The Department of Health have announced this morning on Sky News that North Cumbria Integrated Care is to be one of five Trusts place into a new recovery programme.

It comes ahead of an a new £4 million investment package being discussed at the Board of Directors today to transform the way urgent and emergency care is provided for patients in north Cumbria.

Trudie Davies, Interim Chief Executive said, “We are pleased that some of the deep rooted challenges we have experienced historically in Cumbria have been recognised nationally and we welcome the intensive support that has been announced this morning. We have started to make some improvements in recent months and today we are hoping to approve a further £4m investment into urgent and emergency care. It is clear that we would benefit from additional support and look forward to understanding what we will receive to accelerate the pace of change. We know that NHS England have confidence in this leadership team, and this new intensive support is a once in a life time opportunity to embrace that change to deliver the best possible healthcare for the people of North Cumbria.”

The new £4m investment being discussed by our Board of Directors today is being recommended due to pressure being experienced across urgent and emergency care services, including overcrowding in the Emergency Departments, delays in getting patients to the right place for their care and an increasing demand associated with an ageing population.

An improvement programme has been developed to address these pressures through improving the range of services available, which will mean a hospital admission is often avoided. This includes:

  •  More staffing for the new Urgent Treatment Centre in Carlisle which will allow for the centre to be fully opened to see patients with minor injuries
  • An increase in doctors working in acute medicine so more decisions can be made about patients at evenings and weekends in both Carlisle and Whitehaven
  • An expanded Same Day Emergency Care (SDEC) facility at the Cumberland Infirmary so that patients can be treated on the day without a hospital admission.
  • Making the new SDEC for frail, elderly patients at West Cumberland Hospital permanent and opening one at the Cumberland Infirmary. This supports patients to access the care they need without going through A&E and can include being referred onto the frailty virtual ward
  • Creation of a medical workforce recruitment team to help us to recruit to more vacancies and be less reliant on high-cost temporary agency and locum staff

Trudie Davies, Chief Executive at NCIC, said: “We are putting in place the resources we need to improve access to urgent and emergency care so that we can see more patients, in a timely way, in the right clinical setting.

“We know that our current A&E department in Carlisle is too small for the volume of patients we see which leads to delays and overcrowding. Our new Urgent Treatment Centre, a bigger Same Day Emergency Care department and an expanded acute medical workforce equipped to make key decisions, will be transformative.

“We have an ageing population in Cumbria and many of the patients we see in A&E are frail and elderly. A hospital stay is not always the best outcome for these patients, which is why we are investing in our Frailty SDEC units in Carlisle and Whitehaven. These expert teams have shown that many people can be well enough to go home on the same day without hospital admission, once they have been effectively treated and stabilised”.

“Recruiting experienced doctors can be a challenge in Cumbria and this leads to instability in our clinical teams and higher costs as we rely on agency and locum staff. We are putting in place a specialist medical recruitment team to help us develop an attraction plan based on all the great things Cumbria has to offer.

“As we discuss this major new investment, I want to pay tribute to our dedicated, hardworking staff who show commitment on a daily basis despite the challenges they face. This new package will mean that they are supported to deliver the very best care to our patients.”

Full details of our investment plans are included in the attached factsheet.

North Cumbria Integrated Care NHS Foundation Trust (NCIC) is experiencing pressure across urgent and emergency care services, including overcrowding in the Emergency Departments, delays in getting patients to the right place for their care and an increasing demand associated with an ageing population.

An improvement programme has been developed to address these pressures through improving the range of services available, which will mean a hospital admission is often avoided.

Implementation of the programme will:

  • Improve front-door clinical decision making
  • Expand same day emergency care capacity
  • Reduce avoidable admissions
  • Reduce length of stay
  • Improve patient flow across urgent care pathways
  • Support reductions in Emergency Department waiting times and corridor care
  • Deliver improvements in quality, patient safety and experience through earlier clinical decision making and reduced overcrowding within urgent care pathways

The benefits of the programme are interdependent and require implementation of all four schemes to realise the full operational and financial impact.

Urgent Treatment Centre at CIC

The Urgent Treatment Centre (UTC) at the Cumberland Infirmary is an expansion of the urgent and emergency care facilities at CIC and it will ultimately improve the way the Trust is able to care for patients who need urgent and emergency treatment.

The building of the co-located £12m Urgent Treatment Centre (UTC) next to the Emergency Department (A&E) was completed in January 2026. It has 12 new clinic rooms and separate adult and children’s waiting areas. It will be open for 12 hours a day, seven days a week including bank holidays.

