Connect with us

Published

on

“We’ve got two,” explains Emer Szczygiel, emergency department head of nursing at King George Hospital, as she walks inside a pastel coloured room. 

“If I had my time back again, we would probably have four, five, or six because these have helped us so much in the department with the really difficult patients.”

On one wall, there’s floral wallpaper. It is scored through with a graffiti scrawl. The words must have been scratched out with fingernails.

There are no other implements in here.

Patients being held in this secure room would have been searched to make sure they are not carrying anything they can use to harm themselves – or others.

A nurse in a special mental health A&E room
Image:
Emer Szczygiel wishes the hospital had more of the ‘ligature light’ mental health rooms

Scratched words on floral wallpaper

There is a plastic bed secured to the wall. No bedding though, as this room is “ligature light”, meaning nothing in here could be used for self harm.

On the ceiling, there is CCTV that feeds into a control room on another part of the Ilford hospital’s sprawling grounds.

“So this is one of two rooms that when we were undergoing our works, we recognised, about three years ago, mental health was causing us more of an issue, so we’ve had two rooms purpose built,” Emer says.

“They’re as compliant as we can get them with a mental health room – they’re ligature light, as opposed to ligature free. They’re under 24-hour CCTV surveillance.”

CCTV security screens
Image:
The rooms have a CCTV camera in the ceiling that feeds through to the main control room

There are two doors, both heavily reinforced. One can be used by staff to make an emergency escape if they are under any threat.

What is unusual about these rooms is that they are built right inside a busy accident and emergency department.

The doors are just feet away from a nurse’s station, where medical staff are trying to deal with acute ED (emergency department) attendances.

The number of mental health patients in a crisis attending A&E has reached crisis levels.

Some will be experiencing psychotic episodes and are potentially violent, presenting a threat to themselves, other patients, clinical staff and security teams deployed to de-escalate the situation.

A mental health nurse on a hospital ward
Image:
The team were already dealing with five mental health cases when Sky News visited

Like physically-ill patients, they require the most urgent care but are now facing some of the longest waits on record.

On a fairly quiet Wednesday morning, the ED team is already managing five mental health patients.

One, a diminutive South Asian woman, is screaming hysterically.

She is clearly very agitated and becoming more distressed by the minute. Despite her size, she is surrounded by at least five security guards.

She has been here for 12 hours and wants to leave, but can’t as she’s being held under the Mental Capacity Act.

Her frustration boils over as she pushes against the chests of the security guards who encircle her.

“We see about 150 to 200 patients a day through this emergency department, but we’re getting on average about 15 to 20 mental health presentations to the department,” Emer explains.

“Some of these patients can be really difficult to manage and really complex.”

Emer Szczygiel, emergency department head of nursing at King George Hospital
Image:
Emer Szczygiel says the department gets about 15 to 20 mental health presentations a day

“If a patient’s in crisis and wants to harm themselves, there’s lots of things in this area that you can harm yourself with,” the nurse adds.

“It’s trying to balance that risk and make sure every emergency department in the country is deemed a place of safety. But there is a lot of risk that comes with emergency departments, because they’re not purposeful for mental health patients.”

In a small side room, Ajay Kumar and his wife are waiting patiently by their son’s bedside.

He’s experienced psychotic episodes since starting university in 2018 and his father says he can become unpredictable and violent.

A man and woman sit by a hospital bed
Image:
Ajay and his wife were watching over their son, who’s been having psychotic episodes

Ajay says his son “is under a section three order – that means six months in hospital”.

“They sectioned him,” he tells us.

“He should be secure now, he shouldn’t go out in public. Last night he ran away [from hospital] and walked all the way home. It took him four and a half hours to come home.

“I mean, he got three and a half hours away. Even though he’s totally mental, he still finds his way home and he was so tired and the police were looking for him.”

Ajay Kumar, whose son has been experiencing psychotic episodes since starting university in 2018, speaks to Sky News
Image:
Mr Kumar said his son ran away from hospital and walked for hours to get home

Now they are all back in hospital and could be waiting “for days”, Ajay says.

