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Thousands of women every year have an endometrial ablation on the NHS.

It’s a treatment for heavy periods – and for a lot of women, the 90-second procedure brings relief from the sapping cycle of heavy bleeding.

But the procedure to destroy the womb lining fails in up to a fifth of cases, often leaving women with no treatment options left but a hysterectomy.

People whose ablations have failed describe debilitating, long-lasting pain that fractures mental health, relationships and careers – and doctors who seem to have little idea what’s wrong with them.

Karen Ramage knew immediately after her endometrial ablation in 2021 that something wasn’t right.

The pain only got worse. The month prior, she had run 100 miles. By two weeks after the procedure, she couldn’t walk properly. She couldn’t drive, she couldn’t work, she could barely eat. And she couldn’t find a doctor who would agree the endometrial ablation might be to blame.

“My personal belief is that they just don’t expect anything to go wrong,” she told Sky News.

The discussion of risks beforehand was limited to being warned of adhesions between the womb and bladder or bowel, she says. She was told the worst outcome would be no improvement in her bleeding.

But constant pain set in down her right side, intensifying to “labour-like contraction pains” around the time of her period.

As months passed, she relied on daily doses of Tramadol. Talking to a counsellor, she tried to reckon with how she could live like this: “I felt that everything had been taken away from me.”

Supplied pic of Karen Ramage for feature on endometrial ablation
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Karen Ramage had to pay for a hysterectomy privately after her ablation failed

It took going private for a doctor to tell her definitively her ablation had failed.

“I was probably more relieved that actually somebody would believe in me, because it was this whole thing that nobody would believe that this procedure had caused all of this.”

Facing up to a two-year wait on the NHS for a hysterectomy, she took out a loan to cover the £7,500 cost of having it privately. After months not working, it was a tough financial call – one that meant relying on food banks.

How ablations work – and fail

About one in four women suffer from heavy periods and more than 30,000 women in England had an endometrial ablation on the NHS between 2017 and 2022.

Most were radiofrequency ablations, where electromagnetic energy is used to burn away the lining of the womb.

The womb lining is what grows and sheds each month so the idea is that no lining means no – or lighter – periods.

But if not all the lining is destroyed, it still grows and sheds – but scar tissue can mean the blood gets trapped. It builds up in pockets behind the tissue, sometimes behind a scarred-shut cervix, causing intense pain until it disperses back into the body.

Endometrial ablation

In women who have been sterilised the blood can back up into the fallopian tubes – this is known as PATSS (post-ablation tubal sterilisation syndrome).

In cases of late-onset failure, the lining regrows in the months and years after an ablation.

Some women experience pain cyclically each month, while for others post-ablation pain is constant or just during sex.

Women who spoke to Sky News describe agony worse than labour. One woman would put herself in the recovery position when the pain started because she knew she would blackout. Another came close to losing her job because she needed drugs so strong they made her a “zombie”.

‘Ablation ruined 10 years of my life’

Amanda Connor was told an ablation would “solve all my problems”, but three years later her womb had “completely grown back”. She decided to try the procedure a second time in 2010.

The pattern of monthly pain only intensified over time. It would start in her feet, a tingling fiery burn. By the time it reached her legs, she would be doubled over. Then it raged through her abdomen.

“I couldn’t stand up, I was on the floor writhing about and screaming for hours,” she told Sky News.

Her husband could only watch for so long before he would call an ambulance – just like he did the month prior, and the one before that.

At the hospital they would do the same checks for appendicitis, then pelvic inflammatory disease. But Amanda was sure they were looking for the wrong thing: “It’s not pelvic inflammatory disease, it’s happening every single month.”

Reports of not being believed or “gaslighting” were common among women who spoke to Sky News. One was told her pain must be a bladder infection. Two women were told it was IBS.

Nobody told Amanda it could be a failed ablation. She was the one who brought it up with her gynaecologist.

A scan revealed her womb was a “lump of scar tissue”. The only way to fix it was to remove her womb entirely.

She was shocked when her doctor told her: “Not only have I been totally misled about ablation and how amazing it is – I am now facing a major operation in order to fix it.

“If I could go back I would never have it done.

“Ablation ruined about 10 years of my life. The effect on my marriage, my work life and home life was huge.”

