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A total of 37 NHS trusts increased car parking charges at some point in the two years to March 2024.

Saffron Cordery, interim chief executive of NHS Providers, said: “NHS trusts – most of whom are under huge financial pressure – just couldn’t afford to maintain car parks without charging people to use them.

“The last thing trusts want to do is have to divert money away from patient services.

“City centre and urban hospital car parks where spaces are in great demand are a particular challenge.”

A Department of Health and Social Care spokesperson said in a statement to PA: “Hospital car park charges are the responsibility of individual NHS trusts, however any charges must be reasonable and in line with the local area.

“Free parking is available for all NHS staff who work overnight.”

Here’s a list of the NHS trusts where the charges have increased, based on figures obtained by the Press Association following a Freedom of Information request. Not all trusts reported the figures in the same way.

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Ashford and St Peter’s Hospitals NHS Foundation Trust

Charges were increased from 1 February 2023. Up to 20 minutes remained free, while stays of up to two hours, two to three hours, three to four hours and four to five hours all increased by 50p to £4.50, £5.50, £6.50 and £7.50 respectively.

Stays of five to six hours and the weekly rate remained the same.

Charges for stays of more than six hours increased by £1 to £10.

File photo dated 18/01/23 of a general view of staff on a NHS hospital ward. Nurses have rejected the Government's pay award of a 5.5% rise, it has been announced. Members of the Royal College of Nursing (RCN) in England rejected the deal by two-thirds in a record high turnout of around 145,000. Issue date: Monday September 23, 2024.
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Barking, Havering and Redbridge University Hospitals NHS Trust

Charges were increased from 1 February 2023. Up to 20 minutes remained free, with charges for up to two hours, two to three hours, three to four hours and four to five hours increasing by 50p to £4.50, £5.50, £6.50 and £7.50 respectively.

The day rate of more than six hours increased by £1 to £10. Tariffs for five to six hours remained the same (£8), as did the weekly rate (£25).

Barts Health NHS Trust

Tariffs were increased for patients and visitors during the period at Newham Hospital only.

Up to one hour was a new charge at £2.

Up to three hours increased by 70p to £3.70, while up to six hours increased by £1 to £7.

Charges for an eight-hour stay and up to 24 hours remained the same at £8 and £16.50 respectively.

Blackpool Teaching Hospitals NHS Foundation Trust

The trust increased prices on 1 July 2023. Stays of two hours, two to three hours and three to six hours all increased by 20p to £2.70, £3.20 and £4.20 respectively. Six to 24 hours increased by 30p to £6.30.

East Suffolk and North Essex NHS Foundation Trust

The trust increased primary care tariffs and charges at Ipswich Hospital in August 2022, followed by Colchester Hospital in January 2023.

Up to 30 minutes at both hospitals remained free, although charges for one, two and four hours increased by 20p, 30p and 50p respectively to £2.20, £3.30 and £4.50.

There was a £5.50 charge introduced for five hours and a £10 charge for 24 hours. The price of an eight-hour stay increased to £6.50 from £5.

However, a five-day pass was cheaper at £12, down from £15, while a seven-day pass was £4 cheaper at £14.

In primary care, one hour was free, with two hours costing 30p more at £3.30.

A stay of four hours increased by 50p to £4.50, eight hours was £1.50 more at £6.50 and 24 hours was £2 more at £12.

A five-day pass was £1 dearer at £16, although the price of a seven-day pass remained the same at £18.

East Sussex Healthcare NHS Trust

Tariffs were increased from January 2024:

Up to one hour – Up by 20p to £2

One to two hours – Up by 20p to £3.60

Two to three hours – Up by 25p to £5.20

Three to four hours – Up by 35p to £7

Four to five hours – Up by 40p to £8.50

Five to six hours – Up by £1 to £10.2

Six to 12 hours – Up by £1.10 to £11.80

Twelve to 24 hours – Up by 85p to £18.30

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Frimley Health NHS Foundation Trust

In 2022/23, the trust increased charges for up to two hours from £3.30 to £3.50.

In 2023/24, the tariff for up to two hours increased to £3.80, while three to four hours went up from £5.50 to £6 and a four to five-hour stay increased from £6.50 to £7.