“I don’t know how many. They’re not telling us anything.”

Matthew Trainer, chief executive of Barking, Havering and Redbridge University Hospitals NHS Trust, is at pains to stress nobody is blaming the patients.

“We’ve seen, particularly over the last few years, a real increase in the number of people in mental health crisis coming into A&E for support,” he says.

“And I don’t know if this is because of the pandemic or wider economic pressures, but what we’re seeing every day is more and more people coming here as their first port of call.”

Matthew Trainer, Chief Executive of Barking, Havering and Redbridge University Hospitals NHS Trust
Image:
‘More and more’ people in mental health crisis are showing up at A&E, says Mr Trainer

The hospital boss adds: “If you get someone who’s really distressed, someone who is perhaps experiencing psychosis etc, I’m seeing increasing numbers of complaints from other patients and their families about the environment they’ve had to wait in.

“And they’re not blaming the mental health patients for being here.

“But what they’re saying is being in a really busy accident & emergency with ambulances, with somebody highly distressed, and you’re sat there with an elderly relative or a sick child or whatever – it’s hard for everyone.

“There’s no blame in this. It’s something we’ve got to work together to try to fix.”

New Freedom of Information data gathered by the Royal College of Nursing shows that over the last five years, more than 1.3 million people in a mental health crisis presented to A&E departments.

New Freedom of Information data gathered by the Royal College of Nursing ONE

That’s expected to be a significant underestimate however, as only around a quarter of English trusts handed over data.

For these patients, waits of 12 hours or more for a mental health bed have increased by more than 380%.

Over the last decade, the number of overnight beds in mental health units declined by almost 3,700. That’s around 17%.

The Department for Health and Social Care told Sky News: “We know people with mental health issues are not always getting the support or care they deserve and incidents like this are unacceptable.

“We are transforming mental health services – including investing £26m to support people in mental health crisis, hiring more staff, delivering more talking therapies, and getting waiting lists down through our Plan for Change.”

Claire Murdoch, NHS England’s national mental health director, also told Sky News: “While we know there is much more to do to deal with record demand including on waits, if a patient is deemed to need support in A&E, almost all emergency departments now have a psychiatric liaison team available 24/7 so people can get specialist mental health support alongside physical treatment.

“The NHS is working with local authorities to ensure that mental health patients are given support to leave hospital as soon as they are ready, so that space can be freed up across hospitals including A&Es.”

Patients in a mental health crisis and attending hospital are stuck between two failing systems.

A shortage of specialist beds means they are left untreated in a hospital not designed to help them.

And they are failed by a social care network overwhelmed by demand and unable to provide the early intervention care needed.

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.

Continue Reading

UK

Welfare versus warfare: Sir Keir Starmer’s unresolved question – and why the PM’s pinned his hopes on economic growth

Published

on

By

Welfare versus warfare: Sir Keir Starmer's unresolved question  - and why the PM's pinned his hopes on economic growth

Welfare versus warfare: for decades, it’s a question to which successive prime ministers have responded with one answer.

After the end of the Cold War, leaders across the West banked the so-called “peace dividend” that came with the end of this conflict between Washington and Moscow.

Instead of funding their armies, they invested in the welfare state and public services instead.

But now the tussle over this question is something that the current prime minister is grappling with, and it is shaping up to be one of the biggest challenges for Sir Keir Starmer since he got the job last year.

As Clement Attlee became the Labour prime minister credited with creating the welfare state after the end of the Second World War, so it now falls on the shoulders of the current Labour leader to create the warfare state as Europe rearms.

Please use Chrome browser for a more accessible video player

UK to buy nuclear-carrying jets

Be it Donald Tusk, the Polish prime minister, arguing last year that Europe had moved from the post-war era to the pre-war era; or European Commission chief Ursula von der Leyen calling on the EU to urgently rearm Ukraine so it is a “steel porcupine” against Russian invaders; there is a consensus that the UK and Europe are on – to quote Sir Keir – a “war footing” and must spend more on defence.

