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NHS nurses are striking today in a dispute with the government over pay and patient safety.

Members of the Royal College of Nursing (RCN) will take industrial action on 15 December and 20 December across England, Wales and Northern Ireland for the first time in the union’s 106-year history.

Strikes by ambulance staff and some NHS workers in Scotland were called off after members of two unions voted to accept the Scottish government’s most recent pay deal.

Share your NHS experience – how are the strikes affecting you?

What services will still be provided?

The RCN has provided a list of areas which will be “exempt from the strike action”.

These are chemotherapy, dialysis, paediatric A&E, critical care units such as intensive care and high dependency, and neonatal and paediatric intensive care.

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Other services outside of these “may be reduced” to a Christmas Day or night-duty level.

Following concerns by chief nurses about patient safety, the RCN has confirmed cancer patients will get emergency and clinically urgent surgery on strike days.

Emergency cancer services will be protected – including for those with specific needs due to chemotherapy.

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Protections have also been agreed for mental health and learning disability and autism services as part of an emergency response.

NHS community teams will provide palliative care and clinically urgent interventions, such as insulin – while in-patient areas will see night-duty staffing.

The head of the NHS Confederation said trade unions are committed to maintaining emergency and critical care services, and he was “reasonably confident that we won’t see severe patient harm”.

Matthew Taylor, who speaks for healthcare systems in England, Wales and Northern Ireland, added patients can expect a bank holiday-level of service in hospitals during the industrial action.

What if you need to go to A&E?

“Front-door” urgent care assessment and admission units – including A&E – will see Christmas Day-level staffing.

The NHS says emergency care will continue to be available across the country, and it is “really important” people come forward as normal in an “emergency or in life-threatening cases”.

Paediatric A&E is exempt from the strikes.

Read more:
Health secretary ‘refuses to negotiate on pay’
Nurses ‘working equivalent of one day a week for nothing’

Strikes in the UK – which sectors are affected?

Anyone needing urgent care should use NHS111 online or dial 111 to be assessed, the NHS says.

But if someone is seriously ill or injured and their life is at risk, emergency care should be sought in the normal way by calling 999 or attending A&E.

What if you have a hospital appointment scheduled?

Patients are being advised to attend as planned – unless the NHS provider has contacted them to reschedule.

Even if the hospital trust is affected by strikes, people should attend appointments unless instructed otherwise.

Patients will have been contacted by letter or phone call and offered a new date if their appointment needs to be rescheduled.

Will GP services be available?

Yes – GP services will be running as normal. People should attend their scheduled appointments.

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Govt ‘turns back on nurses’

What services will be directly hit?

There is expected to be widespread disruption to planned care, such as non-emergency operations and outpatient appointments.

Thousands of appointments and operations will need to be rescheduled as they are unlikely to be carried out on the day of action.

Up to 100,000 nurses are estimated to be joining the strike action, which will last for 12 hours on each day.

What other issues have been raised over patient care?

Dame Ruth May, chief nursing officer for England, and her counterparts in Scotland, Wales and Northern Ireland, have written to the RCN general secretary Pat Cullen regarding a series of concerns about safety.

They said chemotherapy is being rescheduled from the strike days at some hospitals – despite the union agreeing it would be exempt nationally.

But an RCN spokesperson said there will be derogation for emergency cancer services, adding: “Cancer patients will get emergency and clinically urgent surgery, it is not in doubt.”

Where will the strikes take place?

