Our strategy describes how, together over the next five years, we will build on the foundations that colleagues across the trust have laid since 2020. We provide hospital and community health services over 2,600 square miles to more than 320,000 people, everywhere from Carlisle to Kendal and the Cumbrian coast to the North Pennines. We’re responsible for delivering over 70 services across 15 main locations and we employ over 6,500 whole time equivalent members of staff.

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Our Trust has had a challenging past, but since 2020 we have been working hard to make improvements for the patients, service users and communities we serve. In 2023, our Maternity services were rated ‘Good’ by the Care Quality Commission (CQC), and in the same year the national inpatient survey rated us as one of the top performing trusts in the country for patient feedback and the care we provide.

Our Integrated Care Communities (ICC) model provides joined-up care closer to people’s homes, with professionals and communities working together to improve overall health and wellbeing.

At the same time, our partnership with the University of Central Lancashire’s Cumbria-based National Centre for Remote and Rural Medicine is providing education and training to equip health professionals with the knowledge and skills to provide gold standard care.

Furthermore in 2025, our exciting collaboration with the University of Cumbria, Imperial College London and the Pears Foundation will see the creation of Cumbria’s first medical school - training doctors with a specifically local medical expertise for our rural and coastal population.

This five-year strategy is the next important step in our journey. It sets out our high-level objectives which build on the progress we have made together – underpinned by our purpose and values which continue to support everything we do.

Our strategy describes how, together over the next five years, we will build on the foundations that colleagues across the Trust have laid since 2020.

Why we need a new strategy

A great deal has happened since the last system strategy which NCIC helped to launch in 2020/21. We have faced and worked through a global pandemic and there are significant challenges facing the NHS and the communities we serve.

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A growing and ageing population with a longer life expectancy but living more years in poor health with multiple long-term conditions.

Pockets of social deprivation, health inequalities and significantly lower life expectancy in many of the communities we serve

The impact of the COVID-19 pandemic on timely access to elective (planned) care that the NHS is working to overcome in order to return to meeting constitutional standards.

Challenges in hard-to-recruit specialities for doctors, nurses and other clinical roles which impact on financial sustainability and timely access to specialty care; contributing to pressures in primary care.

Challenges in social care which mean people who are ready to leave hospital with social care support cannot always access this when they need it and remain in hospital unnecessarily – creating delays in hospital care.

Pressures in primary care that can affect patient access and result in more people attending already busy A&E departments. Delays in patients being treated by us add to the pressure on GPs.

Challenges in our A&E services – increased levels of attendances and waiting times need to be addressed and the Trust needs to work with its partners to look at whole system wide solutions.

The need to become a financial sustainable organisation. Despite the NHS having received growth funding, excess costs associated with the Trust’s Cumberland Infirmary Private Finance Initiative (PFI) scheme; low levels of productivity; the impact of managing inflationary pressures; and recruitment challenges and costs associated with the delivery of healthcare across a large rural area and across our two acute sites increases financial pressures.

Providing services over a large geographical area that has poor transportation systems and a need to increase our digital connectivity in North Cumbria

All of these reasons mean it is the right time to refresh and develop a new NCIC strategy.

What is our new strategy?

From its creation in 1948, the NHS has been a continuous story of challenges, defined obstacles overcome, and new horizons secured. In that time, no challenge or obstacle has been greater than those seen during the COVID-19 pandemic, and the continuing recovery of NHS services from the impact of the pandemic.

The bravery and hard work of health and care colleagues and the efforts and sacrifices of our communities, demand that health and care services emerge stronger over the next five years. The on-going recovery of NHS services has once again led to a renewed focus on the need to work closely together across health and care services.

This is a path that our Trust has led the way on since 2019, when our community health and hospital services came together as North Cumbria Integrated Care NHS Foundation Trust. Our purpose remains unchanged – that is to deliver safe, high quality care every time to our patients

Patients deserve the best care regardless of where they live, and our ambition over the next five years is to become a nationally recognised centre of excellence for integrated rural and coastal medicine and care.

To help us achieve our ambition, we have developed four strategic objectives focused on our patients, people, partners and pounds (financial and environmental sustainability). This will be underpinned by a number of supporting aims and delivered through three phases which will help improve, integrate and grow care

Our Purpose: Safe, high quality care every time

Our Ambition

To become a nationally recognised centre for excellence for integrated rural and coastal medicine and care.​​​​​​​

Our Objectives:

Our Patients:

We will be clinically led to deliver the best possible care and health outcomes for our patients and service users.

Our People:

We will provide a great place to work.

Our partners:

We will work in collaboration with our partners to build integrated and sustainable health and care services for the future.

Our 'Pounds':

We will make the best use of our limited resources and become financially and environmentally sustainable.

