The Cumberland Council Health and Wellbeing Board met on Friday, 26 September 2025, to discuss a range of issues including NHS services, safeguarding, special educational needs, and the Better Care Fund¹. The board was scheduled to hear presentations on intermediate care and discharge delays.

Furness General Hospital Intensive Care Unit Level 3 Care

The board was scheduled to consider a report regarding the safety and sustainability of the Intensive Care Unit (ICU) at Furness General Hospital. According to the report, University Morecambe Bay NHS Trust and the Lancashire and South Cumbria Critical Care Network had been raising concerns about medical staffing at the hospital for several years. In September 2024, a decision was made to temporarily suspend Level 3 (L3) services at Furness General Hospital, meaning that patients requiring ongoing L3 care were transferred to the Royal Lancaster Infirmary. The report stated that independent expert advice from the North West Clinical Senate, and the Lancashire and South Cumbria Critical Care Network had been sought. The Clinical Senate review panel agreed that resuming the original L3 service model at Furness General Hospital would not achieve a safe and sustainable critical care service for the local population in the immediate, medium, or long term. The NW Clinical Senate recommended a supportive network structure incorporating the present and future Furness General Hospital ICU service at L1 and L2. The Critical Care Network presentation stated that Furness General Hospital has faced over a decade of challenges in sustaining an Intensive Care Consultant workforce and that the current model of stabilisation and transfer of L3 patients to the Royal Lancaster Infirmary is safe, effective, and sustainable. The report noted that adult critical care transfers are routine practice across many areas of the UK, and such transfers from Furness General Hospital's ICU have been managed since September 2024 with no adverse events. The Integrated Care Board (ICB) stated that it follows a clear and robust process for any proposed change to service delivery.

Local Enhanced Services

The board was scheduled to discuss a report on Local Enhanced Services (LES). The report stated that earlier in the year, the ICB undertook a major review of locally commissioned services provided by general practices across Lancashire and South Cumbria, to ensure consistent commissioning. This led to the introduction of a suite of LESs that were rolled out to all practices, and also meant that some LESs were decommissioned due to inequity or the service provision being provided under other contracts. The report included tables showing the variations in locally commissioned service provision, and in payment for the General Practice Quality Contract (GPQC) and the LESs. The vision for general practice included consistently commissioning General Practice 'routine' Local Enhanced Services (LES) and refocusing investment in General Practice Long Term Conditions (LTC) care. The review grouped the LES into 2 categories: 'routine' LES and Long Term Condition LES. Following a clinical review, all associated service specifications were updated. The report included tables showing which 'routine' LES have now been consistently commissioned across Lancashire and South Cumbria, and the ask of the Long Term Conditions LES. The report stated that this represents a significant additional investment in Morecambe Bay General Practices and more care closer to home. One of the services reviewed was minor injuries, which was commissioned in a few parts of Lancashire and South Cumbria including practices in South Cumbria. A decision was made to discontinue the general practice service from 1 May 2025, but following concerns from the local community about the loss of the service in Millom, it was agreed that a further clinical review would take place. It has now been agreed that those practices whose patients have the greatest travelling distances and times to access alternative services (Central Lakes Medical Group in Ambleside and Hawkshead and Waterloo House Surgery in Millom) will be able to offer a range of appropriate minor treatments as part of their existing wound care services.

Cumbria Safeguarding Adults Board Annual Report 2024-25

The board was scheduled to consider the Cumbria Safeguarding Adults Board Annual Report 2024-25². The report detailed what the Safeguarding Adults Board has done during the year to achieve its main objective and implement the strategic plan, what each member has done to implement the strategy, and findings from Safeguarding Adult Reviews.

The report stated that the Cumbria Safeguarding Adults Board is a partnership which has a strategic role greater than the sum of the operational duties of core partners, and that the partnership in Cumbria includes 5 statutory partners with wider membership from across the system. The main objective of the Safeguarding Adults Board is to assure itself that local safeguarding arrangements and partners act to help and protect adults in its area with care and support needs. The report outlined the board's strategic objectives for 2022-2027:

