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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.

Danny and Edward in the ambulance
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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”.

Rosemary is reluctant to return to A&E after a previous long wait
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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.

Rosemary arrives at hospital
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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.

Dan (left) and Danny
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.”

Danny with the female cardiac patient
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.

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Teachers’ strike to go ahead after education secretary ‘squandered the opportunity’ to avoid action, union says

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Teachers' strike to go ahead after education secretary 'squandered the opportunity' to avoid action, union says

Talks between the education secretary and the teaching unions have failed and the biggest teachers’ strike in years will go ahead.

Last-minute talks were held by Education Secretary Gillian Keegan on Monday in a bid to resolve a teachers’ pay dispute ahead of planned strikes this week.

Members of the National Education Union (NEU) in England and Wales will now walk out on Wednesday, with more industrial action planned in the following weeks.

The strike on Wednesday is expected to encompass up to half-a-million workers, with teachers due to be joined by train drivers, civil servants, university lecturers, bus drivers and security guards from seven trade unions in what will be the biggest day of industrial action in over a decade.

The NEU has announced seven days of strikes in England and Wales in February and March, with the walkout on Wednesday expected to affect over 23,000 schools.

Mary Bousted and Kevin Courtney, joint general secretaries of the NEU, said: “Gillian Keegan has squandered an opportunity to avoid strike action on Wednesday.

“The government has been unwilling to seriously engage with the causes of strike action.

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“Real-terms pay cuts and cuts in pay relativities are leading to a recruitment and retention crisis with which the education secretary so far seems incapable of getting a grip.

“Training targets are routinely missed, year on year. This is having consequences for learning, with disruption every day to children’s education.”

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Fresh wave of strikes this year- who is taking action and when
Firefighters set to strike for first time since 2003 after real-terms earnings ‘drop by 12%’

In a separate comment, Mr Courtney said: “I regret to say that we didn’t hear anything that enables us to say that the strike shouldn’t go ahead on Wednesday.

“There’s no offer from the secretary of state trying to bridge the gap between us.”

Meanwhile, a headteachers’ union boss has described the talks with Ms Keegan as “deeply disappointing”.

Following the meeting with the education secretary, Geoff Barton, general secretary of the Association of School and College Leaders (ASCL), said: “Parents will have been looking for the government to avert the planned strike on Wednesday.

“Instead, the government continues to talk around the issues rather than putting anything on the table which allows for any meaningful negotiation.

“It is deeply disappointing.”

Mr Barton added: “We are sorry to report that there is therefore no resolution to the dispute and the strike is set to go ahead.”

The teachers’ strike was confirmed shortly before British firefighters voted to carry out nationwide action in a dispute over pay.

About 88% of members of the Fire Brigades Union had voted in favour of strike action, on a 73% turnout, the union said.

Its members had rejected a 5% pay offer in November.

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Rishi Sunak says he acted ‘decisively’ in sacking Nadhim Zahawi following tax affairs row

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Rishi Sunak says he acted 'decisively' in sacking  Nadhim Zahawi following tax affairs row

Rishi Sunak has insisited he acted “decisively” in sacking Nadhim Zahawi as chairman of the Conservative Party after a row over his tax affairs.

Speaking in Country Durham at the launch of his government’s emergency care plan, the prime minister defended his handling of situation and stressed his commitment to “integrity” and the need to follow proper processes.

“What I have done is follow a process, which is the right process,” he said.

“Integrity is really important to me – all of you guys want to see that government is run properly, that it is run with integrity and there’s accountability when people don’t behave in the way that they should or if something doesn’t go right, and that’s what we’ve done.”

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Mr Sunak also promised he would “take whatever steps are necessary to restore the integrity back into politics”.

“The things that happened before I was prime minister, I can’t do anything about,” the prime minister said.

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“What I think you can hold me to account for is how I deal with the things that arise on my watch.

“And as you’ve seen, you know, when it came to Nadhim Zahawi, I asked the independent adviser to look at it straight away, acted on his findings straight away.

“That should give you some confidence that these things matter to me, and that I will take whatever steps are necessary to restore the integrity back into politics, and you can have confidence that the process works.”

Mr Zahawi was sacked as Tory party chairman on Sunday after an ethics inquiry into the handling of his tax affairs found a “serious breach” of the ministerial code.

Mr Sunak had resisted earlier calls from opposition parties to fire Mr Zahawi following reports that he had paid a penalty as part of an estimated £4.8m settlement dispute with HMRC.

But following the conclusion of an inquiry into the matter by his new ethics adviser Sir Laurie Magnus – which found that Mr Zahawi had “shown insufficient regard for the general principles of the ministerial code” – Mr Sunak swiftly removed the former Tory chairman from his post.

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Zahawi sacked over tax row

Critics of Mr Sunak have said he should have acted sooner in dismissing Mr Zahawi.

But the prime minister said it was on the basis of the facts contained in Sir Laurie’s report released on Sunday morning that he was “able to make a very quick decision that it was no longer appropriate for Nadhim Zahawi to continue in government”.

