Workload issues affecting GP trainees’ plans for their future careers

Workload issues affecting GP trainees’ plans for their future careers For the fifth time since 2016, The King’s Fund has surveyed GP trainees on their plans for their own careers and on the future of general practice more generally. Each time we ask questions about trainees’ intended future working patterns, one year, five years and ten years after completing their qualifications. This year’s survey of GP trainees shows excessive workload and intensity is having a significant impact on how trainees plan to work in future.

Health and care workforce in Europe: time to act

Health and care workforce in Europe: time to act All countries of the WHO European Region currently face severe challenges related to the health and care workforce (‎HCWF)‎. This report focuses on identifying effective policy and planning responses to these HCWF challenges across the Region. The report presents an overview of the HCWF situation in the Region (‎focusing on medical doctors, nurses, midwives, dentists, pharmacists and physiotherapists, for whom data are available)‎and identifies relevant policy options, their expected benefits and potential facilitators or barriers to successful implementation. Examples of sound evidence-informed practices in countries are also provided. World Health Organization. European Region

Barriers and opportunities: improving access to mental health support for refugees and people seeking asylum

Barriers and opportunities: improving access to mental health support for refugees and people seeking asylum This report explores access to and experience of mental health support for refugees and people seeking asylum in England. It finds a need for a person-centred, trauma-informed approach where the specific needs of the individual are considered and most appropriate mental health support is offered. It also details an opportunity to improve communication with refugees and people seeking asylum in the provision of mental health support including longer appointment times to overcome language barriers, preference for face-to-face appointments, written and translated communication and consistent access to professional interpreters. British Red Cross

Many English maternity units not meeting safety standards

Many English maternity units not meeting safety standards More than half of maternity units in England fail consistently to meet safety standards, BBC analysis of official statistics shows.

Health regulator the Care Quality Commission (CQC) rates 7% of units as posing a high risk of avoidable harm. A further 48% require improvement.

The figures are slightly worse than a few years ago, despite several attempts to transform maternity care.

The regulator says the pace of improvement has been disappointing. BBC News

Covid: Oxford oncologist in plea to government over Evusheld

Covid: Oxford oncologist in plea to government over Evusheld A leading academic is calling on new Health Secretary Therese Coffey to reconsider rolling out a Covid drug for people with weakened immune systems.

Last month the government decided it would not supply Evusheld in the UK.

But Dr Lennard Lee, an academic medical oncologist from Oxford University who is backed by more than 120 leading scientists and clinicians, said a rethink was needed. BBC News

See also:

• Covid-19 pandemic is over in the US - Joe Biden BBC News
• Why even mild Covid is now being linked to long-term heart trouble The Daily Mail
• UK could face ‘twindemic’ if winter flu surge combines with new Covid wave The Independent
• Covid and poor access to NHS care ‘may be driving irregular heartbeat deaths’ ITV News
• EU health regulator says COVID pandemic not over Reuters

What does the NHS need before winter?

What does the NHS need before winter? The new health secretary, Therese Coffey, says her plan for the NHS in England will have an "ABCD" focus – ambulances, backlogs, (social) care, and doctors and dentists.

She's due to outline more details of her proposals as parliamentary business returns. Sky News

Millions of children regularly suffer poor mental health, survey claims

Millions of children regularly suffer poor mental health, survey claims Millions of teens are struggling to cope with their mental health and social pressures, it has been claimed.

A poll of 1,000 teenagers found 31 per cent had struggled with their mental health, feeling that way for an average of more than two years.

And 56 per cent regularly felt anxious, with social media and the increased cost-of-living blamed. The Independent

Britons of black and south Asian origin with dementia die younger, study finds

Britons of black and south Asian origin with dementia die younger, study finds Britons of black and south Asian origin with dementia die younger and sooner after being diagnosed than white people, research has found.

South Asian people die 2.97 years younger and black people 2.66 years younger than their white counterparts, according to a study by academics from University College London and the London School of Hygiene and Tropical Medicine. The Guardian

See also:

• Incidence, age at diagnosis and survival with dementia across ethnic groups in England: A longitudinal study using electronic health records (open access) Alzheimer's and Dementia

Up to 16million patients could lose their GP in next decade

Up to 16million patients could lose their GP in next decade Sixteen million Britons could be left without a GP within a decade without 'huge investment', doctors argued today.

Doctors' Association UK (DAUK) warned physicians would 'either quit the NHS, the profession or the country unless the new Health Secretary stops the rot'.

Writing in a letter to Therese Coffey, the group added the postcode lottery seen in dentistry 'could soon be replicated across general practice'. The Daily Mail

See also:

• ‘This job is making us ill’: GPs from DAUK call for reform Doctors' Association UK
• One in four people could be left without a GP within a decade, doctors claim The Daily Telegraph
• There is no end point to the work of a GP – it is an almost impossible job to do well | Zara Aziz The Guardian
• Two-thirds of trainee GPs in England plan to work part-time, study finds The Guardian

That's a big problem! Eight out of ten Britons will be overweight or OBESE by 2060, report warns

That's a big problem! Eight out of ten Britons will be overweight or OBESE by 2060, report warns More than eight in ten Britons will be overweight or obese by 2060 – costing the economy £142 billion a year, a report warns.

Experts say the ‘eye-watering’ figures show the UK is in the grip of an ‘obesity emergency’ that threatens to bankrupt the NHS and cut lives short.

They are calling for urgent action to combat the crisis, including policies aimed at improving the nation’s diet and getting people moving. Researchers from the World Obesity Federation and RTI International analysed data from 161 countries for the study. The Daily Mail

See also:

• Economic impacts of overweight and obesity: current and future estimates for 161 countries (open access) BMJ Global Health
• Anti-obesity strategy to be reviewed due to cost-of-living crisis BBC News
• Liz Truss could scrap anti-obesity strategy in drive to cut red tape The Guardian
• Truss plan to axe sugar tax runs into legal and parliamentary hitches The Guardian

We are taking a short break

 Our health news service will return on Wednesday the 21st of September.

Public perceptions of health and social care: what the new government should know

Public perceptions of health and social care: what the new government should know This report presents findings from the second survey in our programme of research into public perceptions of health and social care, delivered in partnership with Ipsos. 

