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The NHS is setting up data-driven “war rooms” as it prepares for what could be England’s “toughest winter on record”, new plans have revealed.

Under the government’s winter preparation plan, which aims to help the NHS cope during the colder months, the 24/7 “care traffic control centres” are expected to be created in every local area.

The hubs, led by teams of clinicians and experts, will manage demand and capacity across England by constantly tracking the number of beds available and people attending hospital.

It is hoped the centres will make it easier and quicker for decisions, such as if hospitals need extra assistance or if ambulances need to be diverted, to be made.

It will mark the first time a system has been used to take stock of all activity and performance within the NHS.

Rapid response teams to help people who have fallen at home are also being set up across the country to prevent unnecessary hospital trips.

NHS England believes this expansion could see about 55,000 ambulance trips freed up to treat other patients each year.

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Under the plans, care providers will also be given more support to deal with falls, with around two in five hospital admissions from care homes currently related to patients falling over.

On top of that, NHS chiefs have vowed to roll out around-the-clock access to professional mental health advice within ambulance services to help give more people access to the correct community support.

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Hospital waiting time hits new high

‘Be prepared for things to get even tougher’

In a letter to all NHS foundation trusts, signed by the health service’s chief executive Amanda Pritchard, chief financial officer Julian Kelly and chief operating officer David Sloman, staff have been told “the coming weeks and months will be difficult”.

“We continue to be in a Level 3 incident, and services are under continued, significant pressure, with challenges including timely discharge of patients impacting on patient flow within hospitals, alongside ongoing pressures in mental health services,” it stated.

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“We therefore all need to be prepared for things to get even tougher over the coming weeks and months.

“We will support you in doing your best under these very difficult circumstances, including as you work with and support clinical leaders to ensure risk is managed appropriately across local systems.”

Respiratory infections expected to take up half of all NHS beds

It comes as the NHS is expecting to see a “very challenging winter”, with respiratory infections, including COVID, flu and pneumonia, predicted to be one of the most significant pressures.

Recent modelling has suggested that such health issues could occupy up to half of all NHS beds throughout the already busy season.

Grandmother had more than 200 emergency call outs in a year – will the new NHS plan help?

The government’s winter preparation plan is designed to take treatment and care to patients in the community as much as possible to ease pressure on hospital attendances and capacity.

So-called “rapid response teams” will target people who have had a fall either at home or in a care home but are not seriously hurt and do not need to be admitted to hospital for treatment.

I spent a day last week with paramedics from the London Ambulance Service. Our third emergency call was to visit Elizabeth 78-year-old grandmother, who lived on her own and who had fallen from her bed.

The paramedics had been called by Elizabeth’s carer. When we got there, they undertook a thorough assessment and thankfully Elizabeth had not suffered any broken bones or bruising.

We spent over an hour with Elizabeth, and rightfully so. She was a Category 2 emergency and needed to be seen by a trained paramedic in case she had seriously hurt herself.

Elizabeth had three ambulances visit her the day before and more than 200 emergency call-outs in the previous year.

If she had adequate care or somebody else to respond to her fall, then all those ambulance trips would not have been necessary.

There will also be a “new 24/7 system control centre created in every local area, which will manage demand and capacity across the entire country”.

This needs more detail. One trust chief executive I spoke to said this (on the face of it, at least) sounded “a bit like spin”.

If the idea is to manage patient flows to hospitals, to see where bottlenecks are building, and then diverting resources to hospitals and trusts in need of urgent help, it should already, to some extent, be happening.

It might be the first time ambulance data is available nationally and monitored 24/7 to react to live situations, but his fear was patients being transported long distances.

What is apparent is that there are genuine fears about what this winter will bring. The government says it “is preparing earlier and more extensively than ever before”.

New “respiratory hubs” will be built locally to look after patients with infections such as acute bronchitis and pneumonia.

There is expected to be a surge in winter respiratory infection, including flu and COVID. Again, the same day access to specialist care is to stop patients being admitted to hospital where possible.

Therefore, the NHS is preparing earlier and more extensively than usual, with the plans also aiming to create extra bed capacity in hospitals and in the community, and a drive to increase the number of 111 and 999 call handlers.

“This winter could be the toughest on record for the NHS, which is exactly why services are working together early to make sure patients get the care they need, where they need it most,” said Matthew Taylor, chief executive of the NHS Confederation.

