Hospital leaders have expressed serious concerns about how they will maintain patient safety as the health service enters “unchartered territory” during “unprecedented” strike action next week.
Junior doctors who are training in England will stage their longest walkout so far between 11 and 15 April.
The 96-hour strike is likely to be the most disruptive in the history of the health service due to the length of the action and the fact doctors have chosen to stage it directly after a long bank holiday weekend.
The bank holiday traditionally causes disruption to the NHS even without the prospect of strike action.
The walkout also coincides with the Easter school holidays, which means many consultant staff who provided cover during the first round of strikes will be unable to do so again due to pre-planned holidays and childcare commitments.
NHS Providers, which represents NHS trusts, said the timing of the strike and its duration present a “range of challenges over and above the disruption seen from the industrial action in recent months”.
It said that during the strike, the NHS will focus resources on emergency treatment, critical care, maternity, neonatal care and trauma.
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But even in these areas, there are “real concerns of a raised risk to safety”, NHS Providers said.
The strikes could lead to delays for some patients starting treatment – for instance, if a new cancer patient needed to start weekly rounds of chemotherapy, the start of their treatment may be delayed until after the strike action to ensure continuity.
Hospital leaders have raised concerns with NHS Providers about the impact of the strike.
“This is less about what planned routine work gets pulled down and everything about maintenance of safety in emergency departments, acute medicine and surgery,” one hospital trust chief executive said.
“Concerned doesn’t begin to describe it.”
Another said: “I am not confident this time that we can maintain patient safety as we will not be able to provide the cover.”
“Many of the consultants who stepped up to do nights last time are not available or are more reluctant this time,” a third said.
While another added: “Those with families almost certainly won’t as [they] can’t rearrange out of school holidays.”
Sir Julian Hartley, chief executive of NHS Providers, said: “It’s clear from our extensive dialogue with trust leaders that we are in uncharted territory.
“Yet again we are seeing colleagues pull out all the stops to minimise disruption and ensure patient safety. But the challenges here are unprecedented.”
Dr Latifa Patel, workforce lead for the British Medical Association, said: “No one understands better than us, the doctors who care for them, that patients are getting a substandard experience 365 days a year from an overstretched and understaffed NHS.
“In this brutal work environment, patient care is at risk every day due to chronic staff shortages and years of underinvestment in equipment and services.
“Junior doctors have no desire to strike, they been pushed into this action by long-term government inaction and now want to bring this dispute to an end as quickly as possible.
“We hope the health secretary will come to the table immediately with a meaningful pay offer so doctors can avoid more strike action and instead return to doing what they want to be doing: caring for their patients.”
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12:01
Why are doctors quitting the NHS?
A department of health and social care spokesperson said: “Four days of strikes by junior doctors will risk patient safety and cause further disruption and postponed treatment.
“The BMA’s demand for a 35% pay rise is totally unreasonable and unaffordable.
“We urge them to come to the table with a realistic approach so we can find a way forward, as we have done with other health unions, which balances fairly rewarding junior doctors for their hard work with meeting the prime minister’s ambition to halve inflation.
“We are working with NHS England to put in place contingency plans to protect patient safety.
“The NHS will prioritise resources to protect emergency treatment, critical care, maternity and neonatal care, and trauma.”
Kemi Badenoch has said hacking into Harriet Harman’s website when she was younger is “not the same” as Rachel Reeves failing to get a £900 rental licence for her home.
The Tory leader, who has called for the chancellor to go for breaking the law, told Sky News’ deputy political editor Sam Coates she was not an MP in 2008 when she got into Labour peer Baroness Harman’s website and changed it so it was pro-Conservative.
Hacking into websites is a criminal offence and can be punishable with a fine or up to a two-year prison sentence for minor offences, or life imprisonment for the most serious.
Asked if she had ever broken the law, Ms Badenoch said: “I don’t believe that I have, but if I had done so, if I had done so when I was in government, then I would have been sacked or I would have been forced to resign.”
But reminded of her hacking episode, she said: “This was something I did in my 20s.
“We’re not talking about something that Rachel Reeves did in her 20s, we’re talking about something she’s doing as chancellor, after she became chancellor.
“It is not the same thing at all.”
She said people should not “try and draw a false equivalence” and said she guessed Baroness Harman’s password to enter the website, adding it was “a summary offence, like speeding”.
“This is whataboutery, we have a government of people who are repeatedly breaking the law,” she added.