To that end the prime minister has committed to increase UK defence spending to 2.5% of GDP by 2027, raiding the overseas development aid budget to do so, and has also committed, alongside other NATO allies, to spend 5% of GDP on defence by 2035.

More on Defence

Please use Chrome browser for a more accessible video player

What is NATO’s 5% defence spending goal?

That is a huge leap in funding and a profound shift from what have been the priorities for government spending – the NHS, welfare and education – in recent decades.

The Institute for Fiscal Studies’ Carl Emmerson said the increase, in today’s terms, would be like adding approximately £30bn to the 2027 target of spending around £75bn on core defence.

Sir Keir has been clear-eyed about the decision, arguing that the first duty of any prime minister is to keep his people safe.

But the pledge has raised the obvious questions about how those choices are funded, and whether other public services will face cuts at a time when the UK’s economic growth is sluggish and public finances are under pressure.

This, then, is one of his biggest challenges: can he make sure Britain looks after itself in a fragile world, while also sticking to his promises to deliver for the country?

It is on this that the prime minister has come unstuck over the summer, as he was forced to back down over proposed welfare cuts to the tune of £5bn at the end of this term, in the face of a huge backbench rebellion. Many of his MPs want warfare and welfare.

Please use Chrome browser for a more accessible video player

Starmer and Merz sign deal on defence and migration

“There’s been a real collision in recent weeks between those two policy worlds,” explains Jim Murphy, who served both as a welfare minister under Tony Blair and shadow defence secretary under Ed Miliband.

“In welfare, how do you provide for the people who genuinely need support and who, without the state’s support, couldn’t survive? What’s the interplay between that and the unconditional strategic need to invest more in defence?

“For the government, they either get economic growth or they have a series of eye-watering choices in which there can be no compromise with the defence of the state and everything else faces very serious financial pressures.”

He added: “No Labour politician comes into politics to cut welfare, schools or other budgets. But on the basis that defence is non-negotiable, everything else, unfortunately, may face those cuts.”

Please use Chrome browser for a more accessible video player

‘There are lines I will not cross’

While the PM sees this clearly, ask around the cabinet table and ministers will admit that the tough choices society will need to take if they genuinely want to respond to the growing threat from Russia, compounded by the unpredictability of Donald Trump, is yet to fully sink in.

There are generations of British citizens that have only ever lived in peace, that do not, like I do, remember the Cold War or The Troubles.

There are also millions of Britons struggling with the cost of living and and public satisfaction with key public services is at historic lows. That is why Labour campaigned in the election on the promise of change, to raise living standards and cut NHS waiting lists.

Ask the public, and 49% of people recognise defence spending needs to increase. But 53% don’t want it to come from other areas of public spending, while 55% are opposed to paying more tax to fund that defence increase.

There is also significant political resistance from the Labour Party.

Sir Keir’s attempts to make savings in the welfare budget have been roundly rejected by his MPs. Instead, his backbenchers are talking about more tax rises to fund public services, or even a broader rethink of Rachel Reeves’s fiscal rules.

Please use Chrome browser for a more accessible video player

Rachel Reeves’s fiscal dilemma

Anneliese Dodds, who quit as development minister over cuts to the overseas aid budget, wrote in her resignation letter that she had “expected [cabinet] would collectively discuss our fiscal rules and approach to taxation, as other nations are doing”, as part of a wider discussion about the changing threats.

In an interview for our Electoral Dysfunction podcast, which will be released later this summer, she expanded on this idea.

She said: “I think it’s really important to take a step back and think about what’s going to be necessary, looking 10, 20 years ahead. It looks like the world is not going to become safer, unfortunately, during that period. It’s really important that we increase defence spending.

“I think that does mean we’ve got to really carefully consider those issues about our fiscal rules and about taxation. That isn’t easy… nonetheless, I think we will have to face up to some really big issues.