Taking legal action

Experiences like this are familiar to Dr Victoria Handley, a lawyer specialising in gynaecological medical negligence cases.

She estimates she’s handled about 1,000 cases relating to endometrial ablation since 2015. Every week she will hear from one or two women who have had complications from ablations.

They report adhesions of the uterus to the bladder or bowel, perforation of the uterus, infertility they weren’t warned about and ultimately needing further surgery.

Women are going to the doctor with heavy periods and ending up needing a hysterectomy, “the most radical thing you can have”, Dr Handley says. A hysterectomy carries risks including incontinence, sexual dysfunction, prolapse and early menopause.

“You’re swapping one problem for another without realising that the problem you’re swapping is actually worse than the problem you’ve got,” she told Sky News.

Dr Victoria Handley, a lawyer specialising in gynaecological medical negligence cases
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Dr Victoria Handley says she has handled about 1,000 cases

Exactly how many women suffer post-ablation complications is hard to pinpoint as research tends to only capture patients who have resorted to further surgery.

A study of more than 110,000 women in England who had an endometrial ablation between 2000 and 2011 found 16.7% had further surgery within five years. Other studies put the number at more than 20%.

Up to one in five ablation patients may have abnormal bleeding or period pain, or both, according to Professor Justin Clark, consultant gynaecologist and spokesperson for the Royal College of Obstetricians and Gynaecologists.

NICE guidelines set out treatment pathways for heavy bleeding. This includes taking a patient’s full history, investigating the cause of the bleeding and exploring conservative options like the coil and pill before an ablation.

A spokesperson for NHS England told Sky News staff should be following this guidance and “should make clear the benefits and potential risks of any recommended treatment so patients can make informed decisions”.

But Dr Handley says in her experience, “a lot of what’s in this guideline is ignored by the medical profession because they’ll go, ‘oh, I know what’s wrong with you’, and I’ll go straight to the surgery, and they don’t actually carry out the investigation and then send them down the correct route”.

Medical negligence cases need to establish a breach of duty; for endometrial ablation this is normally failure to warn of the risk of complications or failure to offer alternatives.

The claimant needs to prove they were injured, and the injury was caused by the breach. They also need to be able to show logically that had they been informed of the risks or alternatives, they would not have gone ahead with the ablation. If those four things don’t align, the case will fail, Dr Handley says.

The majority of cases are settled by NHS trusts out of court, she says, and women tend to receive upwards of £20,000, depending on the injury they have suffered.

Despite the number of cases she has dealt with, she says she has seen no attempt to solve the issue.

“The NHS response is woeful. There’s no joined up thinking at all. There’s no recognition that there’s an overarching problem, and there’s no desire to fix it.”

NHS England and NHS Scotland did not address questions from Sky News about how they are responding to this at an organisation-wide level.

‘It makes me sick to know my womb is burned’

Emma Burchell says she does not believe the risks were discussed in full when she had an ablation – which she calls “the worst decision I ever made”.

“You trust these doctors to do the right thing for you, and then you feel like they’ve not,” she says.

The months since the procedure in May 2022 have been “horrendous”. Constant sharp pain through her back, stomach and legs drove her to the doctor again and again, but she says she wasn’t given pain relief.

Instead she was offered antidepressants. She declined, worried she would be told the pain was “all in her head” if she accepted.

Now she’s considering a hysterectomy. “Do I need my womb?” she questions. “It makes me sick to know my womb is all burned, and it’s sat inside my stomach.”

But getting more surgery isn’t a quick fix. Gynaecological waiting lists in England have more than doubled since the start of the pandemic.

Emma has been put on injections to create a chemical menopause, a process which can help diagnose the cause of gynaecological symptoms, before doctors will consider a hysterectomy. In the meantime, each day is a “battle”.

Supplied pic of Emma Burchell for feature about endometrial ablation
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Emma Burchell says getting an ablation was the ‘worst decision’ she’s ever made

Unsuitable candidates for ablation

A number of factors make an ablation more likely to fail: a younger age, fibroids, previous C-sections, polyps, a retroverted uterus (where the womb tips backwards) and adenomyosis (where the womb lining grows in the muscle of the womb).

