Sexual health providers fear they could be forced to stop seeing vulnerable and at risk patients in some parts of the country unless they receive extra government funding to cover the cost of tackling the Monkeypox outbreak.
In a letter to NHS England, the UK Health Security Agency (UKHSA), and the Department of Health and Social Care, sexual health leaders say on average 25-30% of all services have been replaced by Monkeypox assistance since the first case was identified in early May.
This includes a 90% reduction in access to STI screening in the most affected areas, and half of providers needing to reduce their PrEP delivery services to those at risk of contracting HIV by 25%.
They say this drop in appointments for assessment and treatment has resulted in outbreaks of STIs in several parts of the country.
The letter signed by the British HIV Association, and the British Association for Sexual Health and HIV says: “In some cases this displacement in financial terms means a potential loss of income to clinics of over £600,000 per quarter.
“This level of loss of income risks destabilising clinics, with loss of staff and, as some providers have warned us, the potential exit from the market of some providers.”
Sexual health leaders also say that vaccination funding of £15 per dose delivered has yet to reach any of the clinics, doesn’t meet the cost of providing the service and doesn’t cover providers for work displacement.
In a separate letter to Public Health Directors and Commissioning Officers at District Councils, they pleaded for funding to not be withdrawn while they seek extra funding.
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“After repeated advocacy with the government and with NHS England/Improvement, we are still at the stage of these national agencies repeatedly requesting evidence while this burden on services remains unfunded,” the letter reads.
“We continue to press them for MPX funding and have repeatedly advised them that the exceptional nature of this epidemic, the transmission routes of MPX and its impact should not be considered as routine sexual health expenditure.”
Responding to the letters, a Department of Health and Social Care spokesperson said: “We continue to work closely with the UK Health Security Agency, local authorities and NHS England to manage pressures on sexual reproductive health services and ensure access to routine services is maintained.
“The Public Health Grant will increase in each of the next three years, bolstering sexual health services and enabling people to access treatments faster.”
Sky News analysis has found spending on sexual health clinics has reduced in almost every local authority in England since the service was passed on to local governments’ responsibility in 2013, according to data from local authority revenue expenditure and financing.
There have been 3,654 confirmed or highly probable cases of Monkeypox since 6 May, at its peak in mid-July there were around 60 cases per day. That number decreased throughout August and continues to fall.
More than 45,000 people have received a dose of the Monkeypox vaccine, including around 40,000 gay, bisexual and other men who have sex with men and who are at highest risk of exposure.
Those at highest risk continue to be prioritised but some clinics will offer second doses to provide longer term protection to vulnerable groups two to three months after they receive the first dose, with the NHS inviting those eligible to come forward.
An amber warning for snow and ice, with the risk of freezing rain, covers most of Wales and central England until midday on Sunday.
Freezing rain, which makes up what are commonly known as ice storms in North America, is a rarity in the UK because the conditions for it are quite specific, according to the Met Office.
But what is it and how is it different to snow?
Freezing rain is rainfall that has become “supercooled” as it falls from the sky.
It starts when snow, ice, sleet or hail high up in the atmosphere melts into rain when it falls through the layers of warmer air below.
If the rain then passes through a sub-zero layer of air just above the ground, it can remain liquid and instead become “supercooled”. This is the key to freezing rain.
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Supercooled water will freeze on impact – forming a clear layer of ice on cold surfaces such as trees, roads and power lines.
Why is it dangerous?
It’s once it hits the surface and turns to ice that it canpose a real threat.
The ice is very clear, often referred to as black ice, because it is so difficult to see, making it treacherous for pedestrians and drivers.
Sky News meteorologist Kirsty McCabe explains: “The supercooled rain hits the ground and freezes instantly on impact, and that creates a thin layer of ice, also known as glaze, and it’s clear, so you can’t see the ice, which makes it really treacherous.”
If it hits power lines or tree branches, depending on how much rain there has been, the weight of the ice can cause them to break off because they can’t support the weight.
It can also make it difficult to open your car door if there is enough of it.
From 6pm on Saturday to midday on Sunday an amber warning for snow and ice, with the risk of freezing rain, covers most of Wales and central England, including the Midlands and Liverpool and Manchester in the North West.
