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Senior health leaders have raised concerns about the care of cancer patients during the impending nurses’ strikes – including warnings that some chemotherapy appointments are being rescheduled.

In a letter seen by Sky News political editor Beth Rigby, the head of cancer care for NHS England, Dame Cally Palmer, called on Royal College of Nursing (RCN) union boss Pat Cullen to protect “life-saving” and “urgent” cancer surgery from walkouts, which begin on Thursday.

In another letter obtained by the Times, chief nursing officer for England, Dame Ruth May, says chemotherapy appointments are being rescheduled, and asked for assurances about the care of dying patients during the strikes in England, Wales and Northern Ireland on 15 and 20 December.

Chief Nursing Officer for England, Dame Ruth May
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Chief nursing officer for England, Dame Ruth May

Dame Cally said she was “extremely concerned about the absence of national derogation for urgent cancer surgery”.

A derogation is an exemption, either of an individual or a whole service, from taking part in strike action.

She went on: “I understand how enormously difficult these issues are for all concerned, but our common aim is to ensure we do not cause harm to people undergoing vital cancer treatment to achieve cure or extension of life.

“It’s important there is a clear and consistent decision on urgent cancer in line with the national derogation for chemotherapy and critical care.”

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The RCN insists there will be a derogation for emergency cancer services, as well as for mental health and learning disability and autism services, and said the public was behind its action.

“The public backs our campaign and knows that patients need a strong nursing workforce, but at the moment there are record losses jeopardising safe care,” the union said.

Dame Cally said the strikes were likely to lead to cancelled operations for cancer patients in P1 and P2 categories.

In her letter, she explained P1 surgery “is life-saving, and time critical, and must be maintained”, while P2 is “urgent cancer surgery which has an optimal time window”.

She said rescheduling procedures “is likely to lead to delayed operations and poorer outcomes” and many of these patients will move into the P1 category, requiring life-saving procedures as a result of re-scheduling.

Read more:
Strikes every day before Christmas – which sectors are affected and why

The RCN, however, insisted cancer patients would get emergency and clinically urgent surgery, and in its response to the letter assured that was “not in doubt”.

A spokesperson for the union added: “This is a politically-motivated smear from a government that is failing cancer patients.”

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In their correspondence, the chief nursing officer for England, and her counterparts in Scotland, Wales and Northern Ireland, wrote to Ms Cullen raising a series of concerns about patient safety.

“Many chief nurses/directors of nursing are, of course, RCN members themselves and some have expressed feelings of having been let down by the RCN,” they wrote.

The chief nursing officers said chemotherapy is being rescheduled from the strike days at some hospitals despite the union agreeing it would be exempt nationally.

They wrote that “there are examples of some trusts being asked to submit derogation forms for chemotherapy and organisations now preparing to reschedule chemotherapy from 15th and 20th December”.

The chief nurses also asked for assurances that community nursing services providing “end of life care and good pain and symptom relief” continue in order to “alleviate unnecessary distress” for palliative patients and their families.

The RCN said on Tuesday it had agreed further exemptions to the strike action, including emergency cancer services and “front-door” urgent care assessment and admission units for paediatric-only A&E departments.

“This letter is already out of date, as we have met senior clinicians today and agreed key points. The safety of patients is everybody’s top concern,” the union’s spokesperson said.

The heated letters exchange came at a time when a new report shows the NHS is treating fewer patients than it was pre-pandemic despite more funding and staff – suggesting a long-term COVID impact on the health service’s performance.

The Institute for Fiscal Studies has said the NHS carried out 14% fewer emergency admissions, 14% fewer outpatient appointments and 11% fewer elective and maternity admissions in the latest month of data than it did in the same period in 2019, according to the IFS.

Health Secretary Steve Barclay in Westminster, London, ahead of his meeting with Pat Cullen, the head of the Royal College of Nurses (RCN), as he tries to avert strike action. Nurses have voted to strike in the majority of NHS employers in a row over pay, the first UK-wide strike action in its 106-year history. Picture date: Thursday November 10, 2022.
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Health Secretary Steve Barclay

Why did talks break down?

Talks between the unions and the government to try to avert strike action broke down on Monday, after Health Secretary Steve Barclay was accused of refusing to negotiate on pay.

