A health trust in north Cumbria has successfully filled vacancies to its nursing workforce using a combination of ground-breaking new approaches. 

As well as recruiting over 350 internationally educated nurses over the last two years, a ‘grow your own’ scheme has seen North Cumbria Integrated Care NHS Foundation Trust (NCIC) appointing hundreds of people locally into the Trust and supporting them to develop and train while they work. 

As a result, the nursing vacancy rate at the Trust has dropped to 6.4% which is almost half the national average and the lowest it has ever been in north cumbria. The Trust is now sharing its successes more widely in the NHS as best practice in recruiting to rural healthcare. 

To date we have supported 52 of our health care assistants through their nursing degree with 23 more expected to complete this year.  Among those qualifying last week were Annabel Simpson who is now a community staff nurse after changing her career from a home carer. She joined Penrith Community Hospital as a health care assistant and applied for her nurse apprenticeship which she has now completed after four years. Another is Lauren Kearney who is now a staff nurse on Ward 1 at West Cumberland Hospital. She had been a Health Care Assistant at the hospital for 12 years before deciding to apply to be a registered nurse through the open university. 

And to ensure we are continuing the pipeline of local talent, over three hundred people have recently been appointed as health care assistants or home care practitioners in the last year at one of the Trust’s five mass recruitment events promoted locally within the community. 

In the most recent event, 115 people were offered the chance to start their career with us across all of our locations. There was also an opportunity for some who didn’t have the necessary confidence to join our ‘Step into work’ programme, which provides on the job training and guarantees an interview at the end. People will then be supported to train and develop depending on their wishes and some may also become nurses in the future. 

One of those appointed recently through the mass recruitment events was Alexandra Ali, a former IT worker at the Trust who is following her dream to be a midwife after she tragically lost her daughter when she was six months pregnant. Alexandra has already been successful in getting a care assistant post in maternity and is now pursuing her dream role. 

Amanda Dunkley, Assistant Director People Services at NCIC, said: “We’ve had to develop a sustainable and innovative approach to reduce our vacancies. At the same time as supporting qualified international nurses into the workforce, we have made sure that we also support people locally into our vacancies and the mass recruitment events we have run have been very successful. Candidates are assessed and interviewed together on the same day which has proven to be a very effective way to recruit to a large number of vacancies. Positive feedback from attendees included praise for the welcoming, friendly, and accommodating staff, as well as the calming atmosphere and interesting, informative exercises.” 

Jill Foster, Chief Nurse at the Trust said: “In line with many other areas across the country, addressing our workforce gap has been one of our biggest challenges and our staff regularly feedback that having enough staff is one of our biggest issues. As well as reducing our vacancy rate, we have also been able to increase our nursing establishment, so we now have more people in our nursing workforce than we’ve ever had. Our combined approach to recruitment has also brought us a wonderfully diverse workforce which has improved how we work as an organisation and I’m just looking forward to seeing that vacancy rate come right down as we go through the next few years.” 

If you are interested in a career in nursing, here are the options: 

How can you become a nurse in Cumbria? 

  • Cadets & T Levels: Level 3 college course with placements. After two years cadets will have the qualifications, skills and experience needed to begin work as a health care assistant or to continue their nursing journey. 
  • Nursing associate apprenticeship: two-year programme is open to staff from the Trust to bridge the gap between health care assistants and registered nurses. 
  • Nursing degree apprenticeships: apprenticeship route to a nursing degree open to Trust staff. 
  • There are masters route shortened programmes (2 years) for those with prior health care experience and a degree in a relevant subject – these are traditional route programmes provided by universities and are not available as apprenticeships. MSc Pre-Registration Nursing/Registered Nurse: Adult Nursing - University of Cumbria   
  • University degree: traditional route into nursing, three-year university programme with placements. 

Staff stories


After four years working as a home carer Annabel Simpson saw an opportunity to work as a Health Care Assistant at Penrith Community Hospital.

She said: I’d been doing bank HCA work with the night nurses so I hoped this would get me a way in to the NHS. During my time at Penrith hospital I was given opportunities such as training to do venepuncture as well as other key skills.

“As I developed my skills on the ward I realised I wanted to progress further this is when I applied for a community HCA job and started working at Upper Eden Community nurses.”

After a couple of years working as an HCA developing skills further, Annabel was given the opportunity to apply for a nursing apprenticeship (original 4 year route).

