Emergency care will be prioritised by the NHS next week when strike action by junior doctors will see the biggest disruption of services to date, with thousands of routine appointments postponed.
The industrial action is set to begin on Monday at all trusts in England for 72 hours.
It is the longest continuous period of walkouts to hit the health service in recent months, following strikes by nurses, paramedics and physiotherapists.
However, with around 61,000 junior doctors making up half of the medical workforce and no national derogations having been agreed, the NHS is warning the latest action is expected to see some of the most severe disruption to date, impacting on efforts to cut the record-high waiting list.
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As a result, emergency, critical and maternity care will be prioritised, as well as patients who have waited the longest for elective care and cancer surgery where possible.
Professor Sir Stephen Powis, the medical director of the NHS, said: “The NHS has been working incredibly hard to mitigate the impact of this strike.
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“While we are doing what we can to avoid having to reschedule appointments, there’s no doubt that disruption will be much more severe than before and patients who have been waiting for some time will face postponements across many treatment areas.
“Where there are postponements, we’ll be trying to re-book as quickly as possible. However, it is vital to attend planned appointments unless told otherwise.
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“We have no option but to prioritise emergency and critical care as a matter of patient safety, and we’re asking the public to help us and use 111 online as well as local services like general practice and pharmacies as first points of call, but people should of course always use 999 in a life-threatening emergency.”
The NHS stressed that the measures were needed to make sure safe care continues to be available for those in life-threatening situations.
It said routine appointments and procedures will only be cancelled where unavoidable and patients will be offered an alternative date as soon as possible.
The warning comes after senior leaders reportedly told the Health Service Journal that ministers have not sufficiently sounded the alarm about the risk to patient harm posed by the strikes.
More than 98% of junior doctors from the British Medical Association (BMA) voted to take industrial action in the dispute over pay and conditions.
Talks between the BMA and Health Secretary Steve Barclay at the start of March did not improve matters, with the union saying the cabinet minister “refused to come forth with any improved offer”.
The BMA says that while workload and waiting lists are at record highs, pay for junior doctors has been cut “by more than a quarter since 2008”.
But the government says pay has increased by a cumulative 8.2% since 2019/20 and further wage increases aren’t affordable at a time of record-high inflation.
Health leaders ‘preparing for absolute worst’
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NHS Crisis: ‘Past breaking point’
The NHS Confederation, which represents trusts across the country, urged both sides to “show willingness to compromise and bring these strikes to an end without delay”.
It said health leaders are “preparing for the absolute worst” with some taking down 50% of their planned theatre activity and others are opting for 100%.
Elsewhere one large hospital is having to rearrange more than 2,000 outpatient appointments and over 200 non-urgent surgeries next week.
Matthew Taylor, chief executive of the NHS Confederation, said: “We are disappointed the government and BMA have failed to put a stop to the forthcoming junior doctors strikes, especially after the positive steps that have been made with the other trade unions.”
He added: “… no national exceptions have been agreed to these walkouts, and many trusts will find themselves in a difficult position trying to navigate payment of the BMA’s recommended rate card for consultants when covering the work of junior doctors.
“This means it is likely that disruption to patient services will be like nothing the NHS has seen since industrial action started last December. Thousands of procedures and appointments are likely to be cancelled.”
Virginia Giuffre, who accused Prince Andrew of sexual assault, has died aged 41.
In a statement to Sky’s US partner network NBC News on Friday, her family said she took her own life in the Perth suburb of Neergabby, Australia, where she had been living for several years.
“It is with utterly broken hearts that we announce that Virginia passed away last night at her farm in Western Australia,” her family said.
“She lost her life to suicide, after being a lifelong victim of sexual abuse and sex trafficking.
“Virginia was a fierce warrior in the fight against sexual abuse and sex trafficking. She was the light that lifted so many survivors.
“In the end, the toll of abuse is so heavy that it became unbearable for Virginia to handle its weight.”
Image: Pic: AP
Police said emergency services received reports of an unresponsive woman at a property in Neergabby on Friday night.
“Police and St John Western Australia attended and provided emergency first aid. Sadly, the 41-year-old woman was declared deceased at the scene,” a police spokeswoman said.
