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.
If you are an NHS worker and would like to share your experiences with us anonymously, please email NHSstories@sky.uk
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.
More on Nhs
Related Topics:
“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.
Advertisement
“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’
Please use Chrome browser for a more accessible video player
3:06
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.”
On a dark December morning two years ago, Kiki Marriott left her flat and started walking.
Content warning: This article contains references to suicide.
It was 5am, and she was heading for the station.
“I was numb at that point,” she says.
“I was just so done with trying to survive and just existing… feeling extremely lonely and isolated and didn’t know where to turn.”
She was trapped in a cycle of addiction, gambling all hours and taking cocaine for the maximum buzz.
Image: ‘I didn’t know where to turn,’ says Kiki
“I sat at the train station thinking about my daughter, thinking about the mistakes that I’ve made in the past, thinking that I didn’t want to live this life any more.”
Kiki was waiting for the first train.
But that train was late. And she changed her mind.
Instead of taking her own life, she decided to seek help.
Yet what she would find on that journey of recovery would shock her.
“I just realised that there wasn’t anybody that looked like me, sounded like me, and it got me to thinking, well I can’t be the only black woman suffering with a gambling or cocaine addiction.”
Please use Chrome browser for a more accessible video player
3:39
‘I can’t be the only black woman suffering addiction’
Racial disparities
Research has shown that people from ethnic minority backgrounds are less likely to gamble than white people, but are more likely to suffer harm from gambling.
Despite that, too often they do not seek help.
And YouGov statistics shared exclusively with Sky News shed a light on why.
The survey of 4,000 adults for GamCare, which runs the National Gambling Helpline, found that two-thirds of people from ethnic minority backgrounds who’d gambled in the past year had spent more money than they’d planned, double the amount of white respondents.
They were also more than twice as likely to hide their gambling and nearly three times as likely to feel guilt.
Kiki is not surprised.
“For me, coming from a black community, a black background, what goes on indoors stays behind closed doors,” she says.
“You keep your mouth shut, and you handle your business yourself.”
And when she considered what an addict looked like, it wasn’t someone like her.
“I just thought it’s an old white man’s thing – that they go into the bookies, and they have a drink and they bet.
“I thought, well, that’s not me.”
But Dharmi Kapadia, a senior sociology lecturer from Manchester University, who focuses on racial inequality, thinks there’s more than just cultural pressure at play.
“These explanations of stigma have become dominant,” she says.
“We’ve found that what’s more important is that people don’t want to go and get help from gambling services because of previous racist treatment that they’ve suffered at the hands of other statutory services, for example, when they went to the GP.”
Image: Dharmi Kapadia thinks there’s more than just cultural pressure at play
‘I needed to change’
The stigma felt very real for Kiki, so she hid what she was doing.
“I’ve had trauma in my life. I’ve been sexually abused as a child.
“As the years have gone on, a traumatic event happened in my family that really changed the dynamics of my life and that’s when I moved on from scratch cards to online slots.”
She became hooked – betting around the clock, spending her benefits on 10p and 20p spins on online slots and borrowing money from those around her.
Eventually her daughter moved out when she was 15.
“That’s when everything escalated. I didn’t have that responsibility of keeping up appearances.
“Before that, gas, electric, food shopping, all those things had to be in place.
“I just lived and breathed in my bedroom at that point and yeah, it was very lonely.”
When Kiki left the station that day, she called the National Gambling Helpline.
“For the first time in my life, I was completely honest about everything that I was doing – the lies, the manipulation when I was in active addiction, the secrecy.
“I was completely transparent because I wanted to change. I needed to change.”
‘Where’s all the women?’
Since then, she has undergone constant therapy, including a six-week stint in rehab.
And as she headed home in the taxi, her phone rang.
It was Lisa Walker, a woman who understood gambling addiction. She had won £127,000 playing poker at 29 before losing everything and ending up homeless with her young children.
Image: Lisa Walker (left) sought help from Gamblers Anonymous and was among very few women at her meetings
When she finally asked for help, she too felt she was different, walking into a Gamblers Anonymous meeting to find she was one of only two women in a room with 35 men.
“I was thinking, where’s all the women?” says Lisa.