The union is demanding a pay rise of 5% above the RPI rate of inflation, which was 14.2% in October, but Ms Cullen has hinted that she could compromise if the government negotiates on pay.

Ministers have repeatedly insisted they can’t afford to give inflation-busting pay rises and say they have accepted the independent pay review body’s recommendation of a £1,400 rise.

Meanwhile, members of the Rail, Maritime and Transport union (RMT) began the first of two 48-hour strikes at Network Rail – and 14 train companies – on Tuesday which will last until Friday.

The strikes come at a time of planned industrial action in a whole number of UK spheres, including healthcare – with paramedics also planning to walkout – postal workers, Border Force agents, firefighters, driving instructors, bus operators, airport baggage handlers and even coffin makers.

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What do dolphins get up to beneath the waves? Their poo has the answers

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What do dolphins get up to beneath the waves? Their poo has the answers

Scientists are turning detective to work out what British dolphins are up to beneath the waves – by using forensic-style DNA techniques on their poo.

Conservationists have been studying the 250 or so bottlenose dolphins living in Cardigan Bay, west Wales, over many decades.

Up to now, they have only been able to observe the dolphins as they surface to breathe or play, identifying the animals from the unique marks on their dorsal fins to establish which animals were hanging out together and where.

Dolphins in Cardigan Bay. Pic: Sarah Perry/WTSWW
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Dolphins in Cardigan Bay. Pic: Sarah Perry/WTSWW

But now for the first time scientists are using DNA excreted by the dolphins in their poo to build a more complete picture of their lives.

It allows them to identify the sex of individuals and how they are related to other animals. Signficantly, it also shows what the dolphins have been eating.

Dolphin poo. Pic: Sarah Perry/WTSWW
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Dolphin poo. Pic: Sarah Perry/WTSWW

Dr Sarah Perry, marine conservation manager at The Wildlife Trust of South and West Wales, said: “In order to be able to conserve them, we need to know why they’re here and a big a missing part of that is, what they’re feeding on.

“Is that changing at different times of the year? Are certain species of fish more important to them early on in the year, in the spring, and the summer months, and then does that change over the autumn and winter months?

“Are certain species important for younger animals? We don’t know that, so that kind of information, we need to find out.”

Dr Sarah Perry
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Dr Sarah Perry

Catching dolphin poo involves a large element of luck.

The animals occasionally eject a cloud of waste material as they swim.

But it quickly sinks, so the scientists’ boat needs to be close enough for them to scoop it out of the sea with a fine-meshed net.

A sample is then sent to a lab at the University of Aberystwyth, where DNA is extracted for analysis.

More from Sky News:
PM could scrap divisive policy
Bates attacks Post Office scheme

Scientists on the hunt for dolphin poo.
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Scientists on the hunt for dolphin poo

Dolphins adapting to effects of climate change

Results so far suggest the dolphins are having to adapt to a change in fish species as the water warms.

Dr Niall McKeown
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Dr Niall McKeown

Dr Niall McKeown, a marine biologist at the university, said: “We are seeing large amounts of sardine, sprat, and anchovy.

“This is quite interesting because these are species that are known to have increased in abundance in Welsh waters in recent years in response, we believe, to climate change.”

A scientist analyses a sample
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Dr Niall analyses a sample

Scientists unsure why dolphin numbers are falling

But questions remain about the dolphins.

The number in Cardigan Bay seems to be falling, but scientists are not sure whether that’s a natural cycle or a response to other factors.

Boat noise and disturbance from some fishing activities, such as scallop dredging, could impact the animals, which rely on sound to communicate.

Dr Parry said: “How lucky are we to have such an important population of dolphins here? It’s crazy that we really don’t know that much about them.”

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Sir Alan Bates attacks ‘kangaroo court’ Post Office scheme after ‘take it or leave it’ offer

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Sir Alan Bates attacks 'kangaroo court' Post Office scheme after 'take it or leave it' offer

Sir Alan Bates has accused the government of presiding over a “quasi kangaroo court” for Post Office compensation.

Writing in The Sunday Times, the campaigner, who led a years-long effort for justice for sub-postmasters, revealed he had been given a “take it or leave it” offer that was less than half of his original claim.

