Hospital wards have been restructured as part of a new shake-up to improve care for elderly patients in Carlisle.

The move has seen six beds at the Cumberland Infirmary close – but bosses are confident they won’t be needed as the aim is to keep fewer people in hospital and tackle bed-blocking long term.

North Cumbria University Hospitals NHS Trust has introduced the new ‘frailty pathway’ in a bid to reduce the length of stay for older patients.

A new assessment unit opened at the infirmary on Monday, following the restructure of the hospital’s existing wards.

It has seen staff from Maple A relocate to Elm A, which has become a new 48-hour Frailty Assessment Unit.

This is being supported by the team on the Willow A acute elderly care ward.

Helen Ray, the trust’s chief operating officer, explained why the changes were being made.


Helen Ray “Longer stays in hospital, particularly for frail older people, are associated with increased risk of infection, low mood and reduced motivation, which can affect the patient’s health after they’ve been discharged and increase their chance of being re-admitted,” she said.

“We are currently placing a real focus on this working with our health and social care partners, including the very positive introduction of a Frailty Assessment Unit this week at the Cumberland Infirmary.

“The unit means patients can access support from a specialist team which includes senior consultants, therapy staff and social care workers.

“This high level of focus for this group of patients will help us reduce demands on inpatient beds by offering the most appropriate package of care for each person who accesses the unit.”

Mrs Ray added that they are following national examples of good practice.

“The benefits of a frailty pathway are evidenced nationally with improved patient outcomes and experience as well as improved patient flow through hospital,” she said.

The new model of care will begin before a patient even goes into hospital, in an effort to avoid unnecessary admissions and to ensure they are seen quickly, in the most appropriate setting.

A “comprehensive geriatric assessment” will be carried out to identify patients appropriate for the new frailty unit.

Bosses say it means that patients who meet the criteria will avoid the emergency unit and instead be seen by a specialist as soon as possible.

These patients will then be tracked by the frailty assessment team, consisting of specialist nurses, occupational therapists, physiotherapists and social work support.

The aim is to get them back home as quickly as possible, in order to reduce the risks associated with prolonged hospital stays and likelihood of readmission, as well as freeing up beds.

Earlier this month the trust revealed it was taking urgent action to tackle bed-blocking in Carlisle and Whitehaven.

The hospitals are currently struggling to meet their targets on Delayed Transfers of Care (DTOC), or bed-blockers.

The latest board meeting saw bosses flag this area up as one of their biggest challenges.

The national target is for trusts to have no more than 3.5 per cent of bed days taken up by those waiting for transfer. In north Cumbria the figure is currently 13.3 per cent, and the situation is deteriorating.

At the time, chairwoman Gina Tiller said: “What it means is we have got wards full of patients who shouldn’t be there.”

Following the latest move, no decision has been taken on what Maple A will be used for.

A spokeswoman said discussions are taking place to decide how they can make best use of the space for patients.