Health and social care services are under extreme strain and improvements in life expectancy are stalling. As the new prime minister sets out her agenda for government, understanding what the public thinks should inform policy. And the public perceives the standard of NHS and social care services as having declined in the past 12 months – and is more likely to expect that standards will get worse over the next year rather than improve. But the public also has strong support for the NHS as an institution and points to clear priorities for improving services. The Health Foundation

See also:

• Fix workforce crisis and fund health service properly – public send clear message to government to back the NHS The Health Foundation

Letter to the new Prime Minister : winter health service emergency without urgent government action

Letter to the new Prime Minister : winter health service emergency without urgent government action The NHS Confederation, NHS Providers, the Academy of Medical Royal Colleges, National Voices and the Richmond Group of Charities have penned a joint letter to the new Prime Minister warning that without urgent action on key priorities the NHS risks being trapped in a relentless cycle unable to meet rising patient need and demand.

See also:

• It’s not just Covid: the triple threat that could overwhelm the NHS this winter The Guardian
• Health leaders warn of busy winter for NHS as they call on PM to take action The Independent
• GPs warn of ‘tsunami of demand’ this winter as patient contacts surge 200% The Independent
• NHS waiting list for routine hospital treatment hits new record high of 6.8 million The Independent

Can Therese Coffey deliver her NHS A, B, C and D?

Can Therese Coffey deliver her NHS A, B, C and D? New Health Secretary Therese Coffey has been quick to spell out her priorities.

They are, she says, the A, B, C and D of the NHS - ambulance, backlogs, care, and doctors and dentists.

It is easy to understand why she highlights these areas - they are critical to the immediate future of both the health service and patients in England (health is devolved so she only has responsibility for this nation).

The delays being seen in responding to 999 calls are, quite simply, putting lives at risk. BBC News

See also:

• Angry health unions accuse Coffey of being 'out of touch' and on a 'collision course' with medics The Daily Mail
• Therese Coffey promises to 'deliver for patients': New Health Secretary unveils 'ABCD' of priorities The Daily Mail
• Therese Coffey claims she WON'T seek to change abortion laws The Daily Mail
• Therese Coffey rules out GP visit fees and promises to 'stand up for patients' on access GPonline
• Thérèse Coffey considers paying care homes in England to free hospital beds The Guardian
• ‘Disappointment’ over nursing omission in new health secretary’s priorities Nursing Times

Post-menopause HRT treatment to be sold in UK pharmacies

Post-menopause HRT treatment to be sold in UK pharmacies Women experiencing vaginal dryness as a result of the menopause can now buy a treatment over the counter in the UK.

Estradiol tablets, sold under the brand name Gina10, were previously offered on prescription only.

They will be available to women over the age of 50 who have not had a period for more than a year, as part of hormone replacement therapy treatment (HRT). BBC News

See also:

• Hormone replacement therapy and menopause: What you need to know about HRT BBC News

New malaria vaccine is world-changing, say scientists

New malaria vaccine is world-changing, say scientists A malaria vaccine with "world-changing" potential has been developed by scientists at the University of Oxford.

The team expect it to be rolled out next year after trials showed up to 80% protection against the deadly disease.

Crucially, say the scientists, their vaccine is cheap and they already have a deal to manufacture more than 100 million doses a year. BBC News

See also:

• Efficacy and immunogenicity of R21/Matrix-M vaccine against clinical malaria after 2 years' follow-up in children in Burkina Faso: a phase 1/2b randomised controlled trial (open access) The Lancet Infectious Diseases

Ministers cut NHS Covid jabs ad budget by 63% despite winter wave fears

Ministers cut NHS Covid jabs ad budget by 63% despite winter wave fears Funding to promote the uptake of NHS England’s autumn Covid and flu jabs has been slashed by 63%, it can be revealed, even as the World Health Organization warned of a wave of winter deaths.

The government’s “lifesaving autumn booster rollout” started on Monday, but ministers have cut the £11m budget earmarked for advertising to £4m, it is understood. The Guardian

See also:

• Study finds link between poor mental health and long Covid The Guardian
• Government admits 50 firms were in VIP lane for test and trace contracts The Guardian
• What scientists have learnt from COVID lockdowns Nature
• COVID app that detects virus in your voice 'more accurate than lateral flow tests' Sky News

Life-extending prostate cancer drug rejected for NHS

Life-extending prostate cancer drug rejected for NHS A drug which can extend the lives of some men with prostate cancer will not be approved for use on the NHS.

In final guidance which rubber-stamps an earlier decision, the National Institute for Health and Care Excellence (Nice) said olaparib (also called Lynparza) is not a good use of NHS money at its current price. The Independent

Getting a flu jab may cut your risk of a stroke, study finds

Getting a flu jab may cut your risk of a stroke, study finds Getting your annual flu vaccine could protect you from a stroke, a study suggested today.

Spanish researchers compared the health of more than 75,000 over-40s, including thousands who had suffered a stroke.

Results showed people who had received a jab were 12 per cent less likely to suffer the life-threatening event, compared to people who decided against getting their yearly top-up. The Daily Mail

See also:

• Influenza Vaccination and Risk of Ischemic Stroke: A Population-Based Case-Control Study (abstract) Neurology

I'm leaving the NHS for better pay privately - I wish I didn't have to

I'm leaving the NHS for better pay privately - I wish I didn't have to On my very first day as an NHS Cognitive Behavioural Therapy (CBT) therapist, I was shown around the office by a senior colleague.

It was during this induction that they told me they were actually leaving the NHS to work as a private therapist. At the time I didn’t think much of it, staff turnover in the NHS is nothing new.

Years later, I recognise it was one example of what I can see is a growing trend among therapists. Metro

Parents protest against Northampton council for 'failing' their disabled children

Parents protest against Northampton council for 'failing' their disabled children A group of around 20 parents protested against Northampton council for “failing” to provide education and support for their disabled children.

Parents of disabled children demonstrated outside of West Northamptonshire Council's Angel Square headquarters in Angel Street on Tuesday morning (September 6). Northampton Chronicle and Echo

See also:

• Parents hold backpack protest over failures in SEND provision BBC Northampton

What are the health and care promises that the new Prime Minister inherits?