“Now is the time when we need to look at what other countries are doing. We need to consider whether we have the right system in place.”

Minister for Women and Equalities Anneliese Dodds arrives for a Cabinet meeting in central London. Picture date: Friday February 7, 2025. PA Photo. See PA story POLITICS Cabinet. Photo credit should read: Jordan Pettitt/PA Wire
Image:
Anneliese Dodds quit the government over cuts to the overseas aid budget. Pic: PA

For the Labour MP, that means potentially reassessing the fiscal rules and how the fiscal watchdog assesses government spending to perhaps give the government more leeway. She also believes that the government should look again at tax rises.

She added: “We do, I believe, need to think about taxation.

“Now again, there’s no magic wand. There will be implications from any change that would be made. As I said before, we are quite highly taxing working people now, but I think there are ways in which we can look at taxation, not without implications.

“But in a world of difficult trade-offs, we’ve got to take the least worst trade-off for the long term. And that’s what I think is gonna be really important.”

Those trade-offs are going to be discussed more and more into the autumn, ahead of what is looking like an extremely difficult budget for the PM and Ms Reeves.

Chancellor Rachel Reeves and Prime Minister Sir Keir Starmer at the launch of the 10-year health plan in east London. Pic: PA
Image:
Chancellor Rachel Reeves and Prime Minister Sir Keir Starmer are facing difficult choices. Pic: PA

Not only is the chancellor now dealing with a £5bn shortfall in her accounts from the welfare reform reversal, but she is also dealing with higher-than-expected borrowing costs, fuelled by surging debt costs.

Plus, government borrowing was £3.5bn more than forecast last month, with June’s borrowing coming in at £20.7bn – the second-highest figure since records began in 1993.

Some economists are now predicting that the chancellor will have to raise taxes or cut spending by around £20bn in the budget to fill the growing black hole.

Former Chancellor Jeremy Hunt
Image:
Former chancellor Jeremy Hunt says Labour’s U-turn on cuts to welfare risk trapping Britain in a ‘doom loop’

Jeremy Hunt, former Conservative chancellor and now backbencher, tells me he was “massively disappointed” that Labour blinked on welfare reform.

He said: “First of all, it’s terrible for people who are currently trapped on welfare, but secondly, because the risk is that the consequence of that, is that we get trapped in a doom loop of very higher taxes and lower growth.”

‘This group of politicians have everything harder ‘

Mr Murphy says he has sympathy for the predicament of this Labour government and the task they face.

He explained: “We were fortunate [back in the early 2000s] in that the economy was still relatively okay, and we were able to reform welfare and do really difficult reforms. This is another world.

“This group of politicians have everything harder than we had. They’ve got an economy that has been contracting, public services post-COVID in trouble, a restless public, a digital media, an American president who is at best unreliable, a Russian president.

“Back then [in the 2000s] it was inconceivable that we would fight a war with Russia. On every measure, this group of politicians have everything harder than we ever had.”

Over the summer and into the autumn, the drumbeat of tax rises will only get louder, particularly amongst a parliamentary party seemingly unwilling to back spending cuts.

But that just delays a problem unresolved, which is how a government begins to spend billions more on defence whilst also trying to maintain a welfare state and rebuild public services.

This is why the government is pinning so much hope onto economic growth as it’s escape route out of its intractable problem. Because without real economic growth to help pay for public services, the government will have to make a choice – and warfare will win out.

What is still very unclear is how Sir Keir manages to take his party and the people with him.

Continue Reading

UK

Jay Slater inquest resumes after final effort to trace witnesses – all you need to know

Published

on

By

Jay Slater inquest resumes after final effort to trace witnesses - all you need to know

An inquest into the death of teenager Jay Slater is due to resume today after being adjourned two months ago.

The 19-year-old from Oswaldtwistle, Lancashire, disappeared on the Spanish island of Tenerife after attending the NRG music festival on 16 June 2024.