Great Western Hospitals NHS Foundation Trust

Up to 20 minutes remained free, with the charge for up to one hour increased from £1.10 to £1.50 in 2023/24. Elsewhere:

One to two hours – up by 80p to £3

Two to three hours – up by £1.20 to £4.50

Three to four hours – up by £1.60 to £6

Four to five hours – up £2 to £7.50

Five to six hours – up £2.20 to £10

After 6pm, charges for up to two hours increased by 40p to £1.50, while more than two hours is £1 dearer at £3.

Hampshire Hospitals NHS Foundation Trust

There was a change in durations and charges from 1 December 2022.

Up to 30 minutes remained free, while tariffs for up to one hour increased by 20p to £2.

The trust stopped charging on the half hour, instead charging on the hour. For example, there was no longer a £2.80 charge for one hour 30 minutes.

The tariff changed to one to two hours at a cost of £3. Elsewhere, the £10 eight-to-24-hour stay changed to 12 to 24 hours at a cost of £16.

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Lancashire Teaching Hospitals NHS Foundation Trust

The trust increased its prices for visitors by 3.9%, which it said was in line with inflation.

Leeds Teaching Hospitals NHS Trust

The trust increased the price of staff permits as well as tariffs for visitors.

The price of a standard £30 staff permit, for example, went up by 2.3% to £32.24.

Hourly charges were also increased across its sites, including Leeds General Infirmary and St James’s University Hospital.

London North West University Healthcare NHS Trust

Hourly tariffs were increased by a total of 2.6%, while concessions, including weekly passes, went up by 1.0%. There was no increase to charges for patients having chemotherapy.

Maidstone and Tunbridge Wells NHS Trust

Prices were increased from 2023. Up to 30 minutes remained free, with a charge of £2.50 introduced for 30 minutes to one hour.

Elsewhere, stays of two to four hours, four to six hours and six to eight hours previously cost £4, £6 and £8 respectively, but charges for stays of two to three hours (£4), three to four hours (£5), four to five hours (£6), five to six hours (£7) and six to seven hours (£8) were introduced.

The trust previously charged £10 for stays of eight to 10 hours. Now, a stay of seven to 10 hours costs £10, while 10 to 16 hours is £12 and 16 to 24 hours is £15.

Manchester University NHS Foundation Trust

The trust said it aligned its car parking tariffs for patients and visitors across all its hospital sites following the reinstatement of parking charges.

Medway NHS Foundation Trust

The trust increased charges for stays of up to two hours, two to three hours, three to four hours and four to five hours by 20p, 30p, 40p and 50p respectively to £2.20, £3.30, £4.40 and £5.50.

Stays of between five and 24 hours remained the same at £10.

Mid Cheshire Hospitals NHS Foundation Trust

Charges did not increase for patients during the period.

However, the trust did change its staff charging structure, meaning some worker tariffs increased and others were reduced. Band seven staff and above were charged more for permits.

Milton Keynes University Hospital NHS Foundation Trust

According to its disclosure log, the trust increased tariffs.

The charge for 15 minutes to one hour went up by 10p to £2.80, a three-hour stay increased by 20p to £3.70, up to six hours went up by 20p to £5, up to eight hours increased by 20p to £5.50, while up to 24 hours increased by 40p to £11.

A weekly ticket is now £21, up from £20, and a lost ticket costs £11, up from £10.60.

North Tees and Hartlepool NHS Foundation Trust

The trust increased the tariff at its long-stay car park at the University Hospital of North Tees from 1 December 2023. The rate had previously been £2 per 14 hours and was increased to £2.50 per 14 hours.

All other parking rates remained unchanged from 2022/23 to 2023/24.

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North West Anglia NHS Foundation Trust

Tariffs increased by 20p per hourly session at Hinchingbrooke Hospital and Peterborough City Hospital, but charges were not increased at Stamford and Rutland Hospital.

Northern Lincolnshire and Goole NHS Foundation Trust

The trust increased tariffs for staff and patients during the period.

For the public, up to one hour went from £2.40 to £2.70, one to two hours increased from £3.90 to £4.40, two to four hours went up from £4.40 to £5 and more than four hours increased from £4.90 to £5.50.

Off-site barrier charges for staff increased from £8.50 to £9.60, while off-site non-barrier charges increased from £9.45 to £10.60. The charge for on-site barrier car parks went up from £25.50 to £28.40.

