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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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”.
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.
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.
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.”
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.
He called emergency services but soon “water started seeping in”.
“I thought I’m going to have to get out, I’m going to have to smash a window,” Mr Randles said.
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He wound down his and his son’s windows, and climbed out before rescuing his son.
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1:10
‘Devastating’ flooding in Wales
“The water was chest high, I held him up as high as I could to keep him out of the water.”
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“It wasn’t raining so heavily, I’ve driven in much worse rain,” he added.
Mr Randles, a self-employed roofer who relies on the car for work, said he remained calm during the ordeal and was helped by the fact that Luca was asleep during the rescue.
Mr Randles’ partner Paige Newsome – who was not in the car at the time – said the incident was “really scary”.
“To think I could have actually lost them both – I don’t know how I would’ve lived,” she said.
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The road has been flooding for at least two decades, the couple said.
“What is it going to take for the council to sort it out? Does a fatal incident have to happen? It’s been going on for years,” Ms Newsome said.
The couple are worried about affording another car as well as Christmas celebrations.
But Mr Randles said: “I’m grateful that we got out safely and that we can spend his first birthday and Christmas as a family.”
Storm Bert has brought more than 80% of November’s average monthly rainfall in less than 48 hours to some parts, the Met Office said.
Around 300 flood warnings and alerts are in place in England, with another 100 in Wales and nine in Scotland, as heavy rain and thawing snow bring more disruption across the UK.
A major incident was declared by Rhondda Cynon Taf County Borough Council in South Wales after homes and cars were submerged in water.
‘It is devastating’
Gareth Davies, who owns a garage in Pontypridd, a town in Rhondda Cynon Taf, told Sky’s Dan Whitehead that flooding has put his small business “back to square one”.
As the River Taff burst its banks, the majority of the vehicles in Mr Davis’s garage were so damaged he says they will have to be written off.
“I am gutted,” he said, standing in his flooded garage, most of which is also covered in oil after a drum tipped over.
“How long is it going to take to sort out? I am going to lose money either way. I can’t work on people’s cars when I am trying to sort all of this out.
“It is devastating.”
Mr Davies said he has never had an issue with water coming into his garage until now.
Pointing to one car that had been hoisted into the air before water reached it, he said: “Lucky enough, I did come in this morning just to get that car up in the air.
“I don’t know what to say, I have been working flat out for two years to build this up and something like this happens, and it just squashes it all.
“This has put me back to square one.”
At least two to three hundred properties in South Wales have been affected by flooding, Councillor Andrew Morgan, leader of Rhondda Cynon Taf Borough Council, said on Sunday.
He said the affected buildings are a mixture of residential and commercial properties, after the weather turned out to be worse than what was forecast.
The Labour MP behind the assisted dying bill said she has “no doubts” about its safeguards after a minister warned it would lead to a “slippery slope” of “death on demand”.
In a strongly worded intervention ahead of Friday’s House of Commons vote, Ms Mahmood said the state should “never offer death as a service”.
She said she was “profoundly concerned” by the legislation, not just for religious reasons, which she has previously expressed, but because it could create a “slippery slope towards death on demand”.
Asked about the criticism, Ms Leadbeater said: “I have got a huge amount of respect for Shabana. She’s a very good colleague and a good friend.
“In terms of the concept of a slippery slope, the title of the bill is very, very clear.
“It is called the Terminally Ill Adults (End of Life) Bill. It cannot include anybody other than people who are terminally ill, with a number of months of their life left to live. It very clearly states that the bill will not cover anybody else other than people in that category.”
She wants people who are in immense pain to be given a choice to end their lives, and has included a provision in the legislation to make coercion a criminal offence.
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The matter will be debated for the first time in almost 10 years on Friday, with MPs given a free vote, meaning they can side with their conscience and not party lines.
As a result, the government is meant to remain neutral, so the intervention of cabinet ministers has provoked some criticismfrom within party ranks.
