Payment by Results (PbR), the funding system for a significant portion of NHS care in England, must adapt and change if it is to improve patient care, says the Chairman of the BMA’s Consultants’ Committee, Dr Jonathan Fielden, when responding to the consultation on PbR1, launched today (15 March 2007).

Social care for vulnerable people is being squeezed as a result of NHS deficits, according to the Local Government Association. The LGA says costs are being shunted to social services departments as the NHS in England aims to balance its books. A survey of 95 councils which run social services found two thirds say NHS debts are affecting them.

{mosimage}The Department of Health said the NHS and local authorities had to work together for patients’ benefit. Forty per cent of the councils surveyed by the LGA said the knock on effect of the financial pressure in the NHS was worse than in previous years.

When the organisations were asked what the NHS had done in their area to affect them, half said beds had been closed, and a quarter said there had been a reduction in district nurse numbers. Another 14% said there were increased waiting times for NHS services, such as admission to hospital while 13% said community hospitals had been closed.

In addition, more than a third of the councils in the LGA survey say they are having to take responsibility for more cases normally dealt with by the NHS. The continuing care of elderly patients is the main area where responsibilities overlap.

Almost a quarter (24%) say the local NHS is failing to fund agreed or joint services. This might involve cuts to nursing services, meaning home helps have to take on tasks such as changing wound dressings or checking insulin levels. Funding disputes have increased, the councils reported.

The LGA says there is deep concern on the ground about the trend towards cost-shunting and its impact on already stretched council social care services. Sandy Bruce-Lockhart, chairman of the LGA, said councils did not want to start a war of words with the NHS. But he added: “There are grave financial pressures on both councils and the NHS that are starting to impact on the quality of service.”

In response to the report in today’s Guardian announcing the first trials of the NHS electronic summary care record, Dr Richard Vautrey, deputy chair of the BMA’s IT committee said:

There is a major breakthrough in reducing waiting times and creating choice in the NHS with the opening today by the Health Secretary, Patricia Hewitt, of the first Independent Sector Treatment Centre in London.

One hundred teenagers wearing “hoodies” will demonstrate outside Parliament as part of a campaign calling for Government action to help young people stay out of trouble.

The number of ethnic-minority people in the country will more than double and hit the 10 million mark within two decades, it has been claimed. Oxford’s Professor David Coleman, who has fought a student backlash over his views on immigration, said the face of Britain was “radically changing”.

Children as young as four are being taught about same-sex relationships through fairytales and storybooks with gay and lesbian characters.

Babies will be assessed on their gurgling, babbling and toe-playing abilities when they are a few months old under a legally enforced national curriculum for children from birth to five published by the government yesterday.

{mosimage}Every nursery, childminder and reception class in Britain will have to monitor children’s progress towards a set of 69 government-set “early learning goals”, recording them against more than 500 development milestones as they go. At five, each child will be assessed against 13 scales based on the learning goals and their score, called an early years profile, must be passed to the Department for Education and Skills.

When children enter compulsory schooling, they should be able to read simple sentences using a phonics based approach, count reliably up to 10 and sing simple songs from memory, as well as respecting others’ beliefs and learning to share and take turns.

The Early Years Foundation Curriculum, which comes into effect from September 2008, replaces non-statutory guidance already in place. If nurseries or other care providers want to opt out of the new requirements, for example because they follow an educational philosophy that introduces reading at a later age, they will have to apply for an exemption, and would have to forfeit any state funding.

The Department for Education and Skills’s framework immediately came under attack from the National Confederation of Parent Teacher Associations (NCPTA) and from the Tories for taking an excessively prescriptive approach and targeting children far too young.

Emergency services have been called to deal with an incident at an immigration detention centre in Oxfordshire. Thames Valley Police said 35 officers were dealing with an emergency at Campsfield detention centre near Kidlington.

The government ‘thoroughly mishandled’ the introduction of the new system for out-of-hours health care in England, a group of MPs has said.