According to Professor Clark, “endometrial ablation works best for women above 40 years old with relatively normal sized wombs without significant fibroids”.

Studies stress the importance of making sure women are good candidates for the procedure. A medical device alert from the UK’s Medicines and Healthcare products Regulatory Agency said the same.

Still, Sky News spoke to women who between them had all the contraindications above and had been given an ablation.

Karen Ramage found out after her ablation that she had a retroverted uterus – increasing the chance of ablation failure sixfold – as well as fibroids.

Ablations can be done where women have small fibroids, but she was told in her case it was like trying to “wallpaper over air bubbles and lumps, so it doesn’t cover the whole surface”.

When ablations work

Endometrial ablation support groups have sprung up on Facebook; the largest has more than 14,000 members, mostly in the US.

Women share stories of nerve damage, sepsis, infections, bloating, continued heavy bleeding. It’s nerve wracking reading for people considering the procedure – or who had it done before finding the group.

Samantha Williams hovers in the group, popping up in the comments to share her experience and reassure people. She had an ablation after 18 months of non-stop bleeding and it made a “massive difference” to her quality of life. It stopped the bleeding and hasn’t caused pain.

Read more on Sky News:
New workplace standards for menopause and menstruation support
Women more likely to suffer migraines during menstrual cycle

If you think of treatments for heavy bleeding as the alphabet, she says, a hysterectomy is Z. With her NHS gynaecologist they worked through until they got to Y, an ablation.

The risks were explained, the patient information leaflet was detailed and she was confident it was right for her.

Still, her advice is the same as women who had bad experiences: “Do your homework. But also try everything else first. It shouldn’t ever be the first thing that you do. There’s lots of other options.”

What the NHS says

Sky News contacted NHS England and Scotland, as well as the NHS trusts that treated Karen, Amanda and Emma.

NHS England said endometrial ablation is “one of a number of treatments” for heavy bleeding that is given “when clinically appropriate”.

“While most women do not experience significant pain after this procedure, we strongly encourage any woman with concerns to speak to their clinician or GP,” it said.

A Scottish government spokesperson said “person-centred care” was a priority and involved working in partnership with patients to understand what they need, and how their desired outcomes can be achieved.

“An essential component of this approach involves providing tailored, understandable information so that people are fully informed and involved in decision-making about their care as much as they choose.”

A spokesperson for Bolton NHS Foundation Trust said: “We welcome the opportunity to speak with any patient directly if they had concerns about their care or treatment, so we can fully understand their experience and make improvements where possible.”

NHS Forth Valley again said it followed guidelines and best practice, adding that treatment options may be discussed at multidisciplinary team meetings to identify the most suitable options.

Follow up investigations would be carried out where there is ongoing pain or other symptoms, which could identify unrelated medical conditions as the source of pain, the spokesperson said.

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7/7 bombings: Stories that define the bravery of victims and responders 20 years on

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7/7 bombings: Stories that define the bravery of victims and responders 20 years on

Monday marks 20 years since the 7/7 attacks, which saw four suicide bombers kill 52 people and injure 770 others on the London transport network.

The attacks on 7 July 2005 all happened within an hour of each other, with the bombers having met at Luton railway station in the morning before heading to King’s Cross.

Shezhad Tanweer detonated his device at Aldgate, Mohammed Sidique Khan at Edgware Road, and Germaine Lindsay between King’s Cross and Russell Square – all within three minutes of 8.50am.

Habib Hussain detonated his bomb on board the number 30 bus at Tavistock Square at 9.47am.

Emergency services at Aldgate station after one of the explosions. Pic: PA
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Emergency services at Aldgate station after one of the explosions. Pic: PA

Two decades have passed, but for the victims’ families, survivors and the responders, the impact is still being felt.

Sky News spoke to some of the people profoundly affected by the attacks.

Passenger went back to the tracks to save lives

Adrian Heili was in the third carriage of the westbound Circle Line train heading towards Paddington.

It was in the second carriage that Mohammad Sidique Khan blew up his device at Edgware Road, killing six people.

If Adrian hadn’t been there, it may well have been more.

He managed to get out of the train and, having previously served as a medic in the Armed Forces, instantly made it his mission to save as many lives as possible.

