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A workforce the size of the population of Newcastle needs to be recruited urgently to ease the “gridlocked” health and care system and to prevent serious harm to patients, the country’s care regulator has warned.

The Care Quality Commission (CQC) says it is getting “tougher and tougher” to access care because of a massive shortage in the workforce.

There are around 132,000 vacancies in the NHS and 165,000 across social care, about the same size as the population of the north east city.

And this shortfall in the care sector is having a huge impact on NHS waiting lists, hospital bed availability and accident and emergency response times.

The CQC described the entire health and care system as “gridlocked” and “unable to operate effectively”.

The CQC echoes the warnings raised by health leaders about the need to address the crisis in social care to ease the pressure on the rest of the health system.

Chief Executive Ian Trenholm said the recruitment challenge faced by health and care leaders “is going to translate into real difficulty” this winter and in the years ahead.

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Mr Trenholm said the impact of the gridlock is that people are struggling to see their GP or dentist, wait for longer to get to hospital, and once there can become stuck due to a lack of social care to help them once they are ready to leave.

He said: “And this is not just a care consequence. There’s an economic consequence to all of this as well.

“People who are ill can’t go back to work because they’re in a backlog, in some kind of queue waiting for care.”

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Amanda Pritchard, NHS England chief executive, said there are around 10,000 patients in hospitals who are medically fit to be discharged but must stay because there is no care provision for them in the community.

The CQC said only two in five people are able to leave hospital when they are ready, contributing to record-breaking waits in emergency departments following a decision to admit, and dangerous ambulance handover delays.

It found in some cases almost half a hospital is full of people who are medically fit to be discharged but are waiting for social care support, it said.

Beds are available but some care homes are closing their doors to new arrivals because they cannot provide safe staffing levels.

And some nursing homes are having to re-register as care homes because nursing staff are leaving and they are struggling to recruit replacements.

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Figures from the Association of Directors of Adult Social Services show that more than half a million people (542,002) were estimated to be waiting for assessments, reviews or care to start as of 30 April this year.

Separate data from the workforce body Skills for Care show that the number of filled posts fell – by about 50,000 – between 2020-21 and 2021-22 for the first time on record.

The CQC’s annual report on the state of health and social care in England also warned that the rising cost of living could result in more care staff leaving for better-paid work.

The regulator also pointed to an unprecedented number of care workers in the South East resigning in May and June because of fuel costs.

The CQC said that, without action, more health and care staff will quit, services will be further stretched, and people will be at greater risk of harm.

This will be especially pronounced in more deprived areas, where access to care outside hospitals is under the most pressure.

Analysis: For too long the focus has been on acute care while the crisis in social care has been allowed to grow.

All health and care leaders are saying the same thing.

Health and social care must be seen as the same integrated system.

For too long the focus has been on acute care while the crisis in social care has been allowed to grow.

Years of chronic underfunding has left social care in the state it is now.

But the impact on hospitals and the rest of the health service is now being felt.

The pandemic has swelled the waiting lists and to make any headway on the numbers, patients need to go into hospital and get out as soon as it is safe for them to be discharged.

But patients are going into hospital and staying there because there is nobody left to care for them in the community.

The pandemic helped to change the way we look at social care.

We saw just how vulnerable many people were, and we saw just how undervalued and underpaid social care staff were feeling.

That is why so many have left the sector. Unless pay and rewards are addressed care staff will keep leaving and new recruits will not take their place.

The NHS recognises the importance of social care in preventing patients from coming to hospital in the first place.

Among other measures it is setting up rapid response units to attend to people who have suffered falls.

The vast majority of these patients will not need hospital admittance.

Every time an ambulance crew attends a fall it cannot attend to another emergency.

I spent a day with the London Ambulance Service last week.

Our third emergency that morning was to attend to a 78 year woman who had fallen from her bed.

Elizabeth was thoroughly examined and no serious injury was found.

Records showed that Elizabeth had more than 200 ambulance visits for falls the year before.

If she had a good care package in place then those ambulance visits would not all have been necessary and the paramedics could have been responding more quickly to another emergency.

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Hundreds of barbers, car washes and American sweet shops raided in money laundering crackdown

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Hundreds of barbers, car washes and American sweet shops raided in money laundering crackdown

Hundreds of barber shops and other cash-heavy businesses have been targeted in a three-week money laundering blitz.

