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 last blast furnaces left operating in Britain could see their fate sealed within days, after their Chinese owners took the decision to cut off the crucial supply of ingredients keeping them running.
Jingye, the owner of British Steel in Scunthorpe, has, according to union representatives, cancelled future orders for the iron ore, coal and other raw materials needed to keep the furnaces running.
The upshot is that they may have to close next month – even sooner than the earliest date suggested for its closure.
The fate of the blast furnaces – the last two domestic sources of virgin steel, made from iron ore rather than recycled – is likely to be determined in a matter of days, with the Department for Business and Trade now actively pondering nationalisation.
The upshot is that even as Britain contends with a trade war across the Atlantic, it is now working against the clock to secure the future of steelmaking at Scunthorpe.
The talks between the government and Jingye broke down last week after the Chinese company, which bought British Steel out of receivership in 2020, rejected a £500m offer of public money to replace the existing furnaces with electric arc furnaces.
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The sum is the same one it offered to Tata Steel, which has shut down the other remaining UK blast furnaces in Port Talbot and is planning to build electric furnaces – which have far lower carbon emissions.
Image: These steel workers could soon be out of work
However, the owners argue that the amount is too little to justify extra investment at Scunthorpe, and said last week they were now consulting on the date of shutting both the blast furnaces and the attached steelworks.
Since British Steel is the main provider of steel rails to Network Rail – as well as other construction steels available from only a few sites in the world – the closure would leave the UK more reliant on imports for critical infrastructure sites.
However, since the site belongs to its Chinese owners, a decision to nationalise the site would involve radical steps government officials are wary of taking.
They also fear leaving taxpayers exposed to a potentially loss-making business for the long run.
The dilemma has been heightened by the sharp turn in geopolitical sentiment following Donald Trump’s return to the White House.
The incipient trade war and threatened cut in American support to Europe have sparked fresh calls for countries to act urgently to secure their own supplies of critical materials, especially those used for defence and infrastructure.
Gareth Stace, head of UK Steel, the industry lobby group, said: “Talks seem to have broken down between government and British Steel.
“My advice to government is: please, Jonathan Reynolds, Business Secretary, get back round that negotiating table, thrash out a deal, and if a deal can’t be found in the next few days, then I fear for the very future of the sector, but also here for Scunthorpe steelworks.”
Prince Andrew’s efforts to make money from his Pitch@Palace project have been branded as a “crude attempt to enrich himself” at the expense of “unsuspecting tech founders”, as new documents may shed more light on what he and his team have been attempting to sell.
Today is the deadline for documents to be released relating to Prince Andrew‘s former senior adviser Dominic Hampshire and his interactions with the alleged Chinese spy Yang Tengbo.
In February, an immigration tribunal heard how the intelligence services had contacted Mr Hampshire about Mr Yang back in 2022. Mr Yang helped set up Pitch@Palace China, a branch of the duke’s scheme to help young entrepreneurs.
Image: The alleged Chinese spy, Yang Tengbo, has links with Prince Andrew
Image: Yang Tengbo. Pic: Pitch@Palace
Judges banned Mr Yang from the UK, saying his association with a senior royal had made Prince Andrew “vulnerable” and posed a threat to national security. Mr Yang challenged that decision at the Special Immigration Appeals Commission (SIAC).
Since that hearing, media organisations have applied for certain documents relating to the case and Mr Hampshire’s support for Mr Yang to be made public. SIAC agreed to release some information of public interest. It is hoped they may include more details on deals that he was trying to do on behalf of Prince Andrew.
So what do we know about potential deals for Pitch@Palace so far?
In February, Sky News confirmed that palace officials had a meeting last summer with tech funding company StartupBootcamp to discuss a potential tie-up between them and Prince Andrew relating to his Pitch@Palace project.
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The palace wasn’t involved in the fine details of a deal but wanted guarantees to make sure it wouldn’t impact the Royal Family in the future. Sky News understands from one source that the price being discussed for Pitch was around £750,000 – there are, however, reports that a deal may have stalled.
Photos we found on the Chinese Chamber of Commerce website show an event held in Asia between StartupBootcamp and Innovate Global, believed to be an offshoot of Pitch.