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Ms Pritchard added: “Winter comes hot on the heels of an extremely busy summer – and with the combined impact of flu, COVID and record NHS staff vacancies – in many ways, we are facing more than the threat of a ‘twindemic’ this year.”

The autumn COVID booster programme will continue to be rolled out throughout winter, with more than eight million people already receiving their top-up jab.

People aged 50 or over and those considered at high risk of catching COVID are among those currently able to get the extra dose.

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Manchester synagogue attack: Families pay tribute to ‘kind and heroic’ victims – as police arrest three more suspects

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Manchester synagogue attack: Families pay tribute to 'kind and heroic' victims - as police arrest three more suspects

The families of the two victims of the Manchester synagogue attack have paid tribute to them as “heroic, beloved and cherished”.

Adrian Daulby, 53, and Melvin Cravitz, 66, were killed in the attack at Heaton Park synagogue in Crumpsall on Thursday.

Mr Daulby, a member of the congregation, was shot accidentally when police opened fire on attacker Jihad al Shamie.

The synagogue’s rabbi told Sky News it happened as Mr Daulby “was holding the doors to make sure everyone inside stayed safe”.

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Hero held doors closed to keep everyone safe, rabbi says

His family said he was a “hero” and a “lovely down-to-earth man” whose “final act was one of profound courage and he will forever be remembered for his heroic act”.

The family of Mr Cravitz – a security guard at the synagogue who was attending the service – said he would “do anything to help anyone”.

“He was so kind, caring and always wanted to chat and get to know people,” they said.

“He was devoted to his wife, family and loved his food. He will be sorely missed by his wife, family, friends and community.”

Adrian Daulby. Pic: Family handout
Image:
Adrian Daulby. Pic: Family handout

The tributes came as police said three more people – a man and two women – had been arrested on suspicion of terror offences, bringing the total to six.

They also revealed the attacker had been on bail over a suspected rape, but wasn’t on the radar of counter-terror police.

The Independent Office for Police Conduct (IOPC) is investigating the shooting – standard practice when a member of the public is killed.

The investigation would include “whether police may have caused or contributed to the death” of Mr Daulby.

Sir Stephen Watson, the head of Greater Manchester police, confirmed Mr Daulby’s injury appeared to be “a tragic and unforeseen consequence of the urgently required action taken by my officers”.

‘Gentle giant’

Other relatives of Mr Cravitz told Sky News he was a “gentle giant” who “would never harm a fly”.

His cousin, Phil Bentley, said his death was even more tragic as he would never normally be at the synagogue that early.

Melvin Cravitz. Pic: GMP
Image:
Melvin Cravitz. Pic: GMP

Hindi Cohen, a friend and neighbour, said he was a “lovely man” with a good sense of humour, adding: “Our kids loved him. He called himself uncle Melvin to my kids.”

One of Mr Daulby’s neighbours was also emphatic in his praise for a man he lived next door to for 20 years.

Abdul Rahimi called him “one of the best guys I’ve ever seen in my life” and a “very, very good man”, who often bought books and toys for children on their street.

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Synagogue attack victim was a ‘fantastic guy’

Another neighbour, Waqas Hussain, said the pair bonded over a shared love of nature, animals and birds.

He said Mr Daulby was a cancer survivor, who lived alone and started going to the synagogue more after his father died a few years ago.

“Just one of them people… so innocent, so approachable and so pure,” he told Sky News.

He said his friend hadn’t been fasting for health reasons and was debating whether or not to go the synagogue on Thursday.

Increased police patrols are being put in place near synagogues across the country following the atrocity.

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Manchester attacker – what we know

Lammy heckled at vigil

Police in London and Manchester have urged people not to hold planned protests in the cities this weekend so they can keep officers free.

A vigil for the victims was also held in Manchester on Friday – but Deputy Prime Minister David Lammy walked out to shouts of “shame on you” and boos from a few in the crowd.

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Deputy PM heckled at vigil

“Go to Palestine but leave us alone,” one person shouted.

Another protester shouted “my children’s school was closed today – you allowed this to happen.”

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Attacker’s family condemn ‘heinous act’

Thirty-five-year-old Jihad al Shamie was named as the attacker on Thursday and is believed to be of Syrian descent.

He is understood to have been granted British citizenship when he was around 16, having entered the UK as a young child.

Police shot him dead seven minutes after the first emergency call as they feared he was wearing an explosive device – later identified as a fake.