“The death is being investigated by Major Crime detectives; early indication is the death is not suspicious.”
Sexual assault claims
Image: Prince Andrew has denied all claims of wrongdoing. File pic: Reuters
Ms Giuffre sued the Duke of York for sexual abuse in August 2021, saying Andrew had sex with her when she was 17 and had been trafficked by his friend, the billionaire paedophile Jeffrey Epstein.
The duke has repeatedly denied the claims, and he has not been charged with any criminal offences.
In March 2022, it was announced Ms Giuffre and Andrew had reached an out-of-court settlement – believed to include a “substantial donation to Ms Giuffre’s charity in support of victims’ rights”.
She stuck by her version of events until the end
Of the many dozens of victims of Jeffrey Epstein, it was Virginia Giuffre who became the most high-profile.
She was among the loudest and most compelling voices, urging criminal charges to be brought against Epstein, waving her right to anonymity in 2015.
She told how he and Ghislaine Maxwell groomed her and “passed around like a platter of fruit” to be used by rich and powerful men.
But her name and face became known around the world after she accused Prince Andrew of sexually abusing her when she was 17 years old.
The picture of her together with the prince and Maxwell at the top of a staircase, his hand around her waist, is the defining image of the whole scandal.
Prince Andrew said he had no memory of the occasion. But Giuffre stuck by her version of events until the end.
‘An incredible champion’
Sigrid McCawley, Ms Giuffre’s attorney, said in a statement that she “was much more than a client to me; she was a dear friend and an incredible champion for other victims”.
“Her courage pushed me to fight harder, and her strength was awe-inspiring,” she said. “The world has lost an amazing human being today.”
“Rest in peace, my sweet angel,” she added.
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Dini von Mueffling, Ms Giuffre’s representative, also said that “Virginia was one of the most extraordinary human beings I have ever had the honour to know”.
“Deeply loving, wise, and funny, she was a beacon to other survivors and victims,” she added. “She adored her children and many animals.
“She was always more concerned with me than with herself. I will miss her beyond words.
“It was the privilege of a lifetime to represent her.”
Ms Giuffre said at the end of March she had four days to live after a car accident, posting on social media that “I’ve gone into kidney renal failure”. She was discharged from hospital eight days later.
Raised mainly in Florida, she said she was abused by a family friend early in life, which led to her living on the streets at times as a teenager.
She said that in 2000, she met Ghislaine Maxwell, a British socialite who was convicted in 2021 on federal sex trafficking and conspiracy charges and was sentenced to 20 years in prison.
Image: Ghislaine Maxwell and Jeffrey Epstein. Pic: US Department of Justice
Ms Giuffre said Maxwell then introduced her to Epstein and hired her as his masseuse, and said she was sex trafficked and sexually abused by him and associates around the world.
‘A survivor’
After meeting her husband in 2002, while taking massage training in Thailand at what she said was Epstein’s behest, she moved to Australia and had a family.
She founded the sex trafficking victims’ advocacy charity SOAR in 2015, and is quoted on its website as saying: “I do this for victims everywhere.
“I am no longer the young and vulnerable girl who could be bullied. I am now a survivor, and nobody can ever take that away from me.”
:: Anyone feeling emotionally distressed or suicidal can call Samaritans for help on 116 123 or email jo@samaritans.org in the UK. In the US, call the Samaritans branch in your area or 1 (800) 273-TALK.
Image: Pope Francis meets King Charles and Queen Camilla during a private audience at the Vatican on 9 April. Pic: Vatican Media/Reuters
The trip came just a week-and-a-half after Buckingham Palace confirmed the King had been taken to hospital following side effects related to his ongoing cancer treatment.
Number 10 has confirmed the prime minister received an invite and will attend the ceremony.
Speaking on Tuesday, Sir Keir said there had been “an outpouring of grief and love” for the Pope.
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Sky News inside Vatican
He added: “I think it reflects the high esteem in which he was held, not just by millions and millions of Catholics, but by many others, across the world, myself included.”
