North Cumbria Integrated Care NHS Foundation Trust (NCIC) has announced that it will end the Private Finance Initiative (PFI) contract for the Cumberland Infirmary in Carlisle through a no‑fault voluntary termination that has been agreed with key stakeholders, including NHS England, the Department of Health and Social Care, and HM Treasury.

Procured in 1997 by the Carlisle Hospitals NHS Trust (later evolving into North Cumbria Integrated Care NHS Foundation Trust), the scheme replaced outdated facilities—including the original Cumberland Infirmary, City General Hospital, and City Maternity Hospital—with a modern, purpose-built acute hospital on the existing Infirmary site. A private consortium, Health Management (Carlisle) Limited (originally Health Management (Carlisle) plc, a 50/50 joint venture between AMEC and Interserve Facilities Management Ltd.), was awarded a 45-year concession to finance, design, build, and maintain the facility in exchange for annual payments from the public sector. Construction, led by AMEC, took around 29 months and cost approximately £65–67 million, providing a 444-bed hospital that opened in April 2000 and was officially opened by Prime Minister Tony Blair in June that year. 

The project was groundbreaking as the first PFI hospital to be bond-financed, but it faced early criticisms for design flaws (such as cramped layouts, overheating atriums, and later fire safety concerns over materials), financial pressures from high ongoing PFI payments highlighted by the 2011 coalition government, and operational challenges. In a significant recent development, on 31 December 2025, North Cumbria Integrated Care served notice to voluntarily terminate the PFI project agreement on a no-fault basis—four years ahead of a 30-year break clause—with the exit effective 31 March 2026, following approvals from NHS England, the Department of Health and Social Care, and HM Treasury. This move, supported by ongoing transition work with the contractor and sub-contractor Mitie, aims to deliver better long-term value for money, enhance financial sustainability, and offer greater flexibility for investing in local health services in North Cumbria.