What are the health and care promises that the new Prime Minister inherits? With Liz Truss officially becoming the new Prime Minister after winning the Tory leadership contest, what are the health and care commitments from the 2019 Conservative Party Manifesto that she inherits? Mark Dayan, Lucina Rolewicz and Jessica Morris explore the progress of the main health and care promises that were made. Which are on course to be delivered and which are not? Nuffield Trust

Safer care for all: solutions from professional regulation and beyond

Safer care for all: solutions from professional regulation and beyond This report highlights some of the biggest challenges affecting the quality and safety of health and social care across the UK today. It describes a ‘fragmented and complex’ patient and service user safety framework and calls for action to address the safety issues. The report's main recommendation is the appointment of an independent Health and Social Care Safety Commissioner (or equivalent) for each UK country. These commissioners would identify current, emerging, and potential risks across the whole health and social care system, and bring about the necessary action across organisations. The report goes on to consider four important themes: tackling inequalities; regulating for new risks; facing up to the workforce crisis; and accountability, fear and public safety. Professional Standards Authority

Building better health: what are the estate development and management opportunities presented by integrated care systems?

Building better health: what are the estate development and management opportunities presented by integrated care systems? In July 2022, Good Governance Institute and Primary Health Properties hosted a roundtable discussion to look at the opportunities for estates in integrated care to drive reform, inspire innovation and enable improvement. This long read summarises the discussion that focused on ways in which developing or repurposing NHS estate can enable co-location and greater integration of health and care services.

Adult social care workforce in England

Adult social care workforce in England This research briefing gives an overview of key issues and policy concerning the adult social care workforce in England. Around 1.5 million people worked in the adult social care sector in England in 2021/22, more than in the NHS. The workforce was more diverse than the population as a whole and the majority of workers were women. Around a quarter of the workforce were on zero-hours contracts, including 55 per cent of home care workers. House of Commons Library

Policy paper: Secure data environment policy guidelines

Policy paper: Secure data environment policy guidelines These guidelines set out clear rules for how secure data environments will be used to access NHS health and social care data for research and analysis. Department of Health and Social Care

Therese Coffey inherits NHS 'in crisis'

Therese Coffey inherits NHS 'in crisis' Therese Coffey has inherited an NHS and social care system “in crisis”, health leaders have said.

Experts from across the sector have welcomed Ms Coffey to her new role as Health Secretary but warned that she has taken on the job during a challenging period for the health service.

As well as being appointed as Secretary of State for Health and Social Care for England, Ms Coffey is stepping up to become Liz Truss’s second-in-command as Deputy Prime Minister. The Independent

See also:

• Deputy Prime Minister and Secretary of State for Health and Social Care The Rt Hon Thérèse Coffey MP Gov.UK
• Therese Coffey's views on abortion concerning, charity says BBC News
• Therese Coffey who opposes abortions is to become third Health Secretary in as many months The Daily Mail
• Therese Coffey admits she is not a 'role model' after questions over smoking and weight The Daily Telegraph
• Who is Thérèse Coffey, UK’s new cigar-smoking Health Secretary? Evening Standard
• Thérèse Coffey: convivial pragmatist inherits health service in crisis The Guardian
• Therese Coffey Appointed Deputy Prime Minister And Health Secretary Huffington Post UK
• Health secretary Therese Coffey insists she will not undo abortion laws The Independent
• Cabinet minister Therese Coffey says she would 'prefer that people didn't have abortions' but law won't change Sky News
• Therese Coffey lays out plans as she is named new health secretary and deputy PM Sky News

Excess deaths continue to soar despite Covid deaths decreasing

Excess deaths continue to soar despite Covid deaths decreasing Excess deaths in the UK have continued to soar, as Covid deaths decreased for fourth week in a row, the latest data shows.

A total of 10,942 deaths from all causes were registered in England and Wales in the week to 26 August, according to the Office for National Statistics.

This is 16.6 per cent above the five-year average, the equivalent of 1,556 “excess deaths” during this week. The Independent

See also:

• Deaths registered weekly in England and Wales, provisional: week ending 26 August 2022 Office for National Statistics
• Excess mortality in England and English regions Office for Health Improvement and Disparities

Woman who can smell Parkinson’s disease helps scientists develop test

Woman who can smell Parkinson’s disease helps scientists develop test A woman who can “smell Parkinson’s” has helped scientists develop a test to detect the disease.

The test has been years in the making after academics realised Joy Milne, from Perth, Scotland, who has a heightened sense of smell, could detect the condition.

The 72-year-old noticed her late husband Les developed a different odour when he was 33 – some 12 years before he was diagnosed with the disease, which leads to parts of the brain become progressively damaged over many years. The Independent

See also:

• Super-smeller helps scientists develop test to spot Parkinson's BBC News
• That's breathtaking! Meet the woman who sniffed out her husband's Parkinson's The Daily Mail
• New test for Parkinson’s developed after woman sniffed out the disease The Daily Telegraph

Baby sticky tape skin test can predict eczema risk

Baby sticky tape skin test can predict eczema risk A sticky tape skin test could help predict if young babies are likely to develop bad eczema, say scientists.

The team - from the University of Copenhagen - used it on a group of two-month-olds to painlessly collect and then examine skin cell samples.

They found detectable immune biomarker changes in the cells that were linked with future eczema risk. BBC News

Generation vape: One in ten teenagers now use e-cigarettes - TRIPLE the tobacco smoking rate

Generation vape: One in ten teenagers now use e-cigarettes - TRIPLE the tobacco smoking rate One in ten secondary school pupils in England now use e-cigarettes, according to official data which illustrates the scale of the country's vaping epidemic.

Teenagers are shunning tobacco in favour of the trendy electronic devices, the latest must-have accessory to grace classrooms. Their steep rise in popularity has sparked warnings that the UK is slowly sleepwalking into a public health 'catastrophe'. The Daily Mail

See also:

• Smoking, Drinking and Drug Use among Young People in England, 2021 NHS Digital
• Rise in teenage vaping, as drug use falls - survey BBC News
• Vaping: Nearly one in ten young teenagers in England smoke e-cigarettes Evening Standard
• Are fears about the impact of vaping on young people justified? The Independent
• Teen vaping has become a 'route into nicotine addiction, rather than out of it', expert warns Sky News

How to book an autumn Covid booster vaccine in Northamptonshire and who can get it

How to book an autumn Covid booster vaccine in Northamptonshire and who can get it Thousands of people will be invited for their autumn Covid booster vaccinations across Northamptonshire from Monday (September 5) with jabs available at a record number of sites.

Care home residents and some housebound patients are first on the list for the latest top-up doses. Northamptonshire Telegraph

A Northampton General Hospital team have been nominated for national award

A Northampton General Hospital team have been nominated for national award A Northampton General Hospital team that supports prostate cancer patients has been nominated for a top national award for innovation.