But McCabe says it’s Wales where people should be particularly wary of freezing rain.
What precautions should people take?
The best thing people can do is take extra care when travelling. As it is so hard to see, it’s difficult to judge just how icy road surfaces are.
The RAC says freezing rain is arguably the most treacherous of all conditions for motorists.
They urge people not to drive unless necessary, but say those who do need to should check they have plenty of fuel and oil and check their tyre treads.
They also encourage drivers to make sure their lights are working and check they have screenwash.
The King is deeply saddened by the death of a British man who was killed in the attack in New Orleans on New Year’s Day – amid reports he was the stepson of an ex-royal nanny.
Sky News understands the King was made aware of Mr Pettifer’s death through official channels, was deeply saddened, and has been in touch with the family to share personal condolences.
The 31-year-old’s family said they were “devastated” by his death.
“He was a wonderful son, brother, grandson, nephew and a friend to so many,” the family said in a statement.
“We will all miss him terribly. Our thoughts are with the other families who have lost their family members due to this terrible attack. We request that we can grieve the loss of Ed as a family in private.”
New Orleans’ coroner said the preliminary cause of death for Mr Pettifer was blunt force injuries.
Fourteen people were killed and dozens injured when 42-year-old army veteran Shamsud-Din Jabbar’s rented truck rammed into people in New Orleans’ famous Bourbon Street in the early hours of New Year’s Day.
Jabbar was killed in a shootout with police.
The Federal Bureau of Investigation (FBI) said the attack was “premeditated” and an “evil” act of terrorism, and added Jabbar was “100% inspired by ISIS”, also known as Islamic State.
The preliminary cause of death for all the victims was blunt force injuries, according to the New Orleans coroner.
The coroner has identified most of those killed in the attack, with efforts continuing to identify the final female victim.
• Edward Pettifer, 31, from Chelsea, west London • Andrew Dauphin, 26, from Montgomery, Alabama • Kareem Badawi, 23, from Baton Rouge, Louisiana • Brandon Taylor, 43, from Harvey, Louisiana • Hubert Gauthreaux, 21, from Gretna, Louisiana • Matthew Tenedorio, 25, from Picayune, Mississippi • Ni’Kyra Dedeaux, 18, from Gulfport, Mississippi • Nicole Perez, 27, from Metairie, Louisiana • Reggie Hunter, 37, from Prairieville, Louisiana • Martin Bech, 27, from New York City, New York • Terrence Kennedy, 63, from New Orleans, Louisiana • Elliot Wilkinson, 40, from Slidell, Louisiana • William DiMaio, 25, from Holmdel, New Jersey
An Islamic State (IS) flag, weapons, and what appeared to be an improvised explosive device (IED) were found in the vehicle used in the attack, the FBI said.
The suspect posted five videos on social media before the rampage in support of IS, the agency added.
In his first clip, Jabbar said he was planning to harm his own family and friends, but was concerned headlines would not focus on the “war between the believers and disbelievers”, said Christopher Raia, deputy assistant director of the FBI’s counter-terrorism division.
Jabbar also joined IS “before this summer”, and provided a will, the FBI chief said.
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The half-brother of the attack suspect said ‘this wasn’t the man I knew’
In an interview with a Texas-based TV station, owned by Sky News’ partner network NBC News, Jabbar’s younger half-brother said he was thinking about all those impacted by the attack.
Abdur-Rahim Jabbar said: “This is a tragedy. We’re all grieving about this.”
The suspect was a Muslim, with his sibling adding: “This wasn’t the man I knew. This wasn’t the father, the son that I knew.
“And that also, this isn’t any representation of Islam or Muslims or the Muslim community.”
On 16 January, there’s a strong chance you’ll be able to see Mars as the red planet will be in “opposition”, meaning Earth will be directly between it and the sun.
Just under a week later, on 21 January, you could see five planets – Saturn, Venus, Uranus, Jupiter and Mars – in the night sky after 9pm, according to the Royal Observatory Greenwich.
Four of the planets should be visible to the naked eye, but seeing Uranus will require a telescope or very dark skies.
Anyone hoping to spot celestial phenomena is advised to find a stargazing spot away from light pollution and to allow at least 15 minutes for your eyes to adjust to the darkness.