Not every hospital in the country will be affected by the strike action – but here is a list of those where strikes are scheduled:

England

East Midlands:
• Kettering General Hospital NHS Foundation Trust
• NHS Nottingham and Nottinghamshire ICB
• Northamptonshire Healthcare NHS Foundation Trust
• Nottingham University Hospitals NHS Trust
• Nottinghamshire Healthcare NHS Foundation Trust

Eastern:
• Cambridge University Hospital NHS Foundation Trust
• Cambridgeshire and Peterborough NHS Foundation Trust
• Cambridgeshire Community Services NHS Trust
• Hertfordshire Community NHS Trust
• NHS Hertfordshire and West Essex ICB
• Royal Papworth Hospital NHS Foundation Trust

London:
• Great Ormond Street Hospital for Children NHS Foundation Trust
• Guys and St Thomas NHS Foundation Trust
• Imperial College Healthcare NHS Trust
• NHS North Central London ICB
• Royal Marsden NHS Foundation Trust

North West:
• Alder Hey Children’s NHS Foundation Trust
• Health Education England
• Liverpool Heart and Chest Hospital NHS Found Trust
• Liverpool University Hospitals NHS Foundation Trust
• Liverpool Women’s NHS Foundation Trust
• Mersey Care NHS Foundation Trust
• The Clatterbridge Cancer Centre NHS Found Trust
• The Walton Centre NHS Foundation Trust

Northern:
• Gateshead Health NHS Foundation Trust
• Northumbria Healthcare NHS Foundation Trust
• The Newcastle Upon Tyne Hospitals NHS Foundation Trust

South East:
• Oxford Health NHS Foundation Trust
• Oxford University Hospitals NHS Foundation Trust
• Royal Berkshire NHS Foundation Trust

South West:
• Devon Partnership NHS Trust
• Gloucestershire Health and Care NHS Foundation Trust
• Gloucestershire Hospitals NHS Foundation Trust
• Great Western Hospitals NHS Foundation Trust
• NHS Bath, North East Somerset, Swindon and Wiltshire ICB (BSW Together)
• NHS Devon ICB (One Devon)
• NHS Gloucestershire ICB (One Gloucestershire)
• North Bristol NHS Trust
• Royal Devon University Healthcare NHS Foundation Trust
• Royal United Hospitals Bath NHS Foundation Trust
• Torbay and South Devon NHS Foundation Trust
• University Hospitals Bristol and Weston NHS Foundation Trust
• University Hospitals Plymouth NHS Trust

West Midlands:
• Birmingham Women’s and Children’s NHS Foundation Trust
• Herefordshire and Worcestershire Health and Care NHS Trust
• NHS Birmingham and Solihull ICB (BSol ICB)
• The Royal Orthopaedic Hospital NHS Foundation Trust
• University Hospitals Birmingham NHS Foundation Trust
• Worcestershire Acute Hospitals NHS Trust

Yorkshire and the Humber:
• Bradford Teaching Hospitals NHS Foundation Trust
• Leeds Community Healthcare NHS Trust
• Yorkshire & Humber NHS England
• The Leeds Teaching Hospitals NHS Trust

Wales

• Cardiff and Vale University Health Board
• Powys Teaching Local Health Board
• Welsh Ambulance Services NHS Trust Headquarters
• Hywel Dda University Health Board
• Swansea Bay University Health Board
• Cwm Taf Morgannwg University Health Board
• Betsi Cadwaladr University Local Health Board
• Velindre NHS Trust
• Public Health Wales
• Health Education and Improvement Wales Health Authority
• NHS Wales Shared Services Partnership
• Digital Health and Care Wales

Northern Ireland

• Northern Ireland Practice and Education Council
• Southern Health and Social Care Trust
• Western Health and Social Care Trust
• Belfast Health and Social Care Trust
• Business Services Organisation
• Regulation & Quality Improvement Authority
• Northern Ireland Blood Transfusion Service
• Public Health Agency
• Northern Health and Social Care Trust
• South Eastern Health and Social Care Trust
• Northern Ireland Ambulance Service

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In dramatic move, UK to buy F-35 stealth jets that can carry US nuclear warheads

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In dramatic move, UK to buy F-35 stealth jets that can carry US nuclear warheads

The UK will buy at least 12 F-35 stealth jets that can carry nuclear warheads in the most significant strengthening of its nuclear capability in a generation, the government has said.

Today, Sir Keir Starmer will tell a summit of NATO allies in The Hague that the new squadron will join an alliance mission that can be armed with US nuclear weapons.