“Instinct took over,” he tells Sky News.

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7/7 survivor saw ‘bodies on the track’

His bravery first brought him to Daniel Biddle, who had been blown out of the second carriage and was now trapped in a tight space between the tunnel wall and the track.

Adrian remembers crawling in blood to reach Daniel, who he now calls Danny. His left leg had been blown off, his right severed from the knee down and he lost an eye, along with suffering other extensive injuries.

He pinched shut the artery in Daniel’s thigh to stop the bleeding until paramedics got to him.

Daniel has written a book about his experiences, titled Back From The Dead, and has credited Adrian with saving his life.

Adrian eventually helped first responders carry him out. Then he went back into the tunnel several times over to assist with the evacuation of 12 other people.

He pays tribute to the first responders at the scene, who he says were “amazing”.

“Myself and another gentleman by the name of Lee Hunt were the last to actually leave Edgware Road,” he adds.

“And I remember sitting at the top of the platform on the stairs and just looking out after everyone had left.”

In his book, Daniel has been open about his struggles with PTSD after the attack.

Adrian says he has had a “very good support network” around him to help him deal with the aftermath, and adds that talking about it rather than “holding it in” has been vital.

“It still plays an effect on myself, as it has with Danny,” he says, who he has formed a close bond with.

He says PTSD triggers can be all around the survivors, from police and ambulance sirens to the smell of smoke from cooking.

“But it’s how we manage those triggers that that define us,” he says.

On the 20-year anniversary, he adds: “It’s going to be an emotional time. But I think for me, it’s going to be a time of reflection and to honour those that are not with us and those that were injured.

“They still have a voice. They have a voice with me and I’ll remember it. I’ll remember that day and that, for me, is very important.”

‘Instinctively, I decided to see if there was something I could do to help’

You may recognise Paul Dadge from the photograph below, where he’s helping a 7/7 bombing victim after she sustained severe burns to her face.

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7/7 first responder recalls day of attack

It went viral before the social media age, featuring on the front of national newspapers, and in others across the world.

The Londoner, who was 28 at the time, was on his way to an office in Hammersmith where he had just got a job.

He passed Edgware Road, where he saw a commotion as people rushed out of the station, and an emergency responder go in.

He didn’t yet know that one of the bombers had just set off the explosive in their backpack.

“Instinctively, I decided to see if there was something I could do to help,” he told Sky News.

Paul, who was a former firefighter, made an announcement to those standing outside the station, telling them to stick together if they had been affected by whatever had happened and to wait at a shop near the scene until they had spoken to a police officer.

Many had black soot on their faces, he says, adding that he initially assumed it was due to a power surge.

Eventually the store was evacuated, so Paul went with the victims to a nearby hotel, and it was while doing so that photographers snapped the famous photos of him comforting the victim with a gauze mask, who had been badly burned.

He started noting down the names and details of those who had been injured, along with the extent of their injuries, so that he could pass them onto the emergency services.

It was only three hours after the incident that Paul found out the injuries had been caused by an attack.

His actions had him deemed a hero by the public.

Read more:
How Prevent is tackling extremism 20 years on
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“I know that after that bombing had occurred, everybody worked together as a team,” he says. “I think it’s a bit of a British thing, really, that when we’re really in trouble, we’re very, very good at working together to help each other.”

He says he is still in touch with people he met on that day, including the victim he was photographed with.

He also says the rest of his life has been “carved” by that day, and that he is now much more politically active and conscious of how emergency services respond to major incidents.

He believes emergency services are “a lot more prepared than they were on 7th July”, but adds that he still thinks they would find it “very difficult” to deal with an incident on the scale of the 7/7 attacks today.

‘What is haunting are those screams’

Sajda Mughal is a survivor of the bombing that hit a Piccadilly line train between King’s Cross and Russell Square.

She tells Sky News that about 10 seconds after leaving King’s Cross “there’s a massive bang… which was the explosion”.

“The train shook as if it was an earthquake, and came to a sudden standstill. I fell off my chair to the ground, people fell forward, lights went out.”

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7/7 survivor: ‘We were told don’t look back’

Sajda adds: “The black smoke that was coming through, it was really intense. And then all I could hear was screams. I could hear people screaming, I could hear people shouting, someone grabbing on to me saying, ‘are you okay’.”

