Ambulance response times are currently the worst on record and the NHS is struggling to cope with a surge in demand this winter.
Sky News joined West Midlands Ambulance Service paramedic Danny Thompson and ambulance technician Dan Fiedler for a 12-hour shift.
7am: Elderly couple ‘too scared’ to call 999
Freezing fog hangs over Coventry as Danny and Dan make sure their radios are charged and vehicle fully stocked before heading out.
It is unusually quiet to begin with, but just before 8am they get their first call.
The patient is an elderly man who has fallen and injured his arm. They switch on the sirens and the blue lights flash as they speed through the fog.
Arriving at the house, they find the patient, 86-year-old Edward, in bed. Norma, his wife, is sitting next to him.
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Edward’s arm is swollen and purple. It turns out he fell two days ago.
“It said on the television only call if it’s a matter of life and death,” Norma tells Danny.
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Image: Danny and Edward in the ambulance
He tells her to call straight away in future. They’re worried patients who need help have been put off calling by the advice given on strike days.
“People are a bit scared to call ambulances because they think they’re going to be stuck in corridors or in the back of an ambulance,” Dan says.
As they prepare to take Edward, who has advanced Parkinson’s, to A&E – they chat.
Dan asks Edward how long he and Norma have been married. “62 years,” he says. “How did you meet?” Dan asks. “In the pictures,” Edward replies.
“He thinks I’m superwoman,” Norma tells Danny, as she details how they manage without any carers.
But she’s relieved to see the paramedics.
“When I rang my heart sank because they stop halfway through and say use www… we’re not on world wide web,” she says. “I’m not moaning really, it’s just that we haven’t kept up to date with our technology”.
Image: Rosemary is reluctant to return to A&E after a previous long wait
10am: Woman refuses to ‘freeze’ in A&E despite blood clot fear
“Straight in… very unusual,” Danny remarks as they wheel Edward into the A&E department in Coventry where he’ll have an X-ray to check if his arm is broken.
Back outside in the ambulance, their radio beeps to let them know it’s been 12 minutes since they handed Edward over.
That means they’re expected to be ready for the next call.
The next stop is an elderly patient whose district nurse fears could have a blood clot in her leg.
When they get to her house, Rosemary is sitting upstairs.
Her daughter explains they went to A&E a couple of weeks ago and spent hours waiting in a freezing corridor. They don’t want to go back.
After doing some tests Danny and Dan believe it’s fluid and not a blood clot causing the swelling.
They agree to take her to a same-day emergency care unit at the hospital in Nuneaton.
But on their way a category one call comes in. They’re the closest ambulance, so they apologise to Rosemary, switch on blue lights and head in the direction of the call.
A couple of minutes later though, they’re told to stand down.
They continue on their way with Rosemary and apologise for the diversion as they leave her at the hospital.
Image: Rosemary arrives at hospital
1pm: Seizure and slow heartbeat dealt with in five minutes
They don’t even get the chance to finish their lunch before another category one call comes in.
The details indicate that an elderly woman is having a seizure.
Inside the house they quickly establish there’s a problem with her heart and it’s serious. She’s already lost consciousness once.
They wheel her into the ambulance and carry out ECG tests. Her heart rate is dropping, there’s a risk it could stop.
Danny calls the hospital in Coventry to tell them to have a team ready.
Machines beep and the patient tells them she’s scared.
Danny and Dan work quickly to stabilise her heart rate. Their reassuring tone as they tell her not to worry contrasts with the urgency of the situation.
They get her to A&E within five minutes. Her heart is still beating, but very slowly.
They’re both just relieved that this wasn’t one of the days they’ve been stuck queuing outside hospital.
“The cardiac condition she had can often result in death if it’s not caught in time,” Danny says.
Image: Dan (left) and Danny
4pm: Good news but it was close
After completing all their paperwork, they finally get a lunch break at about 4.30pm. They can take half an hour, unless a category one call comes in. They head back to base where Dan joins a small group of colleagues.
After 30 minutes, Danny comes to get him. There’s another call.
Sirens on, they make their way to a house nearby. They can’t be sure the patient doesn’t have a blood clot, so they take her to A&E.
While there they find out the heart patient has had emergency surgery to fit a pacemaker. She’s doing well.
It’s good news to end the day. But they know it was close.
“Things can’t go on as they are,” Danny says. “Because we’re going to see patients suffering as a result of that.”