The PM’s official spokesperson reiterated to reporters on Monday that Mr Zahawi’s tax penalty was not disclosed to Mr Sunak upon his appointment.

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Who is Nadhim Zahawi? The politician sacked over his tax affairs?
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Yesterday, Labour’s deputy leader Angela Rayner and chairwoman Anneliese Dodds wrote to Mr Sunak asking him to give the public “full transparency” about what he knew about the investigation into Mr Zahawi’s tax affairs and when.

Ms Dodds described Mr Sunak as “weak” for not sacking Mr Zahawi “when this murky affair first surfaced”.

Ms Rayner added: “Rishi Sunak shouldn’t have needed an ethics adviser to tell him that Nadhim Zahawi’s position was untenable, but instead he continued to prop up the man he appointed to cabinet.”

Speaking to Sky News earlier today, shadow international trade secretary Nick Thomas-Symonds suggested the PM could have been lying about what he knew about Mr Zahawi’s tax affairs.

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‘PM must come clean on Zahawi’

Asked whether he believed Mr Sunak has lied about what he knew of the matter, Mr Thomas-Symonds replied: “How could the prime minister not have known about the fact of the investigation when Mr Zahawi declared it in July?”

The row surrounding Mr Zahawi had centred on a tax bill over the sale of shares in YouGov – the polling firm he founded worth an estimated £27m – which were held by Balshore Investments, a company registered offshore in Gibraltar and linked to Mr Zahawi’s family.

Mr Zahawi had insisted he was “confident” he had “acted properly throughout”.

Liberal Democrat deputy leader Daisy Cooper has called on Mr Sunak to withdraw the Conservative whip from Mr Zahawi “if he refuses to stand down as an MP” as he is “simply not fit to represent his constituents”.

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In a letter to Mr Sunak following his sacking – in which he made no apology for his actions – Mr Zahawi told the PM he can be “assured of my support from the backbenches in the coming years”.

Speaking to Sky News on Monday, health minister Helen Whately said she thought the PM followed a “fair” process when deciding to sack the former Conservative party chairman.

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Major search for missing 45-year-old who vanished while walking her dog in Lancashire

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Major search for missing 45-year-old who vanished while walking her dog in Lancashire

A major search is under way to find a 45-year-old woman from Inskip, Lancashire, who vanished while walking her dog.

Nicola Bulley was last seen three days ago – on Friday 27 January – at around 9.15am on a towpath by the River Wyre off Garstang Road in the village of St Michael’s on Wyre.

Police say her mobile phone was found on a bench near the riverbank and they are “extremely concerned” about her, and have urged anyone with information to get in touch.

Emergency crews including Lancashire Police, Lancashire Fire and Rescue, Bowland Pennine Mountain Rescue team and the North West Underwater Search Team have joined the search.

Police dive teams, fire service drones, search dogs, helicopters and mountain rescue volunteers have been sent to the area.

Specialist search officers drive a boat along the River Wyre where Lancashire Police are searching for missing woman Nicola Bulley, 45, who was last seen on the morning of Friday January 27, when she was spotted walking her dog on a footpath by the river in St Michael's on Wyre, Lancashire. Picture date: Monday January 30, 2023.
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Ms Bulley was walking her dog near the River Wyre when she disappeared

Lancashire Police earlier said Ms Bulley’s dog – a brown Spaniel – was also found close to where she was last seen and hope this might help jog the memory of anyone who saw her and may have information relating to her whereabouts.

She is described as white, 5ft 3ins tall, with light brown shoulder-length hair and she speaks with an Essex accent.

Ms Bulley was last seen wearing a long black gilet jacket with a hood, black jeans and olive green ankle wellies. Her hair was tied into a ponytail.

As well as Inskip and St Michael’s on Wyre, she also has links to Thornton Cleveleys.

In an update on Monday, Superintendent Sally Riley appealed for motorists who may have been driving through the area where Ms Bulley was last seen to come forward with any dash cam footage that could help officers.

The force said it is keeping an open mind about where she may be, and detectives investigating the circumstances around her disappearance are following a number of lines of enquiry.

A missing person notice attached to a gate in St Michael's on Wyre, Lancashire, where officers from Lancashire Police are searching for Nicola Bulley, 45, from Inskip, Lancashire, who was last seen on the morning of Friday January 27, when she was spotted walking her dog on a footpath by the River Wyre. Picture date: Monday January 30, 2023.
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A major search is under way to find the missing 45-year-old

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Chief Inspector Chris Barton said on Sunday: “Nicola has now been missing for two days and we are extremely concerned about her.

“Firstly, if anybody saw her on Friday morning and has not yet been spoken to by police, or if anybody has any other information about where she might be, please get in touch with us straight away.

“Enquiries are very much ongoing and we have a team of detectives working tirelessly to establish the circumstances around her disappearance, in addition to a large team of police officers, partner agency and volunteer groups on the ground searching the area around where she was last seen.”

He added officers are aware a large number of people from the local community have organised a search of the area, and urged them to stay safe.

The River Wyre and its banks are extremely dangerous and searching these areas presents a genuine risk to the public, the force said.

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