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.”
The family of a father-of-four who died on holiday in Benidorm say new evidence has further convinced them that foul play was involved in his death.
Nathan Osman, 30, from Pontypridd in South Wales, was on a long weekend break with friends in Benidorm in September 2024.
Less than 24 hours after he arrived, his body was found by an off-duty police officer at the bottom of a remote 650ft (200m) cliff on the outskirts of the resort.
He died from head and abdominal injuries after falling from height, a post-mortem found.
Local police said it was “a tragic accident” that occurred after Nathan left his friends in Benidorm to walk back to his hotel room alone.
But his family believe the investigation into his death has not been adequate, and that the local authorities have never considered the possibility of a homicide.
Their suspicions of foul play were first provoked by the fact that the remote location where Nathan was found was in the opposite direction to the hotel, and some distance away on foot.
They began doing their own investigating, building a timeline of events drawn from sources including CCTV, witness statements and Nathan’s bank records, which they say showed attempts were made to use his bank cards the day after he died.
Now, the family have told Sarah-Jane Mee on The UK Tonight that new phone data they have uncovered suggests he couldn’t have reached the spot he was found on foot.
Image: Nathan’s brother Lee, mother Elizabeth and father Jonathan speak to Sarah-Jane Mee
After getting the phone back a couple of months ago, they say they tracked Nathan’s last movements through a health app.
“There’s a breakdown inside the app of every 10 minutes – the distance, pace, measurement of pace… every detail you can think of,” Nathan’s brother, Lee Evans, tells Mee.
“His pace wasn’t consistent with a fast walk or even a sprint.”
He said it was a faster journey, despite being uphill for 40 minutes, which has convinced the family that he was in a vehicle.
Image: Pic: Family handout
The family also went to visit the area where Nathan was found.
“We were a bit upset, but we were very pleased we went up there”, his mother, Elizabeth, says. “We could see… there’s no way he would have looked at that area and thought, ‘I’m going up here.’
“You can see straight off, there’s no clubs, there’s no hotels up there, there’s just the odd house dotted around. It was just out in the wild, there was nothing up there.”
The family says the phone data has helped them determine that he died around half an hour after he was seen on CCTV walking towards his hotel in the early hours of the morning.
“It was really ridiculous to think that my son would’ve walked up there [the remote location where he died] at 4am in the pitch dark.”
After the family were interviewed by Mee in May, South Wales Police opened its own investigation into Nathan’s death.
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Nathan’s family speaking to Mee in May
Lee says the Welsh force has been “appalled” by the lack of evidence turned over from the local police’s investigation.
His and Nathan’s father, Jonathan, says: “No procedures were followed. Nothing was cordoned off, it wasn’t a crime scene. There’s loads of things that could’ve been taken. Tyre tracks, foot tracks, nothing. No DNA taken.”
Lee says: “All that we’ve done over the last year, this could’ve been squashed within the first week, two weeks [by local investigators].
“We’ve had to find out and keep delving into every possible outcome and overturn every stone possible. We started off with… a needle in a haystack, we had no direction or any support on which way to go.”
Image: Nathan Osman. Pic: Family handout
What does Nathan’s family hope for now?
Nathan’s family say they have located 27 CCTV cameras which could have picked Nathan up in the area, after local investigators didn’t find any.
Elizabeth says that after alerting Spanish police to the locations, they were told that the CCTV “wouldn’t be working” or that footage would’ve already been erased.
“They just surmised everything,” she adds.
But the family, who found the last known CCTV footage of Nathan earlier this year, are convinced there is still hope.
Lee says: “There’s a number of CCTV footage in that area. We know there’s a way of finding a vehicle of some sort.”
But the family admit they may never find whoever could be responsible for Nathan’s death because so much time has been lost.
Elizabeth concludes: “Nathan walks with us every day. We all believe that,” adding that “all we want” is to find the ones responsible for his death and for him to “have the respect of a decent investigation”.
Sky News contacted Spanish police, which declined to comment, adding the case is under judicial review and it doesn’t want to hinder the course of the investigation.
South Wales Police told Sky News: “South Wales Police is carrying out enquiries on behalf of HM Coroner and a family liaison officer has been appointed to provide support.”
Watch the full interview with Sarah-Jane Mee on The UK Tonight from 8pm this evening on Sky News.
A man accused of a mass stabbing on an LNER train in Huntingdon last month and separate attacks over the previous 48 hours, could face a trial next year.
Anthony Williams, 32, is charged with 10 counts of attempted murder and one count of possession of a knife over the alleged attack on a LNER train from Doncaster to London on 1 November.
Williams, refused to attend Monday’s hearing at Cambridge Crown Court, and has yet to enter pleas. But the judge has set a provisional trial date in June.
He is charged with one count of assault occasioning actual bodily harm over an alleged attack on a male police officer in custody.
Williams also faces another count of attempted murder and one count of possession of a knife over a separate incident at Pontoon Dock Docklands Light Railway (DLR) station, in east London, earlier on 1 November.
Image: The aftermath of the mass stabbing. Pic: Reuters
At Monday’s hearing, held in Williams’ absence, the case was joined with seven further charges, bringing the total number of charges to 21.
Williams, who said at an earlier hearing that he is of no fixed abode, had also failed to attend a hearing at Peterborough Magistrates’ Court on 19 November over the seven additional charges.
Image: A forensic officer taking pictures on the train. Pic: Reuters
The seven charges relate to the following incidents in the 24 hours leading up to the train stabbings:
• Attempted murders of a 14-year-old boy at Henry Penn Walk, Peterborough, on 31 October.
• Attempted murder of a 22-year-old man near Pleasure Fair Meadow Road, Peterborough, on 31 October.
• Attempted wounding of a 28-year-old man at Viersen Platz, Peterborough, on 31 October.
• Affray at a barbershop in Peterborough on 31 October.
• Possession of a knife in a public place at a footbridge near Henry Penn Walk, the Rail World car park and Queen’s Walk, all in Peterborough on 31 October.
• Theft of knives from Asda supermarket in Stevenage on 31 October.
• Assault of a 31-year-old man onboard a train travelling from King’s Cross to Peterborough on 1 November.
Agency workers hired to fill the void in the wake of the Birmingham bin strikes have voted for strike action and will be joining the picket.
The first day of the action kicks off today, with a rally organised by the Unite union at the Smithfield depot in Birmingham.
The union said the numbers joining the strike were “growing daily” – but Birmingham City Council said just “a small number” of agency staff were taking part.
The replacement workers recruited by the Job&Talent agency, said they had voted in favour of industrial action “over bullying and harassment and the threat of blacklisting at the council’s refuse department two weeks ago”.
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From September: Birmingham bin strikes six months on
Image: General secretary of Unite Sharon Graham. Pic: PA
Sharon Graham, Unite’s general secretary, said: “Birmingham council will only resolve this dispute when it stops the appalling treatment of its workforce.
“Agency workers have now joined with directly-employed staff to stand up against the massive injustices done to them.”
She added: “Instead of wasting millions more of council taxpayers’ money fighting a dispute it could settle justly for a fraction of the cost, the council needs to return to talks with Unite and put forward a fair deal for all bin workers.
“Strikes will not end until it does.”
Strikes from the bin workers in Birmingham have been ongoing since January, and are likely to continue beyond May next year.
Birmingham City Council said it was “disappointed the dispute has not been resolved as Unite has rejected all our offers”.
“We are continuing to make regular waste collections and our contingency plan is working,” it added.
It also said it found “no blacklisting has taken place” after an investigation and that it “strongly” refuted Unite’s claims of bullying, which it said were “unfounded”.