Monitor and CQC review into whistleblowing concerns at The Christie NHS Foundation Trust – HM Government
This is a review into whistleblowing concerns at The Christie NHS Foundation Trust.

The return of PFI – will the NHS pay a higher price for new hospitals? –  Centre for Health and the Public Interest
This report claims that the Government’s Private Finance 2 initiative is likely to divert more resources away from the NHS in England than the original Private Finance Initiative. It warns that Private Finance 2 deals are likely to be more expensive than existing PFI deals. Analysis of the financing model for the new scheme finds that restructuring the balance of debt and risk capital would increase the rate of return to private investors by 15%, under current market conditions.

The autumn statement: NHS funding – The King’s Fund
The NHS is facing huge pressures as a result of an ongoing funding squeeze, rising demand for services and the need to safeguard quality of care following the Francis report. This briefing says that without the additional £2 billion, staff numbers will be cut, waiting times will rise and quality of care will deteriorate, leaving patients to bear the cost.

Tariff reveals NHS savings targets for 2015-16 – Health Service Journal
NHS pricing authorities will require all providers to deliver another 3.8 per cent in efficiency savings next year, while tweaking the controversial “marginal rate” for emergency admissions to ease the financial strain on smaller hospitals, plus the rest of today’s news and comment

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Some trusts will not become FTs until 2018, says Flory – Health Service Journal
The chief executive of the NHS Trust Development Authority has said some trusts will not be authorised for at least another four years.

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Aspirant FTs could have option to become a mutual – Health Service Journal
NHS trusts could in future choose between becoming a foundation trust or an independent mutually owned company as the provider sector becomes increasingly ‘fluid and uncertain’, HSJ has been told.

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Evidence summaries: Cystic fibrosis / Non-cystic fibrosis bronchiectasis
NICE has published two new unlicensed or off-label medicine evidence summaries (ESUOM37) Cystic fibrosis: long-term azithromycin and (ESUOM38) Non-cystic fibrosis bronchiectasis: long-term azithromycin. Evidence summaries: unlicensed or off-label medicines’ summarise the published evidence for selected unlicensed or off-label medicines that are considered to be of significance to the NHS, where there are no clinically appropriate licensed alternatives. The summaries provide information for clinicians and patients to inform their decision-making and support the construction and updating of local formularies.

NICE guidance
NICE has published the following guidance:

• Erythropoiesis‑stimulating agents (epoetin and darbepoetin) for treating anaemia in people with cancer having chemotherapy (including review of TA142) (TA323) Techology appraisals.
• Dual‑chamber pacemakers for symptomatic bradycardia due to sick sinus syndrome without atrioventricular block (part review of technology appraisal guidance 88) (TA324) Technology appraisals.
• Nalmefene for reducing alcohol consumption in people with alcohol dependence (TA325) Technology appraisals.
• Imatinib for the adjuvant treatment of gastrointestinal stromal tumours (review of NICE technology appraisal guidance 196) (TA326) Technology appraisals.
• Telemetric adjustable pulmonary artery banding for pulmonary hypertension in infants with congenital heart defects. (IPG505) Interventional procedures guidance.
• Insertion of an annular disc implant at lumbar discectomy. (IPG506) Interventional procedures guidance.
• Vitamin D: increasing supplement use among at-risk groups. (PH56) Public health guidelines

Future of services for people with learning disabilities
In 2011, following BBC Panorama’s exposé of Winterbourne View, the government pledged to move all people with learning disabilities and/or autism inappropriately placed in such institutions into community care by June 2014. Three years on, not only has that movement not been achieved, but there are still more people being admitted to such institutions than are being discharged. The CEO of NHS England, asked Sir Stephen Bubb, chief executive of charity leaders body ACEVO, to lead a review exploring how a new national framework of support might be delivered locally and the report from this review has now been published.  Winterbourne View time for change: transforming the commissioning of services for people with learning disabilities and/or autism sets out a series of recommendations of how the system should be overhauled to meet this new framework.

Improving the experience of care for cancer patients
NHS Improving Quality and Macmillan Cancer Support has published Improving the experience of care for cancer patients. This hands-on guide aims to help trusts improve their patients’ experience of cancer care and boost their overall performance. The guide is intended primarily for cancer nurses and multidisciplinary teams, giving them the practical tools needed to deliver successful change programmes and continually improve cancer services. It will also be relevant to commissioners.

