The NHS is facing the “most difficult winter in its history”, with almost 90% of hospital trust leaders feeling “extremely concerned”, research has found.
NHS Providers, which carried out the survey, said that while cases of COVID-19 are “well below” their peak in January, some trusts are “beyond full stretch”.
It is urging the government to offer cash bonuses of about £500 to stop social care staff leaving for jobs in “hospitality, supermarkets, or online firms such as Amazon”.
Chris Hopson, chief executive of NHS Providers, said the bill would come to about £750m.
He said: “While £500 is not as high as some employers in retail and hospital are offering as a ‘golden hello’ in the run up to Christmas, this is a price worth paying if it helps keep social care functioning as we need it to through the winter.”
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The organisation said the “traditional peak of winter demand usually runs from mid-November to end-February, with pressure often greatest in January”.
Health leaders are calling on the government to take “immediate, emergency action to support social care”, it added.
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NHS Providers said it had spoken to 172 board level trust leaders from 114 trusts,
According to its results, 87% are extremely concerned about the impact of winter on their trust and local area.
When asked the same question last year, the figure was 56%.
Moreover, 94% said they are extremely or moderately concerned about staff burnout.
Mr Hopson said that some trust leaders are “finding it impossible to recruit extra staff”.
People who work in care homes in England must now be double-vaccinated, while those in other health settings have been given an April deadline.
Meanwhile, the number of people waiting more than six weeks for a heart scan is 20 times higher than it was before the pandemic, a charity has said.
In addition, analysis from the British Heart Foundation (BHF) has found that NHS England is doing 10,000 fewer echocardiograms (echos) each month than before the pandemic.
Echos look at the structure of the heart and are routinely used to diagnose congenital disease and problems with valves.
The BHF said it is concerned that reduced access to the tests may have created a large backlog of people who need treatment.
“Long waits put lives at risk,” it said. “Delaying a heart disease diagnosis increases the likelihood of death or disability.”
It said the government “must act now” to address the “cardiology NHS workforce crisis” and outline how “newly announced diagnostic centres” could be brought into play.
The most recent figures show that at the end of September, 64,962 people in England had waited more than six weeks for an echo, compared to 3,238 at the end of February 2020, BHF said.
The total waiting list is 149,050, with 44% waiting six weeks or more.
Diane Phillimore, 63, a carer from Calnein Wiltshire, needs an echocardiogram to show if she requires surgery to repair or replace a valve in her heart.
Her original appointment in March 2020 was cancelled because of the pandemic. It has now been rescheduled for this month – 20 months later.
“The whole situation is shocking,” she said. “I just want to know if I need surgery or if my heart is working properly, so I can move forward. Until then, it’s always there in the back of my mind.”
Sonya Babu-Narayan, Associate Medical Director at BHF, said: “Waiting lists for heart treatments were too long even before the pandemic began.
“Without an echocardiogram, doctors can’t see how well the heart is working and if someone needs potentially life saving treatment for heart disease.”
The Department for Health and Social Care has been approached for comment.
Violence has broken out at a St George’s Day event in central London.
The Metropolitan Police released footage showing a group of men – some draped in St George’s flags – clashing with officers in Whitehall.
At one point in the footage, a man appears to hit a police horse with an umbrella.
The Met had earlier warned that those attending the event were expected to include “far right groups and groups linked to football clubs travelling from elsewhere in the UK”.
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Shortly after 2pm, the force posted on X: “The event is not due to start for an hour and regrettably officers are already dealing with disorder.”
“There is an area allocated for this event in Richmond Terrace. This group went past it and continued up Whitehall.
“When officers formed a cordon and asked the group to turn round, they reacted by violently forcing their way through. Mounted officers intervened with horses to restore the cordon.”
The disorder was broken up and the Met said there have been “no further incidents since that altercation”.
The Met earlier said an order was in force in Lambeth and Westminster giving officers the power to require the removal of face coverings after it said several people were seen to be wearing masks.
It added a Section 60 order was issued allowing police to ramp up stop and searches.
St George’s Day is celebrated on 23 April every year, honouring the patron saint of England.