Oxford University Hospitals NHS Foundation Trust

The trust increased tariffs for patients and visitors at John Radcliffe Hospital, Nuffield Orthopaedic Centre and Churchill Hospital on 1 August 2023.

Up to 30 minutes remained free, although 30 minutes to one hour increased from £1.40 to £2.20.

A one to two-hour stay was 10p cheaper at £2.70, as well as a two to three-hour stay which went from £4.20 to £3.70.

Three to four hours increased from £5.60 to £6.20 and the cost for more than four hours went up by £1 to £8. Stays between 8pm and 8am were previously free but now cost £2.

Royal Berkshire NHS Foundation Trust

According to the trust, staff are charged 1.25% when they park on site. It added that a 10% increase in 2023 “was based on the fact that the patient tariff had not been increased for four years” and therefore “10% was a fair increase based on inflation”.

Royal Free London NHS Foundation Trust

The trust increased the costs of its staff permits and parking charges for visitors.

A multi-site pass and a pass for the Royal Free Hospital increased from £94.28 to £99.84 per month for full-time staff from 1 April 2023. Part-time staff are charged £49.82, up from £47.14.

Tariffs for off-peak and weekend parking also increased slightly.

The staff permit tariff at Barnet and Chase Farm hospitals is charged based on a percentage of salary.

These percentages increased from 0.84% to 0.89% for full-time staff and 0.42% to 0.45% for part-time staff at both sites.

For patients, hourly charges were increased across all three hospitals from 1 December 2023.

Royal Surrey NHS Foundation Trust

One hour £3.70 increased to £3.90

Two hours £4.70 increased to £4.90

Three hours £5.30 increased to £5.60

Four hours £5.80 increased to £6.10

Six hours £6.80 increased to £7.10

Twenty-four hours £9.80 increased to £10.30

Sandwell and West Birmingham Hospitals NHS Trust

Charges were increased by 4%.

Surrey and Sussex Healthcare NHS Trust

Tariffs for patients and visitors increased on 15 January 2024.

Stays of up to two hours, two to three hours, three to six hours and six to 10 hours all increased by 50p each to £5, £6, £7, and £8 respectively.

Stays of between 10 and 24 hours increased from £6 to £13.

For staff, charges were reintroduced on 1 June 2023 and are banded by annual salary.

Those earning £23,000 or below pay 50p a day, while those on between £23,500 and £47,600 pay £1.25 a day. Workers on the highest salaries of £48,000 or above pay £1.80 a day.

The Newcastle upon Tyne Hospitals NHS Foundation Trust

Tariffs were increased in October 2022. Up to 30 minutes is free, up from 15 minutes, although charges for up to one hour increased from £1.20 to £2.

One to two hours increased from £2.40 to £4, two to three hours increased from £3.60 to £6 and three to four hours increased from £4.80 to £8.

A standard tariff for four to five hours is £12, up from £6, but will cost patients £8. A standard charge is £18 for five to 24 hours, but is £8 for patients. Previously, the standard charge for five to six hours and six to 24 hours was £7.20.

The Royal Wolverhampton NHS Trust

Stays of less than 15 minutes remained free but there was a 20p increase for stays of up to one hour, one to two hours, two to three hours and four to five hours.

Torbay and South Devon NHS Foundation Trust

The trust changed its prices for patients and visitors from November 2023.

Up to 30 minutes – previously 20 minutes – was now free, with up to one hour costing £1.50. The price for two hours increased from £2.50 to £2.70, three hours was now £3.90, up from £3.50, and four hours cost £4.80, up from £4.50.

The price for stays of five hours and six hours remained the same. The charge for between seven and 24 hours was £15, with the £10.50 tariff for eight hours no longer available.

University Hospital Southampton NHS Trust

The trust upped charges for its short and long-stay car parks from September 2023.

At the short stay, up to one hour increased by 20p, stays of up to two and three hours increased by 40p to £4.90 and £5.90 respectively, while up to four hours increased by 50p to £7.

Stays of up to five hours increased from £7.50 to £8.10, and six hours went from £8.50 to £9.20.

Stays of between six and 12 hours increased by £1 to £14 and between 12 and 24 hours is now £17.30, up from £16.

At the long-stay sites, there was no change to the charge for seven days. Stays of 14 days increased from £38.50 to £41.60 and 30 days was now £59.40, up from £55.