Reconfiguration of clinical services
The Kings Fund has published The reconfiguration of clinical services: what is the evidence? This paper aims to help those planning and implementing major clinical service reconfigurations ensure that change is as evidence-based as possible. It investigates the five key drivers – quality, workforce, cost, access and technology – across 13 clinical service areas, summarising the research evidence and professional guidance available in each. It builds on a major forthcoming analysis of reviews of service reconfigurations commissioned by the National Institute of Health Research and conducted by the National Clinical Advisory Team.

Organisational culture change case studies
The NHS Employers organisation has published a series of case studies dealing with organisation cultural change as applied to various NHS services across the country. The case studies are as follows:

• Northumbria Healthcare NHS Foundation Trust culture change
• Portsmouth Hospitals NHS Trust culture change
• West Midlands Ambulance Service NHS Trust culture change
• Royal Free London NHS Foundation Trust culture change

Long-term health conditions
A new alliance committed to improving care and support for people with long-term conditionshas been launched. The Coalition for Collaborative Care (C4CC) has people with long-term health conditions at the heart of its alliance and brings together some of the sector’s most influential national groups and organisations. With more than fifteen million people in the UK living with a long-term condition, the coalition will champion a system-wide transformation in how they receive and use care and support.

Patient-centred approach to complaints handling
The Francis Inquiry into the failings at Mid Staffordshire NHS Foundation Trust published in February 2013 placed a heavy emphasis on the need, across the NHS, for organisations to recognise the importance of patient complaints and to create robust systems and cultures that were able to deal with and learn from them. The Parliamentary and Health Service Ombudsman, Healthwatch England, and the Local Government Ombudsman, has published My expectations for raising concerns and complaints. This report and the vision it presents flip the perspective away from concentrating solely on the bureaucratic challenge of how to provide a complaint handling service, to a focus on the real experiences of patients and service users themselves in making complaints.

Evaluating health and wellbeing interventions for healthcare staff: key findings – NHS Employers
This guidance encourages NHS organisations to improve the evaluation of their internal health and wellbeing programmes. Findings from the research show that financial pressure on the NHS will make it increasingly difficult for NHS boards to justify their own staff health and wellbeing programmes – unless more evidence and rigor is developed to assess their value.

Commissioning for long-term conditions: hearing the voice of and engaging users – a qualitative multiple case study – Health Services and Delivery Research

The project’s initial aim was to examine how commissioners enable the voice and engagement of people with LTCs and identify what impact this has on the commissioning process and pattern of services. A key outcome of the research was to provide guidance for commissioners on the skills and expertise needed by different commissioners, what actions are most likely to lead to responsive services and the most effective mechanisms and processes for active and engaged commissioning for people with LTCs. Specific objectives were to:

• critically analyse the relationship between the public/patient voice and the impact on the commissioning process
• determine how changes in the commissioning process reshape local services
• explore whether or not any such changes in services impact on the patient experience
• identify if and how commissioners enable the voice and engagement of people with LTCs
• identify how patient groups/patient representatives get their voice heard and what mechanisms and processes patients and the public use to make their voice heard

Finds action needs to be taken by organisations at both national and local levels. PPEI is a circular process and, in itself, extremely fragile. This circular process can be ‘virtuous’ – successful engagement leads to improved involvement and outcomes. However, where involvement is tokenistic or ends, patients and the public become disengaged and less involved and can be described as a ‘vicious circle’

Regulation 5: fit and proper persons: directors and Regulation 20: duty of candour – guidance for NHS bodies – Care Quality Commission
New fundamental standards for all care providers will come into force in April 2015. However, two regulations for NHS bodies that form part of these come into force on 27 November 2014. The fit and proper persons requirement outlines what providers should do to make clear that directors are responsible for the overall quality and safety of care. The duty of candour explains what they should do to make sure they are open and honest with people when something goes wrong with their care and treatment. The fundamental standards, which will be implemented in April 2015, will replace the existing essential standards of quality and safety. They will include guidance for all sectors on the fit and proper persons requirement for directors and the duty of candour.