Campaigners fighting to save community hospital beds believe the threat of closures is the underlying reason for nursing shortages.

Bosses claim that recruitment problems have left them unable to safely staff all of the area’s inpatient units.

As a result they are proposing to close the beds in Wigton, Alston and Maryport.

Yet in Brampton, where the hospital is likely to retain its beds, they have recruited five new nursing staff in recent weeks.

Wigton campaigner George Scott said this proves their case - that you won’t fill vacancies while beds are under threat.

“They have had people in for interviews at Wigton, and that is the main reason they didn’t get anyone. If the hospital had a stable future it would be different,” he said.

The Success Regime’s masterplan included four possible options for community hospitals - none of which would see beds retained in all of the hospitals.

This is despite widespread public opposition, with many hundreds of people in each community turning out to protests and public meetings to stress the value of the beds to local people.

According to Sir Neil McKay, his vision is to see north Cumbria become a centre of excellence for healthcare in remote, rural and dispersed communities.

Yet, in setting out radical plans to transform the local NHS, the Success Regime boss proposes the removal of beds from at least three highly-valued and well-used community hospitals.

One of these is Alston, in one of the most remote, isolated areas of England, often cut off from surrounding communities by snow.

The others are in Wigton, where the hospital serves a huge geographical area stretching from Caldbeck right out to the Solway coast, and Maryport, a hospital situated in one of the most deprived parts of the UK where many residents have no access to cars.

Instead the plan is to look after more people at home, through new care hubs, and prevent hospital admissions.

The hospitals won't close, he stresses, but would have important roles to play in the future of local healthcare.

However as Eveline Dugdale, from Wigton's League of Friends, puts it: "A hospital without beds isn't a hospital. It's a clinic."

Campaigners are now asking the obvious question. How can north Cumbria become a centre of excellence when its most remote, rural and dispersed communities are losing their beds?

The proposals also follow major opposition from all of the communities involved, with protests, petitions, letters and public meeting attendances all leaving bosses in no doubt that local people value their cottage hospital beds and want to see them retained.

The Success Regime insists it has listened.

Sir Neil, who has personally addressed community hospital campaigners across the county, says they originally thought about removing beds from all of the hospitals.

Instead their preferred option is now to keep those in Brampton, Penrith, Keswick, Cockermouth, Workington and Whitehaven's Copeland unit open, and in some cases add more.

But in total, numbers would drop from 133 to 104 as this is seen as sufficient to serve the local population once the care hubs - dubbed Integrated Care Communities (ICCs) - are up and running.

The theory is that these will see GPs, community nurses, social care staff and voluntary organisations working together to prevent far more admissions and get people out of hospital earlier.

Sir Neil says they listened to the opposition about removing beds and decided to keep many of them open, but the Success Regime’s own consultation document suggests otherwise - that once ICCs are established they may revisit that option - stating: "We rejected this option at the present time".

Chris Mitchell, of the Penrith League of Friends, is among those not convinced the remaining hospital beds will be safe long term.

"We know this isn't going away. Even if they approve the preferred option, we feel they will be back. It's going to be a long-running fight,” he says.

So why can't all the hospitals keep their beds, if they are valued by their communities and as well-used as League of Friends groups report, while also helping to ease major bed-blocking problems in the bigger acute hospitals?

Sir Neil says money isn't the driving factor, but recruitment.

Campaigners accept that there have been problems finding enough nurses to fill staffing rotas and provide sufficient cover. Just recently Alston’s beds were closed temporarily for this reason.

However following a push by the Cumbria Partnership NHS Foundation Trust, which runs them, posts were filled. Bosses say staffing across the sites remains "fragile”, but campaigners are convinced more can be done.

Wigton town councillor George Scott believes it is the uncertainty hanging over the hospitals that is affecting recruitment.

“If you went for a job at a company and it was well known that company wasn't going to be in existence in a couple of years time, would you take the job? I rest my case. They have had people in for interviews at Wigton, and that is the main reason they didn't get anyone. If the hospital had a stable future it would be different. They could also ask some older staff to come back one day a week,” he says.

At Brampton hospital, where the beds look more secure, they have had had some real success in recent weeks - taking on three new registered nurses and two healthcare assistants.

John Holland, from its league of friends group, believes similar success could be had elsewhere with the right incentives.

Their group has even offered to stump up a considerable amount of money to help with recruitment both in Brampton and at other hospitals.

Although pleased their hospital is no longer the most at risk, John and fellow members fear for other communities, and are not convinced the care in the community plan will work in large, rural areas.

“Worst affected will be Alston. I can't believe they couldn't be a bit more imaginative and come up with some sort of hybrid beds - a combination of care home and clinical beds, with multi-skilled staff,” says Mr Holland.

Brampton parish council chairman David Moorat is also concerned, adding: “For some people it is really, really bad news. Alston, sadly is to lose it beds. One of the remotest of villages in the whole of Cumbria."

Jane Mayes, an academic who has been closely involved in palliative care research, has lived in Alston for more than 40 years and is concerned.

“Alston community hospital is a perfect example of good end-of-life care, integrated into the GP practice and into the community. It scores highly on all objective measures of what makes for a ‘good’ death,” she explains.

“By closing the beds, the Success Regime will destroy something that the NHS as a whole is committed to achieving - good quality end-of-life care.”

In Maryport, Maurice Tate has similar worries for his community. He fears elderly people will find themselves alone in a hospital miles away from home, with poor transport links meaning their often frail partners simply cannot visit.

Workington MP Sue Hayman is also concerned, publicly slating the Success Regime for failing to carry out proper transport assessments as promised.

Mr Tate adds that Cumbria’s geography makes it almost impossible to care for the majority of patients at home as seems to be proposed.

“The bigwigs from London have got it in their heads that you can do healthcare in a county like Cumbria in the same way as you can in a big city. I'm afraid it's impossible,” he says.

Penrith and the Border MP Rory Stewart strongly backed the campaign to save beds in his constituency.

He says it was “disappointing” that Alston and Wigton still look set to lose them, but believes there is now a chance, during the consultation, to push for care home type beds - funded through Cumbria County Council’s social care budget - to be established instead.

“I think it's a tough negotiation. In an ideal world nothing would change but what's really important to the community is some sort of beds,” he says.

So why have these three hospitals been singled out?

Claire Malloy, chief executive the Cumbria Partnership, explains that they did look at spreading beds across all sites but they ideally need bigger units, with 16 or 24 beds, to meet safe staffing ratios of one registered nurse per eight patients.

She accepts that in theory they may not have ideally chosen these areas to lose beds, but says it was down to the buildings - as it would be much more difficult and expensive to convert these older hospitals to accommodate extra beds.

However during the consultation period she is continuing to travel around all of the community hospitals to meet League of Friends groups, local GPs and others to discuss some of the alternative plans they have put forward. She still feels there are negotiations to be had, and says no final decisions have yet been made.

Mr Mitchell believes this should have happened much sooner, but says the Joint League of Friends - which meets next week to plan its next move - has put a lot of faith in the 'Claire' meetings, and still hopes a compromise can be found.