She was “frozen and just going into that thought process of we’re going to die, and then me thinking I haven’t said bye to my loved ones, I haven’t got married, I haven’t had kids, I haven’t seen the world.”

She says that “what is haunting from that morning are those screams and hearing ‘blood, she’s hurt, he’s hurt'”.

Sajda says that as she and others were escorted out through the carriage to King’s Cross, the emergency services told them not to turn around and don’t look back.

She thinks that was because the rescuers didn’t want them to see injured individuals, “so it was a very, very surreal, very traumatic and emotional experience”.

Sajda, who is the only known Muslim survivor of 7/7, says getting through the attack alive “turned my life around 360”.

“I took that pain and I turned it into a positive because I didn’t want that happening again. And so I left the corporate world, I left my dream to want to change hearts and minds.”

She became involved with the JAN Trust, including its work countering extremism.

“I have travelled across the UK, I’ve worked with thousands of mothers and Muslim mothers. I have helped to educate them on radicalisation. And I’ve heard from mothers whose sons… went to Syria, who joined ISIS and died.”

Calls for a public inquiry

Graham Foulkes, whose son David was killed in the Edgware Road Tube bomb, wants there to be a public inquiry into what happened.

He says a “public inquiry is the only way because at a public inquiry people can be compelled to come and give evidence. At an inquest, they can just say ‘no, I’m not coming’ and that’s what happens”.

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7/7: ‘We should have a son’

He adds: “The fact that we’re here 20 years later, there are unanswered questions and terrorists are still slipping through, still getting past MI5, still get past MI6 and MI5, needs to be answered.

“We need to have a better system in place and by not being honest and open about what happened 20 years ago, we’ve got no mechanism in place at all.

“It’s still the same people making the same decisions that allowed MSK [Mohammed Sidique Khan] to get through and allowed the Manchester Arena attack and the Westminster Bridge attack. It’s still the same people, still the same processes. The processes need to change.”

David Foulkes
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David Foulkes

Speaking of the last 20 years, Graham says: “We’re lucky enough to have a daughter, and we have the two most wonderful grandchildren as well. But we should have a son, and he should have his family.

“And I shouldn’t be having this conversation with you. I should be at home at this time having dinner or going to the pub with David, and it’s not possible to describe the feeling of having your son murdered in such a pointless way.”

‘The resilience was as inspiring as the attack was ghastly’

“Most of all, my thoughts are with the families of the 52 people who lost their lives and also the more than 700 who were injured, some of them horrifically seriously on that day,” Metropolitan Police Commissioner Sir Mark Rowley says.

He also pays tribute to those who stepped forward on the day, like Paul Dadge, and the emergency services, who he says acted “extraordinarily” to help others.

“They and the families and the victims – what strikes me is how they’re still carrying the effects of that day through to today and for the rest of their lives,” he adds, saying you can still see the “heavy burden” many of them carry 20 years on.

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‘We’re in difficult times’, Met Police chief says

The commissioner, who was a senior officer in Surrey at the time, says he remembers the “slow horror” of watching on as investigating and reporting uncovered what had happened.

“The way everyone stepped forward, the bravery… the resilience was as inspiring as the attack was ghastly.”

He says the attacks have led to “massive changes” in counter-terrorism work to better protect the public.

“The first was the changes that brought policing and our security services, particularly MI5, much more close together so that we now have the closest joint operating arrangements anywhere in the world,” he says.

“And secondly, counter-terrorism work became something that wasn’t just about what was based in London and a network was built with bases in all of the regions across the country.”

He adds the unit now has a reach “far stronger and far more effective at protecting communities than we had before that day”.

Asked about those who may still feel under threat from similar attacks now, he says the public has “extraordinary people working hard day in and day out to protect you” and that policing and security services have strengthened due to experiences like that of the 7/7 bombings.

“The efforts of all those who were involved on that day… that all feeds through to today… [and gives us] one of the strongest and most effective preventative approaches you could possibly have,” he says.

“But sadly we are in difficult times and no system will ever be perfect,” he adds, but concludes by saying communities can “be rest assured about the amazing work that’s going on”.