Our Patients ▶

We will be clinically led to deliver the best possible care and health outcomes for our patients and service users.

Improving quality, safety and equity

  • Work with our partners to collectively improve access to seamless end-to-end patient care.
  • Create a culture where patients, their families and carers take the lead in their care.
  • Embed collective learning from incidents, complaints and from other organisations, using a quality improvement approach.
  • Eliminate the elective backlog and return to the constitutional standards of care that our patients should expect - improving over time to become an outstanding healthcare organisation.
  • Provide focused support for fragile services and specialities to help them stabilise, integrate and grow.

Improving performance and productivity

  • Work with our partners to improve patient flow so that patients are able to leave hospital safely sooner - this will include exploring how we can make better use of existing estate and fully utilise our community hospitals as digitally-enabled healthcare hubs.
  • Reduce waiting times for elective, cancer and diagnostic services.
  • Continue to improve the productivity of our services which will commence with the utilisation of our theatres, outpatient services and length-of-stay.
  • Improving the productivity of our services enabling them to free up capacity to treat more patients in a timely way.

Preventing ill health in our population

  • Work with partners to promote improved health and wellbeing and develop as an anchor institute.
  • Reduce premature mortality in people with serious mental illness, learning disabilities and autism.
  • Support babies, children and young people to have the best start in life.
  • Develop community services and partnerships to provide alternatives to hospital, focusing on avoidable admissions to hospital and frailty.

Transforming our services through innovation

  • Exploit digital connectivity through new and emerging virtual technologies that will improve access to services and help.
  • Integrate and expand the range of specialist elective services provided at the West Cumberland Hospital and enable specialist services at the Cumberland Infirmary to develop.
  • Explore opportunities for the development of an integrated emergency care village model on both acute hospital sites.
  • Invest in our current and future estate to support new models of care and new ways of working.

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Our patients

Phase 1: Improve

Building on our Integrated Care Communities (ICC) model we will continue to provide joined-up care closer to people’s homes, with professionals and communities working together to improve overall health and wellbeing.

Phase 2: Integrate

By integrating and connecting our hospitals, people and practice, we will provide seamless services that deliver the right care, in the right place at the right time for every patient. This will involve working as one acute hospital across two sites

Phase 3: Grow

By working together with our partners we will expand access to services and care, delivered in innovative and new ways.

Our People ▶

We will provide a great place to work.

Supporting the wellbeing of our people

  • Invest in the personal health and wellbeing of our people by providing accessible and effective support services.
  • Invest in our workforce to create stronger and more resilient teams.
  • Provide the right training, equipment and infrastructure for our people to deliver high quality care

Developing a culture that is aligned with the Trust values and NCIC way

  • Develop and support our colleagues to lead service improvement to help us achieve outstanding levels of care within our available resources and return to constitutional standards.
  • Empower colleagues to fix frustrations and lead services improvement to help them achieve outstanding levels of care.
  • Enhance our support to colleagues in management and leadership roles - developing compassionate leaders able to create the conditions for a positive workplace culture.
  • Continue to encourage a strong and healthy speak-up culture.

Workforce planning, recruitment and retention

  • Continue to grow our own nursing and AHP workforce.
  • Become a respected training centre for junior doctors.
  • Support our staff to grow their careers through flexible working and training opportunities.
  • Create innovative and exciting hybrid careers.

Succession planning and leadership development

  • Working with partners, develop Cumbria’s first medical school that will train doctors with a specific expertise to support the rural and coastal patient population of north Cumbria with the aim of attracting and retaining more doctors in the future.
  • Develop a leadership improvement and safety institute - providing a resource to support the development of services through expert colleagues trained in improvement methodologies who can help re-engineer services to improve productivity, effectiveness and the quality of care.

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Our people

Phase 1: Improve

We will continue to develop and nurture our own workforce by collaborating with local education providers and other partners to support pathways into different clinical roles for local people.

Phase 2: Integrate

Working with our communities we will develop a pipeline of talent to make our workforce sustainable.

Phase 3: Grow

We will continue to grow our role as an anchor institution to improve our own workforce sustainability but also to support the wider community workforce needs.

Our partners ▶

We will work collaboratively with our partners to build integrated and sustainable health and care services for the future.

Patients and service users

We will support our clinicians to come together with patients and service users, and the latest research, to review and make changes to our services to ensure the delivery of safe high quality care every time.


Anchored in the communities we serve, we will positively contribute to our local area and influence the wider determinants of health by working as a good partner, seeking to be a leader in bringing inward investment into North Cumbria, widening access to employment, continuing to reduce our environmental impact and thus supporting healthy and prosperous people and places.