Police went to 265 premises, including vape shops, nail bars, American-themed sweet shops and car washes across England in a crackdown on high street crime.

The National Crime Agency (NCA) said 35 arrests were made, 97 people suspected to be victims of modern slavery were placed under police protection, and bank accounts containing more than £1m were frozen.

More than £40,000 in cash, some 200,000 cigarettes, 7,000 packs of tobacco, and more than 8,000 illegal vapes were also seized during Operation Machinize, which involved 19 different police forces and regional organised crime units.

Officers also found two cannabis farms containing a total of 150 plants, while 10 shops have been shut down.

The NCA estimates that £12bn of criminal cash is generated in the UK each year with businesses such as barber shops, vape shops, nail bars, American-themed sweet shops and car washes often used by criminals.

Goods seized during their visit to a vape shop in Rochdale.
Pic: GMP/PA
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Goods seized during a visit to a vape shop in Rochdale. Pic: GMP/PA

Police officers at a shop in Tameside. 
Pic: GMP/PA
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Police officers at a shop in Tameside. Pic: GMP/PA

Rachael Herbert, deputy director of the National Economic Crime Centre at the NCA, said: “Operation Machinize targeted barber shops and other high street businesses being used as cover for a whole range of criminality, all across the country.

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“We have seen links to drug trafficking and distribution, organised immigration crime, modern slavery and human trafficking, firearms, and the sale of illicit tobacco and vapes.

“We know cash-intensive businesses are used as fronts for money laundering, facilitating some of the highest harm and highest impact offending in the UK.”

Pic: NCA
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Money laundering crackdown. Pic: NCA

Security minister Dan Jarvis said the operation “highlights the scale and complexity of the criminality our towns and cities face”.

“High street crime undermines our security, our borders, and the confidence of our communities, and I am determined to take the decisive action necessary to bring those responsible to justice,” he said.

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Kara Alexander: Dagenham mother who murdered her two young sons in the bath jailed

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Kara Alexander: Dagenham mother who murdered her two young sons in the bath jailed

A skunk-smoking mother who murdered her two young sons in the bath while in a psychotic state has been jailed for life with a minimum term of more than 21 years.

Kara Alexander was found guilty of drowning Elijah Thomas, two, and Marley Thomas, five, at the home they shared in Dagenham, east London, in December 2022.

Alexander, 47, who had denied two counts of murder, was convicted at Kingston Crown Court in February.

Post-mortems on the boys found they had either been drowned or suffocated – but Alexander accepted at trial that she had placed them in the bath before they “accidentally” drowned.

Returning to Kingston Crown Court on Friday, Mr Justice Bennathan sentenced Alexander to life imprisonment with a minimum term of 21 years and 252 days.

The judge referred to the children’s father finding his deceased sons next to one another as “the stuff of nightmares”.

Mr Justice Bennathan said: “On the evening of 15 December 2022, you’d been smoking skunk.

“You’d been doing so every night for weeks, probably much longer. At some stage, both the boys were in their pyjamas ready for bed, with Elijah also wearing his nappy.

“You drowned them both by your deliberate acts.”

The judge said Alexander “unspeakably” held the boys under water for “up to a minute or two”.

“The bath was probably still run from their normal evening routine and I do not think for a moment that your dreadful acts were pre-meditated,” he said.

The judge said Alexander dried the boys, put them in clean pyjamas and laid them together, tucked in under duvets, on the same bunk bed.

“The next morning, their father, worried by your unusual silence, came and found them. The stuff of nightmares,” he said.

The jury heard how the boys’ father was due to have them that weekend and became increasingly concerned when he had not heard back from Alexander.

When he arrived at their home, she told him the children were upstairs sleeping.

When the father returned downstairs to call for help, Alexander had run away. It took the police around an hour to find her.

The Metropolitan Police said forensic analysis of Alexander’s phone, which had been found in a filled sink, showed it had been in regular use in the run-up to the murders, but on the day the children were found, no calls were made or messages sent.

This led detectives to believe that she had intentionally been avoiding people following their deaths.

Prosecutors said they built their case on showing the boys could not have accidentally drowned and that the only reasonable explanation for their deaths was that Alexander caused them to drown.

