We demanded answers from hospital bosses - and this is what they said...

1. Have staff at West Cumberland Hospital been kept informed of the progress of the Success Regime's work? If so, how and when?

Staff have been kept informed with a number of engagement events before Christmas, with regular weekly staff newsletters, with emails from the chief executive and with monthly manager briefings. We are continuing this engagement programme.

2. Will the health plan concerning hospital services, which is to be completed by March, be made public? When?

It will be made public. The exact publication date has not yet been determined.

3. What plans have been made at West Cumberland Hospital if the A&E consultants leave this year as they have warned?

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4. What progress has been made to address their concerns regarding safety?

The medical director at North Cumbria University Hospitals Trust, has previously said:

“The Trust Board very much supports a safe and viable service for the long-term future at West Cumberland Hospital.

“Our A&E consultants at West Cumberland Hospital formally expressed their concerns to the Trust Board in May 2015 about the long term sustainability of acute medicine. We share these concerns as does the Chief Inspector of Hospitals, who has rated the safety of acute medicine at West Cumberland Hospital as ‘inadequate’ since July 2014.

“We cannot ignore this situation and we all share a common goal which is to ensure a safe and sustainable service for patients in West Cumbria. We are doing all we can to recruit to key vacancies including our innovative partnership with the University of Central Lancashire (UCLan). Whilst our consultants have not formally resigned, it is our duty to plan for all eventualities and all possible worst case scenarios and this means we must have open discussions with our clinical teams.

“We are also working closely with all health partners, as part of the Success Regime, to develop a long-term clinical strategy within the next six months [by April 2016]."

It is also important to note that the Success Regime is making significant progress on a number of fronts including:

- The development of an ambitious vision for the future which declares the intention of West North and East Cumbria becoming a centre of international excellence for integrated health and care provision for rural, remote and dispersed communities.

- The development of integrated care communities – locally based, multiagency/professional teams managing care proactively to prevent unnecessary hospital admissions and to enable the speedier discharge of patients once they are ready to be discharged.

- Agreement to single clinical teams across the health system.

- The development of academic initiatives to support rural medicine and primary care.

- The development of a new medical school by the University of Central Lancashire which would help support clinical recruitment locally.

- Agreement in principle with Newcastle upon Tyne Hospitals NHS Foundation Trust as lead provider for specialised and locally commissioned cancer services.

- Agreement that Newcastle Hospitals become the lead local provider for radiology and oncology services.

5. If the A&E department is downgraded to minor injuries only, does that not make West Cumberland Hospital nothing more than a cottage hospital?

The partners within the Success Regime have been clear that they are fully committed to the continued delivery of accident and emergency services at West Cumberland Hospital and that the hospital has a bright and vibrant future.

6. How much progress has been made to solve the recruitment crisis at West Cumberland Hospital?

Workforce recruitment is one of the major areas of challenge being looked at by the Success Regime, and proposals for ways of addressing this challenge are central to the new clinical strategy.

The medical director for North Cumbria University Hospitals NHS Trust has previously said:

“We have been very open about the challenges we face in recruiting more permanent doctors to work in North Cumbria and the current, but entirely necessary, over-reliance we have on locum staff to ensure safe and effective care for our patients at all times.

“Our efforts remain focused on doing all that we can, together with the support of our partners, to attract a more permanent workforce to Cumbria, which remains one of the core challenges faced by the local health and social care economy.

“Whilst we have had some success in appointing more permanent clinicians over the past few years, we must also look at the wider clinical strategy if we are to truly solve this problem. We are hopeful that the enhanced support we are now receiving from the Success Regime will provide the extra focus and pace urgently required."

Recent recruitment activity includes:

- The highly promoted recruitment campaign, ‘Looking for a fresh start’

- A new recruitment premium was launched last year which could increase the salary of consultants and speciality doctors by up to 15 per cent, as well as attractive relocation packages

- New academic posts upcoming in West Cumbria in partnership with the University of Central Lancashire

7. Does the Success Regime team think it is appropriate to make women travel over 40 miles - many in labour - to give birth?

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8. Does the Success Regime team consider this to offer fair and safe access to basic health services?

Throughout the country women likely to have high risk births already travel to specialist centres of excellence. Women in West Cumbria travel not just to Carlisle but as far as Newcastle. It is, of course, a matter of choice and clinical need. If you are likely to have a high risk birth it is better to be supported in a specialist centre.

More generally, a number of maternity options are being considered as we seek to find a model of care in Cumbria that is clinically sustainable, given the small number of births in West Cumberland Hospital and Cumberland Infirmary Carlisle. The annual numbers of births are as follows (2014/15 data): Cumberland Infirmary Carlisle 1,703; West Cumberland Hospital (WCH) – 1264

The obvious challenges associated with running small units such as these include staff recruitment, retention and difficulties with providing an appropriate range of professional training.

The recent independent local maternity review conducted by the Royal College of Obstetricians and Gynaecologists considered a number of options all of which remain under consideration. Meanwhile Healthwatch Cumbria has been conducting a well-publicised engagement programme on maternity issues and its report will be available in early 2016.

9. Is there still an option on the table to turn West Cumberland Hospital's children's ward into a 'day ward' and make seriously ill children and their families travel over 40 miles for care?

It is important to note that across the country children who are seriously ill are frequently moved from one hospital to another in order that they might access the specialist care, the specialist services and specialist clinicians they need. The most important thing for any seriously ill child is that they get the best care from the very best specialists.

For children who are not seriously ill the NHS is increasingly turning towards short stay assessment units that decide what treatment is needed and then help to ensure it is delivered at home. 

10. Uncertainty about services has hung over West Cumberland Hospital for years, why is that? Do you think it is fair for both patients and staff?

No, it is not fair. Nor is it necessary. The NHS has consistently made it clear that West Cumberland Hospital has a bright and vibrant future.