Integrated Care Board and regional NHS partners

We will continue to work as good partners with our ICB and regional NHS colleagues to accelerate progress in delivering person-centred, integrated and sustainable care.

Local authority and third-sector partners
  • We will continue to work with our local authority and third-sector partners to develop alternatives to hospital, focusing on safe, high-quality care closer to home for frail and older people.
  • We will support collective efforts to improve the infrastructure and connectivity Cumbria needs to improve access to healthcare, economic opportunity and education across our county.

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Our partners

Phase 1: Improve

Continuously improve what we do for our patients and service users by developing systematic, sustainable approaches to enhance the quality of care and our outputs.

Phase 2: Integrate

We will harness the benefits of integration by empowering our people to join up care in new and different ways.

Phase 3: Grow

By forging meaningful alliances with other regional providers, primary care, mental health, local authority, voluntary and third-sector colleagues we will build integrated and sustainable health and care services for the future.

Our pounds (£) ▶

We will make the best use of our resources and deliver financial and environmental sustainability.

Improve the productivity of our services

  • Empower our colleagues to innovate and make the best use of our available resources for the people and communities we serve.
  • Work with our partners to improve patient flow by sharing ideas, resources and facilities.
  • Increase clinical time to care through improved IT systems and more efficient clinical pathways and processes.
  • Improve the productivity of our services ensuring that we reduce / remove waste, adopt and adapt good / leading practices that will help to increase service capacity, increase activity levels and the standards of care we offer to our patients.
  • Seek innovative solutions to reduce the relatively high cost base of the Trust by examining the largest items of expenditure.
  • We will seek creative and innovative ways which will help the Trust obtain increased value for money from the use of our resources.
  • Reduce our deficit over the next 3 to 5 years by capitalising on the above efficiencies and increasing our income base through the delivery of additional activity levels

Working in partnership

Work with our partners to ensure the best use of estate and resources, and to learn from best practice sources such as 'Get It Right First Time' (GIRFT) and Model Hospital, in order to grow the number of patients who can receive their elective care at NCIC.

Environmental sustainability

Embed net zero principles across our services, identifying carbon reduction opportunities in the way care is delivered.

Our pounds (£)

Phase 1: Improve

Support our colleagues and teams through the deployment of 'LEAN thinking' (improving efficiency and effectiveness by eliminating waste) and other improvement methodologies to identify the least wasteful way to provide better, safer healthcare.

Phase 2: Integrate

Become a national exemplar as a fully integrated health and care system, with the trust playing an active role in supporting primary, social care and mental health services.

Phase 3: Grow

Work together with our partners from across the health and care system to expand access to care (allowing the repatriation of Cumbrian patients to provide care closer to home) and changing services which can be delivered in better and new ways.

Our clinically led way of working

Over the five-year life of this strategy, we will increasingly place clinical leadership, in the interests of patients, service users and colleagues, at the heart of the way we make decisions about how our resources are allocated and care is delivered.

We began this in 2020 through the formation of our Clinical Policy Group (CPG), which draws its membership from our clinical directors, nursing and allied health professional leaders, medical director, chief nursing officer, chief pharmacist, executive team, and senior operational managers.

In 2023, we took the next step in our journey by creating eight clinically-led Collaboratives (service groups) - natural care communities of surgeons, physicians, nurses, midwives, scientists, allied health professionals and administrative and support colleagues, which have come together to stabilise, integrate and grow for our patients and service users

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NCIC Collaboratives

Critical Care Anaesthesia and Theatres
Diagnostics and Clinical Support
Emergency Care
ICC and Community Care
Speciality Medicine
Specialist Surgical Care
Surgical Care
Women and Children’s

Each of our eight Collaboratives is chaired by an experienced clinician and, together with our executive directors, they form our senior leadership team.

Bringing it together:

One team, delivering outstanding connected care.

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Delivering and monitoring our strategy

Our strategy will be underpinned by 12 enabling strategies and plans, all of which will be defined and approved by our Board during 2024/25. Key to ensuring the success of our strategy will be how effectively it is implemented and monitored to make sure the benefits at its heart are realised.

The Board will examine progress and delivery arrangements surrounding each of these activities at regular intervals - looking at how well we are meeting our strategic objectives, key measures of success and how well the strategy is delivering its expected benefits.

The context we work in will change over the course of the next five years and, as part of this review process, the Board will undertake an annual review of the strategy to make sure it remains relevant to the organisation and the challenges it faces. In support of our strategy, we will develop a Strategic Implementation Plan which will set out the key activities each year that will support us on our strategic journey and include key change interventions.

Strategies and plans:

Cancer | Carbon Reduction Clinical Communications and Engagement Digital Education Training Estates Financial Recovery Mental Health Nursing and Midwifery | Our People Quality Improvement

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