University Hospitals Bristol and Weston NHS Foundation Trust

Up to 40 minutes was free, while up to two hours cost £3.50. The trust previously charged £1.80 for up to one hour and £3.40 for one to two hours.

A two to four hour stay was now £6, up 20p, while four to six hours increased by 20p to £7.30.

A six to eight-hour stay remained the same at £12 while eight to 24 hours went up by £1 to £16.

University Hospitals Coventry and Warwickshire NHS Trust

Tariffs were increased at University Hospital in Coventry and Hospital of St Cross in Rugby.

At University Hospital up to 10 minutes remained free. Up to one hour increased by 40p to £3.60, two hours went from £4.40 to £5, three hours increased by 70p to £5.70 and four hours went up by 80p to £6.80.

​​​​​​Stays of five hours increased by £1.10 to £8.90, up to six hours is £11, up from £9.70 and a 24-hour stay increased from £11 to £12.50.

At Hospital of St Cross, up to 30 minutes remained free. Up to three hours increased by 30p to £2.30, while up to five hours increased from £4.80 to £5.50. The tariff for up to 24 hours was now £9.70, up from £8.50.

University Hospitals Dorset NHS Foundation Trust

The price of a two-hour stay increased by 40p, while stays of three, four and six hours increased by 30p, 40p and 20p respectively. There was no change to prices for a 24-hour stay, although overnight – between 6pm and 7am – increased by £1.

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Walsall Healthcare NHS Trust

In 2023/34, the trust increased parking for up to one hour to £3.30 from £3.

One to two hours increased from £4 to £4.30, two to three hours increased from £4.50 to £4.80, three to four hours increased from £5 to £5.80, and four to five hours increased from £5.50 to £5.80.

There was no change to charges for 5-6 hours, 6-7 hours, 7-8 hours, 8-9 hours, 9-10 hours, 10-11 hours, 11-12 hours, 12-24 hours, or a weekly pass.

Worcestershire Acute Hospitals NHS Trust

One hour – up by 30p to £3.30

Two hours – up by 40p to £4.40

Three hours – up by 50p to £5.50

Four hours – up by 60p to £6.60

Five hours – up by 65p to £7.15

Six hours – up by 75p to £8.25

Eight hours – up by 85p to £9.35

Twenty-four hours – up by 90p to £9.90

Wrightington, Wigan and Leigh NHS Foundation Trust

Charges increased at the Royal Albert Edward Infirmary, Leigh Infirmary and the Freckleton Street multi-storey in November 2022.

Drop-offs and up to 30 minutes remained free, stays of up to two hours increased by 30p to £3.30, two to four hours and four to 24 hours increased by 50p to £5.50 and £7 respectively.

Charges at Wrightington Hospital and the Thomas Linacre Centre also increased in November 2022.

Drop-offs at up to 30 minutes remained free, while stays of up to one hour and one to two hours increased by 30p each to £2 and £3.

Two to four hours and four to 24 hours increased by 50p each to £5.50 and £7.

York and Scarborough Teaching Hospitals NHS Foundation Trust

The trust said charges were brought in line with nearby council car parks at its York, Scarborough and Bridlington sites as part of the installation of automatic number plate registrations in April 2023.

In York, up to one hour increased by 30p to £2.50, with a 60p increase for two hours (£5), a £1.10 increase for three hours (£7.50) and a 20p increase for four hours to £9. All-day passes increased by 10p to £10.

In Scarborough, one hour increased by 25p to £1.45, two hours increased by 40p to £2.90, three hours went from £3.50 to £4.35 and four hours increased from £4.50 to £5.80. An all-day pass increased by £1.20 to £7.20.

In Bridlington, stays of up to an hour were 20p cheaper at £1. Stays of two, three and four hours remained the same and an all-day pass was made 60p cheaper at £5.40.

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Oleksandr Usyk beats Tyson Fury to retain heavyweight titles

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Oleksandr Usyk beats Tyson Fury to retain heavyweight titles

Tyson Fury has responded after his defeat to Oleksandr Usyk in their heavyweight world title rematch in Saudi Arabia.

British fighter Fury, 36, had hoped to take revenge after his previous defeat to Usyk in May.

The Ukrainian, 37, who had entered the bout as a narrow favourite, retained his WBO, WBC and WBA heavyweight titles with his win at Riyadh’s Kingdom Arena.