The dramatic move will doubtless draw condemnation and concern from Russia and China.

But it comes at a time of growing global insecurity – and as the prime minister and his European and Canadian counterparts scramble to convince Donald Trump they are serious about bolstering their ability to defend Europe, instead of overly relying on the United States.

The US president, a long-standing NATO sceptic, raised questions about whether he would uphold the alliance’s founding Article 5 principle – that an attack on one is an attack on all – before he even arrived in the Dutch city last night.

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‘There’s numerous definitions of Article 5’

An urgent need to keep Mr Trump on side has prompted NATO allies to agree to increase spending on defence and national resilience to a new target of 5% of GDP by 2035.

As part of this push to rearm, Sir Keir will give the Royal Air Force the ability to carry airborne nuclear warheads for the first time since the 1990s.

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“In an era of radical uncertainty we can no longer take peace for granted,” he said.

“These F-35 dual capable aircraft will herald a new era for our world-leading Royal Air Force and deter hostile threats that threaten the UK and our allies.

“The UK’s commitment to NATO is unquestionable, as is the alliance’s contribution to keeping the UK safe and secure, but we must all step up to protect the Euro-Atlantic area for generations to come.”

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What is NATO’s 5% defence spending goal?

It was not immediately clear when the F-35 jets would be bought or how much they will cost, but the new squadron will be part of a NATO-led nuclear deterrence mission.

That is in contrast to the UK’s national nuclear deterrence, based on a fleet of four nuclear-armed submarines, though they too are used to defend the whole of the alliance.

Mark Rutte, the head of NATO, applauded the plan – saying: “The UK has declared its nuclear deterrent to NATO for many decades, ​and I strongly welcome today’s announcement that the UK will now also join NATO’s nuclear mission and procure the F-35A.

“This is yet another robust British contribution to NATO.”

Keir Starmer watches a demonstration by troops as he visits the Netherlands marines training base.
Pic: AP
Image:
Sir Keir watches a demonstration by troops as he visits the Netherlands marines training base. Pic: AP

Aircraft operated by a small number of NATO countries, including Belgium, Germany and the Netherlands, are cleared to carry US-provided nuclear weapons in a war.

The RAF and the Royal Navy already operate F-35B jets that can fly off Britain’s two aircraft carriers, but they are not equipped to drop nuclear warheads.

The new planes will be the F-35A variant, operated by the air force, that take off from land but can fly further and be armed with nuclear or conventional weapons.

The government said they would all be based together at RAF Marham in Norfolk.

The government has long planned to purchase a total of 138 F-35 aircraft, but has so far only acquired around three dozen – seven years since the first jets entered service.

The decision to purchase 12 of the A-variant does not mean extra aircraft.

It just means a diversification in the fleet – something the RAF has long been pushing for – though it’s a decision some in the Royal Navy have long pushed back against, believing it would reduce even further the number of the B-version that operate from their carriers.

Read more:
PM warns of ‘era of radical uncertainty’
Podcast – What is NATO without America?

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Is the UK preparing for war?

The government described the plan to purchase nuclear-capable aircraft as the “biggest strengthening of the UK’s nuclear posture in a generation”.

Defence Secretary John Healey said a major defence review published earlier in the month highlighted new nuclear risks.

“It recommended a new UK role in our collective defence and deterrence through a NATO-first approach,” he said.

However, the public version of the Strategic Defence Review stopped short of making any specific recommendation.

It merely said “the UK must explore how to support the US and its NATO allies in strengthening extended deterrence across the Euro-Atlantic”.

The F-35 aircraft is made by the US defence giant Lockheed Martin, but the British defence company BAE Systems is also a key contributor.

The order will support 20,000 jobs in the F-35 programme in the UK.

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Doctors are using unapproved AI software to record patient meetings, investigation reveals

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Doctors are using unapproved AI software to record patient meetings, investigation reveals

Doctors are using AI software that does not meet minimum standards to record and transcribe patient meetings, according to a Sky News investigation.

