A health trust has been placed in the equivalent of special measures six years after coming out of them.
The University Hospitals of Morecambe Bay NHS Foundation Trust has been put into NHS England's new national Recovery Support Programme.
The trust runs Furness General Hospital in Barrow, the Royal Lancaster Infirmary and Westmorland General Hospital near Kendal.
It said it was "committed to providing the best quality care".
In April this year it was announced health officials were being sent in to oversee the organisation following claims of poor patient care.
It is the currently the subject of an independent review into historical problems in the urology department and another review into cases in trauma and orthopaedics.
NHS England's website said the current move was for trusts which needed the "highest level" of support.
Trust chief executive Aaron Cummins said: "We are committed to providing the best quality care to our patients, including recovering from the additional challenges Covid-19 has posed.
"The Recovery Support Programme provides an opportunity for us all to work together across Morecambe Bay to build better and more sustainable services for those patients for the future."
An NHS England spokesman said the organisation "took action early this year to provide additional improvement support to the trust's senior leaders" and added enrolment in the recovery programme would "provide a system-focused approach" to enable it "to address and resolve the complex issues it faces".
An improvement board has been put in place by NHS England, alongside the appointment of an improvement director, to oversee the trust's work.
The trust was placed in special measures in 2014 after being rated as inadequate following an inspection by the Care Quality Commission (CQC).
The watchdog said it required "intensive support" after finding medical care in one part of the Royal Lancaster was "of particular concern" while the overall recruitment of nurses and doctors was identified as a "fundamental" worry with "too much reliance" on temporary staff.
It was allowed to come out of special measures in December the following year when inspectors noted it had made progress addressing some of the issues it faced.
However, in 2019 the CQC said the trust had gone £64.7m over budget in 2017-18 and had outstanding loans totalling £210m.
Several other health trusts across England have also been placed in the Recovery Support Programme.