Image: Rachel Reeves has apologised for the error and has now applied for the rental licence. Pic: PA
Ms Reeves has said she was not aware she needed a rental licence, required in some areas, to let out her family home in Dulwich, southeast London, after she moved to Downing Street when she was made chancellor.
She has now applied for a licence and apologised to Sir Keir Starmer, who has said that is adequate and there is no need for an investigation.
But Ms Badenoch said Ms Reeves’s position is untenable, given the PM has said “lawbreakers shouldn’t be lawmakers”.
Under the Housing Act 2004, introduced by Labour, councils can decide to introduce selective licensing, where residential landlords in specified areas must have a licence.
Landlords must adhere to certain requirements to obtain a licence, including gas certificates, working carbon monoxide alarms and fire safety regulations for furnishings.
They must secure a licence within 28 days of renting out a home.
Southwark Council, where Rachel Reeves’ house is, charges £900 for a licence, which lasts five years.
Failure to secure a selective licence can result in a penalty of up to £30,000 or an unlimited fine from a court upon conviction.
Landlords can also be made to repay up to 12 months’ rent to the tenant or they can be prevented from renting out the property.
Serious and repeat offenders can be prosecuted, with a sentence of up to five years or an uncapped fine, and they can be put on a rogue landlords database.
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9:59
Tories call for Reeves investigation
Ms Badenoch’s hacking escapade emerged in 2018 after she was asked about the “naughtiest” thing she had ever done in an interview with the Core Politics website.
“About 10 years ago, I hacked into a Labour MP’s website and I changed all the stuff in there to say nice things about Tories,” she said.
The then-Conservative Party’s vice chair for candidates, who became an MP in 2017, said she had apologised and called it a “foolish prank”.
Baroness Harman told Sky News’ Electoral Dysfunction podcast last year Ms Badenoch had posted on her website as if she was the Labour peer, saying she was thinking of joining the Conservative Party.
Ms Badenoch “owned up to it and actually bragged about it”, Baroness Harman said, as she admitted her password at the time was “Harriet Harman”.
For Shelley Mclean, every night is a sleepless one, just to keep her 11-year-old daughter alive.
Missy was born with a rare genetic condition that affects her breathing, digestion and movement.
She spent the first nine months of her life in hospital before coming home with a breathing tube in her throat, a feeding tube in her stomach, and a line into her bowel.
At first, the family had some NHS-funded nighttime care to help keep Missy safe while she slept.
But when her local NHS body decided she no longer met the threshold, that support was taken away.
Image: Missy has a breathing tube in her throat, a feeding tube in her stomach, and a line into her bowel
Now, Missy’s mother is responsible for her care.
“I’m her nurse, her physio, her carer,” says Shelley. “I don’t sleep properly because I’m scared she’ll stop breathing.
“They say we don’t meet the threshold – but I don’t know what more they need to see.”
Every night, Shelley prepares Missy’s medicines, checks her tubes, and monitors her breathing.
“This is an epilepsy medicine,” she says, holding up a syringe.
“If she’s not tolerating food orally, I put it down the tube.”
Despite her exhaustion, Shelley is grateful for the care that once saved her daughter’s life.
“I’m very grateful the NHS saved Missy – she wouldn’t be here without them. But they’re crippling the parents.”
Image: Shelley Mclean cares for her daughter Missy round the clock
The postcode lottery
Children like Missy who leave hospital but still need intensive support are meant to receive what’s called NHS continuing care – specialist help for those with the most complex, life-limiting or life-threatening needs.
But Sky News has seen new data which shows access to this care is deeply inconsistent across England, creating a postcode lottery that leaves many families struggling to survive without the help they require.
New figures obtained by Sky News reveal just how uneven continuing care has become.
NHS spending on children’s continuing care ranges from just 80p to £6 per head depending on where families live.
Out of almost 100,000 children in England with a life-limiting or life-threatening condition, only around 4% – roughly 4,400 – receive NHS continuing care funding.
And more than half of all disabled children referred for this kind of support are rejected.
Anna Bird, chief executive of charity Contact, says the system is leaving thousands of families on the brink.
“We’re not seeing the commitment to make sure those who need continuing care are getting it,” she told Sky News.
“Our research shows there’s a huge postcode lottery – families are running kind of little hospitals at home just to keep their children well and alive.
“They’re being let down by continuing care, and they’re not getting the support they need.”