Image: Donald Trump and Pope Francis meet at the Vatican in 2017. Pic: Reuters
The US president was one of the first to confirm he would be flying to Rome, adding he would be joined by first lady Melania Trump.
Writing on his social media platform Truth Social on Monday, he said: “Melania and I will be going to the funeral of Pope Francis, in Rome. We look forward to being there!”
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Trump: ‘Pope Francis loved the world’
The Pope had been critical of Mr Trump at times during his tenure.
In January, he said it would be a “disgrace” if the president went ahead with his crackdown on immigration, telling an Italian television station: “It would make the migrants, who have nothing, pay the unpaid bill.
“It doesn’t work. You don’t resolve problems this way.”
Mr Milei alluded to their “differences” in his tribute to the late Pope, writing: “It is with profound sorrow that I learned this sad morning that Pope Francis, Jorge Bergoglio, passed away today and is now resting in peace.
“Despite differences that seem minor today, having been able to know him in his goodness and wisdom was a true honour for me.”
Image: Pope Francis meets Ursula von der Leyen at the Vatican in 2022. Pic: Vatican Media/Reuters
The EU Commission President confirmed she would be attending after calling Francis a worldwide inspiration.
“He inspired millions, far beyond the Catholic Church, with his humility and love so pure for the less fortunate,” she said in her tribute.
Council President Antonio Costa, Parliament President Roberta Metsola are also expected to attend.
Here are some of the other notable attendees:
• Ireland’s taoiseach Micheal Martin • Spain’s King Felipe and Queen Letizia • Albanian president Bajram Begaj • Angola’s president Joao Lourenco • Austrian president Alexander Van der Bellen • Bangladesh’s chief adviser and interim leader Muhammad Yunus • Belgium’s King Philippe and Queen Mathilde, along with prime minister Bart De Wever • Canada’s governor general Mary Simon • Cape Verde president Jose Maria Neves • Croatia’s president Zoran Milanovic • Cyprian president Nikos Christodoulides • Czech Republic’s prime minister Petr Fiala • Democratic Republic of Congo president Felix Tshisekedi • Dominican Republic’s president Luis Abinader • East Timor’s president Jose Ramos-Horta • Ecuador’s president Daniel Noboa • Estonia’s president Alar Karis • Finland’s president Alexander Stubb • Gabon’s president Brice Oligui Nguema • German president Frank-Walter Steinmeier and outgoing chancellor Olaf Scholz • Greece’s prime minister Kyriakos Mitsotakis • Honduras president Xiomara Castro • Hungary’s president Tamas Sulyok • Italy’s president Sergio Mattarella and prime minister Giorgia Meloni • Latvian president Edgars Rinkevics • Lithuanian president Gitanas Nauseda • Moldova’s president Maia Sandu • Netherlands’ prime minister Dick Schoof • New Zealand’s prime minister Christopher Luxon • Norway’s Crown Prince Haakon and Crown Princess Mette-Marit • The Philippines’ president Ferdinand Marcos Jr • Poland’s president Andrzej Duda • Portugal’s president Marcelo Rebelo de Sousa and prime minister Luis Montenegro • Romania’s interim president Ilie Bolojan • Sweden’s King Carl XVI Gustaf, Queen Silvia and prime minister Ulf Kristersson • Switzerland’s president Karin Keller-Sutter
Image: Pope Francis walks next to Putin at the Vatican in 2015. Pic: AP
The Russian president will not be attending the funeral, the Kremlin has confirmed.
But the controversial leader paid tribute to the Pope, writing a message to Cardinal Kevin Farrell, who is interim chief of the Catholic Church.
“Please accept my most sincere condolences on the passing of His Holiness Pope Francis,” Mr Putin said.
“Throughout the years of his pontificate, he actively promoted the development of dialogue between the Russian Orthodox and Roman Catholic churches, as well as constructive cooperation between Russia and the Holy See.”
Image: Pope Francis and Benjamin Netanyahu meet at the Vatican in 2013. Pic: AP
The Israeli prime minister is not expected to attend, with the country’s ambassador Yaron Sideman going instead.