She said: “I was hesitant at first as I wasn’t sure I was academic enough but with encouragement from the team I applied and was successful. Four years of training has led me to become a community Staff Nurse in Upper Eden.”

Annabel says she enjoys providing safe, effective care and treatment to patients in their own homes.

She said: “I am passionate about community nursing so I would love to continue to develop further in the community. To be a nurse you have to be able to prioritise people, practice effectively and safely and promote professionalism and trust.”

As a community nurse, Annabel’s day is slightly different to a nurse in an acute setting.

She said: A typical day in community nursing is checking our list to see which patients we have been allocated. Prioritising patients with timed medication such as insulin and patients on a syringe driver. We have other visits such as wound care, drain care, pressure area care, etc. We also have to respond to Rapid visits such as blocked catheters, patients requiring Just In Case (JIC) meds and this is allocated to the staff member with capacity and in the area. No two days are the same which is why I love community nursing.”


Lauren Kearney is a registered Nurse and works at the West Cumberland Hospital on Ward 1 - a surgical ward. Ward 1 not only looks after surgical patients but Gynae, breast cancer patients, orthopaedics, medical, elderly care and end-of-life patients.

Lauren said: “I have worked at West Cumberland Hospital for the past 12 years, starting as a Health Care Assistant then I took a gap year to travel the world.

“I was lucky enough to do this with the support of my managers with a work sabbatical for one year. I came back after my sabbatical and decided it was the right time in my life to study and start my nursing degree apprentice - I was ready for the next big challenge.

Lauren completed her training as a nursing apprentice through the Open University where she was able to study while working full time for NCIC. She said: “The cohort I was in for my nurse training was a small group as we were the first in the county to do our nurse training through the Open University at West Cumberland Hospital.  

“I feel very grateful for the cohort I studied with as I feel myself, Donna, Rachel, Chrissie and Sophie were the first to do this apprentice course and no one really understood the new role at first so it could be very challenging at times but we supported one another throughout the degree.”

To apply for this course you had to have numerous years of experience as a HCA first.

Lauren said: “I believe having so many years experience gives you solid foundations to start your nursing career to become a Registered Nurse. Having already gained the knowledge and experience of a busy acute hospital setting as a HCA, I was already able to carry over my own competences I had as a HCA when transitioning to a registered nurse.”

Lauren says she is “really happy” where she works now and enjoys dealing with the variety of patients that come onto Ward 1.

She said: “I enjoy the fast pace of the acute ward, some days can be difficult on shift but I work with a good supportive team.  To be a nurse can be very tough and very challenging at times. Until you see it first-hand - how much nurses and HCAs do day-to-day and the challenges they have to deal with daily – I don’t think you understand.”

Lauren describes what she thinks makes a good nurse. She said: “To be a good nurse you have to be a certain kind of person. You need to be strong, kind, caring, trustworthy, emotionally  stable to deal with all aspects of the job, compassionate with good communication skills - and now IT skills – as things move to paperless. It is vital for a nurse to need strong communication skills, as they need to be able to communicate well with all members of the multidisciplinary team, patients and their families – sometimes at their worst moments in life.”

Lauren describes a typical day at work.

She said: “I work 12.5 hour shifts. Nurses come into handover in the morning to find out about the patients we will be caring for that day. Each day on Ward 1 can be different depending on how many patients are going to theatre. We start the day by getting patients washed ready for breakfast, cardiovascular observations medications and antibiotics if needed - all before 9am, where we then need to hand over to other members of the multidisciplinary team. We work alongside physios, OTs, discharge navigators, ACPs and consultants making sure each patient’s care needs are supported throughout the day and then patients begin to get reviewed. Throughout the day, we support patient’s needs with personal hygiene, emotional support, exercise, taking them to other appointments and scans while on the ward. Being a nurse is very rewarding, caring for patients.”

She continued: “Each day can be very different as we have a large turnaround of patients so every day can be very different. There are 3x drug round, 3x meal times on a 12 hour shift which can be very time-consuming for each nurse depending how many patients they could be caring for, from 8-15 patients on shift.

“Each patient needs to be cared for individually to their needs.  There is no time in how long you spend with each patient as it all depends on their needs and if they are acutely unwell or needing scans, transferred to other community beds, wounds, end-of-life treatment and spending time and supporting with the patients family or friends. Sometimes there isn’t enough time in the day on a 12-hour shift as some individual needs can be very complex, although sometimes there are so many barriers, I feel everyone I work alongside including other nurses, HCA and all the multidisciplinary team all try and give 110 per cent when caring for patients on Ward 1.  