Image: Danny with the female cardiac patient
7pm: 12-hour shift over
It’s rare to finish on time this winter – but on this occasion, they pull back into base exactly 12 hours after their shift began.
They restock the ambulance and wave to the teams taking over, before heading off into the night.
A care worker who reported the alleged abuse of an elderly care home resident, which triggered a criminal investigation, is facing destitution and potential removal from Britain after speaking up.
“Meera”, whose name we have changed to protect her identity, said she witnessed an elderly male resident being punched several times in the back by a carer at the home where she worked.
Sky News is unable to name the care home for legal reasons because of the ongoing police investigation.
“I was [a] whistleblower there,” said Meera, who came to the UK from India last year to work at the home.
“Instead of addressing things, they fired me… I told them everything and they made me feel like I am criminal. I am not criminal, I am saving lives,” she added.
Image: ‘Meera’ spoke up about abuse she said she witnessed in the care home where she worked
Like thousands of foreign care workers, Meera’s employer sponsored her visa. Unless she can find another sponsor, she now faces the prospect of removal from the country.
“I am in trouble right now and no one is trying to help me,” she said.
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Meera said she reported the alleged abuse to her bosses, but was called to a meeting with a manager and told to “change your statement, otherwise we will dismiss you”.
She refused. The following month, she was sacked.
The care home claimed she failed to perform to the required standard in the job.
She went to the police to report the alleged abuse and since then, a number of people from the care home have been arrested. They remain under investigation.
‘Migrants recruited because many are too afraid to speak out’
The home has capacity for over 60 residents. It is unclear if the care home residents or their relatives know about the police investigation or claim of physical abuse.
Since the arrests, the regulator, the Care Quality Commission (CQC), carried out an investigation at the home triggered by the concerns – but the home retained its ‘good’ rating.
Meera has had no reassurance from the authorities that she will be allowed to remain in Britain.
In order to stay, she’ll need to find another care home to sponsor her which she believes will be impossible without references from her previous employer.
She warned families: “I just want to know people in care homes like these… your person, your father, your parents, is not safe.”
She claimed some care homes have preferred to recruit migrants because many are too afraid to speak out.
“You hire local staff, they know the legal rights,” she said. “They can complain, they can work anywhere… they can raise [their] voice,” she said.
Image: Sky’s Becky Johnson spoke to ‘Meera’
Sky News has reported widespread exploitation of care visas and migrant care workers.
Currently migrants make up around a third of the adult social care workforce, with the majority here on visas that are sponsored by their employers.
As part of measures announced in April in the government’s immigration white paper, the care visa route will be closed, meaning care homes will no longer be able to recruit abroad.
‘Whole system is based on power imbalance’
But the chief executive of the Work Rights Centre, a charity that helps migrants with employment issues, is warning that little will change for the tens of thousands of foreign care workers already here.
“The whole system is based on power imbalance and the government announcement doesn’t change that,” Dr Dora-Olivia Vicol told Sky News.
She linked the conditions for workers to poor care for residents.
Image: Work Rights Centre CEO Dr Dora-Olivia Vicol
“I think the power that employers have over migrant workers’ visas really makes a terrible contribution to the quality of care,” she said.
Imran agrees. He came to the UK from Bangladesh, sponsored by a care company unrelated to the one Meera worked for. He says he frequently had to work 14-hour shifts with no break because there weren’t enough staff. He too believes vulnerable people are being put at risk by the working conditions of their carers.
Migrant workers ‘threatened’ over visas
“For four clients, there is [a] minimum requirement for two or three staff. I was doing [it] alone,” he said, in broken English.
“When I try to speak, they just directly threaten me about my visa,” he said.
“I knew two or three of my colleagues, they are facing the same issue like me. But they’re still afraid to speak up because of the visa.”
A government spokesperson called what happened to Imran and Meera “shocking”.
“No one should go to work in fear of their employer, and all employees have a right to speak up if they witness poor practice and care.”
James Bullion, from the CQC, told Sky News it acts on intelligence passed to it to ensure people stay safe in care settings.
Donald Trump may be denied the honour of addressing parliament on his state visit to the UK later this year, with no formal request yet submitted for him to be given that privilege.
Sky News has been told the Speaker of the House of Commons, Sir Lindsay Hoyle, hasn’t so far received a request to invite the US president to speak in parliament when he is expected to visit in September.