A photo of Prince Louis taken by the Princess of Wales has been released to mark the young royal’s sixth birthday.
The image of a smiling Louis was shared on social media along with the caption: “Happy 6th Birthday, Prince Louis! Thank you for all the kind wishes today.”
The photo was taken in the last few days in Windsor and is understood to be unedited.
It is understood William and Katereleased the image as a way to thank those who sent good wishes while also protecting their privacy.
The same process – a deviation from the usual issuing of the pictures to the press in advance under an embargo – is expected to be followed for Princess Charlotte’s birthday in May.
The change in process is understood to be due to the unprecedented time the family is experiencing.
Photograph’s release breaks with tradition – but these are unprecedented times
A happy little boy smiling for his mum behind the camera, Prince Louis again looks every bit the fun, cheeky boy who has stolen the show at big royal events in recent years.
He is growing up fast, and we’re told the Prince and Princess of Wales are hugely grateful for the birthday wishes they’ve had as he turns six.
But unlike previous years, it wasn’t a given that we were going to see a new photograph of him. Usually, like clockwork, birthday photographs of the children are released, normally taken by the Princess.
But these are described as unprecedented times for them, with Kate being treated for cancer, and their heightened desire for privacy.
There would undoubtedly have been discussions about whether a new picture would just draw the spotlight back onto them, especially when you consider the furore over the last photograph they released for Mother’s Day.
On balance, they clearly decided they wanted to put something out on their social media as any parent would, an unedited picture taken by mum, but not release it to the media the night before as they have done previously.
At the moment, with everything they have going on, you can’t begrudge them for wanting to do things their way.
The Princess of Wales announced in March that she was undergoing preventative chemotherapy.
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March: Princess of Wales reveals she is having treatment for cancer
Louis, meanwhile, was last seen in public on Christmas Day when the Royal Family made their traditional festive appearance on the King’s Sandringham Estate to walk to church.
The release of the photograph comes after Louis’ father, Prince William, resumed royal duties last week in his first public engagement since Kate’s cancer announcement.
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The prince visited a food distribution charity, Surplus to Supper, in Surrey, where he saw how extra food from across the local area was redistributed to small community organisations.
Photos showed him getting busy in the kitchen at the charity’s hub in Sunbury Cricket Club as he made chilli con carne and chopped ingredients under the supervision of head chef Mario Confait.
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William, Kate and their three children missed the Easter Sunday service at St George’s Chapel at Windsor Castle, following the news, despite attending last year.
The King has recognised the public service of his family in a new list of honours, including creating a new role for the Princess of Wales.
King Charles has thanked his daughter-in-law, in a way that only royals can, by making her the Royal Companion of The Order of the Companions of Honour.
The palace say this is a new appointment to the Order.
Royal watchers will see it as a significant move by the King as it’s the first time a member of the Royal Family has ever been appointed to the Companions of Honour.
It was founded by King George V in 1917 to recognise outstanding achievements in the Arts, Sciences, Medicine and Public Service.
The monarch has also appointed Queen Camilla to be Grand Master and First or Principal Dame Grand Cross of the Most Excellent Order of the British Empire. It was a role fulfilled in the past by Prince Philip.
The Order honours a broad cross-section of society, both military and civilian.
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Meanwhile Prince William has been presented with a title held by his father, until he became King in 2022, becoming Great Master of the Most Honourable Order of the Bath.
The order was established by King George I in 1725 but is believed to date back as far as the eighth century, recognising members of the military or civil service for exemplary service.
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The new appointments come at a time when the King has relied on his family for more support in his duties since his cancer diagnosis.
In new appointments to the Order of the Garter, which are traditionally announced on St George’s Day, The Duchess of Gloucester has been made a Royal Lady Companion of the Most Noble Order of the Garter.
She is joined by composer Lord Andrew Lloyd-Webber who is made a Knight Companion of the Most Noble Order of the Garter, along with Air Chief Marshal the Lord Peach, and Lord Kakkar, known for his services to healthcare.
The Order of the Garter is the oldest and most senior Order of Chivalry in Britain.
Each year, it is celebrated with a procession and service in the grounds of Windsor Castle.