“Working as a nurse on a 12-hour days can be very hard and tiring for all the nurses and HCAs on shift, however, I can’t imagine doing any other job, being a nurse has its positive and negatives but the job is so rewarding at times.

“Being a nurse you get great job satisfaction caring for individual’s needs. I feel the NHS is a great place to work and hopefully in the future we will gain lots more nurses and HCAs in the trust.



When Alex Ali was a young girl she wanted to be a midwife when she grew up. She never pursued her dream job because she felt that she wouldn’t be able to cope with the situations that sometimes happened when things don’t go to plan. So she followed a different path and worked in IT alongside her husband, Munna for NCIC.

In 2020, during the national lockdowns Alex and Munna tragically lost their daughter, Nevaeh, when Alex was six months pregnant due to a rare brain condition.

Alex Ali.jpgAlex explained: “That was a horrible time for us, but I can’t speak more highly of the midwives. They made a terrible situation into something bearable, they made me understand that things were going to be ok. I just thought that they were fantastic and I thought – ‘I want to be like you, I want to help people in this position, I want to make these tragedies more bearable for families’. When I heard about the Trust recruitment day for health care assistants I knew that I wanted to follow my dream to become a midwife and took the first step.”

Alex, supported by her husband, came to one of the Trust’s mass recruitment days. The recruitment day is a more relaxed event with group work and a chance to speak to a variety of nursing staff in different roles, from different backgrounds. Candidates are interviewed on the day and offered a role within a week if they are successful. Alex was successful and is now working as a health care assistant at the Cumberland Infirmary.

She said: “I absolutely love it, I love talking to patients and supporting the nursing staff. I’m learning new things all the time and it is one of the best decisions I have made. The ward manager is supporting me to get my care certificate and then I want to do the nurse apprenticeship and eventually I will specialise in midwifery.

“I have come to this from IT – you couldn’t get much further away from nursing, it just goes to show it doesn’t matter what your background is it’s never too late to follow your dream career!”

PDW Nicola Lawson Sandra Dixon and Lisa Richardson.jpgNurse Nicola Lawson graduated as a nurse in May 2023. She works on Larch C elderly care ward at the Cumberland Infirmary.

Nicola started out back in 2010 on Elm B but due to a number of reasons didn’t pass her nurse training. She got a job as a health care assistant and in 2016 became a student Assistant Practitioner on the stroke and neuro ward.

She started back in nursing in 2018 and graduated last week. She said: “It’s been a tough four years as I lost both my parents and there was also the pandemic.

“Despite the difficulties I love my job and I like being collaborative and hearing all the patients stories. I like to see their health improving and them getting better.”

Nicola had some sound advice for anyone thinking of becoming a student nurse. She said: “Get some experience as a health care assistant first. It really helps. Also get your maths and English GCSE. Don’t be too nervous but don’t be full of it either and finally never stop learning. I think you can apply that to everything in life.”

Nicola was supported at the event by her colleagues Sandra Dixon and Lisa Richardson, both nurses on Larch C.

Ami Platten works as a Community Staff Nurse at Hilltop Heights in Carlisle. She said: “I started training about 17PDW Ami and Kim.jpg years ago and if I can do it anyone can. I like delivering care in the homes of our patients as it’s more personal.”

Kim Trotter, who also works at Hilltop Heights as a Community Staff Nurse, also graduated in May. She said: “You have your good days and your bad days but the good ones always outshine the bad ones. I enjoy delivering care at home because the patient is so different in their own environment. In hospital they are ill, at home they have their own things around them and are more relaxed.”

Joanne Wilson, who works on Elm A at the Cumberland Infirmary,PDW Joanne.jpggraduated as a health care assistant in May 2023.

She said: “I had an online business which struggled during covid. At the same time my dad suffered a brain injury in Yorkshire and I cared for him. I saw the NHS from a service users perspective and decided that’s what I wanted to do.”

Joanne was one of the first people to be recruited at one of NCIC’s recruitment fairs last September. She said: “I started in November and I love it. I am using my brain again it’s exciting. The apprenticeship can open a lot of doors. I’d like to continue training and learning and become a nurse if I can.”

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