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Timeline: How terror attack unfolded

Three men also remain in hospital after the attack, with two of them named as Yoni Finlay and Andrew Franks.

One suffered a stab wound, a second was hurt after being hit by a car that al Shamie is said to have driven towards the synagogue, and the third suffered a gunshot wound.

One of the injured victims was working for the Community Security Trust (CST), a charity which provides security to the Jewish community.

Its chief executive, Mark Gardner, said: “One of our CST personnel was seriously injured in yesterday’s terror attack at Heaton Park Synagogue.

“We pray for his continuing recovery and salute the courage of all those who helped stop the terrorist from getting into the shul.”

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What we know about Manchester attacker Jihad al Shamie – as his family condemn ‘heinous act’

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What we know about Manchester attacker Jihad al Shamie -  as his family condemn 'heinous act'

The Manchester synagogue attacker was a British citizen of Syrian descent who came to the UK as a small child and had not previously been on the radar of police or MI5.

Jihad al Shamie, 35, was shot dead by armed officers seven minutes after launching a car and knife attack while wearing what appeared to be a vest with an explosive device, which was later found to be fake.

Manchester attack latest: Police on ‘high alert’ across country

Jihad al Shamie
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Jihad al Shamie

Adrian Daulby, 53, and Melvin Cravitz, 66, were killed after he drove at people outside Heaton Park Hebrew Congregation Synagogue, in Crumpsall, before stabbing a man.

One of the victims killed in yesterday’s attack was shot mistakenly by officers during their attempts to bring the attacker under control, Greater Manchester Police believe.

Three others remain in hospital with serious injuries.

Three people – two men in their 30s and a woman in her 60s – have been arrested on suspicion of the preparation or commission of acts of terrorism.

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Manchester attacker ‘did not stand out’

But Home Secretary Shabana Mahmood said it is “too early” to say if there was a terrorist cell behind the attack on Thursday morning, which took place on Yom Kippur, Judaism’s holiest day.

She said al Shamie, who is of Syrian descent, came to the UK as a “small child” and was naturalised as a British citizen in the mid-2000s.

The home secretary also said he was not known to the security services or police and had not been referred to the government’s Prevent anti-radicalisation scheme.

Asked about the attacker’s name on LBC, which presenter Nick Ferrari translated as “struggle of the Syrian”, she said: “I was very surprised to discover that name myself.

“Actually, as a Muslim, I’ve never heard someone being called Jihad, but it is the name that he was born with – that has always been his name.”

Police presence at a property in Langley Crescent, Prestwich.
Pic: PA
Image:
Police presence at a property in Langley Crescent, Prestwich.
Pic: PA

Al Shamie is believed to have lived in a council house in a quiet cul-de-sac in Langley Crescent, Prestwich, around two miles from the scene.

Videos obtained by Sky News show armed police, with a dog and a chainsaw, raiding the address at around 3.30pm on Thursday.

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In a post on Facebook, apparently from his family, his relatives said the attack “has been a profound shock to us”.

“The al Shamie family in the UK and abroad strongly condemns this heinous act, which targeted peaceful, innocent civilians,” they said.

“We fully distance ourselves from this attack and express our deep shock and sorrow over what has happened.

“Our hearts and thoughts are with the victims and their families, and we pray for their strength and comfort.”

Seen lifting weights

One of al Shamie’s neighbours said: “We used to see him out in the garden working out, doing weights, press-ups.

“He used to change his clothes. One day he would be wearing the full gown, to the floor and the next jeans and pyjama bottoms.”

Geoff Haliwell, 72, told Sky News the property used to be on his window cleaning round and he believed the al Shamie family, including his mother, father and brothers, had lived there for around 20 years.

“There’s no way I could’ve thought they were in any way involved in anything like this,” he said, describing the family as “nice people”.

He said he had also seen Jihad al Shamie use benches to work out and said he would sometimes wear western clothes and at other times “traditional” Syrian dress, but showed no signs of radicalisation.

“[He was a] smashing lad to talk to, just the same as everyone else. He didn’t stand out in any way,” he added.

Another neighbour, Kate McLeish, said she thought al Shamie was “an odd guy” and said he used to park his battered black Kia “quite badly on the road”.

The Syrian British Consortium, an organisation representing Syrians in the UK, said no one in its community networks has been able to identify him or confirm knowing him personally.

