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Feb 24 2024

NHS strike action: Junior doctors in England begin five-day walkout threatening further patient disruption | UK News

Patients face further major disruption as junior doctors in England begin a five-day strike in their ongoing pay row with the government.

Tens of thousands of hospital appointments are set to be cancelled or postponed as a result of the latest walkout which began at 7am on Saturday and will stretch until 11.59pm on Wednesday.

It is the 10th stoppage by junior doctors since last March and follows the longest strike in NHS history in January, which lasted six full days.

“The government could have stopped these strikes by simply making a credible pay offer for junior doctors in England to begin reversing the pay cuts they have inflicted upon us for more than a decade,” Dr Robert Laurenson and Dr Vivek Trivedi, co-chairs of the BMA junior doctors committee, said.

“The same government could have even accepted our offer to delay this round of strike action to give more space for talks – all we asked for in return was a short extension of our mandate to strike.

“The fact that ministers have chosen strike action over what could have been the end of this year’s pay dispute is disappointing to say the least.”

The BMA also expects its strike mandate to be renewed raising the prospect of further industrial action.

What should I do if I’m ill during the strikes?

If your condition is not “serious or life-threatening”, the NHS is asking people to use pharmacists, GPs, or the NHS 111 service in the first instance.

NHS bosses have repeatedly stressed that you should still call 999 in life-threatening situations.

Non-striking medical staff will continue to provide urgent, emergency, and maternity care to people who need it, with those “with the most pressing health needs” prioritised.

People who attend A&E with less urgent needs “may experience longer waiting times than normal”.

Planned appointments and surgeries may have been cancelled, but if you have not been contacted about a rearrangement you should attend as normal, the NHS says.

Health Secretary Victoria Atkins said: “I want to see doctors treating patients, not standing on picket lines.

“In negotiations with the BMA junior doctors committee, we made it clear we were prepared to go further than the pay increase of up to 10.3% that they have already received. They refused to put our offer to their members.

“More than 1.3 million appointments and operations have already been cancelled or rescheduled since industrial action began – five days of further action will compound this.

“The NHS has robust contingency plans in place, and it is vital that people continue to come forward for treatment. But no one should underestimate the impact these strikes have on our NHS.

“So again, I urge the BMA junior doctors committee to call off their strikes and show they are prepared to be reasonable, so that we can come back to the negotiating table to find a fair way forward.”

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Junior doctors have received a pay rise averaging nearly 9% this financial year.

The BMA has been seeking a 35% “pay restoration” as its starting position, but has said it is willing to negotiate.

Junior doctors make up around half of all doctors in the NHS and have anywhere up to eight years’ experience working as a hospital doctor, depending on their specialty, or up to three years in general practice.

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Wes Streeting, Labour’s shadow health secretary, described the latest round of strikes as having “a devastating impact on patients” but said Prime Minister Rishi Sunak was refusing to negotiate.

NHS national medical director Professor Sir Stephen Powis said it is “extremely concerning” that strike action and disruption “are becoming a new normal”.

“For the equivalent of more than one in every 10 days last year, the NHS has had to effectively stop carrying out most routine appointments to prioritise emergency care,” he added.

Deputy chief executive of NHS Providers Saffron Cordery said: “We can’t go on like this. Wave after wave of strikes saps the morale of staff and impacts patients.

“Trust leaders want to get on with the job of giving patients first-class care instead of having to spend too much time and energy planning for and coping with weeks of disruptive strikes.”

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Jan 10 2024

Longest strike in NHS history leads to over 113,000 patient cancellations – and impact may last for ‘months’ | UK News

The longest strike in NHS history, during which junior doctors walked out for six days, led to more than 113,000 patient operations, appointments and procedures being postponed, new figures show.

The industrial action started last Wednesday and continued until yesterday, with 25,446 staff absent from work at the peak, which was the day the strike started, 3 January.

According to NHS data, 113,779 inpatient and outpatient appointments had to be rescheduled, taking the total number since the health service strikes started in December 2022 to 1,333,221.

It means patients are “bearing the brunt” of the action, according to Louise Ansari, chief executive of Healthwatch England.

She said: “The cumulative effect of various strikes now hitting the NHS for more than a year also means people are experiencing multiple cancellations, affecting their confidence in health services, often leaving them in pain, feeling stressed and anxious.”

NHS leaders have warned the impact caused by the strike could last for “months”.

Professor Sir Stephen Powis, the national medical director for NHS England, said frontline staff were “very concerned” about the next few weeks as the “cold weather bites” and more people may need to be treated in hospital.

“This puts an incredible strain on staff who have been covering striking colleagues as we continue to navigate one of the most difficult times of year,” he said.