In some areas, campaigners say local NHS bodies have cut back on support even for children with the most serious medical conditions.
Parents report being told their child no longer qualifies for help despite their needs remaining unchanged.
For Shelley, that decision means she rarely sleeps through the night.
“If I don’t go to her, she could be dead,” she says quietly. “She could have a fit and… you know, she could be dead.”
Image: Shelley, Missy and her brother
In a statement, NHS Cheshire and Merseyside said: “We understand Ms Mclean will be disappointed with the decision relating to her daughter’s funding.
“While we’re unable to comment on individual cases due to our commitment to patient confidentiality, all patients are reviewed jointly by health and care professionals to ensure they are receiving the most appropriate care for their needs.
“Patients who wish to discuss their funding decision are able to contact NHS Cheshire and Merseyside using the contact details included in their patient letters.”
But campaigners say that without national standards – and without the law forcing consistent assessments – those reviews will continue to vary wildly from one area to the next.
The result is that parents like Shelley find themselves trapped between two systems – the NHS and social care – neither of which can agree who is responsible.
“I’m not the type of person who wants to ask anyone for help,” she says. “But it’s brought me to my knees.”
For Shelley, that gap is more than bureaucratic. It’s personal, relentless, and exhausting.
“I would invite them to come and have a week in my position – to try to wake up every hour, on the hour, every night. Then they might understand.”
Campaigners say no parent should have to shoulder that burden alone – and they want ministers to act.
They’re calling on the government to make continuing care a statutory entitlement, with consistent assessments, proper funding, and transparency about who gets help and who doesn’t.
Until then, families like Shelley’s will continue to do the work of the NHS from their own homes – unpaid, unsupported, and exhausted.
Image: Shelley feeding Missy
The Department for Health and Social Care said: “Our thoughts go out to Shelley and Missy – everyone should have access to high-quality, compassionate care.
“As part of our 10-Year Health Plan, the government is shifting more healthcare out of hospitals and into the community, to ensure patients and their families can get the care they need, where and when they need it.
“Integrated Care Boards are responsible for meeting the needs of local people – including Children and Young People’s Continuing Care and ensuring the care requirements of people like Missy and Shelley are met.
“This government has set out best practice, and provided guidance around assessments, decision-making and agreeing care packages for Children and Young People’s Continuing Care.”
Sir Keir Starmer has dismissed calls for an investigation into his chancellor after she apologised for putting her family home up for rent without obtaining the necessary licence.
The newspaper reported that the chancellor rented her family home in Dulwich when she moved into Number 11 Downing Street, but was unaware she had to obtain a licence to do so.
Some London boroughs require private landlords to obtain a specific kind of licence if they are putting their property up for rent – including Southwark Council, where Ms Reeves’ home is listed.
The newspaper said Ms Reeves had now applied for a licence, but the Conservatives have called for an investigation.
A spokesperson for Ms Reeves said: “Since becoming chancellor, Rachel Reeves has rented out her family home through a lettings agency.
“She had not been made aware of the licensing requirement, but as soon as it was brought to her attention, she took immediate action and has applied for the licence.
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“This was an inadvertent mistake and in the spirit of transparency, she has made the prime minister, the independent adviser on ministerial standards and the parliamentary commissioner for standards aware.”
It is understood that Sir Laurie Magnus, the prime minister’s ethics adviser, has not launched an investigation into Ms Reeves.
Sir Keir said further investigation into the issue was “not necessary” after consulting Sir Laurie.
In a letter to Ms Reeves, he suggested her apology was a “sufficient resolution”.
Daisy Cooper, deputy leader of the Liberal Democrats, said the chancellor was adding to the government’s “list of scandals”.
“The chancellor is meant to be delivering growth but the only thing she appears to be growing is the government’s list of scandals,” she said.
“Just weeks before the budget, this risks seriously undermining confidence in this government and its ability to focus on the urgent tasks at hand.”
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Under the proposal, sellers, instead of buyers, would be responsible for paying the tax.
The chancellor is understood to be looking at an annual 1% charge on the amount a property’s value exceeds £2m – a £10,000-a-year levy for homes worth £3m.
Another proposal would see capital gains tax (CGT) charged when someone sells their main home, based on the amount it has increased in value during ownership.
Reports suggest this would only be applied to the most expensive properties, with a possible threshold of £1.5m, which would affect about 120,000 homeowners and higher-rate taxpayers getting CGT bills of nearly £200,000.