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Boy, four, dies after gravestone falls on him at Rawtenstall Cemetery in Lancashire, police say

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Boy, four, dies after gravestone falls on him at Rawtenstall Cemetery in Lancashire, police say

A four-year-old boy has died after a gravestone fell on him at a cemetery, police have said.

The boy was fatally injured at Rawtenstall Cemetery on Burnley Road, Haslingden, at lunchtime on Saturday, Lancashire Police said.

Paramedics tried to save him but “tragically” the boy died in the “devastating” incident, the force said in a statement.

Officers were called to the cemetery at 1pm “following reports a gravestone had fallen onto a child.

“Tragically, and despite the best efforts of the emergency services, the boy sadly died. Our thoughts are with his loved ones at this devastating time.”

His death was not being treated as suspicious and a file will be sent to the coroner “in due course”.

Rossendale Borough Council posted on X on Saturday evening: “We are deeply saddened by the tragic death of a young child at Rawtenstall Cemetery today. Our thoughts are with the family at this devastating time.

More on Lancashire

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Andy MacNae, Labour MP for Rossendale and Darwen, said on Facebook his thoughts went out to the family and everyone affected by the “tragic incident”.

Local councillor Liz McInnes also wrote on Facebook it was “a terrible tragedy. My heartfelt and deepest sympathies to the family of this poor boy. The whole of Rawtenstall is grieving”.

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How Prevent is tackling young extremism 20 years after the 7/7 bombings

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How Prevent is tackling young extremism 20 years after the 7/7 bombings

Radicalised nine-year-olds, teenagers mixing incel culture with extreme right ideologies and a Muslim who idolises Hitler – this is just some of the casework of those tasked with deradicalising young extremists in the UK.

Monday will mark 20 years since the 7/7 attacks on the London transport network when four suicide bombers killed 52 people and injured 770 others.

A year later the government set up its deradicalisation programme Prevent as part of its counter-terrorism strategy.

Sky News has spoken to two leading intervention providers (IPs) at Prevent who both say their work is getting ever more complex and the referrals younger.

The Metropolitan Police’s Prevent co-ordinator, Detective Superintendent Jane Corrigan, has also told Sky News it is “tragic” that when it comes to terrorism, “one in five of all our arrests is a child under 17”.

She believes parents should talk to their children about what they are reading and seeing online.

“Parents instinctively know when something doesn’t feel right when their child is becoming withdrawn or isolated – not wanting to engage,” she says.

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People worried that someone they know has thoughts that could lead to terrorism can refer them to Prevent.

File pic: iStock
Image:
File pic: iStock

‘A pic-n-mix of ideologies’

Home Office figures show 11-year-olds are the largest age group to get referred.

Concerning cases are passed on to IPs such as Nigel Bromage who told Sky News: “Often there will be a pic-n-mix of ideologies.

“From my own examples and experience, we are aware of people looking at the incel culture and mixing that with some far-right elements.”

Jason Farrell with Nigel Bromage
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Sky’s Jason Farrell with intervention provider Nigel Bromage, who was exposed to extremism when he was a child

Incels, meaning “involuntary celibates” are men who have been unable to have a relationship with women despite wanting one and become misogynistic and hateful as a result.

Like many IPs, Mr Bromage from Birmingham comes from an extremist background himself, having once been a regional organiser for the proscribed Neo-Nazi group Combat 18.

For him too, it began as a child.

“It all started with someone giving me a leaflet outside my school gates,” Mr Bromage says.

“It told me a horrific story about a mum getting killed by an IRA bomb explosion – and at the end of the leaflet there was a call to action which said: ‘If you think it’s wrong then do something about it’.”

He developed a hatred for Irish republican terrorism which morphed into general racism and national socialism.

“At the very end I thought I was going to go to prison, or I would end up being hurt or even killed because of my political beliefs,” he says.

Nigel Bromage
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Mr Bromage says his youngest case involved a nine-year-old

Boy, 9, groomed by his brother

Mr Bromage reveals his youngest case was a nine-year-old who had been groomed by his brother.

“He was being shown pro-Nazi video games, and his older brother was saying ‘when I go to prison or I get in trouble – they you’re the next generation – you’re the one who needs to continue the fight’,” he says.