He was reported missing and, after an extensive search and rescue mission and significant media attention, his body was found a month later on 15 July.

An inquest into the teenager’s death began in May at Preston Coroner’s Court, but was adjourned the same day, to the disappointment of Mr Slater’s mother Debbie Duncan.

Dr James Adeley, a senior coroner for Lancashire and Blackburn with Darwen, made the decision after a number of witnesses who had been asked to give evidence could not be traced or were unable to attend.

After making a final effort to trace key witnesses, the inquest will now resume on 23 and 24 July. Here is all you need to know.

What happened to Jay Slater?

On 17 June 2024, just days into his first holiday without his family, Mr Slater was reported missing.

The night before, he is believed to have left his friends at the Papagayo nightclub in the resort of Playa de las Americas and made an hour-long drive to a modest Airbnb in the tiny village of Masca, with two people he had met on the holiday.

Phone data reveals Mr Slater’s last known location was the Rural de Teno park – a mountainous area popular with hikers.

The 19-year-old’s disappearance sparked a huge 29-day search effort – with emergency services, local volunteers and Mr Slater’s family combing a large mountainous area of the island searching for any trace of the teenager.

Within days, Facebook groups dedicated to the case had also been set up – with some quickly attracting hundreds of thousands of members.

Please use Chrome browser for a more accessible video player

July 2024: Where was Jay Slater found?

The Spanish civil guard released a statement on 15 July to say they had “located the lifeless body of a young man in the Masca area after 29 days of constant search”.

What happened during the first inquest hearing?

Mr Slater’s mother Debbie Duncan, stepfather and other family members gathered at the inquest in Preston Coroner’s Court on 21 May.

Home Office pathologist Dr Richard Shepherd said Mr Slater’s injuries were “entirely consistent” with a fall from a great height and gave an official cause of death as a head injury.

“The injuries were so severe I have no doubt he would have been instantly unconscious from the moment of that blow to the head. Death could well have been instant, the injury was so severe,” Dr Shepherd said.

Pic: Reuters
Image:
The search and rescue mission was launched a day after Jay Slater was reported missing. Pic: Reuters

He said there was no suggestion that the teenager had been assaulted or restrained.

Toxicology expert Dr Stephanie Martin said traces of MDMA and MDA, commonly known as ecstasy, along with cocaine and alcohol, were also found in Mr Slater’s body.

Detective Chief Inspector Rachel Higson, from Lancashire Constabulary, told the court that messages from Mr Slater’s friends advising him to go home were found on his phone

Pic: Reuters
Guardia Civil agents and police officers organise the search for the young Briton Jay Slater in the Masca ravine, on the island of Tenerife, Spain, June 26, 2024. REUTERS/Borja Suarez
Image:
Civil Guard agents and police officers in the Masca ravine. Pic: Reuters

Officers were flanked by specialist sniffer dogs from Madrid

DCI Higson said at 8.35am on 17 June, his friend Ms Law sent him a message saying: “Before it gets boiling get back to wherever you have come from.”

At 8.50am there was the last known outgoing communication from Mr Slater’s phone, a 22-second call from him to Ms Law in which he is believed to have said he had cut his leg on a cactus, he was lost in the mountains and his phone battery was on 1%.

A view of Preston Coroner's Court, Lancashire, at the opening of the inquest into the death of Nicola Bulley, who disappeared on January 27
Image:
The inquest is taking place at Preston Coroner’s Court. Pic: PA

Who are the missing witnesses?

The witnesses that the court tried to trace the first time included Bradley Geoghegan, Brandon Hodgson and Lucy Law, who were all with Mr Slater in Tenerife.

At the time of the first inquest it is believed they were not in the UK and were unable to attend.

Read more from Sky News:
How search for missing teenager captured nation’s attention
Inside the valley where Jay Slater’s body was found

The two men who were staying at the Airbnb property Mr Slater travelled to before his disappearance – Ayub Qassim and Steven Roccas – were unable to be traced, despite summonses being issued.