“I can’t be the only woman in the world with a gambling addiction, so that got me thinking, what services are out there for women?”
It was the catalyst to set up support for female gamblers in April 2022.
Since then, Lisa has helped close to 250 women, but all but four have been white.
One of those four was Kiki.
‘There’s no getting away from it’
“It just baffles me… Why aren’t they reaching out for support? Is it the shame? Is it stigma?” says Lisa.
But another concern is that it’s simply too easy to hide the gambling.
“Getting on the train this morning, 90% of people are on their phones, and we don’t know whether they’re playing slots,” she says.
“I could probably sit here now and sign up for 50 online casinos and probably get over a thousand free spins.
“I just think there’s no getting away from it because it’s 24 hours a day.”
Image: Kiki says she now has an ‘amazing’ relationship with her daughter
Kiki’s flat in Woolwich, where once she couldn’t even go to the bathroom without gambling, has become the place where she runs her own online peer mentoring groups.
“Feeling understood and validated for your experiences, for how you was raised… the core beliefs that you’re taught from a young age, to have somebody that looks like you, talks like you, has the same cultural background… it’s extremely important to make you feel understood, to make you feel validated,” she says.
‘You can learn from it’
Kiki will need to attend support groups for life to keep her addictions at bay.
But she has a clear goal, just as Lisa did.
“My focus is to help other people, help empower other people to choose themselves, to show them that there is light after so much darkness… that you don’t have to be a victim of your circumstances, that you can choose to grow from it and learn from it and heal from it,” she says.
For Kiki, there was so much at stake.
“It was either I was going to die or I was going to become a woman and a mother that my daughter could come back to and respect again.”
And that has happened. Kiki’s daughter is 19 now.
Image: Kiki now helps others suffering from gambling addiction
“We’ve got an amazing relationship today. I’ve took full accountability for the mistakes that I’ve made.
“She’s extremely proud of where I am today.”
It’s more than Kiki could have dreamt of two years ago.
Now all she wants is to help others escape the endless cycle of addiction.
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
To speak to an adviser on the National Gambling Helpline, call 0808 8020 133
Sir Keir Starmer has declared it his “moral mission” to “turn the tide on the lost decade of young kids left as collateral damage”.
The government launches its 10-year youth plan today, which has pledged £500m to reviving youth services.
Culture Secretary Lisa Nandy has also warned that young people are now “the most isolated in generations” and face challenges that are “urgent and demand a major change in direction”.
But despite the strong language, the Conservatives have warned that “under Labour, the outlook for the next generation is increasingly bleak”.
Launching the 10-year strategy, Sir Keir said: “As a dad and as prime minister, I believe it is our generation’s greatest responsibility to turn the tide on the lost decade of young kids left as collateral damage. It is our moral mission.
“Today, my government sets out a clear, ambitious and deliverable plan – investing in the next generation so that every child has the chance to see their talents take them as far as their ability can.”
What’s in the government’s strategy?
Under the plans, the government will seek to give 500,000 more young people across England access to a trusted adult outside their homes – who are assigned through a formal programme – and online resources about staying safe.
The prime minister said the plans will also “ensure” that those who choose to do apprenticeships rather than go to university “will have the same respect and opportunity as everyone else”.
OTHER MEASURES INCLUDE
Creating 70 “young futures” hubs by March 2029, as part of a £70m programme to provide access to youth workers – the first eight of these will open by March next year;
Establishing a £60m Richer Young Lives fund to support organisations in “underserved” areas to deliver high-quality youth work and activities;
Improving wellbeing, personal development and life skills through a new £22.5m programme of support around the school day – which will operate in up to 400 schools;
Investing £15m to recruit and train youth workers, volunteers and “trusted adults”;
Improving youth services by putting £5m into local partnerships, information-sharing and digital tech.
The plan comes following a so-called “state of the nation” survey commissioned by Ms Nandy, which heard from more than 14,000 young people across England.
Launching the strategy, she said: “Young people have been crystal clear in speaking up in our consultation: they need support for their mental health, spaces to meet with people in their communities and real opportunities to thrive. We will give them what they want.”