The proposal is to recruit GPs to be employed by NCIC on a permanent basis. Alongside the GPs, we will also aim to recruit nurses, healthcare assistants and pharmacy resource on a fixed term basis which would be reviewed after six months to determine the staffing model needed on a permanent basis

The existing Emergency Department was built with enough capacity to see 30,000 patients per year. It now sees over 70,000 patients per year which means it is often overcrowded and a difficult environment to provide the best possible care. It is estimated that more than 40 patients a day who are currently attending the Emergency Department at CIC could be more appropriately seen in the UTC. This shift will reduce overcrowding in A&E and improve patient experience and waiting times. The UTC is not a replacement for the type of care provided by a GP practice or pharmacy.

Now the build has been completed, the Emergency Department team has already started to use the new clinic rooms to provide a better care environment for patients and to reduce overcrowding. Recruitment is underway to employ GPs, nurses, healthcare assistants before the UTC can be fully opened and be classed as an Urgent Treatment Centre. Having the correct staffing model in place is key to being able to provide a full service in both the Emergency Department and Urgent Treatment Centre and to maximise the benefits it will bring to emergency care services in north Cumbria.

Expansion of Acute Medicine Consultant workforce

Recruiting more Consultants in Acute Medicine will allow us to expand and improve the delivery of our Acute Medicine services at both the Cumberland Infirmary and West Cumberland Hospital.

Benefits will include:

  • Ensuring the service is fully staffed 7 days a week at CIC
  • Strengthening the medical rota at WCH with more weekends covered with a clinical decision maker
  • Creating a dedicated consultant in Same Day Emergency Care at WCH Monday-Friday
  • Creating a MATCH practitioner Monday-Friday (more on MATCH on page 4)
  • Supporting the Frailty service
  • A reduction in spending on overtime/agency doctor

Although there is limited availability of acute medically trained consultants across the country which is a risk to this business case. Therefore, we need investment in training acute care practitioners, investment in nursing staff and our resident doctor workforce.

Expansion of the Medical Same Day Emergency Care Units (SDECs)

We have capital investment in place to develop a much-improved Same Day Emergency Care facility on our Cumberland infirmary site. The expanded facility will enable us to separate medical and surgical SDECs and will make a big contribution to improving the flow of patients from our Accident and Emergency Department.

If more Consultants in Acute Medicine are recruited, the opening times of our Medical SDECs at CIC and WCH could be extended.

Currently, both of our SDECs at CIC and WCH close at 8pm on weekdays and the unit at WCH is not operating seven days a week. As well as more consultants, resident doctor and nursing staff would also have to be increased to provide a seven-day a week, extended hours service in line with NHS best practice.

It is proposed that the SDEC hours expand to closing at 10pm on weekdays and open for 12 hours each day at weekends. This supports our A&E departments and helps patients to get quicker access to the care they need without an unnecessary hospital admission.

Creation of Hospital @ Home Hubs for Frailty patients at WCH and CIC

To help us achieve our overall vision of providing more care closer to home and to enhance the care we provide to frail, older people, we have started an eight week pilot based on the Copeland Unit at West Cumberland Hospital.

The pilot Hospital@Home Frailty SDEC (Same Day Emergency Care) is utilising two of the beds on the Copeland Unit to see frailty patients who would otherwise been referred into hospital via A&E. Patients can receive treatment on the unit such as IV therapies which they previously would have been admitted to hospital for. The virtual wards team is also present in the new SDEC to identify patients suitable for the frailty virtual ward.

We know hospital beds are not the best place for frail patients to be; therefore this pilot aims to assess, treat and discharge patients on the same day, putting appropriate care in place at home if necessary.

In north Cumbria, we have an ageing population and we are seeing more frail and elderly patients in our emergency departments and hospital wards. We know that 10 days spent in a hospital bed equates to 10 years off your life expectancy with a risk of infections, deconditioning and delirium. A lengthy hospital stay makes it less likely that an elderly or frail person can return home and live independently

The pilot started on 9th February with a nurse consultant in place on secondment. We have had a successful start with patients being identified through the MATCH service and A&E. After three weeks, we saw 25 patients with 75% of those patients avoiding an admission into hospital.

The business cases now propose that we introduce the hub permanently at WCH as well as creating another one at CIC.

Across multiple Trusts in the UK, the implementation of an acute frailty service has led to significant improvements in:

  • 12 hour and 4 hour performance
  • Bed days and length of stay
  • Meeting national health care standards
  • Ensuring quality of care
  • Preventing deconditioning
  • Patient flow
  • Reducing costs

MATCH – Multi Agency Telephone Co-ordination Hub

In May 2025, the Multi Agency Telephone Coordination Hub (MATCH) was set up at Wigton Hospital to be a single point of access for GP referrals for any patients with a medical issue for across the geographical area covered by NCIC. The service includes a triage nurse, therapist professional of the day, a Hub Coordinator and representation from North West Ambulance Service.

Since the launch of the service, nearly 4,000 referrals were received in a seven-month period and 60% of the calls received resulted in avoiding an A&E attendance.