The Uro-Oncology Nurse Specialist Team are finalists in the Macmillan Professionals Excellence Awards 2022 in the Innovation Excellence category. Northants Life 

Northampton: Cancer centre among projects in funding bid

Northampton: Cancer centre among projects in funding bid A wellbeing hub, a cancer care centre and an animal welfare unit are among projects in Northampton in line for a share of £63.5m in funding.

West Northamptonshire Council has applied for Levelling Up Funding for the schemes, including a swimming pool, cinema and library in Weston Favell.

In July, it promised £25.1m for the area's revamp if a £20m bid is agreed.

Councillor Dan Lister said all projects created jobs and had a shared approach to "tackling local challenges". BBC Northampton

See also:

• £63.5m of funding for new cancer ward, wellbeing hub, cinema and library submitted by council Northants Live

New PM will inherit an NHS in its most challenging state for decades, warn NHS leaders

New PM will inherit an NHS in its most challenging state for decades, warn NHS leaders The incoming Prime Minister will urgently need to grip the crisis facing the NHS ahead of winter by providing the extra support that hospitals, ambulances, mental health and GP services need to deal with the intense and rising pressure they are under. 

NHS leaders say the Prime Minister will inherit an NHS in the most challenging state it has been in for decades, with front-line services facing up to lengthening waiting times and other pressures which are undermining the NHS being the best it can be for our patients. NHS Confederation

See also:

• BMA urges new Prime Minister to tackle NHS pressures, or face an uncontrollable crisis this winter BMA
• Health and Social Care Secretary Steve Barclay Oral Statement on urgent and emergency care Department of Health and Social Care
• New Prime Minister needs a plan to prevent the cost-of-living crisis becoming a health crisis The Health Foundation
• New PM Liz Truss must act now to protect health service Royal College of Nursing
• New prime minister: Seven big questions for Liz Truss BBC News
• You've got 10 days to avoid NHS strike call, nurse chief tells Liz Truss The Daily Mail
• What are the biggest issues facing the NHS and what has Liz Truss promised to do to fix them? Evening Standard
• What policies will Liz Truss pursue as Britain’s new prime minister? The Guardian
• Health Secretary is told frontline staff believe NHS has 'collapsed'  The Independent
• What will Liz Truss becoming Prime Minister mean for nurses and the NHS? Nursing in Practice
• NHS leaders warn new PM inherits ‘an NHS in its worst state in living memory’ Nursing Notes
• New PM will 'inherit an NHS in its most challenging state for decades' PharmaTimes

The geriatric medicine workforce 2022

The geriatric medicine workforce 2022 This report examines data collected by the Royal College of Physicians (RCP) on the consultant and Higher Specialty Trainee geriatric medicine workforce. This data, which was collected between 2019 and 2021 as part of the RCP’s annual workforce census, demonstrates the staffing challenges facing older people’s healthcare. Despite the growth in medical student places, there are not enough specialist healthcare professionals being trained and retained to meet the needs of the population as it ages. British Geriatrics Society

Dismissed for too long: the impact of migraine on children & young people

Dismissed for too long: the impact of migraine on children & young people An estimated one in ten children are living with migraine. This potentially limits their development and ability to take part in education, social activities, and other important parts of growing up. It can also be hard for children to understand and explain their pain, and there are fewer treatment options for them than there are for adults. Based on a variety of workshops and surveys with children and young people who have migraine, parents and carers, and education professionals, this report highlights a clear need for better understanding of how migraine impacts children and for tailored information, guidance and support for children and young people of different ages who have migraine. Migraine Trust

Gender inequalities made women twice as likely to break lockdown laws, according to new report

Gender inequalities made women twice as likely to break lockdown laws, according to new report Many women felt compelled to break lockdown laws, which banned meeting friends and family at home, due to caring responsibilities, a major new report has found.

The report, by the University of York and funded by the Nuffield Foundation, found that women were nearly twice as likely than men to break laws prohibiting meeting with others indoors.

The findings highlight how many of the laws imposed during the pandemic clashed with existing gender inequalities, with women bearing the brunt of trying to balance childcare with work commitments, the authors of the report say.

See also: 

• Law and compliance during Covid-19 (report) Nuffield Foundation
• Why the UK Complied with COVID-19 Lockdown Law (open access) King's Law Journal
• China approves inhaled Covid vaccine BBC News
• Booster vaccine chaos begins: Last-minute scramble to find army of volunteers to deliver jabs The Daily Mail
• Do you really need another Covid jab as a major new booster campaign begins? The Daily Mail
• COVID-19 autumn booster vaccination programme begins GPonline
• COVID-19: Women were nearly twice as likely as men to break lockdown rules, study suggests - but why? Sky News

NHS COVID-19 vaccine bookings to open to millions of people as autumn booster campaign kicks off

NHS COVID-19 vaccine bookings to open to millions of people as autumn booster campaign kicks off The lifesaving autumn booster rollout kicks off in care homes in England today, as the NHS COVID-19 vaccination programme moves to the next phase.

From Wednesday, around seven million people, including people aged 75 and over, people who are immunosuppressed and health and care workers will be able to book in online or by calling 119.

Millions of invitations will be landing on doormats from Wednesday 7 September inviting people to book their appointment for the following week without delay. NHS England

Health chiefs are told to combat fraud that costs cash-strapped NHS £1.2bn a year

Health chiefs are told to combat fraud that costs cash-strapped NHS £1.2bn a year NHS bosses must do more to combat medical fraud that costs taxpayers up to £1.2billion a year, the Health Secretary has demanded.

Stephen Barclay claims NHS England hasn't done enough to stop crooks stealing money that should go to improve care.

In a letter to chief executive Amanda Pritchard – seen by the Daily Mail – he calls on officials to introduce measures that make it more difficult for fraudsters to succeed.

How much is Covid-19 to blame for growing NHS waiting times?

How much is Covid-19 to blame for growing NHS waiting times? The pandemic has had an enormous impact on health and care services, but to what extent is it to blame for the current pressures facing the NHS? Jessica Morris and Sarah Reed take a closer look at access and waiting times before and after the start of the Covid crisis. Quality Watch

See also:

• Covid-19 not solely to blame for scale of NHS care backlog Quality Watch
• NHS backlog would have been at 'alarming' levels affecting five million patients even without Covid The Daily Mail
• More than five million people would still be on NHS waiting lists even without the pandemic The Daily Telegraph
• The NHS will recover with an 'all hands on deck' approach The Independent

What are the health and care challenges for the next Prime Minister?