Read more:
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The number of cancellations could be double those reported as hospitals pre-emptively did not book in pre-planned operations during strikes, according to experts.

Matthew Taylor, chief executive of the NHS Confederation, said: “The national figure for the cancelled appointments over the last year of industrial action, in our view, significantly underestimates it because actually a lot of trusts pre-emptively didn’t make appointments in the first place.

“So you have to more or less double that figure in order to get the actual number of appointments and procedures that were cancelled.”

What do junior doctors want?

The British Medical Association (BMA), which represents junior doctors, has called for a 35% pay rise for them but the government has stated the demand is “not affordable, even over several years”.

The union claims junior doctors in England were subjected to a 26.1% real terms pay cut between 2008 and 2022.

The government gave junior doctors an 8.8% pay rise last summer, with an extra 3% offered during the last round of negotiations towards the end of the year.

The BMA said it rejected the 3% offer because it does not make up for a real-term pay cut of nearly a quarter of their salary for junior doctors since 2008.

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NHS consultants took strike action in September and October and agreed to an extra 4.95% pay rise for senior doctors on top of the annual 6% increase already offered to them by the government.

This will be voted on by members of their union this month.

A Department of Health and Social Care spokesperson said: “Despite the significant pressure, the healthcare system has coped well thanks to the hard work of consultants, nurses and other healthcare staff who worked during industrial action.

“The strikes may have ended but their repercussions will be felt for weeks and months to come.

“We want to put an end to damaging strikes once and for all, and if the BMA junior doctors’ committee can demonstrate they have reasonable expectations, we will still sit down with them.”

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Oct 6 2023

Former doctor Hossam Metwally who was jailed for drugging partner during exorcisms ordered to pay patient he secretly recorded | UK News

A former doctor who was jailed for voyeurism and injecting his partner with drugs during a series of exorcisms, has been ordered to pay more than £50,000 to a woman he secretly recorded while she was undressed during treatment.

Hossam Metwally used hidden cameras to film the woman, who cannot be named for legal reasons, after asking her to change into a medical gown before leaving the room.

The offences came to light in 2021, before Metwally was jailed for 14 and a half years for injecting his partner with drugs during a series of exorcisms.

Metwally was convicted of endangering Kelly Wilson’s life, leaving her close to death with multiple organ failure.

He made dozens of video recordings of himself administering fluids through a cannula to Ms Wilson while chanting as part of a “dangerous perversion” of the Islamic Ruqyah ritual, Sheffield Crown Court previously heard.

Before sentencing, Metwally admitted two unrelated offences of voyeurism by taking pictures and video of two female patients, without their knowledge and in a state of undress, during treatment sessions.

One of these women brought a misuse of private information claim against him at the High Court in London earlier this year.

On Friday, Mrs Justice Steyn ruled the woman was entitled to damages of £51,092, including money for her future
psychological treatment.

Metwally, the court heard, would ask the woman to get changed into a medical gown before leaving the room but still recording her on hidden cameras.

She said she was “totally shocked by what has happened to me”, that she felt “violated and vulnerable” and said that her “trust in people has gone”.

In her judgment, Mrs Justice Steyn said: “The claimant was owed an obligation of trust”, something that was breached “repeatedly”.

The judge said: “He [Metwally] obtained, retained and edited the footage for his own sexual gratification, continuing to do so years after the appointments.”

His actions left the woman with PTSD, the judge said, adding she “struggled to leave the house and had experienced a recurrence of her depression”.

Metwally did not attend the hearing and was not represented.

In May last year, a Medical Practitioners Tribunal Service panel concluded he should be erased from the medical register after it ruled his fitness to practise was impaired because of his convictions.

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Sep 8 2023

NHS trust and ward manager charged with manslaughter after patient dies at hospital in Redbridge | UK News

An NHS trust and a ward manager have been charged with manslaughter after a patient died at a hospital in Redbridge.

Alice Figueiredo, 22, died at Goodmayes Hospital on 7 July 2015.

She had been a patient at the hospital prior to her death, and an investigation was first launched in 2016.

Detectives from the Met’s Specialist Crime Command carried out a number of inquiries, and a file of evidence was referred to the Crown Prosecution Service (CPS) in March 2021.

Two years later, the CPS authorised the force to charge the North East London NHS Foundation Trust with corporate manslaughter and an offence under the Health and Safety at Work Act.

Benjamin Aninakwa, 52, of St Francis Way, Grays, was also charged with gross negligence manslaughter and an offence under the Health and Safety at Work Act.

He was a ward manager at Goodmayes Hospital.

