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.
Newly released emails from Jeffrey Epstein include one in which the late paedophile financier describes how Andrew Mountbatten-Windsor did have his photo taken with victim Virginia Giuffre.
Ms Giuffre, who took her own life earlier this year, claimed in her recently released autobiography that – as a teenager – she had sex with Andrew on three occasions after being trafficked by Epstein and Ghislaine Maxwell.
The details have emerged after thousands of files from the Jeffrey Epstein estate were released by Republicans on the House Oversight Committee.
The email that discusses the photograph was one of those released and features an exchange with a journalist in 2011.
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A picture emerged in 2011 of Andrew, which has become infamous, showing the former prince with his arm around Virginia Giuffre, apparently taken in Ghislaine Maxwell’s London home.
Although the name of the “girl” is redacted, Epstein appears in his email exchange to be referring to Ms Giuffre, who at the time had spoken to The Mail on Sunday, which had published the photo and her account of encountering Andrew while travelling with Epstein. After cutting ties with Epstein, she moved to Australia. She also changed her surname from Roberts to Giuffre.
An email from Epstein to the journalist read: “The girl has fled the country with an outstanding arrest warrant. The da (sic) after she accused others, said in writing that she has no credibility, she was never 15 years old working for me, her story made it seem like she first worked for trump at that age and was met by ghislaine maxwell.
“Total horseshit, the daily mail paid her money, they admitted it, with the statement that it took money to coax out the truth.
“Yes she was on my plane, and yes she had her picture taken with Andrew, as many of my employees have.
“I have never misled you, this girl is a total liar, they (sic) authorities should check her australian immigration form… I will ask if they will cooperate – Prince people.”
In a different email exchange in March 2011 about an inquiry from a news reporter, Epstein messages someone listed as “The Duke”, which is thought to be Andrew.
Epstein told him: “Im not sure how to respond, the only person she didn’t have sex with was Elvis.”
It prompted the following response: “Please make sure that every statement or legal letter states clearly that I am NOT involved and that I knew and know NOTHING about any of these allegations.
“I can’t take any more of this my end.”
It is not clear if Epstein, who killed himself in 2019 while awaiting trial on sex-trafficking charges, was writing about Ms Giuffre.
In a separate email to a publicist in July 2011, Epstein writes: “The girl who accused Prince Andrew can also easily be proven to be a liar.
“I think Buckingham Palace would love it. You should task someone to investigate the girl Virginia Roberts, that has caused the Queen’s son all this agro (sic).
“I promise you she is a fraud. You and I will be able to go to ascot (sic) for the rest of our lives.”
Speaking to Newsnight in 2019, Andrew said: “I have absolutely no memory of that photograph ever being taken… you can’t prove whether or not that photograph is faked or not…
“That’s me but whether that’s my hand or whether that’s the position I… but I don’t… I have simply no recollection of the photograph ever being taken.”
Decades of abuse of thousands of young men by staff at a detention centre in County Durham was “ignored and dismissed” by the prison service, the police and the Home Office, an investigation has found.
Warning: Readers may find the content below distressing
The Prisons and Probation Ombudsman (PPO) has issued a report into how “horrific” physical and sexual violence was allowed to continue against 17 to 21-year-olds at the Medomsley Detention Centre in Consett.
It named officer Neville Husband who was thought to have groomed and attacked hundreds of trainees in Medomsley’s kitchens. He was described by the ombudsman “as possibly the most prolific sex offender in British history”.
Image: Neville Husband in December 1983. File pic: NCJ Archive/Mirrorpix/Getty
The abuse at Medomsley continued “unchallenged” for the entire 26 years of its operation, from 1961 to 1987, according to the report from ombudsman Adrian Usher. There was, he said, “extreme violence and acts of a sadistic nature”.
The centre held inmates who were all first-time offenders and who had been convicted of crimes ranging from shoplifting and non-payment of fines to robbery.
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Image: A sign for the centre in July 1998. Pic: Elliot Michael/Mirrorpix/Getty
Several members of staff were convicted after investigations by Durham Constabulary in 2001 and 2023 found widespread abuse of more than 2,000 detainees at Medomsley.
But the ombudsman investigated what authorities knew about the abuse, whether there were opportunities to have intervened at the time and what was done about any opportunities.
Husband ‘used power with devastating effect’
Husband was finally convicted of sexual assault and was jailed in 2003 and again in 2005. He died in 2010.
Mr Usher said: “The illegitimate power imbalance that existed between Husband and the trainees and other staff further flourished within a culture of collusion and silence from other employees.
“Husband used this power with devastating effect.”
Image: Then home secretary Leon Brittan visiting in 1985. Pic: Geoff Hewitt/Mirrorpix/Getty
Trainees ‘physically abused’
Trainees were physically abused from the moment they arrived, when they bathed, were strip searched, during physical education, while working and even during medical examinations, the PPO found.
Victims were targeted for being perceived as gay or weak. Inmates who failed to address staff as “sir” would be punched.
Witnesses said baths were either scalding hot or freezing cold. A number of them said if they were ill, painkillers could be taped to their forehead and they would be told to run around until the pill had dissolved.
