Cumbria's ambulance service must make vital safety and leadership improvements after inspectors raised concerns.

England's Chief Inspector of Hospitals has given the North West Ambulance Service (NWAS), which runs the service across Cumbria, a rating of "requires improvement" following an inspection by the Care Quality Commission.

Staff shortages in Cumbria were among the key concerns.

The overall rating is broken down into five areas, specifically requiring improvement in two - safety and well-led. The other areas - effective, caring and responsive - were rated good.

The CQC carried out an announced focused inspection at the trust between May 23 and 26 last year, followed by an unannounced inspection on June 6.

NWAS is responsible for ambulance services across Cumbria, Lancashire, Merseyside, Cheshire and Greater Manchester.

Inspectors visited the emergency operations centre, urgent and emergency care, and patient transport services, as well as looking at the 111 service.

Chief Inspector of Hospitals Professor Sir Mike Richards said: “Inspectors found a number of improvements were needed.

“The overall vacancy rate for the trust was 5.7 per cent at the time of the inspection. This was a particular issue in Cumbria," he said.

“There were concerns surrounding staff training and whether the service had enough staff to meet the needs of the service and patients."

Prof Richards added that 35 new European paramedics had been appointed in Manchester and there were plans to appoint more, including 24 in north Cumbria.

"The trust was aware that the recruitment of additional staff was a managerial challenge and was using a number of initiatives to manage this deficit, such as the employment of paramedics from other countries," he explained.