Both will appear at Barkingside Magistrates’ Court on Wednesday, 4 October.

Detectives have met with Ms Figueiredo’s family and informed them of this development.

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Apr 6 2023

Hospital leaders fear for patient safety ahead of ‘unprecedented’ strike by junior doctors | UK News

Hospital leaders have expressed serious concerns about how they will maintain patient safety as the health service enters “unchartered territory” during “unprecedented” strike action next week.

Junior doctors who are training in England will stage their longest walkout so far between 11 and 15 April.

The 96-hour strike is likely to be the most disruptive in the history of the health service due to the length of the action and the fact doctors have chosen to stage it directly after a long bank holiday weekend.

The bank holiday traditionally causes disruption to the NHS even without the prospect of strike action.

The walkout also coincides with the Easter school holidays, which means many consultant staff who provided cover during the first round of strikes will be unable to do so again due to pre-planned holidays and childcare commitments.

NHS Providers, which represents NHS trusts, said the timing of the strike and its duration present a “range of challenges over and above the disruption seen from the industrial action in recent months”.

It said that during the strike, the NHS will focus resources on emergency treatment, critical care, maternity, neonatal care and trauma.

But even in these areas, there are “real concerns of a raised risk to safety”, NHS Providers said.

The strikes could lead to delays for some patients starting treatment – for instance, if a new cancer patient needed to start weekly rounds of chemotherapy, the start of their treatment may be delayed until after the strike action to ensure continuity.

Last month’s 72-hour walkout led to about 175,000 hospital appointments and operations being postponed.

Hospital leaders have raised concerns with NHS Providers about the impact of the strike.

“This is less about what planned routine work gets pulled down and everything about maintenance of safety in emergency departments, acute medicine and surgery,” one hospital trust chief executive said.

“Concerned doesn’t begin to describe it.”

Another said: “I am not confident this time that we can maintain patient safety as we will not be able to provide the cover.”

“Many of the consultants who stepped up to do nights last time are not available or are more reluctant this time,” a third said.

While another added: “Those with families almost certainly won’t as [they] can’t rearrange out of school holidays.”

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Sir Julian Hartley, chief executive of NHS Providers, said: “It’s clear from our extensive dialogue with trust leaders that we are in uncharted territory.

“Yet again we are seeing colleagues pull out all the stops to minimise disruption and ensure patient safety. But the challenges here are unprecedented.”

Dr Latifa Patel, workforce lead for the British Medical Association, said: “No one understands better than us, the doctors who care for them, that patients are getting a substandard experience 365 days a year from an overstretched and understaffed NHS.

“In this brutal work environment, patient care is at risk every day due to chronic staff shortages and years of underinvestment in equipment and services.

“Junior doctors have no desire to strike, they been pushed into this action by long-term government inaction and now want to bring this dispute to an end as quickly as possible.

“We hope the health secretary will come to the table immediately with a meaningful pay offer so doctors can avoid more strike action and instead return to doing what they want to be doing: caring for their patients.”

A department of health and social care spokesperson said: “Four days of strikes by junior doctors will risk patient safety and cause further disruption and postponed treatment.

“The BMA’s demand for a 35% pay rise is totally unreasonable and unaffordable.

“We urge them to come to the table with a realistic approach so we can find a way forward, as we have done with other health unions, which balances fairly rewarding junior doctors for their hard work with meeting the prime minister’s ambition to halve inflation.

“We are working with NHS England to put in place contingency plans to protect patient safety.

“The NHS will prioritise resources to protect emergency treatment, critical care, maternity and neonatal care, and trauma.”

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Jan 30 2023

Virtual hospital wards no substitute for real people, says patient waiting for hip operation | UK News

Carlo Zamboni used to climb in the Scottish Highlands in the school holidays.

Today, crossing his small flat is a mission for the retired teacher. Nudging 70, he’s on the NHS waiting list for a hip operation and a diagnosis to confirm the Parkinson’s disease his hand tremors suggest.

We were speaking to him as NHS England said it was planning to free up space by treating up to 50,000 elderly and vulnerable patients in “virtual wards” at home.

Three months ago a fall put Carlo in hospital.

“I fell over in a graveyard, lost my balance for some reason,” he said. “I was suspected of possibly developing Parkinson’s disease nine months previously, so I was taken to hospital.”

After a week he was discharged into the reality of Britain’s overwhelmed health and care system; a care trap for those, like Carlo, not sick enough to be in hospital, but not quite poor enough to qualify for social care.

“I thought I wasn’t satisfactorily cured or knew what was wrong with me, because they couldn’t diagnose or do the test for Parkinson’s,” he said.