The Jewish state and the Vatican have had strong relations in the past, with Israel sending a presidential delegation to the funeral of Pope John Paul II in 2005, and Pope Francis visiting Israel in 2014.
But their relationship has deteriorated since the start of the war in Gaza.
A month after the conflict started in 2023, a dispute broke out over whether Pope Francis had used the word “genocide” to describe events in Gaza. Palestinians who met with him said he did, but the Vatican said he did not.
The Pope met relatives of Israeli hostages on the same day.
Israeli officials have since lobbied the Vatican to be more forceful in its condemnation of Hamas.
In January, the Pope called the humanitarian situation in Gaza “shameful”, prompting criticism from Rome’s chief rabbi, Riccardo Di Segni, who accused Francis of “selective indignation”.
Rabbi Di Segni says he will be attending the funeral, despite it taking place on the Jewish sabbath.
Is there a seating plan?
The seats are assigned in advance, with the heads of state sitting in French alphabetical order based on their country’s name, rather than on the individual’s.
This applies to everyone apart from the presidents of Italy and Argentina, who get the best seats because the Pope lived in Italy and was an Argentinian native.
The head of the Catholic Church in England and Wales has told Sky News it’s “intimidating” to be one of those responsible for choosing the next pope.
Vincent Nichols is among four UK cardinals in Rome for the Pope’s funeral on Saturday.
Following the funeral, and after nine days of mourning, cardinals from around the world will gather in the Vatican’s Sistine Chapel to cast their votes, with white smoke announcing to the world when a new pope has been elected.
Image: Cardinal Vincent Nichols speaks to Sky’s Anna Botting
Cardinal Nichols told Sky’s Anna Botting: “I hope nobody goes into this conclave, as it were, with the sole purpose of wanting to win. I think it’s very important that we go in wanting to listen to each other… It has to be together, trying to sense what God wants next. Not just for the church.”
He described the procession that took Pope Francis to lie in state as “the most moving thing I’ve ever attended here”.
Describing the Pope as a “master of the gesture and the phrase”, he also recalled the pontiff’s last journey away from the Vatican.
Cardinal Nichols said Pope Francis had visited the Regina Coeli prison, telling the inmates: “You know, except for the grace of God, it could well have been me … Don’t lose hope, God has you written in his heart.”
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‘Pope touched the hearts of millions’
The Pope later told his doctor his last regret was not being able to wash the feet of the prisoners during that visit.
Becoming emotional, he also said the final message he would like to have given Pope Francis is “thank you”.
The 88-year-old died peacefully on Easter Monday, the Vatican confirmed.
Heads of state – including Sir Keir Starmer, Donald Trump and Emmanuel Macron – have all confirmed their attendance at his funeral, which takes place on Saturday at St Peter’s Square.
You can watch full coverage of the funeral live on Sky News on Saturday
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Where will Pope Francis be buried?
Talking about the seating plan at the funeral, Cardinal Nichols said he understood it to be “royalty first, then heads of state, then political leaders”.
Cardinal Nichols explained event would be “exactly the same Catholic rite as everyone else – just on a grander scale”.
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3D map shows pope’s funeral route
In a break from tradition, Pope Francis will be the first pope in a century to be interred outside the Vatican – and will instead be laid to rest at his favourite church, Santa Maria Maggiore Basilica in Rome’s Esquilino neighbourhood.
He will also be buried in just one simple wooden coffin, instead of the traditional three coffins which are usually used for pontiffs.
Born in Crosby near Liverpool, Cardinal Vincent Nichols hoped to be a lorry driver as a child – but as a teenager reportedly felt the calling to join the priesthood while watching Liverpool FC.
As cardinal, he is known for leading the church’s work tackling human trafficking and modern slavery, for which he received the UN Path to Peace Award.
He was criticised by the UK’s Independent Inquiry into Child Sexual Abuse, which said he “demonstrated a lack of understanding” of the impact of abuse and “seemingly put the reputation of the church first”.
Cardinal Nichols, responding to the findings, previously told Sky News he was “ashamed at what has happened in the context of the Catholic Church” and promised to improve the church’s response.
He has appeared to rule himself out of the running for pope, telling reporters he was “too old, not capable”.