It was confirmed to MPs who have raised concerns about the US president being allowed to address both houses.
Kate Osborne, Labour MP for Jarrow and Gateshead East, wrote to the speaker in April asking him to stop Mr Trump from addressing parliament, and tabled an early-day motion outlining her concerns.
“I was happy to see Macron here but feel very differently about Trump,” she said.
“Trump has made some very uncomfortable and worrying comments around the UK government, democracy, the Middle East, particularly around equalities and, of course, Ukraine.
“So, I think there are many reasons why, when we’re looking at a state visit, we should be looking at why they’re being afforded that privilege. Because, of course, it is a privilege for somebody to come and address both of the houses.”
But the timing of the visit may mean that any diplomatic sensitivities, or perceptions of a snub, could be avoided.
Image: France’s President Emmanuel Macron addressed parliament during his state visit this month
Lord Ricketts, a former UK ambassador to France, pointed out that parliament isn’t sitting for much of September, and that could help resolve the issue.
In 2017, he wrote a public letter questioning the decision to give Donald Trump his first state visit, saying it put Queen Elizabeth II in a “very difficult position”.
Parliament rises from 16 September until 13 October due to party conferences.
The dates for the state visit haven’t yet been confirmed by Buckingham Palace or the government.
However, they have not denied that it will take place in September, after Mr Trump appeared to confirm they were planning to hold the state visit that month. The palace confirmed this week that the formal planning for his arrival had begun.
With the King likely to still be in Scotland in early September for events such as the Braemar Gathering, and the anniversary of his accession and the death of Queen Elizabeth on the 8th September, it may be expected that the visit would take place sometime from mid to the end of September, also taking into consideration the dates of the Labour Party conference starting on the 28th September and possibly the Lib Dem’s conference from the 20th-23rd.
Image: Mr Trump has said he believes the trip to the UK will take place in September. Pic: Reuters
When asked about parliamentary recess potentially solving the issue, Ms Osborne said: “It may be a way of dealing with it in a very diplomatic way… I don’t know how much control we have over Trump’s diary.
“But if we can manoeuvre it in a way that means that the House isn’t sitting, then that seems like a good solution, maybe not perfect, because I’d actually like him to know that he’s not welcome.”
A message from the speaker’s office, seen by Sky News, says: “Formal addresses to both Houses of Parliament are not automatically included in the itinerary of such a state visit.
“Whether a foreign head of state addresses parliament, during a state visit or otherwise, is part of the planning decisions.”
Image: Mr Trump made his first state visit to the UK in June 2019 during his first presidency. File pic: Reuters
It’s understood that if the government agrees to a joint address to parliament, the Lord Chamberlain’s office writes to the two speakers, on behalf of the King, to ask them to host this.
It will be Mr Trump’s second state visit.
During his first, in 2019, he didn’t address parliament, despite the fact that his predecessor, Barack Obama, was asked to do so.
It was unclear if this was due to the fact John Bercow, the speaker at the time, made it clear he wasn’t welcome to do so.
However, it didn’t appear to dampen Mr Trump’s excitement about his time with the Royal Family.
Speaking earlier this year, he described his state visit as “a fest” adding “it’s an honour… I’m a friend of Charles, I have great respect for King Charles and the family, William; we have really just a great respect for the family. And I think they’re setting a date for September.”
It is expected that, like Mr Macron, the pageantry for his trip this time will revolve around Windsor, with refurbishment taking place at Buckingham Palace.
Liverpool have retired the number 20 shirt in honour of Diogo Jota – the first time it has made such a gesture.
The club said it was a “unique tribute to a uniquely wonderful person” and the decision was made in consultation with his wife and family.
The number 20 will be retired at all levels, including the men’s and women’s first teams and academy squads.
A statement said: “It was the number he wore with pride and distinction, leading us to countless victories in the process – and Diogo Jota will forever be Liverpool Football Club’s number 20.”
The club called it a “recognition of not only the immeasurable contribution our lad from Portugal made to the Reds’ on-pitch successes over the last five years, but also the profound personal impact he had on his teammates, colleagues and supporters and the everlasting connections he built with them”.
Image: Jota’s wife joined Liverpool players to view tributes at Anfield on Friday. Pic: Liverpool FC
Image: Pic: Liverpool FC
Newly-married Jota died alongside his brother when his Lamborghini crashed in northern Spain on 3 July.