“You could feel the pressure to get people out of the hospital. I totally understand the crisis but it’s a crisis we could have planned for. And we didn’t plan for it.”

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Carlo is not alone. His brother pops in to help, he’s had support from charities and the local church food bank, and a district nurse visits once a week to check a catheter, the legacy of a collapsed bowel.

He does not qualify for social care support, however. Modest savings and a potential inheritance put him above the earnings threshold.

The local council has installed wall rails and a rope bannister at the top of the stairs to his flat, but the 400 yard walk to the chemist still takes an hour and leaves him exhausted.

How to deal with the needs of people like Carlo, living with multiple morbidities, is one of the fundamental challenges facing the health service in a crisis like no other.

One reason emergency services are overwhelmed is because a fifth of beds are occupied by people who could be at home if only they could be discharged safely. This winter has seen huge pressure to speed up that process.

With social care denuded by low pay and a staffing shortage, NHS England wants to scale up the use of technology, prescribing wearable devices to vulnerable people so they can be monitored remotely from home rather than a precious hospital bed.

Carlo says the “hospital at home” plan might help. “It’s a possibility worth exploring and experimenting with, but there’s no replacement for real people,” he told us.

What he really wants, though, is the government to honour the NHS commitment.

“I expect the NHS to remain true to its principles and I expect people to have faith in the NHS.

“Our generation were promised cradle-to-grave care. And I hope that promise is upheld – for more generations.”

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Sep 23 2022

Modified herpes virus shows promise killing off cancer cells – with one patient seeing disease vanish | UK News

A modified herpes virus has shown promise killing off cancer cells – with one patient seeing the disease vanish entirely.

Patients were injected with a drug that was a weakened form of the cold sore virus – herpes simplex – that has been modified to kill tumours.

While more research is needed, it could offer a lifeline for those living with advanced-stage cancer.

Krzysztof Wojkowski, 39, a builder from West London, went from end-of-life care to being cancer free after joining the trial.

Mr Wojkowski was diagnosed with Mucoepidermoid carcinoma, a type of salivary gland cancer, in May 2017.

Despite multiple surgeries, he was told that there were no treatment options left, before being given the opportunity to join the RP2 trial at The Royal Marsden in 2020.

He said: “I was told there were no options left for me and I was receiving end of life care, it was devastating, so it was incredible to be given the chance to join the trial at The Royal Marsden, it was my final lifeline.

“I had injections every two weeks for five weeks which completely eradicated my cancer. I’ve been cancer free for two years now, it’s a true miracle, there is no other word to describe it.

“I’ve been able to work as a builder again and spend time with my family, there’s nothing I can’t do.”

The genetically engineered virus, which is injected directly into the tumours, is designed to have dual action – it multiplies inside cancer cells to burst them from within and it also blocks a protein known as CTLA-4, releasing the brakes on the immune system and increasing its ability to kill cancer cells.

Rare to see such promise in early trials

Three out of nine patients treated with RP2 saw their tumours shrink.

Seven out of 30 patients who received both RP2 and the immunotherapy nivolumab also benefitted from treatment.

In this group, four out of nine patients with melanoma skin cancer, two out of eight patients with the eye cancer uveal melanoma, and one out of three patients with head and neck cancer saw their cancer’s growth halt or shrink.

Of the seven patients receiving the combination who saw a benefit, six remained progression-free at 14 months.

It is rare to see such a good response rate in early-stage clinical trials, according to the study leader Professor Kevin Harrington, professor of biological cancer therapies at The Institute of Cancer Research, London, and consultant oncologist at The Royal Marsden NHS Foundation Trust.

He said: “Our study shows that a genetically engineered, cancer-killing virus can deliver a one-two punch against tumours – directly destroying cancer cells from within while also calling in the immune system against them.

“It is rare to see such good response rates in early-stage clinical trials, as their primary aim is to test treatment safety and they involve patients with very advanced cancers for whom current treatments have stopped working.

“Our initial trial findings suggest that a genetically engineered form of the herpes virus could potentially become a new treatment option for some patients with advanced cancers – including those who haven’t responded to other forms of immunotherapy.

“I am keen to see if we continue to see benefits as we treat increased numbers of patients.”

Exploiting the features of viruses

Professor Kristian Helin, Chief Executive of The Institute of Cancer Research, London, said it is possible to exploit some of the features of viruses.

They said: “Viruses are one of humanity’s oldest enemies, as we have all seen over the pandemic. But our new research suggests we can exploit some of the features that make them challenging adversaries to infect and kill cancer cells.

“It’s a small study but the initial findings are promising. I very much hope that as this research expands we see patients continue to benefit.”

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