“The sub-postmaster compensation schemes have been turned into quasi-kangaroo courts in which the Department for Business and Trade sits in judgement of the claims and alters the goal posts as and when it chooses,” he said.

“Claims are, and have been, knocked back on the basis that legally you would not be able to make them, or that the parameters of the scheme do not extend to certain items.”

More than 900 sub-postmasters were prosecuted between 1999 and 2015 after faulty Horizon accounting software made it look as if money was missing from their accounts.

Many are still waiting for compensation despite the previous government saying those who had their convictions quashed were eligible for £600,000 payouts.

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‘It still gives me nightmares’

After the Post Office terminated his contract over a false shortfall in 2003, Sir Alan began seeking out other sub-postmasters and eventually took the Post Office to court.

More on Post Office Scandal

A group litigation order (GLO) scheme was set up to achieve redress for 555 claimants who took the Post Office to the High Court between 2017 and 2019.

Sir Alan, who was portrayed by actor Toby Jones in ITV drama Mr Bates Vs The Post Office, has called for an independent body to be created to deliver compensation.

He added that promises the compensation schemes would be “non-legalistic” had turned out to be “worthless”.

It is understood around 80% of postmasters in Sir Alan’s group have accepted a full and final redress, or been paid most of their offer.

Read more:
Post Office scandal explained

Who are the key figures in the scandal?

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‘Lives were destroyed’

A Department for Business and Trade spokesperson told Sky News: “We pay tribute to all the postmasters who’ve suffered from this scandal, including Sir Alan for his tireless campaign for justice, and we have quadrupled the total amount paid to postmasters since entering government.

“We recognise there will be an absence of evidence given the length of time which has passed, and we therefore aim to give the benefit of the doubt to postmasters as far as possible.

“Anyone unhappy with their offer can have their case reviewed by a panel of experts, which is independent of the government.”

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PM could lift controversial benefit cap in budget – as Farage makes two big election promises

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PM could lift controversial benefit cap in budget - as Farage makes two big election promises

Sir Keir Starmer could decide to lift the two-child benefit cap in the autumn budget, amid further pressure from Nigel Farage to appeal to traditional Labour voters.

The Reform leader will use a speech this week to commit his party to scrapping the two-child cap, as well as reinstating winter fuel payments in full.

The prime minister – who took Westminster by surprise at PMQs by revealing his intention to row back on the winter fuel cut – has previously said he would like to lift the two-child cap if the government could afford it.

There are now mounting suggestions an easing of the controversial benefit restriction may be unveiled when the chancellor delivers the budget later this year.

According to The Observer, Sir Keir told cabinet ministers he wanted to axe the measure – and asked the Treasury to look for ways to fund the move.

It comes after the government delayed the release of its child poverty strategy, which is expected to recommend the divisive cap – introduced by former Tory chancellor George Osborne – is scrapped.

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Why did Labour delay their child poverty strategy?

Ministers have already said any changes to winter fuel payments, triggered by mounting political pressure, would only be made when the government’s next fiscal event rolls round.

The Financial Times reported it may be done by restoring the benefit to all pensioners, with the cash needed being clawed back from the wealthy through the tax system.

The payment was taken from more than 10 million pensioners this winter after it became means-tested, and its unpopularity was a big factor in Labour’s battering at recent elections.

Before Wednesday’s PMQs, the prime minister and chancellor had insisted there would be no U-turn.

More from Sky News:
PM’s winter fuel claim ‘not credible’
Starmer vs Reeves – the ‘rift’ in Downing Street

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Will winter fuel U-turn happen?

Many Labour MPs have called for the government to do more to help the poorest in society, amid mounting concern over the impact of wider benefit reforms.

Former prime minister Gordon Brown this week told Sky News the two-child cap was “pretty discriminatory” and could be scrapped by raising money through a tax on the gambling industry.

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Brown questioned over winter fuel U-turn

Mr Farage, who believes Reform UK can win the next election, will this week accuse Sir Keir of being “out of touch with working people”.

In a speech first reported by The Sunday Telegraph, he is expected to say: “It’s going to be these very same working people that will vote Reform at the next election and kick Labour out of government.”

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