What are the health and care challenges for the next Prime Minister? What are the immediate health and care pressures the next Prime Minister will need to address once they're in post? Podcast from The King's Fund

Fuel poverty, cold homes and health inequalities in the UK

Fuel poverty, cold homes and health inequalities in the UK This report reviews the evidence on both the direct and indirect impacts of fuel poverty and cold homes on health; the inequalities in who this effects the most, and the relation between health inequalities and climate change. It makes the case for prioritising reducing fuel poverty through policy suggestions at both the national and local level. Institute of Health Equity

Expansion of polio sewage surveillance to areas outside London

Expansion of polio sewage surveillance to areas outside London Following the findings of poliovirus in sewage samples collected from the London Beckton Sewage Treatment Works, which covers parts of North and East London, the UK Health Security Agency (UKHSA) working with the Medicines and Healthcare product Regulatory Agency (MHRA) are now expanding the surveillance to a range of areas outside of the capital.

JCVI advises use of additional bivalent vaccine for autumn booster campaign

JCVI advises use of additional bivalent vaccine for autumn booster campaign Following on from the previous advice on which vaccines should be used in this year’s autumn booster programme, the Joint Committee on Vaccination and Immunisation (JCVI) has updated its published advice to include an additional bivalent vaccine now approved by the Medicines and Healthcare products Regulatory Agency (MHRA). UK Health Security Agency

See also:

• Independent report: COVID-19 vaccines for autumn 2022: JCVI advice, 3 September 2022 Department of Health and Social Care
• Guidance: The R value and growth rate UK Health Security Agency
• Research: Consensus statements and medium-term projections on COVID-19 UK Health Security Agency
• Guidance: Emerging infections and zoonoses: epidemic intelligence scanning procedures UK Health Security Agency

Covid: Millions invited for booster jabs from Monday

Covid: Millions invited for booster jabs from Monday Millions of people will be invited for their autumn Covid booster jab in England and Scotland next week, with care home residents the first to receive them.

Although infections are falling, health bosses are predicting a resurgence of Covid and flu this autumn and winter.

They are urging those eligible to protect themselves from serious illness by getting vaccines against both. BBC News

See also: 

• EU watchdog passes first blood test for diagnosing long Covid The Daily Mail
• Omi-gone! Covid wave crashes to lowest level since June - with fewer than a million now infected The Daily Mail
• Covid app that detects virus in your voice ‘more accurate than lateral flow tests’ The Daily Telegraph
• UK approves second Covid vaccine targeting Omicron variant The Guardian
• Covid-19 booster jab programme gets under way The Independent

Fixing the NHS - a near impossible job for new PM?

Fixing the NHS - a near impossible job for new PM? On Monday we will find out who will be the new prime minister. But as summer makes way for autumn, the alarm bells are ringing loud and clear in the NHS.

And while the cost of living crisis has dominated the attention during the leadership contest, talk to anyone in the NHS and they will tell you they are worried what the coming months will bring.

Put simply, this summer has been worse than any winter this century. Dr Adrian Boyle, of the Royal College of Emergency Medicine, says the demise has been so sharp that the service is "struggling to perform even its central function - to deliver care safely and effectively". BBC News

NHS whistleblower Shyam Kumar wins case against regulator

NHS whistleblower Shyam Kumar wins case against regulator A doctor who was sacked for raising patient safety concerns has won a case against England's hospital regulator, the Care Quality Commission (CQC).

Orthopaedic surgeon Shyam Kumar worked part-time for the CQC as a special adviser on hospital inspections, but Manchester Employment Tribunal found that he was unfairly dismissed. BBC News

Care homes will 'go to the wall' over energy costs putting further strain on the NHS

Care homes will 'go to the wall' over energy costs putting further strain on the NHS Many care homes could be forced to close because of sky high energy bills this winter putting further strain on the NHS, experts in the sector have warned.

Providers cannot cut back on consumption and will “go to the wall” because “there’s nowhere to go”, they warned. The Independent

Ministers to make it easier for foreign nurses and dentists to work in NHS

Ministers to make it easier for foreign nurses and dentists to work in NHS Ministers will introduce legislation as soon as parliament returns on Monday to tackle the NHS’s worsening staffing crisis by making it easier for overseas nurses and dentists to work in the UK.

The move is part of a drive by the health secretary, Steve Barclay, to increase overseas recruitment to help plug workforce gaps in health and social care. The Guardian

Child cancer deaths have HALVED since late 80s thanks to UK's world-leading trials and research

Child cancer deaths have HALVED since late 80s thanks to UK's world-leading trials and research The number of children dying from cancer in Britain has almost halved in the past 33 years.

Since the late Eighties, the mortality rate has plunged thanks to world-leading research and trials in the UK. The Daily Mail

Routine surgeries could be postponed due to blood shortages

Routine surgeries could be postponed due to blood shortages Routine surgeries could be delayed because of a shortage of blood, experts have warned. Supplies are at around half their normal levels and hospitals have been told they should be ready to implement emergency measures – possibly as early as this month – should the situation get worse. The Daily Mail

World Suicide Prevention Day: Where events, help and training is available in Northamptonshire

World Suicide Prevention Day: Where events, help and training is available in Northamptonshire This World Suicide Prevention Day (September 10), Northamptonshire Healthcare Foundation Trust (NHFT) is partnering with the Samaritans, Northampton Filmhouse, the Grosvenor shopping centre and Northampton Town Football Club to raise awareness and tackle the stigma around the subject. Northampton Chronicle and Echo

See also:

• World Suicide Prevention Day Northamptonshire Healthcare NHS Foundation Trust
• Eleven ways to protect your mental health Northamptonshire Telegraph

NHS simply doesn't have enough staff to deliver everything being asked of it

NHS simply doesn't have enough staff to deliver everything being asked of it Today's vacancy figures are staggering and further proof that the NHS simply doesn't have enough staff to deliver everything being asked of it.