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The judge said there was every sign Alexander was a “caring and affectionate” mother to both children before the events of 15 December 2022.

He pointed out that their father said Alexander “never shouted or raised her voice at the boys” and “never showed violence to the boys”.

The judge said: “From all that I have read and seen of you, I have no doubt that every day when you awake you will remember and grieve for the little boys whose lives you snatched away.”

Mr Justice Bennathan said Alexander was in a psychotic state when she killed her sons and that it was cannabis induced.

He said Alexander had a previous psychotic episode in 2016 in which cannabis also probably played a part, but acknowledged he could not be sure she was aware that the drug could trigger another psychotic state.

In his sentencing remarks, Mr Justice Bennathan warned of the dangers of drugs.

He said: “The heavy use of skunk or other hyper-strong strains of cannabis can plunge people into a mental health crisis in which they may harm themselves or others.

“If any drug user does not know that, it’s about time they did.

“At your trial, Kara Alexander, the three psychiatrists who gave evidence disagreed about a number of things, but on that they were unanimous.

“It will comfort nobody connected to this case, but if these events bring home that message to even a few people, some slight good may come from what is otherwise an unmitigated tragedy.”

Detective Chief Inspector Paul Waller, who led the investigation, said: “This is an incredibly tragic case, which has left a father without his two beloved boys and a family without two young brothers.

“Kara Alexander will spend the next two decades behind bars, where the memory of what she has done will haunt her forever.

“To the family and friends of Elijah and Marley, while no amount of time will erase the pain of such a loss, I hope this sentence serves to bring some semblance of justice.

“I hope you can now move on with your life, remembering the boys as you knew them, and treasuring the happy times you spent with them.”

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‘I don’t look at myself as a dying person anymore’: New drug that slows incurable breast cancer now available on the NHS

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'I don't look at myself as a dying person anymore': New drug that slows incurable breast cancer now available on the NHS

A groundbreaking new cancer treatment, hailed by patients as “game-changing”, will be available via the NHS from today.

The drug capivasertib has been shown in trials to slow the spread of the most common form of incurable breast cancer.

Taken in conjunction with an already-available hormonal therapy, it has been shown in trials to double how long treatment will keep the cancer cells from progressing.

“I don’t look at myself anymore as a dying person,” says Elen Hughes, who has been using the drug since February this year.

“I look at myself as a thriving person, who will carry on thriving for as long as I possibly can.”

Ellen Hughes has been using the drug capivasertib
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Elen Hughes says capivasertib has extended her life and improved its quality

Mrs Hughes, from North Wales, was first diagnosed with primary breast cancer in 2008.

Eight years later, then aged 46 and with three young children, she was told the cancer had returned and spread.

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She says that capivasertib, which she has been able to access via private healthcare, has not only extended her life but improved its quality with fewer side effects than previous medications.

It also delays the need for more aggressive blanket treatments like chemotherapy.

New breast cancer drug capivasertib
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Capivasertib is now available from the NHS

“What people don’t understand is that they might look at the statistics and see that [the therapy] is effective for eight months versus two months, or whatever,” says Mrs Hughes.

“But in cancer, and the land that we live in, really we can do a lot in six months.”

Mrs Hughes says her cancer therapy has allowed her “to see my daughter get married” and believes it is “absolutely brilliant” that the new drug will be available to more patients via the NHS.

The National Institute for Health and Care Excellence approved capivasertib for NHS-use after two decades of research by UK teams.

Professor Nicholas Turner, from the Institute of Cancer Research which led the study, told Sky News it was a “great success story for British science”.

Professor Nicholas Turner, from the Institute of Cancer Research which led the study
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Professor Nicholas Turner wants urgent genetic testing of patients with advanced breast cancers to see if they could benefit

The new drug is suitable for patients’ tumours with mutations or alterations in the PIK3CA, AKT1 or PTEN genes, which are found in approximately half of patients with advanced breast cancer.

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Prof Turner says hundreds of patients could see the benefit in the immediate future, with thousands more people identified over time.

“We need new drugs that will help our existing therapies work for longer, and that’s where this new drug, capivasertib comes in,” says Prof Turner.

“It doubles how long hormone therapy treatment works for, giving patients precious extra time with their families.”

He called for urgent genetic testing of patients with advanced breast cancers to see if they could benefit.

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