Landowners' trees blamed for knocking down Tarr Steps
Image copyrightSOMERSET COUNTY COUNCILImage captionThe stones, some weighing up to two tonnes, were put back into place on Thursday
Calls have been made for landowners to manage their woodlands better to help prevent the stones of an ancient bridge in Exmoor being washed away.
The Tarr Steps in Exmoor National Park across the River Barle were knocked out of place during storms in November.
Conservation manager Rob Wilson North said the "big problem" was "the water bringing fallen debris from the woodland".
The bridge has now been rebuilt for the second time in four years.
'Jewel in the crown'
Mr Wilson North, who works for the national park, added landowners must share some of the blame and manage their land better.
Tarr Steps is made up of 17 spans and stretches nearly 164ft (50m) across the river.
Its exact age is unknown, with several theories claiming Tarr Steps date from the Bronze Age, while others date them to about 1400 AD.
The repair work involved putting the pieces together - with some weighing up to two tonnes - much like a jigsaw as each stone is numbered.
Cabinet member for highways at Somerset County Council, David Fothergill, said: "It is an ancient scheduled monument, it's Grade I listed.
"It attracts huge numbers of people to Exmoor in terms of tourism and the local economy, it's the jewel in the crown for Exmoor and we do need to look after it."
Image copyrightSOMERSET COUNTY COUNCILImage captionSomerset County Council is responsible for the upkeep of the ancient bridge
Tarr Steps has been damaged many times throughout its long history, most recently in 2013.
Due to its protected status, the bridge must be put together exactly as before.
The council added that additional work had taken place to repair an upstream "tree protection boom" to prevent trees falling into the river and hitting the bridge.
It also said the Tarr Steps could be better protected if landowners did not stack timber along the river.
Image copyrightSOMERSET COUNTY COUNCILImage captionThe bridge has been washed away twice in four years
By James GallagherHealth and science reporter, BBC News website
Image copyrightGETTY IMAGES
A drug that can reverse aspects of ageing has been successfully trialled in animals, say scientists.
They have rejuvenated old mice to restore their stamina, coat of fur and even some organ function.
The team at Erasmus University Medical Center, in the Netherlands, are planning human trials for what they hope is a treatment for old age.
A UK scientist said the findings were "impossible to dismiss", but that unanswered questions remained.
The approach works by flushing out retired or "senescent" cells in the body that have stopped dividing.
They accumulate naturally with age and have a role in wound healing and stopping tumours.
But while they appear to just sit there, senescent cells release chemicals that cause inflammation and have been implicated in ageing.
The group of scientists created a drug that selectively killed senescent cells by disrupting the chemical balance within them.
"I got very rebellious, people insisted I was crazy for trying and for the first three times they were right," Dr Peter de Keizer told the BBC.
'Crazy'
On the fourth attempt he had something that seemed to work.
He tested it on mice that were just old (the equivalent of 90 in mouse years), those genetically programmed to age very rapidly and those aged by chemotherapy.
The findings, published in the journal Cell, showed liver function was easily restored and the animals doubled the distance they would run in a wheel.
Dr de Keizer said: "We weren't planning to look at their hair, but it was too obvious to miss."
Image copyrightPETER DE KEIZER
He also said there were a lot of "grey" results - things that seemed to improve in some mice but not all.
The drug was given three times a week and the experiments have been taking place for nearly a year.
There are no signs of side-effects but "mice don't talk", Dr de Keizer said. However, it is thought the drug would have little to no effect on normal tissues.
When asked if this was a drug for ageing, Dr Keizer told the BBC News website: "I hope so, but the proof of the pudding is in the eating as you say.
"In terms of mouse work we are pretty much done, we could look at specific age-related diseases eg osteoporosis, but we should now prepare for clinical translation."
Commenting on the results, Dr Dusko Ilic, a stem cell scientist at King's College London, said: "The finding is impossible to dismiss.
"[But] until more high-quality research is done, it is better to be reserved about these findings.
"Though, I would not be surprised if manufacturers try to capitalise on this and, in a few years, we could buy this peptide as a supplement over the counter."
Prof Ilaria Bellantuono, Professor in Musculoskeletal Ageing, University of Sheffield, called for further tests on "heart, muscle, metabolic, cognitive function" to take place.
But added: "The use of this peptide in patients is a long way away.
"It requires careful consideration about safety, about the appropriate group of patients for whom this peptide can be beneficial in a reasonable period of time so that positive effects can be easily measured at an affordable cost."