With nearly one in 10 posts in trusts in England now vacant and tens of thousands more right across the health and care system, many staff face unsustainable workloads and 'burnout' as they strive to bring down waiting lists and treat patients as quickly as possible in the face of ever-growing demand. NHS Providers

See also:

• NHS Vacancy Statistics England April 2015 – June 2022 NHS Digital
• Government still lacks proposals to retain NHS staff BMA
• NHS staff vacancy numbers paint a bleak picture NHS Confederation
• 'Enough is enough' says RCN General Secretary as NHS nursing vacancies in England at record high Royal College of Nursing
• Boosting funding and pay are the best ways to fix NHS staffing UNISON
• Record one in 10 NHS posts in England vacant, new data shows Evening Standard
• NHS vacancies in England at 'staggering' new high as almost 10% of posts empty The Guardian
• NHS staff vacancies at highest level since records began The Independent
• Government ‘asleep at the wheel’ as NHS job vacancies hit ‘staggering’ high The Independent
• The NHS needs immigration – don't cut non-British staff out of the narrative The Independent
• Number of unfilled nurse jobs jumps by over 8,000 in just a year Nursing Notes
• Student nurse numbers headed ‘in the wrong direction’ Nursing Notes

Folic acid added to flour to prevent brain and spinal conditions in foetuses

Folic acid added to flour to prevent brain and spinal conditions in foetuses The number of pregnancies affected by life-threatening issues such as spina bifida could fall by more than a fifth as the government moves one step closer to actively adding folic acid to non-wholemeal flour.

Following a consultation with industry and stakeholders on whether to add folic acid to non-wholemeal flour, a public health policy which has already been successful in Australia, New Zealand and Canada, today the government is consulting on its proposal to add 250 micrograms of folic acid per 100 grams of flour. Department of Health and Social Care

National flu and COVID-19 surveillance reports published

National flu and COVID-19 surveillance reports published The main points from this week’s national influenza and COVID-19 surveillance report are:

Surveillance indicators suggest that, at a national level, COVID-19 activity has decreased in most indicators in week 34 of 2022.

The number of acute respiratory infection incidents (suspected outbreaks) decreased in England in week 34 to 111 compared to 124 in the previous week. Department of Health and Social Care

430,000 Britons have long Covid two years after infection, says ONS

430,000 Britons have long Covid two years after infection, says ONS An estimated 430,000 Britons were still suffering from long Covid two years after first contracting the virus, according to data released by the Office for National Statistics.

One in every 32 people in the UK was estimated to have some form of long Covid at the end of July, equivalent to 2 million people. Of those, around 1.5 million said their symptoms were adversely affecting their daily activities, while 384,000 said their ability to undertake daily activities had been “limited a lot”. The Guardian

See also:

• Prevalence of ongoing symptoms following coronavirus (COVID-19) infection in the UK: 1 September 2022 Office for National Statistics 
• Long Covid: 11-year-old on Leeds long Covid clinic help BBC News
• Boris defends Covid lockdowns YET AGAIN: PM insists orders DID NOT plunge the NHS into chaos The Daily Mail
• Chengdu locks down 21 million people in fresh Covid outbreak The Guardian
• ‘Record-high’ 892,000 people living with long Covid for a year, figures show The Independent
• People with health conditions invited to come forward for Covid booster vaccine ITV News

Prostate cancer symptoms and treatment: What to check for

Prostate cancer symptoms and treatment: What to check for Bill Turnbull's campaigning saved lives and encouraged "thousands and thousands" of men to come forward for prostate cancer testing, experts say.

The broadcaster died from the disease, at the age of 66, on Wednesday.

When Turnbull revealed his diagnosis, in 2018, referrals to the NHS increased by about 20%, according to charity Prostate Cancer UK, and calls to its helpline saw a large increase. BBC News

See also:

• Prostate cancer NHS UK
• Prostate cancer symptoms Prostate Cancer UK

Next PM must overhaul social care as level of unmet need astonishing, say charities

Next PM must overhaul social care as level of unmet need astonishing, say charities The new prime minister must “turn the page” on social care to transform it amid an “astonishing” level of unmet need, charities have warned.

The Care and Support Alliance (CSA), which represents more than 60 charities, is calling on the next Conservative Party leader to act fast, with research suggesting one in eight older people is going without the social care they need. The Independent

Major breakthrough as new treatments for most severe form of skin cancer could be developed

Major breakthrough as new treatments for most severe form of skin cancer could be developed Scientists have developed a novel way to stop the growth of melanoma – a major breakthrough that offers hope of one day effectively treating the cancer.

Melanoma is the fifth most common cancer in the UK, with around 16,000 new cases diagnosed each year. The Independent

Why your blood type could predict your stroke risk: Type As are 16% more likely to suffer one

Why your blood type could predict your stroke risk: Type As are 16% more likely to suffer one A person's blood type may be linked to their risk of having an early stroke, research suggests.

US researchers reviewed dozens of studies into genetics and ischaemic strokes, the most common type.

They found people with blood type A are 16 per cent more likely to suffer one before the age of 60, compared to everyone else. The Daily Mail

See also:

• Contribution of Common Genetic Variants to Risk of Early Onset Ischemic Stroke (abstract) Neurology

Women are at greater risk of missing a potentially deadly heart disease diagnosis

Women are at greater risk of missing a potentially deadly heart disease diagnosis Key signs that a woman is suffering from heart disease or will soon suffer a potentially deadly cardiovascular issue are often missed because they are more subtle than they are in men, leading cardiologists warn. The Daily Mail

See also:

• State of the Science: The Relevance of Symptoms in Cardiovascular Disease and Research: A Scientific Statement From the American Heart Association (open access) Circulation

Leukaemia patient warns others for the symptoms to look out for

Leukaemia patient warns others for the symptoms to look out for A leukaemia patient from Northamptonshire is urging people to be aware of the symptoms - as it might just save their life. Hannah Mahoney, 30, from Towcester, never thought cancer would happen to her.

After falling ill and googling her symptoms, she knew there was a chance it could be leukaemia. However, she is now in remission from acute promyelocytic leukaemia and has become a homeowner while landing her dream job as an emergency medical technician in the East Midlands Ambulance Service. Northants Live

7 new community diagnostic centres to offer more patients life-saving checks

7 new community diagnostic centres to offer more patients life-saving checks 7 new community diagnostic centres (CDCs) will open to help bust the Covid backlogs, diagnose patients more quickly and meet future demands on the NHS, the Health and Social Care Secretary has today confirmed. Department of Health and Social Care

COVID-19 alert level reduced to 2

COVID-19 alert level reduced to 2 Based on UKHSA advice, the UK Chief Medical Officers and NHS England National Medical Director have recommended to ministers the COVID alert level moves from level 3 to level 2.

