The NHS Commissioning Board (NHSCB) has appointed nine managing directors for commissioning support services (CSS) in the first recruitment round.

Eight of the nine appointments are confirmations of current interim roles.

Another 14 CSSs wait to have leaders appointed in August, following the second round.

The NHSCB announced in mid-June that it would direct the recruitment of senior staff to the CSS organisations in order to ensure a balanced distribution of experienced individuals.

In late June, it added that lack of interest from current PCT leaders meant two recruitment rounds would be necessary.

Dame Barbara Hakin (pictured), the NHSCB’s Director of Commissioning Development, said the interview panel was primarily concerned with was that the candidates were “senior enough leaders to create an organisation of this magnitude from scratch” and were skilled in managing staff and customers.

The eight interim managing directors confirmed as CSS leaders are:

• Robert Bacon – Birmingham, Black Country and Solihull Commissioning Support Service

• Stephen Childs – North East Commissioning Support

• Keith Douglas – Commissioning Support South

• Jan Hull – Best West Commissioning Support

• Derek Kitchen – Staffordshire Commissioning Support Service

• Rachel Pearce – Arden Commissioning Support Service

• Andrew Ridley – North Central and East London Commissioning Support Service

• Sarah Whiting – North West London Commissioning Support Service.

Ming Tang, who supported commissioning in the West Midlands and now directs the NHSCB’s business intelligence programme, will be managing director of a ninth CSS.

Jan Hull, former Director of Commissioning for NHS Somerset, commented: “I am confident that Best West Commissioning Support will continue to develop as a strong business organisation retaining core NHS values. I see this role as a continuation of supporting patient care, just through a slightly different route.”

A debt of £19m owed by NHS North Yorkshire and York will be written off to provide the area’s CCGs with a clean slate.

The PCT’s debts, which it blames partly on past underfunding, could rise to £50m before it is dissolved in April 2013.

The decision to write off the debt is part of a Department of Health policy to ensure that CCGs take over from NHS trusts without any ‘legacy debts’.

Christopher Long, Chief Executive of NHS North Yorkshire and York, told a trust board meeting the £19m debt was a “best-case scenario” and the actual figure could reach £50m.

Speaking in Parliament, York Central MP Hugh Bayley (pictured) said: “NHS North Yorkshire and York inherited a deficit when it was set up, and despite external consultants and two top NHS managers being brought in to deal with the problem, that deficit has continued year by year, so the Government has to address the underlying funding problem.”

Health Secretary Andrew Lansley replied that PCTs historically “did not cope” with financial restrictions. “It is up to the new clinical leadership in Yorkshire to make these things happen more effectively,” he added.

NHS North Yorkshire and York said the trust’s debt is “historical”, though it noted that overspend on contracts continues. It attributed the problems to a “relatively low funding allocation” and the region’s “diverse geography”.

A new antibiotic to treat C. difficile infection (CDI) has been approved for restricted use by the Scottish Medicines Consortium (SMC).

Dificlir (fidoxamicin) from Astellas Pharma is accepted within NHS Scotland for treatment of adults with a first CDI recurrence on the advice of a specialist.

SMC declined to approve the drug for first-line use in adults with severe CDI.

The decision was based on clinical trial data showing Dificlir to be similar in efficacy to vancomycin (the standard treatment) as a first-line therapy for CDI, but twice as effective in treating recurrent CDI.

CDI is a serious healthcare-acquired infection often linked to use of broad-spectrum antibiotics. It increases hospital stays by three days and treatment costs by 50% on average, with complications including bowel surgery.

In Scotland, which has suffered a number of CDI outbreaks, the disease affects over 2,000 people each year, costing over £2m and causing death in 10% of cases.

Dificlir is an oral medication that acts locally on C. difficile bacteria in the gut, blocking their metabolism and reducing the growth of the infection.

Professor Robert Masterton, Director of the Institute of Healthcare Associated Infection at the University of the West of Scotland, said: “With the increasing elderly population the threat of further CDI outbreaks cannot be ignored. It is important that we employ all possible measures to contain this disease. Widespread and early access to the new antibiotic fidaxomicin will, I believe, make a real difference.”

An Astellas spokesperson said the company would continue to gather data to support the use of Dificlir as a first-line CDI therapy.

Sir Mike Richards, the Department of Health’s National Cancer Director, has joined the NHS Commissioning Board in a key clinical position.

The leading oncologist will take one of the critical leadership roles on the board and oversee the improvement of England’s mortality rates from major diseases.

The aim is outlined as ‘domain one’ in the NHS Outcomes Framework. It is expected there will be four other directors who will oversee the improvement of the Framework’s other four domains.

The former chair of the National Cancer Research Institute was chosen for his combination of clinical credibility and ability to navigate NHS politics.

It’s understood that the majority of other national clinical directors have been excluded from applying for similar positions due to their civil service contracts.

Employees working in hospital trusts or in or in primary care and not for a PCT have also been excluded from applying due to the Commissioning Board’s human resources policy.

A host of NHS trusts received bailouts totalling more than £1 billion in the last six years, a report from the National Audit Office (NAO) has shown.

The Department of Health was forced to issue four struggling foundation trusts and 17 other trusts the money between 2006 and 2012 to pay creditors and staff.

Amyas Morse, Head of the NAO, said that it was clear “parts of the service are under strain.”

Research found that South London Healthcare NHS Trust – which recently became the first to go into administration – needed a total of £356m from the DH to break even over the last six years. It has yet to pay back the money.

Barking, Havering and Redbridge University Hospitals NHS Trust also required £195m from the DH to cover its debts.

Last year, trusts needed £253m from the DH, the report found – a huge increase from the £76m requested between 2010 and 2011.

The NAO now estimates that NHS trusts and foundation trusts will need approximately £300m more in bailouts next year to cover ailing finances – despite a surplus of £2.1bn across the NHS.

Meanwhile, official figures from the Department of Health showed that ten NHS hospital trusts recorded deficits last year.

Mid Yorkshire Hospitals was £19m in the red, Surrey and Sussex Healthcare ended with a £6m deficit, Mid Essex Hospital Services Trust ended up with £2m debts and Newham University Trust recorded losses of £200,000.

Hospital trusts in the capital struggled to control finances more than any other part of the country with the region finishing £96m in the red overall.

Sir David Nicholson, NHS Chief Executive, said the “demands of an ageing population and increased costs owing to developments in drugs and advancing medical technologies present challenging financial conditions in a constrained economic environment.”

He added that “all parts of the NHS” will need to take “bold, long-term measures” to meet financial challenges.