Royal Lancaster Infirmary to shut two whole wards for good - but only once it’s ‘safe’ to do so

Two wards at the Royal Lancaster Infirmary are set to close permanently as part of a plan to provide more care in the community.

The 48 beds that make up the Castle View unit will be shut in phases - but only once hospital bosses have deemed it “safe” to do so.

That means none of the facilities will be taken out of use until alternative out-of-hospital services - and the system for discharging patients into them - have the capacity to cope, NHS leaders have insisted.

To that end, no firm dates have been fixed for the closures - but a meeting of Lancashire County Council's health and adult services scrutiny committee was told that the “aim” was for one of the two 24-bed wards to be decommissioned towards the end of this year.

One councillor warned that making such a move at the height of winter - when space in hospitals is at premium - was likely to “sit very badly” with the public.

However, the cross-party committee voted by a majority that the ward shutdowns were not a “substantial variation” in service - meaning the NHS will not have to undertake a formal public consultation on the issue. Health chiefs have nevertheless committed to continue what they describe as other, “more meaningful” engagement activity.

Committee members were told that the concept of care “closer to home” was a key component of the national NHS 10-year plan - and so what was being proposed in North Lancashire was “nothing radical”, according to the co-medical director of the Lancashire and South Cumbria Integrated Care Board, Andy Curran.

Castle View’s wards specialise in rehabilitation and therapy to prepare often elderly patients to return home, especially in cases where the discharge process for them is complex. However, a snapshot taken earlier this month found that “the majority” of patients on the two wards did not meet the criteria for needing a hospital bed - as was also the case for a quarter of those across the Royal Lancaster as a whole.

The meeting heard that ongoing efforts to prevent unnecessary hospital admissions - and reduce the length of time patients spend on a ward if they are admitted - both hinge on the availability of suitable community-based services, provided by the NHS and also the voluntary sector.

The committee was told that the deployment of ‘rapid community response’ teams means more people can be safely assessed and supported at home rather than being brought into hospital - while so-called ‘virtual wards’ enable them to be looked after remotely.

Dr. Curran said the difference between what was happening in North Lancashire now and other longstanding attempts to try to reduce hospital admissions, was the order in which the work was being undertaken.

“As the demand [for spaces] is going down, that's when the beds will be closed. In the past…we've closed the beds to force other forms of care pathway to [be utilised].

“What we are not doing is closing beds and kicking patients out - that would be entirely inappropriate. It's putting in place an alternative to inpatient care to enable those beds to close - not the other way round,” he explained.

Dr. Curran added that patients preferred to avoid a hospital stay if possible and would benefit from not "decondition[ing]" by being laid up unnecessarily. However, he stressed hospitalisation would sometimes be unavoidable.

Meanwhile, Anna Telfer, chief nursing officer at University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT) - which runs the Royal Lancaster - said “safety” was “absolutely seen as the overriding consideration” regarding when the decision would be taken to close the beds.

“Patient safety, quality of care and access remain…our priorities,” she said.

However, Chorley councillor Margaret France - a retired GP and one of the district authority representatives on the scrutiny committee - balked at the possibility of reducing bed numbers on the wards at a time when patients in accident and emergency were likely to be “being nursed in corridors”.

“I think this will sit very badly with the public when you're talking about closing 24 beds towards the end of this year. It seems to me that it would make more sense to…have those as a resource for A&E departments, [which] are absolutely strapped at this time of year, said Cllr France.

She suggested the proposed shift to community care could work, but required a more "gradual" approach.

Ms. Telfer - who will have to give any bed closures the green light before they are implemented, along with the UHMBT chief medical officer - said work was under way to create nine extra bed spaces in A&E itself, but added that the focus on reducing the lengths of stay for patients admitted to hospital would also contribute to the eventual elimination of “corridor care”.

Committee chair, County Cllr Graham Dalton - who represents Lancaster Rural North - sought reassurance that the overhaul would not simply transfer “pressures” from the NHS onto the county council, which is responsible for adult social care.

However, Dr. Curran said the UHMBT area was an “exemplar” of how the health service and local authorities are “working together” to integrate care.

Meanwhile, committee member - and Lancaster Rural East division county councillor - Shaun Crimmins asked whether the reduction in beds was driven by a need to cut costs.

Dr. Curran said he expected the changes to be relatively “relatively cost neutral”, adding: “This is about where we spend our money.”

The meeting heard that an extra £7m had been invested in “enhanced” GP services to enable community access to some medical tests and support for long-term conditions that might otherwise have required hospital intervention - taking the budget for such provision to around £10m in the Royal Lancaster’s patch.

The apparent absence of any financial impetus for making the planned changes stood in contrast to a presentation the committee received back in February when it was asked to consider the closure of only one ward - and was told that that move would save what was presented as a much-needed £1.7m in 2026/27.

On that occasion, members had resolved that what was on the table did amount to substantial variation in services - and so required a full public consultation.

Faced with the same question again - but now with double the bed numbers on the line - several members struggled with the fact that while they may now have been persuaded that changes in the ‘direction of travel’ for delivering care justified the ward closures, felt the move remained significant enough to be classed as "substantial".

Deputy committee chair, County Cllr Hamish Mills - who represents Lancaster South - said he did not believe all of the reasons for the committee’s decision in February had been addressed, including a query over whether other organisations could “safely absorb” the demand caused by the bed closures.

However, committee member County Cllr Mohammed Iqbal cautioned his colleagues against forcing the NHS down the route of formal consultation, which would delay their plans and not “help the patients”.

The meeting heard that there was no national definition of what constitutes a ‘substantial variation’ in services and that members had to make the judgement for themselves.

Two votes were taken, with a majority both supporting the bed closure policy and not deeming it a substantial change. Only the county councillors on the committee were eligible to vote, not those councillors representing a district authority.