A workforce the size of the population of Newcastle needs to be recruited urgently to ease the “gridlocked” health and care system and to prevent serious harm to patients, the country’s care regulator has warned.
The Care Quality Commission (CQC) says it is getting “tougher and tougher” to access care because of a massive shortage in the workforce.
There are around 132,000 vacancies in the NHS and 165,000 across social care, about the same size as the population of the north east city.
And this shortfall in the care sector is having a huge impact on NHS waiting lists, hospital bed availability and accident and emergency response times.
The CQC described the entire health and care system as “gridlocked” and “unable to operate effectively”.
The CQC echoes thewarnings raised by health leaders about the need to address the crisis in social care to ease the pressure on the rest of the health system.
Chief Executive Ian Trenholm said the recruitment challenge faced by health and care leaders “is going to translate into real difficulty” this winter and in the years ahead.
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Mr Trenholm said the impact of the gridlock is that people are struggling to see their GP or dentist, wait for longer to get to hospital, and once there can become stuck due to a lack of social care to help them once they are ready to leave.
He said: “And this is not just a care consequence. There’s an economic consequence to all of this as well.
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“People who are ill can’t go back to work because they’re in a backlog, in some kind of queue waiting for care.”
Amanda Pritchard, NHS England chief executive, said there are around 10,000 patients in hospitals who are medically fit to be discharged butmust stay because there is no care provision for them in thecommunity.
The CQC said only two in five people are able to leave hospital when they are ready, contributing to record-breaking waits in emergency departments following a decision to admit, and dangerous ambulance handover delays.
It found in some cases almost half a hospital is full of people who are medically fit to be discharged but are waiting for social care support, it said.
Beds are available but some care homes are closing their doors to new arrivals because they cannot provide safe staffing levels.
And some nursing homes are having to re-register as care homes because nursing staff are leaving and they are struggling to recruit replacements.
Figures from the Association of Directors of Adult Social Services show that more than half a million people (542,002) were estimated to be waiting for assessments, reviews or care to start as of 30 April this year.
Separate data from the workforce body Skills for Care show that the number of filled posts fell – by about 50,000 – between 2020-21 and 2021-22 for the first time on record.
The CQC’s annual report on the state of health and social care in England also warned that the rising cost of living could result in more care staff leaving for better-paid work.
The regulator also pointed to an unprecedented number of care workers in the South East resigning in May and June because of fuel costs.
The CQC said that, without action, more health and care staff will quit, services will be further stretched, and people will be at greater risk of harm.
This will be especially pronounced in more deprived areas, where access to care outside hospitals is under the most pressure.
Analysis: For too long the focus has been on acute care while the crisis in social care has been allowed to grow.
All health and care leaders are saying the same thing.
Health and social care must be seen as the same integrated system.
For too long the focus has been on acute care while the crisis in social care has been allowed to grow.
Years of chronic underfunding has left social care in the state it is now.
But the impact on hospitals and the rest of the health service is now being felt.
The pandemic has swelled the waiting lists and to make any headway on the numbers, patients need to go into hospital and get out as soon as it is safe for them to be discharged.
But patients are going into hospital and staying there because there is nobody left to care for them in the community.
The pandemic helped to change the way we look at social care.
We saw just how vulnerable many people were, and we saw just how undervalued and underpaid social care staff were feeling.
That is why so many have left the sector. Unless pay and rewards are addressed care staff will keep leaving and new recruits will not take their place.
The NHS recognises the importance of social care in preventing patients from coming to hospital in the first place.
Among other measures it is setting up rapid response units to attend to people who have suffered falls.
The vast majority of these patients will not need hospital admittance.
Every time an ambulance crew attends a fall it cannot attend to another emergency.
I spent a day with the London Ambulance Service last week.
Our third emergency that morning was to attend to a 78 year woman who had fallen from her bed.
Elizabeth was thoroughly examined and no serious injury was found.
Records showed that Elizabeth had more than 200 ambulance visits for falls the year before.
If she had a good care package in place then those ambulance visits would not all have been necessary and the paramedics could have been responding more quickly to another emergency.
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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2:33
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.”
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.
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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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.”
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.”
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.
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.”
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.
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.
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.
Image: 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.
Image: 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.
Image: Michael Ives carrying Ethan outside the family home in Garden City, Deeside, Flintshire. Pic: North Wales Police/PA
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.
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.
Image: Michael Ives being interviewed by police officers. Pic: North Wales Police/PA
Image: 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.
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.