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Grandparents of Ethan Ives-Griffiths jailed for two-year-old’s murder

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Grandparents of Ethan Ives-Griffiths jailed for two-year-old's murder

A couple who murdered their two-year-old grandson have been jailed for life.

Michael Ives, 47, and Kerry Ives, 46, were found guilty of his murder and cruelty to a child in July after a trial at Mold Crown Court.

They were jailed for minimum terms of 23 years and 17 years respectively.

Their grandson Ethan Ives-Griffiths was dangerously dehydrated, severely underweight and had 40 visible bruises or marks when he collapsed with a catastrophic head injury at his grandparents’ home in Flintshire, North Wales, on 14 August 2021.

Kerry and Michael Ives were found guilty of Ethan's murder. Pic: North Wales Police/PA
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Kerry and Michael Ives were found guilty of Ethan’s murder. Pic: North Wales Police/PA

Ethan’s mother, Shannon Ives, 28, who had been staying with her son at her parents’ home, was found guilty of causing or allowing his death and child cruelty.

Ethan's mother Shannon Ives. Pic: North Wales Police/PA
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Ethan’s mother Shannon Ives. Pic: North Wales Police/PA

The court heard Ethan was made to stand with his hands on his head as a punishment when he misbehaved.

CCTV footage shown to jurors during the trial showed Michael Ives carrying his grandson by the top of his arm in a way described by prosecutor Caroline Rees KC “as though Ethan was just a bag of rubbish to be slung out”.

The video, taken from the back garden of the family’s four-bedroom home, showed Ethan appearing unsteady on a trampoline, or lying down, while other children bounced.

Michael Ives carrying Ethan outside the family home in Garden City, Deeside, Flintshire. Pic: North Wales Police/PA
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Michael Ives carrying Ethan outside the family home in Garden City, Deeside, Flintshire. Pic: North Wales Police/PA

Michael Ives carrying Ethan in the back garden. Pic: North Wales Police
Image:
Michael Ives carrying Ethan in the back garden. Pic: North Wales Police

Michael Ives was seen to point a garden hose at him, placed the toddler’s hands on his head, and gestured to another child to punch him.

After watching the video in court, Michael Ives said he felt “ashamed” and admitted being cruel and neglectful but denied mistreating Ethan in other ways.

He said his daughter was “quick-tempered” and would slap Ethan a couple of times a day, but Shannon Ives claimed her parents were “horrible” and abused her as a child.

Ethan Ives-Griffiths. Pic: North Wales Police/PA
Image:
Ethan Ives-Griffiths. Pic: North Wales Police/PA

Michael and Kerry Ives, originally from Wolverhampton, were in the living room with Ethan at the time of his collapse while his mother was on the phone upstairs.

The pair told the jury “nothing” had happened to the toddler before he fainted as they watched television.

Kerry Ives said she immediately called her daughter to come downstairs, but the court heard it was 18 minutes before she called emergency services.

Ethan was taken to the Countess of Chester Hospital and later transferred to Alder Hey Children’s Hospital in Liverpool, where he died two days later.

Michael Ives being interviewed by police officers. Pic: North Wales Police/PA
Image:
Michael Ives being interviewed by police officers. Pic: North Wales Police/PA

Kerry Ives being interviewed by police officers. Pic: North Wales Police/PA
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Kerry Ives being interviewed by police officers. Pic: North Wales Police/PA

He was found to have abdominal injuries likely to have been caused by blows in the days before his collapse, as well as bruises consistent with grip marks on his leg and face.

Experts said Ethan would have died of dehydration within days had he not suffered the head injury, and at the time of his death weighed just 10kg.

Ethan’s fatal head injury was said to have been caused by deliberate force or shaking, and occurred at the time, or in the minutes before, he collapsed.

Ethan with his father Will Griffiths. Pic: North Wales Police/PA
Image:
Ethan with his father Will Griffiths. Pic: North Wales Police/PA

Following the verdicts, Ethan’s father Will Griffiths said: “He will be remembered for the smiley, outgoing, loving child that he was. He can now rest in peace, knowing that justice has been served.”

Child protection register

The court heard the youngster had been placed on the child protection register, requiring him to be seen every 10 days.

But when Shannon Ives last saw her social worker, on 5 August 2021, she spoke to him on the doorstep and told him Ethan was having a nap.

No one answered the door when social worker Michael Cornish went to visit in the days before Ethan’s death and a scheduled appointment with a health visitor on 13 August was cancelled.

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