• Voice of experience
• Challenge
• Communities Partnership
• Learning

Key achievements included 6 lunch & learn sessions with 501 participants, and a Safeguarding Conference. The report stated that wider partners are essential to support the delivery of strategic objectives, and that partners celebrate and showcase their single agency achievements to reflect safeguarding is everybody's business . The report included information on Safeguarding Adult Reviews (SARs), including a thematic self-neglect SAR with 24 recommendations that informed the 2025/26 Business Plan. The report included details of SARs relating to Donna and Poppy, and data showing that the profile of adults where safeguarding concerns were raised was highest for females aged 18-64 in Cumberland and in Westmorland & Furness. The highest abuse type across Cumberland was neglect & acts of omission, and emotional & psychological abuse was highest in Westmorland & Furness. Abuse in the person's own home was the highest abuse type. Looking forward to 2025 - 2026, the report stated that the board will publish a thematic self-neglect SAR report to inform activity, establish multi-agency Practitioner Forums, learn from examples of when things go well, support partners through system changes and seek assurance of safeguarding leadership, host a facilitated development session to identify opportunities to strengthen Pan Cumbria SAB arrangement, and explore and implement measures to manage SAR pressures.

Special Education Needs and Disability (SEND) Update

The board was scheduled to receive a Special Educational Needs and Disability (SEND) Update. The report provided updates on several areas related to SEND:

• Current position
• Ofsted/CQC Cumberland Local Area SEND Inspection – July 2025
• SEND & AP Strategy
• SEND Partnership Governance
• Development of Specialist Places SEND Sufficiency Strategy
• Dedicated Schools Grant (DSG) Management Plan

The report stated that the number of EHC needs assessment requests has risen from a monthly average of 36 per month in 2019 to 58 requests per month in 2024-25 academic year, and that in Cumberland, EHCPs have increased by 8.7% in the last 12 months with the July 2025 figure standing at 3065. In 2024 42% of plans were issued on time, and from January 2025 – July 2025 this figure has now dropped to 9.7% of new EHCPs being completed within statutory timeframes. The report stated that a team of additional agency staff started working to reduce the backlog of annual reviews in May and 83% of the scoped backlog has now been completed, but that the backlog of Annual reviews from May to date is increasing. The number of requests received for Education, Health, and Care Needs Assessments (EHCNA) was 553 in 2023, rising by 30.5% to 772 in 2024. The report stated that the Cumberland SEND and AP Local Area Partnership was inspected jointly by Ofsted³ and the Care Quality Commission between 23rd June and 11th July 2025, and that following publication of the report, Cumberland Local Area was given an outcome 2, which means The local area partnership's arrangements lead to inconsistent experiences and outcomes for children and young people with SEND. The local area partnership must work jointly to make improvements. Full inspection within 3 years. The report identified two priority areas:

• The partnership should ensure that contributions to inform the development of children's and young people's EHC plans come from all partners, especially health and social care, so that the needs of these children and young people are fully reflected.
• The partnership should continue to strengthen its understanding of the impact of its work to improve outcomes for children and young people with SEND.

Key strengths identified in the report included that the partnership demonstrates ambition and energy in developing plans for improvement, that leaders have a realistic understanding of strengths and weaknesses, and that the SEND and AP strategy is well-considered and supported by the partnership board. The report stated that the Department for Education (DfE) SEND Advisors supporting the Local Area have attended the last three meetings of the SENDAP Strategic Partnership Board in a peer support capacity, and that the Local Area DfE and NHS England advisors continue to work with partners to further strengthen the Local Area's SEND governance arrangements and are supporting partners to work together to deliver the Local Area's strategic priorities. In 2024 the Executive Board approved the establishment of two new Resourced Provisions at two LA maintained schools, and the DfE has also approved the establishment of three new Resourced Provisions at Academies. The report included a table setting out the schools, location, designation, and the number of commissioned places at each of the Resourced Provisions. The report stated that the SEND Sufficiency Plan 2024 clearly sets out the continued need for additional specialist places and highlights the gaps that we currently have across Cumberland in relation to geographical location, placement type (RP/special school), age and primary need, and that we are working towards a target of establishing an additional 200 specialist places before the end of 2026. The report stated that the DSG conditions of the grant 2024 to 2025 require that any local authority with an overall deficit on its DSG account at the end of 2023 to 2024 financial year, or whose DSG surplus substantially reduced during the year, must be able to present a plan to the DfE for managing the future DSG spend.