NHS Providers predicts its members, which account for nearly two-thirds of health spending, will get £89.1bn in 2017-18 - that is 2.6% more than they got this year, but crucially just half of the 5.2% demand is expected to grow by.
Patient safety 'at risk'
Chief executive Chris Hopson said it was time for the government to "sit up and listen".
He described the goals for next year - to get back to hitting the waiting time targets for A&E and hospital operations, while balancing the budget - as "mission impossible".
"NHS trusts will strain every sinew to deliver the commitments made for the health service. But we now have a body of evidence showing that, with resources available, the NHS can no longer deliver what the NHS constitution requires of it.
"We fear that patient safety is increasingly at risk."
The analysis carried out by NHS Providers predicts that the numbers waiting in A&E longer than the four-hour target will increase by 40% next year to 1.8m, while the numbers waiting beyond the 18-week target for routine treatments, such as knee and hip operations, will go up by 150% to around 100,000.
A Department of Health spokeswoman said extra money was being invested in the NHS and pointed out the Budget had set aside more funding for social care, which would also help relieve the pressures on hospitals in particular.
She added the government had a "strong plan to improve performance" and accused NHS Providers of failing to acknowledge the steps that were being taken.
Care firms have cancelled contracts with 95 UK councils, saying they cannot deliver services for the amount they are being paid, a BBC Panorama investigation has found.
Some firms said they could not recruit or retain the staff they needed.
The Local Government Association said it was the result of "historic under-funding" and an ageing population.
The government declined an interview but said English councils had received £9.25bn for social care.
The figure for the number of cancelled contracts comes from a Freedom of Information request, which was responded to by 197 of 212 UK councils.
According to the research, carried out for Panorama by Opus Restructuring and Company Watch, 69 home care companies have closed in the last three months and one in four of the UK's 2,500 home care companies is at risk of insolvency.
Councillor Izzi Seccombe from the Local Government Association - which represents councils across England and Wales - said: "We have warned that the combination of the historic under-funding of adult social care, and the significant pressures of an ageing population and the national living wage, are pushing the care provider market to the brink of collapse.
"These figures show the enormous strain providers are under, and emphasises the urgent need for a long-term, sustainable solution to the social care funding crisis."
Many home care companies say their biggest problem is recruitment and retention of carers.
The Centre for Workforce Intelligence estimates at least two million more carers will be needed by 2025 in England alone, in both in-home care and care homes, to cope with growing demand.
Image captionThere are 800,000 home care workers in the UK
One home care company, Cymorth Llaw, which had contracts with three councils in north Wales, told Panorama it had recently stopped working with one - Conwy, which had initially paid £14.20 an hour for care.
It offered to raise that to £15, but the company decided that still wasn't enough and handed back the contract.
Ken Hogg, at Cymorth Llaw, said: "We didn't think we could do it for the money - it was as simple as that.
"We pay as much [in wages] as we possibly can and we've always paid above what was the national minimum wage and the national living wage.
"[Carers] get a mileage allowance, they get paid travelling time between their clients."
Image captionKen Hogg says council funding barely covers his care home company's costs
Mr Hogg said the company was legally obliged to pay 1% pension and 13.8% national insurance contributions, along with training and other staff-associated costs, which "doesn't leave a great deal".
Conwy Council said it was committed to supporting vulnerable people in communities, despite the financial challenges.
Home care company Mears used to have a contract with Liverpool City Council but cancelled it in July, saying £13.10 an hour was not enough to cover costs.
Mears said it needed at least £15 an hour, and like other companies across the UK, argued its costs are often greater than what councils pay.
Alan Long, executive director at Mears, said: "That was a terrible thing to do for both service users and for care staff.
"We absolutely did not take that lightly, but frankly what choice did we have?
"We just cannot do the two most basic things that you need to do in home care - pay staff the absolute minimum of a living wage and be able to recruit enough people to deliver the service that Liverpool Council actually expected from us."
Bed shortages
The industry's trade body, the United Kingdom Homecare Association, said many companies were really struggling.
Colin Angel, its policy and campaigns director, said some care providers are "really desperate" and "really do not know whether they're going to be able to continue in business, beyond the next year".
He added: "That means they're really having to make some hard commercial decisions, whether they might need to cease trading or indeed just hand back work to local councils."
The nationwide shortage of carers is leaving many elderly people stuck in NHS wards, which results in bed blocking.
