closer to home for patients in Cumbria, we are not reviewing Ruskin Unit, in Carlisle.

There is a national and regional focus on:

  • preventing illness
  • reducing long and unnecessary stays in hospital
  • improving the care and treatment available in the local community

National ambitions for inpatient mental health services have been set by 

  • the NHS 10-Year Health Plan
  • NHS Commissioning Frameworks for Mental Health Inpatient Services
  • the NHS Culture of Care Standards for Mental Health Inpatient Services. 

We expect the Modern Service Framework for Dementia and Frailty in Autumn 2026.

National policy focuses on prevention and care closer to home. Strengthening community-based treatment through Neighbourhood Health Centres and Crisis provision is key. This will offer integrated, holistic care and support, closer to families and communities. This helps reduce avoidable admissions to hospital. It will also support earlier discharge from hospital.

People must feel confident in the quality and safety of inpatient services. A smaller number of high-quality inpatient facilities will provide sustainable and effective care. These will focus on person-centred support, and faster discharge back to community services. This allows us to deliver care closer to home.

The North East and North Cumbria Integrated Care Board (NENC ICB) strategy also follows these national principles. The ICB is committed to models of care across the region which:

  • reduce avoidable admissions
  • increase the quality of inpatient care for older adults
  • reduce long stays in hospital through improved community services.

This will be achieved through:

  • Strengthening community services, including mental health crisis support, for older adults.
  • Ensuring inpatient wards offer evidence-based, person-centred care for older people. This care must address mental health and frailty needs.
  • Redirecting resources to a smaller number of beds, helping people to spend less time in hospital.

These national and local priorities will shape the future of our inpatient services. 

Possible future scenarios 

We are exploring several possible ways to meet peoples’ needs in the future. 

There are benefits and challenges for each of these scenarios. We want to hear your views and feedback. Click on each item below to read a more detailed overview.

This list is not exhaustive. We might consider other opportunities and scenarios, based on what we hear from people during this engagement. 

We would continue with the reduced number of beds. (7 beds each at Roker, Mowbray, and Woodhorn.)

Benefits:

  • This maintains the individual wards.
  • This is particularly relevant to the specific male / female units at Roker and Mowbray on the Monkwearmouth site.
  • It would enable us to open more beds, if there was an urgent need.
  • The reduced number of beds helps to keep stays in hospital shorter. It supports ‘flow’ back into the community. 

Risks:

  • Running three separate units with fewer beds is more expensive.
  • The option to open more beds could see numbers creeping back to the old levels. This can lead to longer stays in hospital and delayed discharges. It also requires more staff.  

What would be needed to make it work?  
This is already currently in operation.  
 

This would merge Roker and Mowbray, creating one unit with 14 beds.

Benefits:

  • Would create a vacant ward. This could be used for future opportunities.
  • Creates savings through economies of scale, by combining staffing and building costs.
  • Staff could be redeployed to other services. This may reduce the need for temporary staff elsewhere.

Risks:

  • If this merged ward became mixed sex, there would be no single sex organic units across the Trust. 
  • If this merged ward remained single sex, patients of the opposite sex would need to be admitted to a ward in another area. This goes against the principle of providing care closer to home. Family and carers may need to travel further for visits. This may also create challenges around follow-on care and links to community services.

What would be needed to make it work? 

Some minor adaptations may be needed to the building.

This could include EMI Nursing homes, Intermediate Care provision, and day services provision.

This would require discussions with voluntary sector organisations, Local Authorities, community services etc. Together, we would need to scope out what support is needed for people to move smoothly in and out of hospital.

Benefits:

  • Promotes working together with system partners.
  • Developing robust support to support timely discharge.
  • Opportunities to identify alternatives that prevent admission to hospital.

Risks:

  • We must make sure that any future services address the current challenges. They need to offer alternatives / prevent hospital admission, and support timely discharge.
  • Potential commissioning / procurement arrangements for CNTW.
  • May impact on financial savings.

What would be needed to make it work? 

  • Productive discussions with partners. 
  • Commitment and financial contribution from all partners towards any agreed future models.
     

This would see both organic and functional patients being co-located in one unit at St George’s Park. However, the two groups of patients would be kept separate. The two services would still operate as separate pathways within the unit.

Benefits:

  • Would create a vacant ward. This could be used for future opportunities.
  • Creates savings through economies of scale, by combining staffing and building costs.

Risks:

  • Changing the layout and the flow of the unit could be detrimental for dementia patients. This could cause confusion and clashes between patients.
  • There is limited capital funding available to make changes to the unit.

What would be needed to make it work?  
Funding may be needed to change the building layout to support the two pathways.
 

Benefits:

  • Would create a vacant ward. This could be used for future opportunities.
  • Closing a ward would offer immediate financial savings. 
  • Staff could be redeployed to other services. This may reduce the need for temporary staff elsewhere.

Risks:

  • This would result in patients from Northumberland being admitted to a ward in another area. This goes against the principle of providing care closer to home. Family and carers may need to travel further for visits. This may also create challenges around follow-on care and links to community services.

What would be needed to make it work?  
Support and buy-in from key stakeholders across Northumberland, particularly patients and carers, Local Authorities, and the ICB.
 

We want to hear from you

We are now starting an engagement programme. This will shape how we provide Older Adult services in the future.

We want to hear from 

  • Staff
  • Patients and service users
  • Families and carers
  • Partner organisations
  • Local communities across the North East and North Cumbria 

We want to hear your views on how we can best meet the needs of older people who need to be admitted to hospital.
 

Share your views via our online survey

Come and talk to us at one of our events:

  • Wednesday 19 August, 10:30 – 11:30am: Monkwearmouth Hospital, Sunderland, Meeting Room 1 and 2, Main Building.
  • Thursday 20 August, 4:00 – 5:00pm: St Georges Park, Morpeth, Kiff Kaff.
  • Monday 24 August, 6pm – 7pm: online – click here to join the online meeting.
  • Tuesday 25 August, 2:00 – 3:00pm: St Nicholas Hospital, Newcastle, Jubilee Theatre.
  • Tuesday 1 September, 2:00pm – 3:00pm: Monkwearmouth Hospital, Sunderland, Meeting Room 3, Main Building.
  • Monday 7 September, 6pm – 7pm: online – click here to join the online meeting.

If you would like to arrange a meeting, please contact CorporateAffairs@cntw.nhs.uk

This engagement process will be open until 25 September 2026. 

We will share what we hear with the North East and North Cumbria Integrated Care Board (ICB). The ICB will then decide whether a full public consultation is needed. (If it is, the ICB will lead the consultation process.)