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Who is alleged Chinese spy, Yang Tengbo?
Documents, released in relation to the investigations into Mr Tengbo, have also shown how much the duke has always seen Pitch as a way of potentially making money. One document from 21 August 2021 clearly states “the duke needed money at the time, and saw the relationships with China through Pitch as one possible source of funding”.
But Prince Andrew’s apparent intention to use Pitch to make money has led to concerns about whether he is unfairly using the contacts and information he gained when he was a working royal.
Norman Baker, former MP and author of books on royal finances, believes it is “a crude attempt to enrich himself” and goes against what the tech entrepreneurs thought they were signing up for.
He told Sky News: “The data given by these business people was given on the basis it was an official operation and not something for Prince Andrew, and so in my view, Prince Andrew had no right legally or morally to take the data which has been collected, a huge amount of data, and sell it…
“And quite clearly if you’re going to sell it off to StartupBootcamp, that is not what people had in mind. The entrepreneurs who joined Pitch@Palace did not do so to enrich Prince Andrew,” he said.
Rich Wilson was one tech entrepreneur who was approached at the start of Pitch@Palace to sign up, but he stepped away when he spotted a clause in the contract saying they’d be entitled to 2% equity in any funding he secured.
He feels Prince Andrew is continuing to use those he made a show of supporting.
He said: “It makes me feel sick. I think it’s terrible – that he is continuing to exploit unsuspecting tech founders in this way. A lot of them, I’m quite grey and old in the tooth now, I saw it coming, but clearly most didn’t. And a lot of them were quite young.
“It’ll be their first venture and you’re learning on the trot, so to speak. So to take advantage of people in such a major way – that’s an awful, sickening thing to do.”
We approached StartupBootcamp who said they had no comment to make, and the Duke of York’s office did not respond.
With reports that a deal may have stalled, it could be a big setback for the duke – especially with questions still about how he’ll continue to pay for his home on the Windsor estate now that the King no longer gives him financial support.
The UK is in talks with Brazil over the “potential sale” of the Royal Navy’s two amphibious assault ships that are being ditched to cut costs, the Ministry of Defence has confirmed.
Defence experts said the fact HMS Bulwark – which has only just received an expensive refit – and HMS Albion are being flogged off underlines the pressure on the defence budget even though Sir Keir Starmer keeps talking up his promises to boost expenditure.
The two warships can be used to deploy Royal Marines to shore – a vital capability at a time of growing global threats.
News of the possible sale was first revealed in Latin American media.
One report said the Royal Navy and Brazilian Navy had signed an agreement that would see the UK giving information to the Brazilians on the state of the two ships prior to any purchase.
Asked about the claim that the UK would sell the assault ships to Brazil, a Ministry of Defence spokesperson said: “We can confirm we have entered discussions with the Brazilian Navy over the potential sale of HMS Bulwark and HMS Albion.
“As announced in November, both ships are being decommissioned from the Royal Navy. Neither were planned to go back to sea before their out of service dates in the 2030s.”
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James Cartlidge, the shadow defence secretary, appeared to question the wisdom of the move.
“At Defence orals [House of Commons questions] on January 6th Defence Secretary John Healey said: ‘HMS Bulwark and HMS Albion were not genuine capabilities’,” Mr Cartlidge wrote in a post on social media.
“They’ve just been sold to Brazil.”
Matthew Savill, the director of military science at the Royal United Services Institute, said the plan to sell the vessels demonstrates there “is still life in both these ships”.
He said: “The fact that the UK is prepared to sell off useful amphibious capability – which could be used in evacuation operations or other cases where air transport is difficult – shows just how tight finances are even with the promised budget increase.
“The replacements for these ships are still several years away and won’t be available until the 2030s.”
Mr Savill added: “As an aside, Brazil will probably have greater amphibious capacity than the UK, having previously bought HMS Ocean, the UK’s helicopter assault ship.”
HMS Albion and HMS Bulwark entered service two decades ago.
Both are currently held at lower readiness having not been to sea since 2023 and 2017 respectively.
HMS Ocean, a helicopter-landing vessel and once the largest warship in the Royal Navy, was sold to the Brazilian Navy in 2018 after 20 years in service.