Government figures show there are more than 6,500 people across Britain stuck in an acute hospital bed, despite being well enough to leave.
In England, a third of these are waiting for a home care package.
Image captionColin Angel has concerns that more care home companies may close in the coming months
Mike Furlong, manager of the Granby Rehabilitation Unit in Liverpool, told Panorama that while on average people spend 28 days at the care facility, "some patients have been with us 12 and 14 weeks because all the therapy is complete, but unfortunately there's no care package available at the end of it".
Liverpool City Council said that, over the last seven years, its budget had been cut by £330m and it now needed to find a further £90m over the next three years.
Samih Kalakeche, Liverpool's director of adult social services, said: "Is there a crisis in the home care services? I'll say yes, there is - and it's not just money, it's the sheer volume of demographics.
"We've got an ageing population which we welcome, but we don't have enough people coming into the industry."
'£2bn extra'
Earlier this month, Chancellor Philip Hammond announced £2bn extra for social care for English councils over the next three years.
Scotland, Northern Ireland, and Wales will decide how they spend their extra funding.
But the industry says that with an increasingly ageing population, it's just not enough to keep pace with demand.
The government has said it will be bringing forward more proposals later this year, to ensure a financially sustainable social care system.
Panorama: Britain's Home Care Crisis - Monday, 20 March, 20:30 GMT, BBC One
The GMC has set out advice to doctors before next week's series of one-day strikes and voiced a stronger warning than previously about the possible impact of the strike action.
GMC chair Prof Terrence Stephenson, said doctors have a right to strike but they must consider whether it will cause significant harm to patients.
The GMC will investigate any case where a patient has come to significant harm because of actions by a doctor.
Prof Stephenson told the BBC's Today Programme: "The idea that you can take a third of the workforce out of a busy emergency service for five days and have no consequences seems to me unlikely.
"We are quite clear in our guidance that every single individual doctor most put their patients first. And we make it clear that they are personally accountable for their actions and must be able to justify what they did afterwards if allegations our made against them."
He urged every doctor in training to "pause and consider the implications for patients."
Meanwhile, Chris Hopson, of NHS Providers, said: "The GMC is right to be 'extremely concerned' about the impact the series of strikes by junior doctors will have on patients.
"We share the GMC's view that the scale of action planned at such short notice cannot be justified."
Consultants will cover junior doctors in providing emergency care, as they did during two days of walkouts in April.
Hospitals will see junior doctors stage walkouts from 08:00 to 17:00 from:
Monday 12 September to Friday 16 September
Wednesday 5 October to Tuesday 11 October (although the weekend will be covered)
Monday 14 November to Friday 18 November
Monday 5 December to Friday 9 December
Image copyrightPA
The warning from the GMC comes after senior doctors last week urged the government and junior doctors to restart negotiations to avoid the series of strikes.
While some medical colleges have said the planned strikes are disproportionate, others say they support the junior doctors' stance.
The row over their pay and conditions has escalated into the worst industrial relations dispute in the history of the NHS.
The BMA has said the government could stop the strikes by calling off the imposition of the contract, which is due to be rolled out from October.
A spokesman said: "Patient safety remains doctors' priority and, since the announcement last week of further action, the BMA has been liaising with NHS leaders so that plans can be put in place swiftly to minimise disruption for patients."
But Prime Minister Theresa May last week told doctors to stop "playing politics" in the dispute and urged the union to cancel the strikes.
The imposed contract
Image copyrightPA
Basic pay to rise between 10% and 11% on average
Supplements paid for frequent weekend working - those working one in two will get 10% on top of basic salary
Nights to attract an enhanced rate of 37% above normal time
Replaces old system whereby weekend or night work can attract up to double time
First doctors to go on new terms in October with much of the rest of the workforce to follow by next summer
The British Medical Association says it is not fair on those who work the most weekends or part-timers
Junior doctors have already taken part in six strikes this year, including two all-out stoppages.
Industrial action was put on hold in May when the two sides got back round the table at conciliation service Acas.
That resulted in the agreement of a new contract, which BMA leaders encouraged members to accept.
But when it was put to the vote, 58% of medics rejected it, prompting the resignation of the BMA junior doctor leader Johann Malawana and causing ministers to announce once again that they would impose the new terms and conditions.
SOMERSET COUNTY COUNCIL
SOMERSET COUNTY COUNCIL
SOMERSET COUNTY COUNCIL