NHS bosses have demanded GPs and hospitals stop using artificial intelligence software that could breach data protection rules and put patients at risk.

A warning sent out by NHS England this month came just weeks after the same body wrote to doctors about the benefits of using AI for notetaking – to allow them more time to concentrate on patients – using software known as Ambient Voice Technology, or “AVT”.

Health Secretary Wes Streeting will next week put AI at the heart of the reform plan to save the NHS in the 10-year plan for the health service in England.

But there is growing controversy around software that records, transcribes and summarises patient conversations using AI.

In April, NHS England wrote to doctors to sell the benefits of AVT and set out minimum national standards.

However, in a letter seen by Sky News, NHS bosses wrote to doctors to warn that unapproved software that breached minimum standards could harm patients.

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Text of warning letter with highlighted sections
NHS warning letter with text highlighted
Image:
The version seen in the GP demonstration to Sky News complies with all NHS England standards and guidance

The 9 June letter, from the national chief clinical information officer of NHS England, said: “We are now aware of a number of AVT solutions which, despite being non-compliant … are still being widely used in clinical practice.

“Several AVT suppliers are approaching NHS organisations … many of these vendors have not complied with basic NHS governance standards.

“Proceeding with non-compliant solutions risks clinical safety, data protection breaches, financial exposure, and fragmentation of broader NHS digital strategy.”

Sky News has previously revealed the danger of AI “hallucinations”, where the technology makes up answers then lies about them, which could prove dangerous in a healthcare setting.

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Is ChatGPT reliable despite its ‘hallucinations’?

NHS England sets minimum standards but does not tell NHS trusts and healthcare providers which software providers to use.

Sky News can now reveal there is growing pressure on NHS England and similar bodies to be more proactive.

Dr David Wrigley, deputy chair of the British Medical Association’s GP committee, said: “Undoubtedly, as a GP myself and my 35,000 colleagues, we’ve got responsibilities here – but in such a rapidly developing market when we haven’t got the technical knowledge to look into this.

“We need that help and support from those who can check that the products are safe, check they’re secure, that they’re suitable for use in the consulting room, and NHS England should do that and help and support us.”

Dr Wrigley continued: “We’re absolutely in favour of tech and in favour of taking that forward to help NHS patients, help my colleagues in their surgeries.

“But it’s got to be done in a safe and secure way because otherwise we could have a free for all – and then data could be lost, it could be leaking out, and that just isn’t acceptable.

“So we are not dinosaurs, we’re very pro-AI, but it has to be a safe, secure way.”

Matthew Taylor, chief executive of the NHS Confederation
Image:
The head of the NHS Confederation says the letter is ‘a really significant moment’

The spectre of dozens of little-known but ambitious AI companies lobbying hospitals and surgeries to get their listening products installed worries some healthcare professionals.

There are huge profits to be made in this technological arms race, but the question being asked is whether hundreds of different NHS organisations can really be expected to sift out the sharks.

Matthew Taylor, chief executive of the NHS Confederation, said the letter was “a really significant moment”.

He said it was right for the NHS to experiment, but that it needed to be clearer what technology does and does not work safely.

“My own view is that the government should help in terms of the procurement decisions that trusts make and should advise on which AI systems – as we do with other forms of technology that we use in medicine – which ones are safe,” Mr Taylor said.

“We’ll need [government] to do a bit more to guide the NHS in the best way to use this.”

When pressed whether in the short term that actually makes it sound like it could be quite dangerous, Mr Taylor replied: “What you’ve seen with ambient voice technology is that kind of ‘let a thousand flowers bloom’ approach has got its limits.”

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Godfather of AI warns of its dangers

Earlier this year, the health secretary appeared to suggest unapproved technology was being used – but celebrated it as a sign doctors were enthusiastic for change.

Mr Streeting said: “I’ve heard anecdotally down the pub, genuinely down the pub, that some clinicians are getting ahead of the game and are already using ambient AI to kind of record notes and things, even where their practice or their trust haven’t yet caught up with them.

