Objective To determine the effect of an early intervention program in an acute care setting on the length of stay in hospital of elderly patients with proximal femoral fractures. Setting Acute orthopaedic ward of a large teaching hospital. Design and participants A randomised controlled trial comparing 38 Intervention patients with 33 Standard Care patients. Intervention Early surgery, minimal narcotic analgesia, intense daily therapy and close monitoring of patient needs via a multidisciplinary approach versus routine hospital management. Main outcome measures Length of stay (LOS); deaths; level of independent functioning. Results Mean LOS was shorter in the Intervention group than in the Standard Care group (21 days v. 32.5 days; P <0.01). After adjusting for other factors that could affect LOS (eg, age, sex, pre‐trauma functional levels, pre‐trauma comorbidity and postsurgical complications), the Intervention program was significantly predictive of shorter LOS (P = 0.01). The Intervention group did not experience greater numbers of deaths, deterioration in function or need for social support than the Standard Care group. Conclusion This early intervention program in an acute care setting results in significantly shorter length of hospital stay for elderly patients with femoral fractures.

There are still 10 English local educational authorities (LEAs) that are wholly selective and a further 10 with some grammar and secondary modern schools. This article examines the academic performance of pupils in secondary modern schools and the funding of these schools using national data sets matching pupils' performance at Key Stage 2 and General Certificate of Education (GCSE) as well as data on funding from Section 52 statements. Students in secondary modern schools gained one less grade on average than equivalent students in comprehensive schools while grammar school pupils obtained five grades more. After taking account of the cost factors and grant entitlements that influence funding per pupil, secondary modern schools in the years 2000/01–2002/03 were funded around £80 less per pupil while grammar school pupils received over £100 more per pupil compared to comprehensive schools. Secondary modern schools were more likely to be in financial deficit than comprehensive and particularly grammar schools. Thus, students are academically disadvantaged by attending secondary modern schools, which in most selective LEAs do not receive sufficient additional funding to offset the depressing effects on attainment of the increased social segregation arising from a selective system.

No abstract

This paper examines the relationship between special educational needs (SEN) and resource levels and looks at two LEAs as case studies. One LEA uses a professional audit approach to allocate resources for pupils with special educational needs but without statements while the other LEA uses educational tests. Interviews were conducted with headteachers, special educational needs coordinators (SENCOs) and heads of department in English, mathematics and science. A theoretical framework is used to evaluate the two LEAs’ resourcing policies against the criteria of simplicity, equity, effectiveness, efficiency and accountability.

No abstract