Right care, right place: proposed reduction in beds at Royal Lancaster Infirmary

What is being proposed?

The NHS in Lancashire and South Cumbria is investing in a variety of ways to reduce demand on hospital services by increasing capacity in the community. This includes investing in more primary care, partnership working in local communities and collaboration with voluntary, community, faith and social enterprise organisations. This is part of a national shift to move care from acute settings closer to communities in neighbourhoods.

As a result of this work, University Hospitals of Morecambe Bay NHS Foundation Trust is proposing to close two wards (48 beds in total) in the Castle View Unit at the Royal Lancaster Infirmary (RLI).

If approved, the closures would happen gradually:

Stage 1: One ward (24 beds) would close in late 2026.

Stage 2: The second ward (24 beds) would close later, but only if it is safe to do so.

The case for change was presented to the NHS Lancashire and South Cumbria Integrated Care Board on 19 March 2026 and was approved. However, no final decision has been made to close any wards and a detailed pre‑consultation business case will now be developed.

Why is this change being considered?

At the moment, too many people remain in hospital beds even after they no longer need hospital‑level treatment. This isn’t anyone’s fault – it's how the system has evolved – but it isn’t what patients want, and it isn’t what’s best for their health.

Healthcare professionals are clear: when people, especially older people, stay in hospital longer than they need to, their health can worsen. Longer stays can lead to:

• Loss of strength and mobility
• Reduced confidence
• Memory decline
• Loss of independence

This can make it harder for patients to return home and may mean they need more support in the future. People recover better and faster at home or in community settings, when it’s safe for them to do so.

At the same time, the NHS is under real financial pressure. Wards being used for patients who don’t need acute hospital care take money away from services like emergency care and planned treatment.

What’s happening now?

Almost a third of patients at RLI stay in hospital even after they are medically ready to be discharged. Many are waiting for community support, rehabilitation, or care packages. This creates knock‑on delays across the hospital, affecting:

• New admissions
• Treatment times
• Patient flow
• Safety and experience

To fix this, the Trust is strengthening its home‑first approach, expanding virtual wards and hospital‑at‑home services, increasing therapy support, and working closely with councils to reduce delays.

Additionally, NHS Lancashire and South Cumbria Integrated Care Board (ICB), which plans and commissions £5.5 billion of health services, is investing more in interventions which help reduce demand on acute services.

As more people receive care in the right place, the need for hospital beds decreases. This is what makes the bed reduction possible, pending further assurance and approval.

Right care, right place

This proposal is not about cutting services. It is about:

• Making sure people receive the right care, in the right place, at the right time.
• Reducing unnecessary hospital stays.
• Shifting care closer to home where possible.

The wards in Castle View were originally used for rehabilitation but are now mostly used for patients who are simply waiting for onward care – not for those needing acute medical treatment. These patients would be better supported outside the hospital.

Evidence shows that every extra day in hospital can slow recovery, especially for older people. Helping people return home sooner supports better outcomes, independence and wellbeing.

The proposal reflects national NHS priorities to shift care:

• From hospital to community: moving care away from hospitals and closer to home, focusing on community and primary care.
• From sickness to prevention: shifting focus from merely treating illness to preventing it, addressing health issues earlier.
• From analogue to digital: modernising services through digital technology to reduce admin, improve efficiency, and enhance patient experience.

The Trust has also reviewed how the proposed changes might affect different groups, and initial assessment shows no disproportionate impact on disadvantaged communities.

Improvements already underway

The Trust has already been working on ways to reduce unnecessary hospital stays, including:

• Virtual wards/hospital at home, allowing patients to be monitored safely at home
• Faster discharge processes, so people can go home as soon as they’re medically ready
• Closer working with councils and community services to reduce waiting times for care packages and rehabilitation
• Better in‑hospital processes so care and discharge planning happen earlier

Any reduction in beds would only take place when there is clear evidence that it is safe and sustainable. This is why the proposal is phased rather than immediate.

Work is also continuing to strengthen primary and community care so more people can be treated outside of hospital and closer to home. One example is the ICB’s increased investment in primary care through local enhanced services (LES). In Morecambe Bay, funding for GP practices increased from £2.9 million to £9.9 million in 2025/26. This additional investment enabled services to be standardised across practices and expanded the range of care available locally, including support for people with long‑term conditions, dementia and end‑of‑life care, wound care, and diabetes and anti‑coagulation services.

Meanwhile, neighbourhood teams in Morecambe Bay are already delivering care in community settings, working from places where residents naturally gather and making best use of local assets. A strong example is the partnership at Kendal Leisure Centre, where the NHS integrated musculoskeletal service is co‑located with community facilities, helping people with pain, mobility and long‑term conditions to access support outside hospital.

This neighbourhood approach brings together NHS services, primary care, councils, voluntary and community partners to provide joined‑up, preventative support. Programmes such as ESCAPE‑pain and physical activity referral services are helping people stay active and independent, reducing the need for hospital treatment and lowering demand on the wider health system.

Financial considerations

Although the focus is on people receiving care in the most appropriate setting, the financial impact is also important.

Lancashire and South Cumbria is one of the most financially pressured health systems in England. Running hospital wards for people who no longer need hospital care is not sustainable.

Each ward costs £1.77 million per year to operate. Closing these wards would allow the Trust to reinvest money where it has the greatest benefit for local people.

Ensuring care is delivered in the right setting helps make the best use of NHS resources.

What do the proposed changes mean for staff?

If the changes go ahead in future, the Trust will fully support affected staff. This includes:

• A structured redeployment process
• Matching staff to suitable alternative roles
• Training, induction and wellbeing support

The Trust recognises that change can be unsettling and will prioritise supporting colleagues throughout.

Next steps

These changes are being proposed to ensure people receive the right care in the right setting. Staying in hospital longer than necessary can cause real harm – loss of mobility, confidence and independence.

People consistently say they want to recover at home or in community settings, and evidence shows this leads to better outcomes.

Now that the case for change has been approved, the Trust and ICB will:

• Develop a pre‑consultation business case
• Carry out further assurance work
• Follow NHS England’s formal service change process

The Trust and ICB are committed to listening to local communities. There will be several opportunities for people to share views and experiences, and updates will be published publicly.

Have your say

To further develop this proposal, in partnership with University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT), we are seeking the views of people who live in the North Lancashire, Westmorland and Furness areas in relation to hospital and community care. 

To share your personal experiences and views please complete the short questionnaire.