“Now, lots of issues there – not encouraging it – but it does tell me that contrary to this, ‘Oh, people don’t want to change, staff are very happy and they are really resistant to change’, it’s the opposite. People are crying out for this stuff.”

Read more from Sky News:
National investigation launched into maternity services
Every baby in the UK to receive DNA testing

GP Anil Mehta
Image:
GP Anil Mehta says AI software helps cut paperwork and patients are ‘extremely reassured’

Doctors who use AI that complies with national standards already say there are big benefits.

Anil Mehta, a doctor in the health secretary’s Ilford constituency, told Sky News he backed his MP’s drive for more AI technology in healthcare.

Dr Mehta demonstrated the version of Ambient Voice Technology that he uses.

This software, Accurx Scribe, has been developed and deployed in line with all current NHS England requirements for AVT, and there is no suggestion this product breaches any rules, standards or guidance.

Indeed, the company which developed it meets weekly with NHS England on creating a standardised approach to scale the benefits across the NHS.

“I spend 30% of my week doing paperwork,” Dr Mehta said.

“So I think once I’ve explained all of those features of what we’re doing, patients are extremely reassured. And I haven’t faced anybody that’s not wanted to have me do this.

He added: “(I) think that consultation with your doctor is extremely confidential, so that’s not changed at all.

“That remains confidential – so whether it’s a vulnerable adult, a vulnerable child, teenager, young child with a parent, I think the concept of that confidentiality remains.”

An NHS spokesperson said: “Ambient Voice Technology has the potential to transform care and improve efficiency and in April, the NHS issued guidance to support its use in a safe and secure way.

“We are working with NHS organisations and suppliers to ensure that all Ambient Voice Technology products used across the health service continue to be compliant with NHS standards on clinical safety and data security.”

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UK weather: Another heatwave could be on the way this weekend, forecasters say

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UK weather: Another heatwave could be on the way this weekend, forecasters say

Another heatwave could be on the way this weekend, forecasters say.

Temperatures could reach 30C, but some showers are expected before then amid more changeable weather.

Some parts of the UK will experience highs of 29C on Saturday, with the potential for 30C on Sunday and 31C on Monday, according to the Met Office.

Last Saturday was the hottest day of the year so far, with a provisional temperature of 33.2C recorded in Charlwood, Surrey.

The Met Office confirmed “many places” in England and “one or two areas” in Wales, including Cardiff, entered a heatwave last Friday.

A heatwave is recorded when an area reaches a certain temperature – the level of which varies across the UK – for three consecutive days.

Music fans can expect a mixture of sunshine and rain at this week’s Glastonbury Festival, where more than 200,000 people are expected to attend.

A person sunbathes in Furnivall Gardens, Hammersmith, west London. Pic: PA
Image:
Some parts of the UK entered a heatwave last week. Pic: PA

‘Risk of showers and thunderstorms’

Oli Claydon, from the Met Office, said Wednesday would be “warmer” with “an increasing risk of showers and thunderstorms”.

He said temperatures would reach a maximum of 27C on Thursday, with potential for heavy showers in the east and more persistent rain in the northwest of Scotland into the evening.

“Friday will see a maximum of 27C again as the high, the showers will clear away to the northeast, with local drizzle in parts of the South West and Wales through the day,” Mr Claydon added.

The South East of England is expected to experience the highest temperatures, potentially reaching 29C on Saturday and 30C on Sunday.

Temperatures could reach up to 31C on Monday, but there was lower certainty around that, Mr Claydon added.

Mr Claydon said it was possible the South East of England “could be looking at a short-lived localised heatwave”.

“When we had the warm spell last week it was much more widespread, we’re not likely to see that,” he added.

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Trump swears on camera
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So far, this month’s average daytime temperature is 19.2C, slightly above the June average of 17.68C.

But the Met Office said that temperatures were expected to fall next week.

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