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At least 195,000 procedures and hospital appointments in England had to be rescheduled due to the junior doctors strike last week – but the true figure is likely to be higher.

Some 20,470 inpatient procedures were rescheduled, along with 175,755 outpatient appointments, making a total of 196,225.

An average of 26,145 staff per day were absent from work as a result of the industrial action.

However, NHS England says a high number of trusts haven’t reported their figures, so the stats provided so far are “not the full picture”.

The number of cancellations is the highest to hit the NHS since walkouts began in the long-running pay dispute.

NHS national medical director, Professor Sir Stephen Powis, said: “Today’s figures lay bare the colossal impact of industrial action on planned care in the NHS.

“Each of the 195,000 appointments postponed has an impact on the lives of individuals and their families and creates further pressure on services and on a tired workforce – and this is likely to be an underestimate of the impact as some areas provisionally avoided scheduling appointments for these strike days.”

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NHS junior doctors take part in a march and rally in the centre of Birmingham, on the final day of the British Medical Association's 96-hour walkout in a dispute over pay. Picture date: Friday April 14, 2023.
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NHS junior doctors take part in a march and rally in the centre of Birmingham

He added: “Our staff now have an immense amount of work to catch up on hundreds of thousands of appointments, all while continuing to make progress on tackling the backlog of people who have been waiting the longest for treatment.

“We have now seen nearly half a million appointments rescheduled over the last five months, and with each strike, it becomes harder.

“While our staff are doing all they possibly can to manage the disruption, it is becoming increasingly difficult and the impact on patients and staff will unfortunately continue to worsen.”

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A senior A&E doctor gives an insight into his day at a London emergency department during junior doctors’ strike.

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‘All options on table’ for ‘unprecedented’ coordinated NHS strikes
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It comes as Rishi Sunak admitted meeting his promise to cut NHS waiting times will be “more challenging” as a result of further strikes.

Latest figures showed a record 7.22 million people were waiting to start routine hospital treatment at the end of February.

The prime minister claimed on Monday he was “still hopeful” NHS waiting lists could be driven down.

Mr Sunak said: “In spring this year I said we would practically eliminate those waiting a year and a half for their treatment and we were on track to do that – the industrial action obviously makes that more challenging but we are pushing hard to meet that target.”

He added: “I do remain hopeful – of course industrial action makes these things more challenging.”

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Prosecutors consider more charges against Lucy Letby

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Prosecutors consider more charges against Lucy Letby

Prosecutors are considering whether to bring further criminal charges against Lucy Letby over the deaths of babies at two hospitals where she worked

The Crown Prosecution Service said it had received “a full file of evidence from Cheshire Constabulary asking us to consider further allegations in relation to deaths and non-fatal collapses of babies at the Countess of Chester Hospital and Liverpool Women’s Hospital”.

“We will now carefully consider the evidence to determine whether any further criminal charges should be brought,” it added.

“As always, we will make that decision independently, based on the evidence and in line with our legal test.”

Letby, 35, was found guilty of murdering seven children and attempting to murder seven more between June 2015 and June 2016 while working in the neonatal unit of the Countess of Chester Hospital and is currently serving 15 whole-life orders.

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Letby worked at the Countess of Chester Hospital and Liverpool Women’s Hospital

She is understood to have carried out two work placements at Liverpool Women’s Hospital, where she trained as a student, between October and December 2012, and January and February 2015.

Police said in December that Letby was interviewed in prison as part of an investigation into more baby deaths and non-fatal collapses.

A Cheshire Constabulary spokesperson said: “We can confirm that Cheshire Constabulary has submitted a full file of evidence to the CPS for charging advice regarding the ongoing investigation into deaths and non-fatal collapses of babies at the neo-natal units of both the Countess of Chester Hospital and the Liverpool Women’s Hospital as part of Operation Hummingbird.”

Detectives previously said the investigation was looking into the full period of time that Letby worked as a nurse, covering the period from 2012 to 2016 and including a review of 4,000 admissions of babies.

Letby’s lawyer Mark McDonald said: “The evidence of the innocence of Lucy Letby is overwhelming,” adding: “We will cross every bridge when we get to it but if Lucy is charged I know we have a whole army of internationally renowned medical experts who will totally undermine the prosecution’s unfounded allegations.”

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Three managers at the hospital where Lucy Letby worked have been arrested on suspicion of gross negligence manslaughter.

On Tuesday, it was confirmed that three managers at the Countess of Chester hospital had been arrested on suspicion of gross negligence manslaughter in a separate investigation.

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Police said the suspects, who occupied senior positions at the hospital between 2015 and 2016, have all been bailed pending further inquiries.

There is also an investigation into corporate manslaughter at the hospital, which began in October 2023.

A public inquiry has also been examining the hospital’s response to concerns raised about Letby before her arrest.

In May, it was announced the inquiry’s final report into how the former nurse was able to commit her crimes will now be published early next year.

Earlier this year, Letby’s lawyers called for the suspension of the inquiry, claiming there was “overwhelming and compelling evidence” that her convictions were unsafe.

In February, an international panel of neonatologists and paediatric specialists told reporters that poor medical care and natural causes were the reasons for the collapses and deaths.

Their evidence has been passed to the Criminal Cases Review Commission (CCRC), which investigates potential miscarriages of justice, and Letby’s legal team hopes her case will be referred back to the Court of Appeal.