Labour peer Charlie Falconer told Sky News Ms Mahmood’s remarks were “completely wrong” and suggested she was seeking to impose her religious beliefs on other people.
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8:51
Kevin Hollinrake says he will be in favour of the assisted dying bill
Asked about his comments, Ms Leadbeater said it was important to remain “respectful and compassionate throughout the debate” and “for the main part, that has been the case”.
She added: “The point about religion does come into this debate, we have to be honest about that. There are people who would never support a change in the law because of their religious beliefs.”
Ms Leadbeater went on to say she had “no doubts whatsoever” about the bill, which has also been objected by the likes of Health Secretary Wes Streeting and former Labour prime minister Gordon Brown.
Asked if she has ever worried about people who don’t want to die taking their own lives because of the legislation, Ms Leadbeater said: “No, I don’t have any doubts whatsoever. I wouldn’t have put the bill forward if I did.
“The safeguards in this bill will be the most robust in the world, and the layers and layers of safeguarding within the bill will make coercion a criminal offence.”
There is a lot at stake this week for Sophie Blake, a 52-year-old mother to a young adult, who was diagnosed with stage four cancer in May 2023.
As MPs vote on whether to change the law to allow assisted dying, Sophie tells Sky News of the day her life changed.
“One night I woke up and as I turned I felt a sensation of something in my breast actually move, and it was deep,” she says, speaking from her home in Brighton.
“Something fluidy, a very odd sensation. I woke up and made a doctor’s appointment.”
Sophie underwent an ultrasound followed by a biopsy before she was taken to a room in the clinic and offered water.
“They said, ‘a hundred percent, we believe you have breast cancer’.”
But it was the phone call with her mother that made it feel real.
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“My mum had been waiting at home. She phoned me and said ‘How is it darling?’ and I said ‘I’ve got breast cancer,’ and it was just that moment of having to say it out loud for the first time and that’s when that part of my life suddenly changed.”
Sophie says terminal cancers can leave patients dreading the thought of suffering at the end of their lives.
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“What I don’t want to be is in pain,” she says. “If I am facing an earlier death than I wanted then I want to be able to take control at the end.”
Assisted dying, she believes, gives her control: “It’s an insurance policy to have that there.”
Disability rights advocate Lucy Webster warns that for people like Sophie to have that choice, others could face pressure to die.
“All around the world, if you look at places where the bill has been introduced, they’ve been broadened and broadened and broadened,” she tells Sky News.
Lucy is referring to countries like Canada and Netherlands, where eligibility for assisted deaths have widened since laws allowing it were first passed.
Lucy, who is a wheelchair user and requires a lot of care, says society still sees disabled people as burdens which places them at particular risk.
“I don’t know a single disabled person who has not at some point had a stranger come up to us and say, ‘if I were you, I’d kill myself’,” she says.
The assisted dying bill, she says, reinforces the view that disabled lives aren’t worth living.
“I’ve definitely had doctors and healthcare professionals assume that my quality of life is inherently worse than other people’s. That’s a horrible assumption to be faced with when [for example] you’ve just gone to get antibiotics for a chest infection. There are some really deep-seated medical views on disability that are wrong.”
Under the plans, a person would need to be terminally ill and in the final six months of their life, and would have to take the fatal drugs themselves.
Among the safeguards are that two independent doctors must confirm a patient is eligible for assisted dying and that a High Court judge must give their approval. But the bill does not make clear if that is a rubber-stamping exercise or if judges will have to investigate cases including risks of coercion.
Julian Hughes, honorary professor at Bristol Medical School, says there’s a very big question about whether courts have the room to take on such a task.
“At the moment in the family division I understand there are 19 judges and they supply 19,000 hours of court hearing in a year, but you’d have to have an extra 34,000,” he explains.
“We shouldn’t fool ourselves and think that there wouldn’t be some families who would be interested in getting the inheritance rather than spending the inheritance on care for their elderly family members. We could quickly become a society in which suicide becomes normalised.”