Joint Commissioning Strategy for Children and Young People with Special Educational Needs and Disabilities (SEND) 2025 to 2027

The board was scheduled to consider a report presenting the Joint Commissioning Strategy for approval. The report stated that Cumberland Council, North East and North Cumbria Integrated Care Board (ICB) and Lancashire and South Cumbria ICB have collaborated to develop this Strategy, which sets out their intentions to work together on the commissioning of services for children and young people who have special educational needs and/ or disabilities. The report stated that a number of organisations have responsibility for providing and commissioning services for children special educational needs and disabilities (SEND) within Cumberland, including the Local Authority and both ICBs, as well as education settings, including schools, academies and colleges. The Joint Commissioning Strategy has been developed by commissioners from Cumberland Council and North East and North Cumbria ICB, working with Lancashire and South Cumbria ICB, and reflects the shared understanding of what joint commissioning will involve for Cumberland and focusses on the most important areas for development. The Strategy covers the whole commissioning cycle, defining joint commissioning as:

• Understanding the needs of our SEND population;
• Describing commissioners' plans to meet the needs of children and young people with SEND;
• Delivering to meet the needs of the children and young people with SEND;
• Reviewing the effectiveness of existing commissioning arrangements in meeting need.

The report stated that developing effective systems for identifying and understanding needs and outcomes for children and young people will underpin any joint commissioning work, and that commissioning agencies will work together to understand services which are already commissioned, how they align and whether any changes would help to meet needs more effectively. A key commitment within the Strategy is the involvement of children, young people and families across the commissioning process, including seeking their feedback and working towards their involvement in co-design of services. Collaboration will also take place across the region, in particular within the wider Cumbria area, due to the footprints of Cumberland and Westmorland and Furness Councils and the ICBs not being co-terminus. The report stated that the draft Strategy has been reviewed at the Strategy, Implementation and Action Plan Review Group within the SEND and Alternative Provision (AP) Partnership and has also been discussed at the SEND and AP Partnership Board, and that commissioners from the Council and ICBs are now meeting regularly as a Children's Joint Commissioning Group, to discuss commissioning plans and share data.

Better Care Fund – Quarter 1 Report

The board was scheduled to consider the Better Care Fund (BCF) – Quarter 1 Report. The report stated that the Better Care Fund (BCF) programme supports local systems to successfully deliver the integration of health and social care in a way that supports person-centred care, sustainability and better outcomes for people and carers. For 2025 to 2026, the objectives of the BCF reflect the government's commitment to reform via a shift from sickness to prevention and from hospital to home. To support a stronger focus on helping people stay independent for longer and reducing the risk of needing to spend time in hospital or long-term residential care, all HWBs are required to set local goals for maximum levels of unplanned hospital admissions, delayed hospital discharges and long-term care home admissions. The primary purpose of BCF reporting is to ensure a clear and accurate account of continued compliance with the key requirements and conditions of the fund, and the secondary purpose is to inform policy making, the national support offer and local practice sharing by providing a fuller insight from narrative feedback on local progress, challenges and highlights on the implementation of BCF plans and progress on wider integration. The Quarter 1 report includes:

• Reporting against the BCF National Conditions;
• Reporting against the BCF Metrics;
• Providing a high-level update on BCF income and expenditure.

The report stated that the section 75 agreement for the BCF plan has not been finalised and signed off, with a date of 30/09/25 expected. The outstanding action is final content for new schemes to be agreed at JCB. The report included a summary of the metric performance, and a table setting out that there have been no changes to the expected levels of BCF income compared to the agreed BCF plan, and that actual expenditure at Q1 is running at 23% of the total planned income for 2025-26.

Intermediate Care Programme Update

The board was scheduled to receive a presentation from the Director of Adult Social Care and Housing regarding the Intermediate Care Programme. The presentation defined intermediate care as Providing support for a short time to help patients recover and increase independence , for a maximum period up to 6 weeks, free to the patient, and discharge to assess (D2A). The presentation stated that a collaborative initiative between Cumberland County Council and North Cumbria Integrated Care NHS Foundation Trust, has exemplified an innovative approach to integrated health and social care, operating across three local authority facilities, providing 28 therapy-led beds designed to support individuals in regaining independence and returning home safely, championing the principle of no place like home. The presentation outlined the local picture and assets, including Integrated Care Communities (ICCs), Community Hospitals, and Cumberland Council Intermediate Care Beds. The vision for what we want to achieve in Cumberland is; A sustainable Intermediate Care Service, that aligns our systems, promotes prevention and independence, and improves the health and wellbeing outcomes for our local communities . The presentation outlined strategic aims, modelling for the future, and the Intermediate Care Board and Task and Finish Group Structure.

Discharge Delays

The board was scheduled to receive a presentation from North Cumbria Integrated Care NHS Foundation Trust regarding Discharge Delays. The presentation included an overview of all pathways, and information on Pathway 1, Pathway 2, and Pathway 3.