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More criminal charges being considered over baby deaths at Lucy Letby hospitals

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More criminal charges being considered over baby deaths at Lucy Letby hospitals

The Crown Prosecution Service has said it is considering whether to bring further criminal charges over the deaths of babies at hospitals where Lucy Letby worked.

The CPS said it had received “a full file of evidence from Cheshire Constabulary asking us to consider further allegations in relation to deaths and non-fatal collapses of babies at the Countess of Chester Hospital and Liverpool Women’s Hospital”.

“We will now carefully consider the evidence to determine whether any further criminal charges should be brought,” it added.

“As always, we will make that decision independently, based on the evidence and in line with our legal test.”

Letby, 35, was found guilty of murdering seven children and attempting to murder seven more between June 2015 and June 2016 while working in the neonatal unit of the Countess of Chester Hospital and is currently serving 15 whole-life orders.

She is understood to have carried out two work placements at Liverpool Women’s Hospital, where she trained as a student, between October and December 2012, and January and February 2015.

On Tuesday, it was confirmed that three managers at the Countess of Chester hospital had been arrested on suspicion of gross negligence manslaughter.

Police said the suspects, who occupied senior positions at the hospital between 2015 and 2016, have all been bailed pending further inquiries.

There is also an investigation into corporate manslaughter at the hospital, which began in October 2023.

A public inquiry has also been examining the hospital’s response to concerns raised about Letby before her arrest.

In May, it was announced the inquiry’s final report into how the former nurse was able to commit her crimes will now be published early next year.

Earlier this year, Letby’s lawyers called for the suspension of the inquiry, claiming there was “overwhelming and compelling evidence” that her convictions were unsafe.

In February, an international panel of neonatologists and paediatric specialists told reporters that poor medical care and natural causes were the reasons for the collapses and deaths.

Their evidence has been passed to the Criminal Cases Review Commission (CCRC), which investigates potential miscarriages of justice, and Letby’s legal team hopes her case will be referred back to the Court of Appeal.

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‘Catastrophic failure’ led to Heathrow power outage – with chances missed to prevent it

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'Catastrophic failure' led to Heathrow power outage - with chances missed to prevent it

A power outage that shut Heathrow Airport earlier this year, causing travel chaos for more than 270,000 passengers, was caused by a “catastrophic failure” of equipment in a nearby substation, according to a new report.

Experts say the fire at the North Hyde Substation, which supplies electricity to Heathrow, started following the failure of a high-voltage electrical insulator known as a bushing, before spreading.

The failure was “most likely” caused by moisture entering the equipment, according to the report.

Two chances were also missed that could have prevented the failure, experts found, the first in 2018 when a higher-than-expected level of moisture was found in oil samples.

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Moment Heathrow substation ignites

Such a reading meant “an imminent fault and that the bushing should be replaced”, according to guidance by the National Grid Electricity Transmission.

However, the report by National Energy System Operator (NESO) said the appropriate responses to such a serious issue were “not actioned”, including in 2022 when basic maintenance was postponed.

“The issue therefore went unaddressed,” the report added.

The design and configuration of the airport’s internal power network meant the loss of just one of its three supply points would “result in the loss of power to operationally critical systems, leading to a suspension of operations for a significant period”, the report added.

Heathrow – which is Europe’s biggest airport – closed for around 16 hours on 21 March following the fire, before reopening at about 6pm.

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Heathrow bosses were ‘warned about substation’

Around 1,300 flights were cancelled and more than 270,000 air passenger journeys were disrupted.

Tens of millions of pounds were lost, thousands of passengers were stranded, and questions were raised about the resilience of the UK’s infrastructure.

More than 71,000 domestic and commercial customers lost power as a result of the fire and the resulting power outage, the report said.

NEOS chief executive, Fintan Slye, said there “wasn’t the control within their [National Grid’s] asset management systems that identified that this [elevated moisture levels] got missed.

“They identified a fault, [but] for some reason the transformer didn’t immediately get pulled out of service and get repaired.

“There was no control within the system that looked back and said ‘oh, hang on a second, you forgot to do this thing over here’.”

Sky’s science and technology editor, Tom Clarke, pointed to the age of the substation’s equipment, saying “some of these things are getting really very old now, coming to the end of their natural lives, and this is an illustration of what can happen if they are not really well maintained”.

The report also highlights a lack of joined-up thinking, he said, as “grid operators don’t know who’s critical national infrastructure on the network, and they don’t have priority”.

Responding to the report’s findings, a Heathrow spokesperson said: “A combination of outdated regulation, inadequate safety mechanisms, and National Grid’s failure to maintain its infrastructure led to this catastrophic power outage.

“We expect National Grid to be carefully considering what steps they can take to ensure this isn’t repeated.

“Our own Review, led by former Cabinet Minister Ruth Kelly, identified key areas for improvement and work is already underway to implement all 28 recommendations.”

In May, Ms Kelly’s investigation revealed that the airport’s chief executive couldn’t be contacted as the crisis unfolded because his phone was on silent.

Energy Secretary Ed Miliband, who commissioned the NESO report, called it “deeply concerning”, because “known risks were not addressed by the National Grid Electricity Transmission”.

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Mr Miliband said energy regulator Ofgem, which opened an investigation on Wednesday after the report was published, is investigating “possible licence breaches relating to the development and maintenance of its electricity system at North Hyde.

“There are wider lessons to be learned from this incident. My department, working across government, will urgently consider the findings and recommendations set out by NESO and publish a response to the report in due course.”

The Metropolitan Police previously confirmed on 25 March that officers had “found no evidence to suggest that the incident was suspicious in nature”.

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