But, the fight went to the scorecards with all three judges scoring the fight 116-112 in Usyk’s favour.

“I swear to God, I thought I won it by at least three rounds,” Fury said shortly after the fight.

“I felt a little Christmas spirit in there and I think he got a little Christmas gift from them judges. An early Christmas gift.

“I was confident I had won that fight again. I thought I’d won both fights but then again I’ve gone home with two losses on my record. I will always believe until the day I die that I won that fight.

“I’m not going to cry over spilt milk. It’s happened now.”

Fury left the ring without doing an interview, leaving his promoter Frank Warren to speak on his behalf.

“How can Tyson only get four rounds in this fight? It’s impossible,” Warren told TV network DAZN, adding he thought Fury had won.

“Only four rounds. Each of them gave him four rounds, four different rounds. I’m not saying this because I’m biased, but everyone along the front there all thought it went the same way.

“It’s nuts. It’s nuts, I don’t get it. I’m really disappointed with that. I thought he was in control of the fight and boxed extremely well. Usyk was on the back foot for most of the fight, but it is what it is.”

Tyson Fury reacts during a press conference after losing his latest boxing match. Pic: Action Images via Reuters/Andrew Couldridge
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Fury reacts during a press conference after losing his latest boxing match. Pic: Action Images via Reuters/Andrew Couldridge

Usyk became the only man to inflict a professional defeat on Fury when he beat him on points in May, becoming the first boxer to hold all four major heavyweight belts at the same time and the first undisputed champion in 24 years.

But his reign over the four belts ended just a month later when he gave up his IBF belt to fight Fury in a rematch because he was unable to make a mandatory defence against the organisation’s interim belt-holder, Daniel Dubois.

“I win,” Usyk said simply after the fight, “it’s good”.

Oleksandr Usyk celebrates winning his bout. Pic: Action Images via Reuters/Andrew Couldridge
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Usyk celebrates winning his bout. Pic: Action Images via Reuters/Andrew Couldridge

He also paid tribute to Fury.

“He’s a great fighter, a great opponent and it was a great 24 rounds. Unbelievable 24 rounds in my career. Thank you so much,” Usyk said.

Daniel Dubois, the IBF heavyweight title holder, was quick to call for a fight with Usyk following the result.

“I want my revenge,” he told Usyk directly. “Let’s go.”

Oleksandr Usyk and Tyson Fury stare at each other for 11 minutes
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Usyk and Fury stared at each other for 11 minutes ahead of the fight

Dubois, 27, defended the IBF belt with a fifth-round knockout of fellow British rival 34-year-old Anthony Joshua in October.

He faces Joseph Parker on 22 February and the Usyk win could set up a future fight to unify all of the titles.

Ahead of the bout, Usyk and Fury engaged in a stare-down for more than 11 minutes in a head-to-head press conference on Thursday.

Fury weighed in at a career-high 20 stones 1lbs, while Usyk weighed 16 stones 2lb, the heaviest he has recorded, although both men were fully clothed when they stepped on the scales.

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Princess of Wales asked Lady Gabriella Windsor to help with Christmas carol service

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Princess of Wales asked Lady Gabriella Windsor to help with Christmas carol service

It’s been revealed that the Princess of Wales asked Lady Gabriella Windsor, whose husband died earlier this year, for her help to plan her annual carol service.

During the summer, Kate invited Lady Gabriella, the daughter of Prince and Princess Michael of Kent, to join her team organising her annual Together at Christmas event at Westminster Abbey.

The heart-warming gesture was very much in tune with the overall theme of the service, recognising those who have shown love, kindness and empathy to others in their communities.

Speaking of Lady Gabriella’s reaction, a friend said she felt “honoured” and “very touched and grateful to the princess to be asked to contribute to her very special concert”.

The Princess of Wales arrives for the Together At Christmas carol service at Westminster Abbey in London. Picture date: Friday December 6, 2024.
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The Princess of Wales arriving for the carol service earlier this month. Pic: PA

Kate is understood to have been incredibly grateful for her contribution.

Lady Gabriella’s husband, financier Thomas Kingston, died on 25 February from a head injury and a gun was found near his body at his parents’ home in the Cotswolds.