“Really, he had no interest in the racist games – he just wanted to impress his brother and be loved by his brother.”

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Every year, nearly 300 children who are 10 or younger are referred to Prevent.

Home Office figures show that over the last six years 50% of referrals were children under the age of 18.

Eleven-year-olds alone make up a third of total referrals, averaging just over 2,000 a year, with the figure rising even higher in the most recent stats.

Another IP, Abdul Ahad, specialises in Islamic extremism.

He says the catalyst for radicalisation often comes from events aboard.

Ten years ago, it was Syria, more recently Gaza.

“It is often a misplaced desire to do something effective – to matter, to make a difference. It gives them purpose, camaraderie and belonging as well – you feel part of something bigger than you,” he says.

The wreckage of a double-decker bus after the blast at Tavistock Square. Pic: PA
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Fifty-two people were killed on 7 July 2005 when four suicide bombers blew up three London Underground trains and a bus. Pic: PA

Clients want someone to ‘hear them’

Some of his clients “don’t fit into any particular box”.

“I’m working with a guy at the minute, he’s a young Muslim but he idolises Hitler and he’s written a manifesto,” he says.

“When you break it down, some people don’t know where they fit in, but they want to fit in somewhere.”

Mr Ahad says the young individual mostly admires Hitler’s “strength” rather than his ideologies and that he was drawn to darker characters in history.

Often his clients are very isolated and just want someone to “hear them”, he adds.

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Abdul Ahad
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Intervention provider Abdul Ahad specialises in Islamic extremism

Mr Ahad is also an imam who preaches at the Al-Azar Mosque in South Shields, a well-regarded centre for community cohesion and outreach.

He uses his understanding of the Islamic faith in his Prevent sessions to help guide his referrals away from extreme interpretations of the Koran by offering “understanding and context”.

He says: “We quote the correct religious texts – we explain their responsibility as a Muslim living in the UK and we re-direct their energies into something more constructive.”

Common theme of mental health issues

Mental health problems are a common theme among those referred to Prevent including depression and autism.

A recent inquest into the death of autistic teenager Rhianan Rudd found she took her own life after being radicalised by two white supremacists.

Her mother was critical of Prevent, as well as the police and MI5 after she had referred her daughter to the deradicalisation programme and Rhianan was subsequently charged with terrorism offences.

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Last month a coroner found some failings in the processes around protecting Rhianan, but none of them attributable to Rhianan taking her own life.

Det Supt Corrigan says a referral doesn’t mean individuals end up being arrested or on an MI5 watchlist.

She says: “You’re not reporting a crime, but you are seeking support. I would say the earlier you can come in and talk to us about the concerns you have the better. Prevent is just that – it is a pre-criminal space.

“It’s tragic when you see the number of young people being arrested for very serious charges. Just look at terrorism – one in five of all our arrests is a child under the age of 17. We need to think about how we respond to that.”

Prevent has been criticised for failures such as when Southport killer Axel Rudakabana failed to be recognised as needing intervention despite three referrals, or when MP David Amiss’ killer Ali Harbi Ali went through the programme and killed anyway.

Axel Rudakubana. Pic: Merseyside police
Image:
Axel Rudakubana failed to be recognised as needing intervention despite three referrals. Pic: Merseyside police

It’s harder to quantify its successes.

Mr Ahad says he understands why the failures hit the headlines, but he believes the programme is saving lives.

He says: “I think the vast majority of people get radicalised online because they are sitting in their room reading all this content without any context or scholarly input. They see one version of events and they get so far down the rabbit hole they can’t pull themselves out.

“I really wish Prevent was around when I was a young, lost 15-year-old because there was nothing around then. It’s about listening to people engaging with them and offering them a way of getting out of that extremism.”

File pic: iStock
Image:
File pic: iStock

‘Radicalisation can happen in days to weeks’

Det Supt Corrigan says: “I’ve sat with parents whose children have gone on to commit the most horrendous crimes and they all spotted something.

“Now, with hindsight, they wished they had done something or acted early. That’s why we created this programme, because radicalisation can happen in days to weeks.”

Twenty years on from 7/7 the shape of the terrorist threat has shifted, the thoughts behind it harder to categorise, but it is no less dangerous.

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