Image: Ombudsman Adrian Usher (left) and senior investigator Richard Tucker
Medomsley leaders at every level ‘failed’
Mr Usher said: “Leaders at every level at Medomsley, including the warden, failed in their duty to protect the best interests of those under their charge. Either staff in leadership roles were aware of the abuse, in which case they were complicit, or they lacked dedication and professional curiosity to such an extent as to not be professionally competent.”
“The knowledge of abuse by the Prison Service, the police, the Home Office and other organisations of authority was ignored and dismissed. The authorities failed in their duty to keep detainees safe,” Mr Usher added.
The report highlights a complaint, written in 1965, of an officer striking an inmate with “a distinct blow”. The handwritten response below dismisses it as “playfulness”.
Staff ‘took law into own hands’
A letter sent to all detention centre wardens in 1967 refers to the “increasing number of complaints of assault” and warns of staff “taking the law into their own hands” with discipline going “beyond the legitimate”.
The police officers who delivered 17-year-old Eric Sampson to Medomsley in December 1977 told him he was going to “get the hell kicked out” of him there, he said.
Image: Eric Sampson called the centre ‘hell on earth’
Victim – ‘I could have been killed’
“The violence I had done to me was terrible. I could have been killed in there,” said Mr Sampson. “Every day and night was hell on earth for the full nine weeks.
“With all the abuse, and obviously the sexual abuse, it totally ruined my life. It should never have happened in the first place, or it should have been stopped.”
The inquiry spoke to 79 victims and witnesses.
Over 2,000 former inmates came forward to give their testimony to Operation Seabrook, a police investigation that led to five retired officers being convicted of abuse in 2019.
Lawyer David Greenwood, who represents victims of the abuse at Medomsley, said he has been contacted by men who were held at 20 other detention centres around the country, alleging similar violence.
“I think it was a systematic thing. These prison officers were cogs in a big machine which was designed, culturally or by training, to treat boys really badly,” he said.
Image: Lawyer David Greenwood suggested abuse may have been widespread
Mr Greenwood is calling for a wider inquiry into abuse at all of the detention centres.
What have the police said?
The ombudsman’s report found police officers from both Durham and Cleveland police were “aware that physical and sexual abuse was taking place at Medomsley from as early as 1965 due to complaints of abuse made at police stations”.
It said officers who ignored, dismissed or took no action “failed in their duty to report and investigate crime”.
In response to the report, Durham Constabulary has publicly apologised for “the force’s historic failure to investigate decades of horrifying abuse”.
Chief Constable Rachel Bacon said: “This report makes for extremely difficult reading. It exposes shameful failings by police at that time: both to recognise that the physical violence meted out by staff at Medomsley amounted to abuse or to adequately investigate allegations by those victims who did have the bravery to come forward and report what happened to them.
“I am satisfied that policing standards at Durham Constabulary are worlds apart from those which sadly appear to have existed at that time.”
Cleveland Police said in a statement: “All victims of any form of abuse or exploitation should always be listened to and action taken to prevent any further forms of abuse, and we acknowledge this was not the case many decades ago.
“We know cases like this have a lasting impact upon victims and Cleveland Police has, and continues to, improve its service and support to all those affected by abuse, especially those in cases of children and young people.”
The ombudsman’s report pointed out that the victims have never received a public apology and the complaints process for children in custody remains the same today as it was at the time of the abuse.
Mr Usher said: “I leave it to all of the bodies in this investigation to examine their organisational consciences and determine if there is any action taken today, despite such an extended passage of time, that would diminish, even fractionally, the trauma that is still being felt by victims to this day.”
Seven men have been charged with more than 40 offences against 11 teenagers after an investigation into child sexual exploitation in Bristol.
The alleged offences took place between 2022 and 2025 when the victims were in their mid to late teens.
Police said an investigation into claims of group-based sexual abuse in the city began in late 2023.
The men were arrested in April 2024 and bailed, but were detained again yesterday and are due to appear at Bristol Magistrates’ Court this morning.
The seven charged are:
Mohamed Arafe, 19, (Syrian): Six child sexual exploitation charges and one count of sexual assault. He also faces two counts over the supply of cocaine and ecstasy.
Sina Omari, 20, (Iranian): Two counts of rape; five child sexual exploitation charges; two counts of making an indecent photo of a child; two counts over the supply of cocaine and ecstasy.
Wadie Sharaf, 21, (Syrian): One count of rape; one count of attempted rape; three counts of sexual assault; one count of sexual activity with a child.
Hussain Bashar, 19, (British): One count of rape.
Mohammed Kurdi, 21 (British): Two counts of rape; two child sexual exploitation charges; two counts over the supply of ecstasy and cannabis.
Unnamed 19-year-old man: Four counts of rape; one child sexual exploitation charge; one count of distributing an indecent photo of a child, two counts over the supply of cocaine and ecstasy.
Unnamed 26-year-old-man: Two counts of rape and one count of sexual assault.
All five men named by police are from Bristol. Police also released details of their nationalities, along with their names and ages.
Officers said safeguarding measures and support have been made available to the victims.
Superintendent Deepak Kenth said the case would be a “huge shock to our communities” but they were working “tirelessly” to stop child sexual exploitation in the city.
“We’ve held events in Bristol city centre and continue to work with hotels, taxi drivers, and other businesses, to raise awareness about the signs of exploitation and the need to report any concerns or issues to the police,” he said.