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Kate Middleton hosts Christmas carol service

In October a coroner concluded he took his own life and during the inquest his widow warned about the effects of drugs used to treat mental health problems after the hearing was told Mr Kingston was prescribed drugs following complaints of trouble sleeping following stress at work.

Lady Gabriella, also known as Ella to her friends, supported Kate and played an advisory role with the organising team around the music performances that featured during the service.

The carol service took place on 6 December, with Kate joined by Prince William and their three children Prince George, Princess Charlotte, and Prince Louis, who all held candles during the service, as did the other guests in the congregation.

The service, shown on television on Christmas Eve, will start with a recorded voiceover from the Princess, featuring extracts from a letter given out alongside this year’s order of service.

She will say: “The Christmas story encourages us to consider the experiences and feelings of others.

“It also reflects our own vulnerabilities and reminds us of the importance of giving and receiving empathy, as well as just how much we need each other in spite of our differences.

“Above all else, it encourages us to turn to love, not fear. The love that we show ourselves and the love we show others.

“Love that listens with empathy, love that is kind and understanding, love that is forgiving, and love that brings joy and hope.”

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Olympic cycling champion Sir Chris Hoy, who is terminally ill with prostate cancer, lit a candle, as did Lindsey Burrow, the wife of former rugby league star Rob Burrow who died in June following a much-publicised battle with motor neurone disease.

Readings were given by Prince William and actors Richard E Grant, Michelle Dockery, Sophie Okonedo, and Olympic swimming gold medallist Adam Peaty.

The service will be broadcast as part of the programme Royal Carols: Together At Christmas, screened on ITV1 and ITVX on Christmas Eve, and will also feature three films about people and organisations who have inspired, counselled and comforted others in their times of need.

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‘I walk into a room and people start coughing’: Rare condition makes people allergic to sufferers

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'I walk into a room and people start coughing': Rare condition makes people allergic to sufferers

On rare occasions that Medinah leaves her home, people around her will cough, sneeze and rub their eyes.

“I am the allergen,” the 23-year-old, who did not want her full name used, tells Sky News.

She is one of a group of people with a condition so rare it does not have an official medical name.

It is known simply as People Allergic To Me – often shortened to PATM.

Medinah spent a year online searching her symptoms before she found social media support groups and the name that had been coined there.

During those months, she worried she was “crazy”: “I thought, yes, I’m losing it now. But then after a year and the constant reactions with people, I just realised this cannot be in my head, I can’t be crazy, I’m seeing this in real time.”

Hay fever-type symptoms

Several of the people in those groups spoke to Sky News. They described people developing hay fever-type symptoms in their presence, saying as much as 90% of a room would start coughing, choking, or sneezing when they entered.

They detailed the immense toll of isolating themselves to avoid these reactions. Some said they had been suicidal; others talked of losing friends, giving up jobs, and spending hundreds of pounds on possible remedies.

Last year, PATM sufferers had a glimmer of hope. A researcher in Japan published the first cohort study on the condition – and it indicated there could be a physical cause.

Medinah for PATM feature
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Medinah has suffered from People Allergic To Me since 2020

Speaking to Sky News from Tokyo, Professor Yoshika Sekine from Tokai University describes what he found when he compared the skin gases emitted by 20 people with PATM to a control group of 24.

He discovered the PATM group had “very specific characteristic skin gas patterns”, giving off higher levels of certain chemicals that are known to provoke respiratory symptoms in people exposed to them.

One of them, toluene, is used in the manufacture of explosives, paints and plastics and as a solvent in some types of paint thinner and glue. It can cause irritation to the eyes, nose, throat and respiratory tract, according to Public Health England – and people with PATM emitted 39 times more of it than the control group.

The other chemicals Prof Sekine identified as being particularly important are sulphur compounds, which have a “very strong, pungent odour” and hexanol, which has a hay-like smell.

These chemicals are known to trigger respiratory symptoms and skin irritation and are both linked to sick building syndrome, a condition recognised by the World Health Organisation where people are made ill by the building in which they live or work.

The study concluded: “We must carefully consider the possibility that the chemicals emitted by the PATM group may induce chemical intolerance in those around them.”

‘You feel you don’t have the right to live’

It’s been about 18 months since Fahima started noticing reactions from people around her.

“Wherever I go, if I go into a shop, if I’m out, if I walk past someone, people will sneeze and hysterically cough,” she tells Sky News.

