Special measures are set to be lifted from north Cumbria's hospitals - after nearly four years.

It comes after inspectors from the Care Quality Commission found improvements had been made at both the Cumberland Infirmary and West Cumberland Hospital .

North Cumbria University Hospitals NHS Trust was among 11 nationally to be placed in special measures back in July 2013.

It followed a high-profile review by Sir Bruce Keogh, sparked by concerns over death rates. Yet almost four years later, North Cumbria is the only one that has failed to shake off the label.

But staff are today celebrating after hearing that, following an inspection last December, England's chief inspector of hospitals is finally satisfied that enough progress has been made.

Professor Sir Mike Richards therefore made a recommendation that the Carlisle and Whitehaven hospitals are now taken out of special measures, and this has been approved by NHS Improvement

However he said there is still work to do. The trust has therefore been given an overall rating of "requires improvement" rather than "good", despite some areas meeting the latter criteria.

“In the past two years there have been significant changes to the senior management team; they have worked well together, with external support, to address the issues identified in both Sir Bruce Keogh’s Review and in our subsequent inspections," he said.

“Although there has been progress, particularly in the effectiveness of the services being provided, there is still a lot of work to do.

“The senior team are aware of the challenges and issues and have developed strategies to meet these, but still need embedding."

Recruitment - both in nursing and medical staffing - was one of the key areas bosses had been told to improve on.

They found this has now happened in some areas, though there remain vacancies across the hospitals and a reliance on locum doctors. The trust must therefore work to fill posts in medical and surgical services, and children's services - including the special care baby unit at the Cumberland Infirmary.

But Prof Richards added: "There have been some staffing improvements within medical care at West Cumberland Hospital, with the trust securing long-term locum contracts and implementing a staffing support agreement with Cumberland Infirmary.”

The report adds that access and flow across the emergency department, medical care, surgical services, and outpatients remains a significant challenge. The trust is not currently meeting the national four-hour target for emergency patients in A&E, and inspectors found that patients experienced overnight delays waiting for beds.

Cancelled surgery also remains an issue, with the trust cancelling 1,410 operations between 2015 and 2016. Of these, 12 per cent were not rescheduled and treated within 28 days.

A total of 292 planned operations were cancelled in Whitehaven and 573 in Carlisle for non-clinical reasons.

Inspectors also noted a number of patients moving wards after 10pm at the West Cumberland Hospital.

Delays obtaining suitable community care where adding to patient flow issues, particularly in medical care services.

Cancellation of outpatient clinics was also flagged up by inspectors, with no clear plan in place to address this, while turnaround times in radiology were not up to scratch.

Record-keeping had improved, though further work was needed.

Morale was said to be "variable", with staff not always feeling their contribution was recognised and appreciated.

Inspectors also reported: "We were advised of ongoing bullying allegations within the theatre department at Cumberland Infirmary.

"The trust was aware of theatre staff being unhappy when requested to support core ward areas at times of staff shortage.

"We were assured that appropriate action plans were in place and being monitored."

The CQC did however also single out many positives, as well as highlighting some examples of outstanding practice.

They said staff knew the process for reporting and investigating incidents, received feedback and felt supported by managers.

Transfer of critical care patients to other hospitals was good.

The CQC also said patients received care in a "clean, hygenic and suitably maintained environment" and the trust was meeting its target on hospital superbugs. Safeguarding processes were also praised.

Inspectors added: "Patients were positive about the care they received. Staff were committed to delivering high quality care.

"Staff interactions with patients were compassionate, kind and thoughtful. Patient privacy and dignity was maintained at all times."

It was also noted that the new management team was committed to developing clinical leadership and addressing workforce issues.

Overall the CQC concluded that although progress has been made, "work is still needed to ensure that patients receive consistently safe, effective and well-led healthcare".

It will continue to monitor progress and inspectors will return at a later date to check improvements have been made.