The must-read stories and debate in health policy and leadership.

Last week, NHS England wrote to staff and confirmed the next stage of its restructure would be done in a “very targeted” way and also would be much smaller than previous rounds.

As highlighted by HSJ columnist Julian Patterson in the comments, the unusual phrasing suggests that “carefully selecting who to make redundant is reserved for special occasions”, but according to the NHSE letter, it is because of the high number of staff departures and the fact it is almost at its desired new organisational size.

And although the total spend on redundancy is not known (old Health Education England spent £13m alone in the last financial year according to board papers) it also stressed the need to save public money and keep people in their jobs.

And after several delays, the end is in sight; the letter confirms the redundancy process should be complete early next year, with stage three starting for all directorates and regions in January. 

One year on

Trusts hit by disruption caused by a cyber attack are still seeking compensation a year on, HSJ has learned.

Around a dozen trusts were left without access to patient records, some for months, following an attack on tech firm Advanced last August.

The incident impacted the Carenotes electronic patient record, an Advanced product aimed at mental health and community services, and the outage caused widespread disruption including leaving trusts unable to report on key performance metrics. One affected organisation, Devon Partnership Trust, claimed the financial impact was more than £2m.

One year on and two trusts, Birmingham Women’s and Children’s Foundation Trust and Mersey Care FT, have confirmed they are still in discussions with Advanced regarding compensation. Meanwhile, Herefordshire and Worcestershire Health and Care Trust and Tavistock and Portman FT said they were still making internal decisions about seeking compensation in addition to financial reimbursement and a credit note specifically for the outage period.

No examples of harm to patients has been reported publicly, but NHSE has been reviewing it, several trusts told HSJ. NHSE had not responded at the time of publication.

Many organisations said they had switched their EPR completely or were planning to following the attack.

Also on today

This fortnight’s North by North West takes a look at strained relations with governors at not one, but two providers in the region. Meanwhile, as the junior doctors’ strike rumbled on, HSJ learned trusts which had sought derogations had had them turned down while one has had a derogation for maternity services revoked. And in this week’s Mythbuster, Steve Black argues the NHS is at risk of adopting the view of Hollywood blockbusters that managers are a hindrance rather than a help.