In that time, she’s shifted to working entirely from home. She has stopped attending her nine-year-old son’s school plays because “I don’t want to impact the children”.

She shops in the early, quiet hours. The school run is the only time she regularly leaves the house.

“From the minute I wake up, the first thought is, how are people going to react to me today? I have to minimise myself so that I don’t impact other people.”

She says she also gives off an odour that developed from sweat to fish and then faeces.

There is a medically recognised condition called trimethylaminuria (TMAU) – sometimes called “fish odour syndrome” for the smell sufferers emit – that is sometimes grouped together with PATM.

However, there are PATM sufferers who say their symptoms are not accompanied by any discernible smell.

Dr Robin Lachmann, one of the country’s leading doctors specialising in TMAU, tells Sky News that unlike PATM, TMAU is a condition “which we understand well and can treat”.

A key difference is that while people around the patient may find the odour unpleasant, “these responses aren’t allergic”.

Fahima took a test for TMAU which came back negative – but even getting the test took a year of “legwork” on her part, she says.

“With PATM, doctors say even if you want to get tested, there’s no diagnosis. There’s no way to treat it.”

The reactions Fahima gets aren’t just involuntary coughs and sneezes, she says, but insults and abuse.

“You know what? I don’t blame people. Especially the people that are having allergic reactions to us, we’re physically making them sick, so I don’t expect them to have any other reaction.”

But it’s “draining”, she says, and makes her “incredibly depressed”.

“It makes you feel like you don’t have the right to live, almost. Because why should you be in a place making someone else feel uncomfortable?”

Anonymous woman at the window. Pic: iStock
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Sufferers describe isolating themselves to avoid reactions from other people. Pic: iStock

Fahima says the allergic reactions vary depending on her diet. If she eats a lot of sugar, meat or carbohydrates, the following day she will notice a lot of people sneezing.

Her son mostly doesn’t react to her, she says, but when she eats meat his reactions are so severe she will give him an antihistamine.

Prof Sekine says while skin gases are typically influenced by diet, he hasn’t yet been able to find a link for PATM. But he has spoken to people who have improved their symptoms by cutting out dairy, increasing their intake of antioxidants and working on boosting good gut bacteria.

He also suggests why not everyone reacts to people with PATM. He says it could be to do with sensitivity to chemicals, with some people affected by very low doses in the air around them.

Just as not everyone suffers from hay fever when there’s a high pollen count, not everyone will be sensitive to the higher chemicals in the skin gases of PATM patients.

‘It’s all in your head’

The PATM sufferers who spoke to Sky News invariably said they had been told the condition was “all in their head”.

There is a recognised psychological condition that bears similarities to PATM called Olfactory Reference Disorder, or ORD.

People with ORD are preoccupied with the belief they are giving off a bad smell despite there being no odour, explains Professor David Veale, a consultant psychiatrist at the Nightingale Hospital.

It can have a “devastating” impact on peoples’ lives as they dedicate their energy to tackling the perceived problem and avoid social situations out of fear of being “shamed, humiliated, rejected”, he says.

“They are very stressed and very disabled by it. But no one can convince them that they can’t smell them. They think they’re just saying that to be nice.”

Prof Veale says the difference between PATM and ORD appears to be that ORD patients are preoccupied with their perceptions of what other people think about an imagined smell, while PATM sufferers perceive physical reactions in other people.

Prof Sekine also identifies this difference in his research, concluding PATM is unique “in that it affects the people around them, at least based on descriptions by people with PATM”.

Woman sneezing in an office. Pic: iStock
Image:
File pic: iStock

Sandra, who did not want to use her real name, says she seriously considered whether her condition could “be in my head” after her doctor suggested she had ORD.

“I’d had too many incidents happen for that to be true,” she says.

“I was even bullied at work about it in one job.”

Almost 60, Sandra has lived with the condition for 15 years. She says she used to have a good career, but no longer works “partly due to the stress and anxiety that this causes”.

Her first sign of PATM came when she returned to work after a bout of sickness and her boss had a “sneezing fit” every time he came into her office.

A deep clean didn’t sort what she thought was a dust issue – and then she noticed other colleagues reacting in the same way, then friends and even her husband.

“Eventually it occurred to me that it must be me causing this, which filled me with horror,” she says.

“When the reactions are at their worst, I have a similar reaction myself, that is I become allergic to myself.

