NORTH Cumbria's NHS trust has taken steps - including assigning a staff member to oversee the emergency department waiting room - after receiving an enforcement notice from the Care Quality Commission (CQC).
The enforcement notice was issued following an unannounced inspection of the trust's Emergency Department (ED) at the Cumberland Infirmary Hospital in Carlisle.
CQC is the intendent regulator of health and social care services in England.
Inspectors found areas of good practice during their unannounced visit in February, as well as a number of concerns.
The inspection team revisited in March 2026 for a further review and as a result, the trust received formal notification of a Section 31, which grants the CQC the ability to impose conditions on a provider’s registration.
CQC issued the enforcement notice as the trust was found to be in breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
Trudie Davies, chief executive officer (CEO) of North Cumbria Integrated Care (NCIC), told directors at April's board meeting that staff were "positive and motivated", during the inspection, "despite the challenging environment they are working in."
She said that senior leaders were preparing a response to the CQC after receiving its initial report.
NCIC has said it takes the CQC’s concerns very seriously and measures have been put in place to respond to the issues identified.
The main areas of concern were around the care of mental health patients in the Emergency Department and oversight of patients in the waiting area.
Immediate actions taken by the trust include:
- A healthcare assistant or registered nurse is now assigned to the ED waiting room to improve the oversight of patients while they wait and to identify and support any patients with deteriorating conditions.
- The dedicated mental health assessment room has been reviewed and works have been completed including removal of a sink and new furniture
- New processes have been put in place to ensure that mental health risk assessments are carried out quickly when a patient arrives in the ED and any safeguarding measures are put in place to protect that patient during their time in the department. A recent mental health assessment audit showed that the department is now consistently achieving 100 per cent compliance with patients receiving an assessment
Gill Findley, chief nurse at NCIC said: "We know that all of our colleagues come to work to do a good job for their patients everyday so naturally it is very disappointing and concerning to receive an enforcement notice from the CQC.
"The most important thing is to take immediate action to resolve the issues raised and to make sure they are resolved on a permanent basis rather than a temporary fix. The team in the Emergency Department have responded really well to the notice and have been determined to make the necessary improvements.
Ms Findley said: "We recognise that we need to improve our urgent care facilities at the Cumberland Infirmary. The ED was originally designed to accommodate 30,000 patients a year and we are now seeing around 70,000.
"That is why we are investing £4million into our urgent and emergency care services to help us to stream less urgent cases to the most appropriate place and free up ED for the critically ill patients. It is important that we provide our staff with the facilities and staffing levels they need to enable them to provide the best possible care to our patients."
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The CQC inspection team also identified areas of good practice during their inspection, including:
- Staff delivering kind, calm and compassionate care in challenging circumstances
- Patients provided positive feedback about the care they received
- Staffing were positive about their chief executive and felt she understood the challenges and listened to concerns
Ms Findley said: "I would like to thank the ED team for their response to the CQC’s findings and for delivering kind and compassionate care despite the challenging environment they are working in.
"I would also like to offer reassurance to our local communities that we take this action extremely seriously and we are doing all we can to improve urgent and emergency care services across the Trust."
Requirements set out in the act include the need to asses and mitigate "risks to the health and safety of service users," ensure premises used by service users are safe and that timely planning takes place when care is shared with or transferred to other providers.
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