County Durham and Darlington NHS Foundation Trust

Ratings - Well-led

• Well-led Our assessments of NHS trusts now focus on leadership. We no longer rate trusts overall for their safety, effectiveness and responsiveness or how caring they are. We do still publish those ratings for the services they provide.

  Inadequate

Our view of the service

County Durham and Darlington NHS Foundation Trust is an NHS acute and community services trust consisting of Darlington Memorial Hospital, University Hospital North Durham, Bishop Auckland Hospital, Chester-Le-Street Community Hospital, Shotley Bridge Community Hospital, Sedgefield Community Hospital, Richardson Community Hospital, Weardale Community Hospital and Peterlee Community Hospital.

Services include acute medicine, urgent and emergency care, maternity services, acute frailty units, rehabilitation services and surgical services to a local population of approximately 650,000 people.

The Trust employs over 7,500 people across the sites.

Our last trust-level assessment at County Durham and Darlington NHS Foundation Trust was in 2019. The inspection looked at how well led the trust was. At that time, we rated them as Good.

Following concerns identified in 2025, we undertook an inspection of the Trust’s surgical services. As a result, we asked the Trust to take urgent action and issued a Section 29A Warning Notice. We found that the ineffective senior leadership previously in place at the Trust contributed to the failures identified during our assessment of surgical services. In the three months leading up to our well-led assessment of the Trust, there were several changes within the senior leadership team, including the appointment of a new Chief Executive Officer (CEO) and a new interim Chair. Consequently, we wanted to assess how well led the Trust was overall.

Our assessment of County Durham and Darlington NHS Foundation Trust included an on-site visit on 2-4 December 2025. We observed a board meeting as well as internal Operational Performance & Assurance Committee (OPAC) and Integrated Quality & Assurance Committee (IQAC) meetings. We also held focus groups with staff members and the Council of Governors.

We assessed all 8 of the quality statements in the well-led key question using our current framework methodology for NHS trusts. We reviewed evidence for all quality statements under our single assessment framework.

Each quality statement assessed is awarded a score. Details on how we score can be found on our website: https://www.cqc.org.uk/about-us/how-we-do-our-job/ratings

You can find further information about how we carried out our assessments at: https://www.cqc.org.uk/about-us/how-we-do-our-job/what-we-do-inspection

We looked for evidence that there was an inclusive and positive culture of continuous learning and improvement that was based on meeting the needs of people who used services and wider communities. We checked that leaders proactively supported staff and collaborated with partners to deliver care that was safe, integrated, person-centred, sustainable and reduced inequalities.

This is the first assessment for this service under our single assessment framework. We rated the well led key question as inadequate.

We found the following breaches of regulation:

Regulation 16 - The Trust must ensure that complaints are reviewed and acted upon in a timely manner. The potential for learning lessons from complaints and lack of action planning means opportunities are missed to prevent patients being exposed to the risk of harm.

Regulation 17 - The Trust must implement and operate an effective governance and risk management system to ensure the safe and effective delivery of care.

Regulation 17 - The Trust must ensure that incidents reported are reviewed and acted upon in a timely manner. The potential for learning lessons from incidents and lack of action planning means opportunities are missed to prevent patients being exposed to the risk of harm.

Regulation 19 - The Trust must ensure it has appropriate and adequate processes in place to ensure the safe recruitment of all staff.

People's experience of this service

The Trust’s inpatient survey showed that County Durham and Darlington NHS Foundation Trust scored ‘about the same’ as other trusts nationally in each overall category and scored ‘somewhat better than expected’ in areas of ‘having enough to drink’, ‘involvement in discharge decisions (if wanted)’, ‘given enough notice of discharge’ and ‘expected care/support available after discharge’.

The Trust’s CQC national maternity survey showed that County Durham and Darlington NHS Foundation Trust scored ‘about the same’ as other trusts in each reviewed category.

The national urgent and emergency care survey rated the Trust as ‘about the same’ as other trusts nationally. However, the question relating to keeping patients updated about waiting times scored ‘somewhat worse’ than other trusts nationally.

We looked at the most recent Friends and Family Test results for the Trust. In December 2025, people rated their experience of services at the Trust as ‘Very good/good’ in the following areas: Outpatients - 89%, Maternity - 93%, A&E - 60% and Inpatients - 95%. These results were based on 479 responses out of a total number of 38,022 eligible participants. This equates to a 1.3% response rate.

Patient and care surveys evidenced people’s experiences as being generally positive. However, response rates were low which impacts the reliability of the scores.