Macclesfield District General Hospital was purpose built in the early 1980s replacing a much older traditional infirmary.

[5] In May 2016 Arvato said the contract was no longer commercially viable, demanding £2.4 million a year (more than double the contract price of £1.1 million a year) to continue after the end of the contractual period in April 2017.

[6] The Trust gained a contract for sexual health services when Cheshire West and Chester Council decided to transfer it from Countess of Chester Hospital NHS Foundation Trust in December 2014.

[9] In July 2016 the board announced that it no longer believed the organisation is sustainable in its current form, forecasting a deficit in 2016/7 of £20m.

[10] The sustainability and transformation plan for Merseyside and Cheshire proposed to downgrade the emergency department at Macclesfield District General Hospital to a minor injuries and illnesses unit,[11] but within a fortnight, after widespread opposition it was altered to read "“The clear view is that the best model of care will include an A&E department at Macclesfield staffed by hospital doctors and clinicians.”[12] It is planning a joint electronic patient record system with Mid Cheshire Hospitals NHS Foundation Trust using Meditech's Expanse, which is cloud based and should operate from 2024.