Image: Lisa Nandy will speak about the plan on Sky News on Wednesday morning. Pic: PA
But the Conservatives have criticised the government for scrapping the National Citizen Service (NCS), which ended in March this year.
Shadow culture secretary Nigel Huddlestone said “any renewed investment in youth services is of course welcome”, but said Labour’s “economic mismanagement and tax hikes are forcing businesses to close, shrinking opportunities while inflation continues to climb”.
“The system is more than broken – it crossed that limit a long time ago,” says Palestinian asylum seeker Ibrahim Altaqatqa.
Ibrahim came to the UK two years ago on a tourist visa – then claimed asylum.
In the time he’s been waiting to have his claim processed, he’s met his partner Yvonne, who is English, and five weeks ago their baby daughter Alisha was born.
Image: Ibrahim with partner Yvonne and five-week-old daughter Alisha
But his asylum claim remains unresolved, and he says he can’t return to his home near Hebron in the West Bank because of his political activism.
“I can’t just be stuck like this,” he says. “I can’t just waste day after day of my life waiting for somebody to say ‘OK, we give you a decision’.”
He wants to move on with his life and be allowed to work, he says.
“I don’t think you need two years to process any asylum claim. I don’t think there’s any case that’s complicated to that level. I’m not single any more. I’ve got other responsibilities now.”
Image: Alisha was born in the UK five weeks ago
‘I’d be happy to join hotel protests’
Formerly a farmer in the Golan Heights, Ibrahim says he’s well aware of the shifting public mood over immigration and shares frustration over the money being spent on asylum seekers.
“I don’t think they are putting their anger toward the right group,” he says. “On many occasions, I spoke with a lot of them – the people who were protesting by the hotel.
“I said ‘if you are really angry and if you really want to save your country, I will be more than happy to come with you and let’s go together to protest’.”
Please use Chrome browser for a more accessible video player
0:32
Protests over plans to house asylum seekers in barracks
Ibrahim says he stayed in three Home Office-funded asylum hotels and claims at one point he got scabies.
He claims the food and conditions were so bad at one point, he left and slept on the streets.
Huge backlog of asylum claims
Meanwhile, the National Audit Office (NAO), the UK’s independent public spending watchdog, has published a study on the processing and costs of people claiming asylum, examining the causes of delays and inefficiencies.
It analysed a sample of 5,000 asylum claims lodged almost three years ago and found 35% of them have so far been granted, while 9% of the claimants have been removed from the UK.
But the claims of more than half – 56% – remain unresolved.
Ruth Kelly, NAO chief analyst, says ministers have tended to take “short-term reactive interventions to fix problems, but then these have led to other pressures forming elsewhere in the system and new backlogs forming”.
“That’s led to wasted funds, poor outcomes for asylum seekers, and harm to the government’s ability to meet its obligations to citizens.”
The NAO estimates in the last year the Home Office and Ministry of Justice spent nearly £5bn on asylum – more than £2bn of that on asylum hotels.
It says there is a lack of a “whole system” approach within the Home Office; no shared objectives and there needs to be more robust shared data.
The NAO said it found the Home Office’s effectiveness and value for money are being undermined because of fundamental barriers that mean people seeking asylum spend extended periods waiting in the system.
The government has announced a raft of new measures to overhaul the asylum system but the watchdog points out they will take time and parliamentary approval to introduce.
In November, the home secretary acknowledged some people who are coming to the UK are economic migrants seeking to abuse the system, with even genuine refugees passing through other safe countries searching for the most attractive place to seek refuge.
Please use Chrome browser for a more accessible video player
2:40
Beth Rigby: The two big problems with Labour’s asylum plan
Government vows to ‘restore order’
With asylum claims falling across Europe but rising in the UK, the government says it wants to reduce illegal migrant arrivals and increase the removal of people with no right to be in the UK.
A Home Office spokesperson said the home secretary “recently announced the most sweeping changes to the asylum system in a generation to deal with the problems outlined in this report.
“We are already making progress – with nearly 50,000 people with no right to be here removed, a 63% rise in illegal working arrests and over 21,000 small boat crossing attempts prevented so far this year.
“Our new reforms will restore order and control, remove the incentives which draw people to come to the UK illegally and increase removals of those with no right to be here.”