“I have other symptoms like a bad taste in my mouth, itchy throat, itchy skin with a mild rash on my abdomen and spiking mild temperature.”

But making others react is the worst part: “It makes me feel dreadfully guilty to be causing all of this and I have severe anxiety and depression as a result.”

Alex’s 24-year-old brother Miguel first noticed PATM symptoms about 10 years ago, but didn’t tell his family until he was 19.

Many people with PATM say close relatives do not get symptoms, and Alex does not notice himself reacting to his brother.

He says it’s also hard to say whether more people cough and sneeze around his brother because it’s such a commonplace thing – but Miguel will notice every cough or nose scratch, and someone having a coughing fit can be enough to make him stay in his room for days.

Alex recalls being at a restaurant with their grandparents when Miguel first told them about the condition, and his grandmother agreed she could hear people “just constantly coughing in the restaurant”.

“That seemed like an increase to what’s normal. But then how do you know what normal is if you’re not paying attention to it?”

PATM is easy to write off as “just” psychological because “it sounds ridiculous”, Alex says, but his first concern when his brother opened up about the condition was to find a way to cope with the impact on his mental health.

“That’s the important thing – and then it doesn’t matter whether it’s real or not.”

What causes PATM?

The cause of PATM is a puzzle to sufferers and researchers alike. Some people say their symptoms started during a time when they were eating a lot of fast food or experiencing high stress.

Sufferers trade theories about possible triggers: a disrupted gut microbiome, fungal infections, sinus problems.

“You’re like your own doctor, your own medical team,” Medinah says. “I literally stay up all night researching.”

Sandra and another person who spoke to Sky News found their PATM flared after a course of antibiotics, while others described developing skin issues before other symptoms.

MEBO Research, a small collective of researchers investigating rare genetic metabolic diseases, has conducted exploratory studies of PATM without being able to pinpoint a cause beyond an apparent issue with the body’s “detoxification process”.

Mehmet Ali, MEBO’s director of community outreach and strategy, tells Sky News PATM needs attention and research from the medical community.

Prof Sekine’s research also did not identify a cause – although it is his goal to find it. “I would like to define the criteria for what PATM is, and what it is not. This is a very difficult point,” he says.

Without even a criteria of what PATM is, there is no formal diagnosis. NHS England told Sky News it follows NICE guidelines, and there are none for PATM.

A spokesperson for NICE said it “can only look at treatments that are licensed by the UK regulators… If they have not been licensed for PATM, we cannot recommend them for the condition”.

But finding a treatment seems a distant dream to sufferers who share remedies on Facebook and Reddit: supplements of every variety, antibiotics, digestive enzymes, probiotics, herbal treatments.

Sufferers go to extreme lengths in search of solutions. Fasts; eliminating sugar, gluten and dairy; raw veganism and its opposite, the “carnivore diet” – essentially just eating meat, eggs and dairy.

But what might grant one person temporary relief doesn’t necessarily work for someone else.

Sandra sees no end to her 15 years of misery: “We are all just waiting for a cure with our lives in effect on hold but I’m nearly 60 now and not confident it will happen in my lifetime.”

‘It crushes you like nothing has crushed you before’

Amir, who did not want to use his real name, says without family relying on him “I wouldn’t be here, that’s how bad I feel sometimes”.

He describes a life that has become “really, really unbearable”. He says he has lost all his friends “because they can’t be in the same areas as me” and even avoids the mosque.

“I do an experiment – I stay out of the room to see if anyone is coughing, then go in the room for a few minutes. The majority of people will start reacting.”

Not everyone with PATM who spoke to Sky News isolates themselves. Some hold down jobs and socialise – but none seem immune to the mental health impacts of the condition.

They describe the loneliness of not just being physically isolated, but of being misunderstood by doctors, friends and family; the guilt of feeling you’re making another person ill; the despair of there being no treatment or cure.

Medinah describes her mental health as “shattered, it’s non-existent”.

“In the beginning it crushes you, it crushes you in a way that nothing has ever crushed you before.”

She says she quit her job as a teaching assistant because she was getting “aggressive” reactions, and now life is at a “complete stop”.

She gets emotional talking about the future: “I don’t feel excited at all. I don’t even like to think about it. The reality is so sad. I can’t even go to the local park, I can’t do anything.”

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.

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