Hospitals and the wider health systems remain extremely busy overall but the summer BA.4 and BA.5 wave is subsiding and direct COVID severe illness is now a much smaller proportion of this. Severe COVID cases, direct COVID healthcare pressures, direct COVID deaths and ONS community positivity estimates have decreased. Department of Health and Social Care

See also:

• Guidance: UK COVID-19 alert level methodology: an overview UK Health Security Agency

Covid: Pregnant women targeted with false vaccine claims

Covid: Pregnant women targeted with false vaccine claims Covid vaccination advice in pregnancy has not changed, contrary to false social media posts, UK health agencies have clarified.

Inaccurate messages shared by thousands claimed that pregnant or breastfeeding women were now recommended not to take the vaccine.

In fact, the NHS says the vaccine is both safe and strongly recommended for this group. BBC News

See also:

• Covid inquiry to examine Boris Johnson's pandemic decisions BBC News
• Moderna receives FDA green light for COVID-19 booster targeting the Omicron variant The Daily Mail
• UK's Covid alert is downgraded to level two as hospital pressure and infections decline The Daily Mail
• WHO: New COVID cases, deaths keep falling nearly everywhere The Independent

Review into Nottingham NHS maternity failings launches

Review into Nottingham NHS maternity failings launches A review into failings at a city's NHS maternity units has launched, with a call for affected families to come forward.

The review, led by midwife Donna Ockenden, will examine how dozens of babies died or were injured at the Nottingham University Hospitals (NUH) trust.

Ms Ockenden previously led an inquiry into the UK's biggest maternity scandal at Shrewsbury and Telford NHS Trust.

NUH said it welcomed the review. BBC News

See also:

• Nottingham maternity crisis: What are families calling for? BBC News

African-Caribbean people with type 1 diabetes ‘at higher risk of kidney disease’

African-Caribbean people with type 1 diabetes ‘at higher risk of kidney disease’ Ethnicity is a risk factor in people with type 1 diabetes developing kidney disease, a study suggests.

The findings also indicate that people of African-Caribbean heritage living with diabetes have nearly a 60% greater risk of advanced kidney disease. The Independent

See also:

• African Caribbean Ethnicity Is an Independent Predictor of Significant Decline in Kidney Function in People With Type 1 Diabetes (abstract) Diabetes Care

Steve Barclay ‘to tell NHS to scrap targets and focus on key areas’

Steve Barclay ‘to tell NHS to scrap targets and focus on key areas’ Health Secretary Steve Barclay will reportedly tell the NHS to scrap some of its targets and focus on cutting wait times for areas including ambulances, operations and GP appointments. The Independent

See also:

• Crackdown on NHS bureaucrats costing taxpayers £2.8billion a year: Steve Barclay launches plan The Daily Mail
• NHS can’t do it all and must scrap targets, warns Health Secretary The Daily Telegraph

"This is just not safe for anyone": the NHS doctors at breaking point

"This is just not safe for anyone": the NHS doctors at breaking point Medics explain how relentless scrutiny and gruelling hours are driving them to leave the profession. The New Statesman

NHS leaders warn of service cuts as hospital energy bills soar

NHS leaders warn of service cuts as hospital energy bills soar Hospital trusts in England face “eye-watering” rises in energy bills of £2m a month each due to the fuel price surge, with NHS leaders saying patients may face longer waiting times or even see their care “cut back” as a result.

NHS trusts are concerned they will have to make critical choices on staff levels and the services they provide in order to keep operating, with energy costs predicted to be as much as three times higher than a year ago. The Guardian

See also:

• Hospitals will be hit with “eye watering” energy bills this winter (open access) British Medical Journal
• NHS hospitals face paying an extra £2MILLION a month for energy this winter The Daily Mail
• Practices could cut staff, stop COVID-19 jabs or hand back contracts as energy bills rocket GPonline
• NHS hospitals to spend millions on crippling energy costs this winter The Independent
• Hospitals facing paying extra £2,000,000 a month for energy bills Metro

Bed-blocking crisis means medically-fit NHS patients have to wait up to 9 MONTHS to be discharged

Bed-blocking crisis means medically-fit NHS patients have to wait up to 9 MONTHS to be discharged The NHS bed-blocking crisis was laid bare today by shock data that revealed some patients are having to wait nine months to be discharged — despite being declared medically fit to leave enough to leave.

Nearly 13,000 hospital beds, one in seven, are filled with patients healthy enough for discharge.

They should be moved to a care home or offered home support, but staff shortages in the social care sector mean many languish on wards for weeks. The Daily Mail

 

See also:

• Patients fit for discharge stuck in hospital for up to nine months HSJ
• Medically fit patients waiting months to be discharged from England’s hospitals The Guardian

Has the Women’s Health Strategy listened to what women really need?

Has the Women’s Health Strategy listened to what women really need? The Women’s Health Strategy promises to address the poor experiences and worse health outcomes that women endure. The underlying cause of these issues is that the health system has historically been built by men for men. Consequently, women are often not listened to or believed by the health and care system. So, the crucial question is, will this strategy change the culture in the NHS of women not being listened to about their health and wellbeing? The King's Fund

Realising the benefits of provider collaboratives

Realising the benefits of provider collaboratives NHS trusts will play a critical role in delivering the key purposes of integrated care systems, often through partnership arrangements that will act as delivery vehicles within ICSs including provider collaboratives, place-based partnerships and neighbourhood multi-disciplinary teams. This briefing: provides a brief overview of how provider collaboratives are developing across England; illustrates some of the emerging benefits that collaboratives are working to realise; explores how trust leaders see the role of provider collaboratives developing within ICSs; and identifies some key enablers and risks trust boards need to consider. NHS Providers

Our position on industrial action

Our position on industrial action We are aware that some nursing and midwifery professionals are expected to be balloted in the coming weeks and months on industrial action. When this happens, we are often asked about how industrial action, including strike action, relates to the NMC Code of conduct for nurses, midwives and nursing associates. As the nursing and midwifery regulator, we’ve taken this opportunity to update our existing statement on industrial action and ensure we are highlighting our latest resources. Nursing and Midwifery Council

NHS rolls out new electric vehicles to help patients and the planet

NHS rolls out new electric vehicles to help patients and the planet New NHS electric vehicles are hitting the road this summer, helping to relieve pressure on ambulance services across the country while also helping the NHS cut its carbon footprint.

