Hospital bosses say they need to recruit more nurses to solve shortages and plan for the future of the NHS.
A number of overseas nurses from the Philippines and Romania have recently started work within North Tees and Hartlepool NHS Foundation trust.
But the trust, which runs Hartlepool hospital and the University Hospital of North Tees, in Stockton, says it still has just over 30 full-time equivalent registered nurse vacancies and around 12 registered midwife positions to fill.
A further intake of 14 Filipino nurses are due to join the trust next month.
Trust leaders acknowledged the need to recruit more nurses to help reduce costs for agency staff and to fit in with NHS plans for closer integration between health service providers currently being developed.
Trust chief executive Alan Foster said: “It’s good news the number of vacancies are reducing, hopefully we will see costs for covering extra shifts and using agencies start to reduce.”
He added: “We need to do more to train nurses as quickly as possible.
“We have had discussions with Teesside University about setting up our own training courses or being more pro-active.”
Mr Foster said providing extra training to nurses so they can do more work in the community was important given an ongoing shortage of GPs.
He said the trust’s ambition was also necessary as a new Sustainability and Transformation Plan for the Durham, Tees Valley and parts of North Yorkshire is being developed.
Every health and care system in England will produce a multi-year STP showing how local services will evolve and become sustainable over the next five years.
They include the chance for closer cross-border working and integration between primary, acute and social care.
Trust chairman Paul Garvin said: “If we are not very careful we will find a real shortage of nurses.
“It would be helpful to work with the CCGs (clinical commissioning groups) in developing a co-ordinated plan particularly for the STP area otherwise we will just end up stealing nurses from each other.
“It will just become an absolute mess. We need to hang on to the nurses that we have got and invest in training for the future.”
Julie Lane, acting director of nursing, patient safety and quality, said one neighbouring trust had around 200 vacancies.
The trust is planning another overseas recruitment drive in September.