Mr Slater’s mother Ms Duncan told the court in May that she wanted “these people to be sat in front of us, because our son went on holiday and didn’t come back, so there’s questions we need to ask”.

Coroner Dr Adeley said he would adjourn the inquest in an effort to find the witnesses and give Ms Duncan the “answers you want”, but it remains unknown if the key witnesses will appear at the inquest on Thursday and Friday.

Continue Reading

UK

Off-the-shelf medical tests are failing to back up accuracy promises with evidence, study finds

Published

on

By

Off-the-shelf medical tests are failing to back up accuracy promises with evidence, study finds

Off-the-shelf medical tests that promise to diagnose conditions ranging from vitamin deficiencies to cancer are lacking evidence to back up their accuracy, a study has found.

Thirty self-testing kits were purchased from a range of mainstream supermarkets, pharmacies and health and wellbeing shops by researchers from the University of Birmingham in 2023.

The kits tested for vitamin deficiency, blood cholesterol, menopause and bowel cancer. These tests are often marketed as tools for empowerment and early detection at a time when the NHS is already over-stretched.

Accuracy claims were made for 24 of these tests however, and nearly six out of 10 (14) promised 98% accuracy. However, evidence supporting these claims was largely unavailable, according to a series of papers published by the British Medical Journal (BMJ).

In addition, 18 of the tests (60%) were found to have errors that could lead to a wrong result. This included 11 that had problems with equipment, 10 showing issues with the sampling process and 15 that had problems with the instructions of interpretation of results.

Where information about what types of accuracy methods were available, about a third of those compared their test with another similar test – not a proper, trusted medical test.

Most of the tests also did not explain who they tested them on to provide the accuracy data.

These types of testing kits are not subject to the same stringent checks that a new medication would have to go through.

The University of Birmingham’s Professor Jon Deeks, a corresponding author of the study, said: “Our findings highlight concerns about the value of these self-tests because the instructions for use for many of them recommended seeing a doctor regardless of the test result (positive or negative).”

Can these tests cause harm?

Dr Clare Davenport, co-author of the study, said the benefit of many of these tests “is lacking”.

“This is in contrast to well-established self-tests, such as pregnancy tests,” she said.

“We are worried that consumers concerned about their health and tempted by the convenience of buying a test over the counter may be harmed if they use these tests in the wrong way.”

A false positive on such a test may lead to anxiety, unnecessary investigations and even overtreatment, while a false negative could lead to delays in treatment.

Read more:
Trump diagnosed with
chronic venous insufficiency
Should kids under 7 drink slushies?

Pic: University of Birmingham
Image:
Pic: University of Birmingham

Researchers are now calling for better regulation and guidance from manufacturers, retailers and healthcare professionals to protect consumers of off-the-shelf health self-tests.

There were some limitations to the test – namely that they were bought two years ago and were not intended to be a sample of what is available across the country.

“But given what they do say about where they got the tests, I’d be surprised if they aren’t pretty much the same anywhere nowadays,” said Professor Kevin McConway, emeritus professor of applied statistics at The Open University.

He said the results were “scary and concerning”.

“I don’t doubt the findings of the researchers, that many of the available tests don’t make it clear who could make good use of them, how accurate the results might be, or what someone should do in the light of their results.”

‘History offers cautionary tales’

“Self-tests should not be dismissed outright though,” wrote Jessica Watson from the Centre for Academic Primary Care, and Margaret McCartney, from the University of St Andrews, in an editorial for the BMJ.

“History offers cautionary tales: when home pregnancy tests were first introduced, some doctors argued that women could not be trusted to use them.

“Clearly that is not the case.

“The use of HIV self-tests has been extensively and carefully evaluated, with decades of research, including large randomised controlled trials.”

However, they say that these examples are of tests that are “binary” with yes or no answers, and are integrated within healthcare systems, “with clear actions to be taken based on the results”.

The study was funded by the National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre.

Continue Reading

Trending