Eight ambulance trusts are trialling 21 zero-emission vehicles of various types, with six of the new green vehicles dedicated to mental health response in the community – designed to cut emergency response times for people with mental health needs and help reduce demand on traditional double-crewed ambulances. NHS England

Monkeypox cases confirmed in England – latest updates

Monkeypox cases confirmed in England – latest updates Latest updates on cases of monkeypox identified by the UK Health Security Agency.

HRT Taskforce presents recommendations to support future supply

HRT Taskforce presents recommendations to support future supply Action will be taken to make supplies of hormone replacement therapy (HRT) more resilient as Head of the HRT Taskforce Madelaine McTernan presents her key recommendations to support future management of the supply chain.

The recommendations will inform the work of the department and the UK wide menopause taskforce as Ms McTernan has returned to working full time as the Director General of the Vaccine Taskforce as preparation for the autumn booster campaign ramps up. Department of Health and Social Care

HRT tsar returns to role overseeing Covid boosters

HRT tsar returns to role overseeing Covid boosters Madelaine McTernan, who was recently appointed hormone-replacement therapy (HRT) tsar, to help deal with UK supply issues, has returned to her role overseeing vaccines, ahead of the planned autumn Covid booster campaign.

Access to the medication for menopause symptoms has improved over the four months she has been head of the HRT Taskforce, the government says.

But stocks of some products remain low. BBC News

See also:

• Wuhan lab at centre of Covid cover-up claims detects brand NEW virus The Daily Mail
• How would a shorter Covid isolation period work, and would it affect case numbers? The Guardian
• There’s some good news in the battle against long Covid The Guardian
• Long Covid causes erectile dysfunction and hair loss as symptoms list widens The Independent
• Life as a young person with long COVID: “You go through so many phases of up and down, it’s like being on a rollercoaster forever” World Health Organization

Hip fracture care too slow in some hospitals, study says

Hip fracture care too slow in some hospitals, study says There are big differences in how well patients with hip fractures are cared for by hospitals in England and Wales, a Bristol University study says.

In some hospitals one in 10 people died within a month of surgery - more than three times worse than in the best.

Getting patients into theatre quickly and out of bed the next day for physio are key ways to improve care.

People should receive the same, high-quality care wherever they live, the researchers said. BBC News

See also:

• Multiple hospital organisational factors are associated with adverse patient outcomes post-hip fracture in England and Wales: the REDUCE record-linkage cohort study (open access) Age and Ageing
• Recovery from a hip fracture varies widely among NHS hospitals, study finds University of Bristol
• Hip patients in deadly postcode lottery for care which leaves some twice as likely to die The Daily Mail
• Hip fracture patients more than twice as likely to die at some hospitals The Daily Telegraph
• Hip fracture recovery ‘varies between hospitals’ – study The Independent

Advanced cyber-attack: NHS doctors' paperwork piles up

Advanced cyber-attack: NHS doctors' paperwork piles up Doctors say it could take months to process mounting piles of medical paperwork caused by a continuing cyber-attack on an NHS supplier.

One out-of-hours GP says patient care is being badly affected as staff enter a fourth week of taking care notes with pen and paper.

The ransomware attack against software and services provider Advanced was first spotted on 4 August. BBC News

See also:

• NHS cyberattack causing ‘total chaos’ in hospitals could take a year to recover The Independent

There are five ways we can tackle the NHS staffing crisis

There are five ways we can tackle the NHS staffing crisis “The National Health Service and the adult social care sector are facing the greatest workforce crisis in their history”, said Parliament’s Health and Social Care Select Committee in July. The aspirations to rebuild services post-Covid, and tackle rising waiting times and other access challenges, are limited by the same challenge: there are simply not enough staff. The Independent

Faecal transplants to be offered to hundreds with antibiotic-resistant superbug

Faecal transplants to be offered to hundreds with antibiotic-resistant superbug Hundreds of people with a hard-to-treat superbug are to be offered faecal transplants to tackle their infections.

A faecal microbiota transplant (FMT) involves taking healthy bacteria "in a mixture of prepared processed stool from a healthy donor" to the intestine of another person. Sky News

See also:

• NICE recommends transplant with good bacteria taken from poo to resolve recurrent Clostridium difficile infections NICE
• Faecal transplants recommended for Clostridium difficile BBC News
• NHS patients struggling with superbugs to be offered poo transplants The Guardian
• Poo transplants to be offered to hundreds of NHS patients with superbugs The Independent

Common virus can contribute to the development of type 2 diabetes, study suggests

Common virus can contribute to the development of type 2 diabetes, study suggests A common type of herpes virus could increase your risk of developing type 2 diabetes, new research suggests.

Researchers at Ludwig Maximilian University and Helmholtz Munich in Germany have found that the herpes virus can contribute to the development of the condition.

Their study followed previous research that suggested viruses (including rubella and hepatitis C) are associated with type 1 diabetes (an autoimmune disease not linked to obesity). The Daily Mail

See also:

• Health impact of seven herpesviruses on (pre)diabetes incidence and HbA1c: results from the KORA cohort (open access) Diabetologia
• New study reveals that herpesvirus infection may increase the risk of developing diabetes Diabetologia

End of the family doctor? Patients are hit as 474 GPs' surgeries close their doors in a decade

End of the family doctor? Patients are hit as 474 GPs' surgeries close their doors in a decade Nearly 500 GP practices have permanently shut in the last decade without being replaced, according to stark figures unearthed in an investigation.

It means almost 1.5million people have been forced to travel further afield to seek treatment because new surgeries haven’t opened in their postcode area.

The research also shows that traditional family doctor-patient relationship is being lost because the average practice that shut treated fewer people in the vicinity. The Daily Mail

See also:

• GP shortage closes surgeries - even as patients desperately await appointments ITV News
• Revealed: The GP practices that have closed for good and why they have closed Pulse
• Full UK map: The areas where practice closures have left a gap in provision Pulse

NHS is hurtling towards a 'winter of discontent' with 'distinct possibility' doctors strike

NHS is hurtling towards a 'winter of discontent' with 'distinct possibility' doctors strike Britain faces a 'winter of discontent' in the NHS with a 'distinct possibility' doctors will strike over pay, one of the country's top medics warned today.

Philip Banfield, chairman of the British Medical Association, said doctors are having to decide daily which patients live or die because of the 'terrible state' of the NHS. The Daily Mail