Serious recruitment difficulties, not cost-cutting, have been blamed for major changes to north and West Cumbria’s health services.

Proposals unveiled by the Success Regime include cutting community hospital beds and downgrading services in the west.

The plan is to care for more people at home, through new care hubs, and reduce the need for hospital stays. Long term this would see the total number of acute hospital beds in Carlisle and Whitehaven drop from a combined total of about 600 to nearer 500.

Meanwhile, more patients requiring emergency care would be transferred by ambulance to the Cumberland Infirmary, with the West Cumberland Hospital focusing on planned day surgery and diagnostics.

Despite calls for key services, such as consultant-led maternity and a 24-hour children’s ward to be retained in west, bosses say this is simply not possible due to problems recruiting.

Sir Neil McKay, chairman of the Success Regime, said difficulties recruiting paediatricians in the west is a particular issue, which then has a knock-on effect staffing the hospital’s special care baby unit.

He said there is currently only one permanent paediatrician in Whitehaven, and efforts to recruit more have consistently proved unsuccessful, largely due to a national shortage.

Campaigners have raised serious concerns about safety, particularly for mothers in labour and their unborn babies.

But Sir Neil said women would be carefully assessed ahead of birth, and those deemed at risk would arrange to give birth in Carlisle. For those using the midwife unit, there would be contingency plans if complications arose during labour.

Asked whether he would recommend a family member gives birth at Whitehaven, he said: “If something goes wrong there will be a dedicated ambulance available 24/7. We will have a contingency plan if that is already taking someone.

“If there are problems with the roads – and the chances of that happening are very slim – we will have a contingency plan. It might involve an air ambulance or some other means. If you take all the factors together I would say you would have a perfectly safe delivery.”

He added that long term safety could be an issue if changes aren’t made. “The service currently is safe. The worry is that if we don’t do something it won’t be safe and sustainable for the next 10 years or so.”

Ultimately Sir Neil said he would not be part of any plan that would put people at risk.

Stephen Eames, chief executive of North Cumbria University Hospitals NHS, agreed that staffing is the main issue – with the current model not giving doctors the chance to keep their skills up to date.


Stephen Eames “Both our hospitals are among seven of the smallest in the country. That poses workforce issues, ensuring we meet national standards. These are the big issues that are driving change,” he said.

Sir Neil added that cuts to community hospital beds are also led by staffing issues – this time difficulties filling nursing posts.

Despite being brought in by the Government largely to plug a growing financial deficit in the local NHS – which he predicts will grow to £163m over the next five years if changes aren’t made – he insisted money was not the overwhelming driver in the new plans.

“We are driven by how we make services even safer and fit for purpose, not just for a couple of years but for 10 years or more,” he said.

A key part of the plan is to to roll out Integrated Care Communities (ICCS) – care hubs based within each community, joining up health and care services – will reduce the need for inpatient beds.

Asked why there was no option to retain all of the hospital beds, Sir Neil said: “It seems pretty compelling to us that if ICCs work as we believe they can, and difficulties staffing small units, the case for change is overwhelming.

"During the engagement we had an idea we would not need beds at all but rowed back from that because we thought it was unreasonable. Then we looked at just three sites but thought actually that wasn’t suitable either.”


Claire Molloy He stressed that no decisions have been made, with Claire Molloy, chief executive of the Cumbria Partnership NHS Foundation Trust, currently visiting all the community hospitals to look at alternative proposals drawn up by local campaigners and GPs.

Mrs Molloy said that they have looked carefully at bed configurations and staffing rotas and feel 104 is the optimum number, but spreading them over nine sites would spread staff too thin.

Asked why Maryport, Wigton and Alston are in the firing line, she said: “The main issue for those three hospitals is an estates issue. They were the ones that would be more challenging to be able to turn them into 16 bedded units that met all our requirements.”

But she accepted that those three areas have other challenges, and losing community beds would have knock-on effects. She therefore said she is

Sir Neil said they were still open to other solutions, and urged the public to come forward if there are possibilities that the feel haven’t yet been explored. However he stressed that they would not be guided by public opinion alone.

He said: “It’s not a vote. It’s not a referendum.

“Clearly if there is an overwhelming view that this or that isn’t acceptable, we need to think carefully about that but nobody holds a veto,” he explained.

Stephen Childs, new chief executive of NHS Cumbria Clinical Commissioning Group (CCG), added: “The public view is a powerful view but not the only consideration.”

He added that there would be an independent analysis of the feedback and proposals before any final decisions are made.