Elizabeth Simpson is recovering from a nasty bout of pneumonia.
Her oxygen levels dropped so low that she could have been taken to hospital.
That made her feel anxious because at 80 years old she didn’t want to be separated from her family.
She also knew she would be at greater risk of a hospital-acquired infection.
That was a valid concern as the latest NHS data shows COVID infections caught in hospitals are rising.
“If you go into hospital at my age you might catch something else. It’s much more relaxing at your own home because you can go to bed, have a cup of coffee or whatever you want. And the side effect of it all is people having to visit you in hospital – the stress,” Mrs Simpson said.
Luckily for Mrs Simpson she was referred to the virtual wards team at Frimley Park Hospital in Surrey.
This unit, one of the first in the country to set up a remote hospital service, is tasked with treating acute patients at home.
This has benefits for the hospital and the patient.
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Image: Gemma Cash has seen an improvement in the treatment of patients using virtual wards
Firstly, it stops unnecessary patient admissions and also helps with the discharge of patients who can continue their treatment at home.
This eases pressure on hospital capacity, improving the flow of patients through the system.
Secondly, patient recovery times are known to improve when treated at home.
One of the nurses visiting Mrs Simpson at home is Gemma Cash, an advanced clinical practitioner with Frimley Health NHS Foundation Trust.
Mrs Cash says she has seen an improvement in the treatment of patients like Mrs Simpson.
“We didn’t have to wait for her to get into an ambulance to go to A&E, to wait in the queue in A&E to be assessed. From 111 we’ve cut out that middleman and we come straight here and do that assessment directly,” she said.
Image: The virtual ward is run by a team at Frimley Park Hospital
Virtual wards, remote monitoring and rapid discharge teams are all part of the wider government effort to ease pressure on the NHS.
Trusts that have been able to employ these specialist consultant-led teams report some success with the easing of pressure on acute services.
It is a model that the NHS is likely to pivot towards in the future as more emphasis is placed on preventing patients needing to attend hospital and stay for ongoing treatment.
But the success of this programme is dependent on the recruitment and retention of trained staff.
There is already a shortage of nurses and the workforce crisis extends right across the NHS.
It also does not address the long-term crisis in social care which is driving the pressure on hospitals who are unable to discharge medically-fit patients. This number has grown again to almost 14,000 across England.
This and the recruitment and retention of trained staff is an ongoing problem for doctors like Lucy Abbott, consultant geriatrician and chief of service for community services and older peoples’ medicine, who established Frimley’s virtual ward team.
Dr Abbott told me: “Clearly workforce is our biggest, biggest challenge, and we need to have highly-skilled professionals looking after people with frailty and as you say, that care, that support from social services as well.”
I asked Dr Abbott if her service could be a substitute for a lack of social care.
“No, no,” she replied. “We have to work together.”
The pressure on the NHS is easing slightly. But it would be a dangerous mistake to think the NHS winter crisis is over.
The workforce shortages, compounded by ongoing industrial action by nurses and ambulance workers and the need to address the serious problems in social care, mean the pressure is likely to continue for some time.
Hayat Tahrir al Sham (HTS) went from a jihadist movement once aligned to al Qaeda to forming the official government of Syria.
It was a monumental transformation for them, their country and the wider Middle East.
But potentially too for British people who went to Syria– and who were stripped of their citizenship as a result, on the grounds of national security.
Tauqir Sharif, better known as Tox, went to Syria in 2012 as an aid worker. He was accused of being part of a group affiliated with al Qaeda, which he denies, and the then-home secretary Amber Rudd deprived him of his British citizenship in 2017.
“As of now, I am deprived of my UK citizenship but I’m not a convicted terrorist – and the reason for that is because we refused, we boycotted, the SIAC [Special Immigration Appeals Commission] secret courts, which don’t allow you to see any of the evidence presented against you,” he said.
“And one of the things that I always called for was, look, put me in front of a jury, let’s have an open hearing.”
Image: Tox went to Syria in 2012
HTS is still a proscribed terrorist organisation but the British government has now established relations with it.
Foreign Secretary David Lammy travelled to Damascus to meet the jihadist-turned-Syrian interim president – the man who swapped his nom de guerre of al Jolani for Ahmed al Sharaa.
Image: David Lammy shakes hands with Ahmed al Sharaa in Damascus. Pic: X / @DavidLammy
If the UK government takes HTS off the terror list, what does that mean for those who lost their citizenship after being accused of being part of it?
People who joined HTS are only a subset among the scores of people who have had their citizenship revoked – a tool the UK government has been quick to use.
According to a report by the Parliamentary Joint Human Rights Committee, the UK “uses deprivation of citizenship orders more than almost any country in the world”.
The peak of that was in 2017, and mainly in relation to Syria – especially in the case of people joining Islamic State, perhaps most famously Shamima Begum.
Image: Shamima Begum was stripped of her British citizenship on national security grounds
And because people cannot be made entirely stateless, and need to have a second nationality, or be potentially eligible for one, there are worries of racism in who the orders apply to.
Countries like Pakistan and Bangladesh offer dual nationality, whereas other nations do not. In 2022, the Institute of Race Relations said “the vast majority of those deprived are Muslim men with South Asian or Middle Eastern/North African heritage”.
Legal grey areas
Sky News submitted Freedom of Information requests to the Home Office asking for a breakdown of second nationalities of those deprived of citizenship, but was refused twice on national security grounds.
The independent reviewer of terrorism legislation, Jonathan Hall KC, told Sky News there are issues around transparency.
“I do think there is a problem when you have people whose relationship with the country that they’re left with is really technical and they may never have realised that they had that citizenship before and may never gone to that country,” he said.
“Me and my predecessors have all said, owing to how frequently this power is used, it should be something that the independent reviewer should have the power to review. I asked, my predecessor asked, we’ve both been told no, so I agree there’s a lack of transparency.”
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“We can’t sort of go through previous cases nitpicking through it, wasting time and money to bring it up to date,” he added.
“We can’t be naive because the intent to go out, the decision to go in itself is a huge decision for them. So it shows commitment when they’re there, they then, if they take an active participation in the organisations that they’ve been accused of joining, again, that involves training and perseverance and dedication to the cause.”
But those born and raised in Britain, who joined the same cause, and lost their citizenship as a result, might reasonably ask why that should remain the case.
Criminals face being banned from pubs, sports grounds and concerts under new government plans to give judges powers to pass tougher community sentences.
The new measures, which would apply to people in England and Wales, “should remind all offenders that, under this government, crime does not pay”, Justice Secretary Shabana Mahmood said.
Offenders’ freedom could also be curtailed with limits on driving, travel bans and restriction zones confining them to specific areas, the government said.
Similar measures could also apply to prisoners let out on licence, while drug testing would be expanded to include all those released, rather than just those with a history of substance misuse.
While judges are currently able to impose limited bans for specific crimes, such as football bans for crimes committed inside a stadium on match day, the new measures would allow for such bans to be handed down for any offence.
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12:16
Inside one of Britain’s most overcrowded prisons
The justice secretary said: “When criminals break society’s rules, they must be punished.
“Those serving their sentences in the community must have their freedom restricted there too.
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“These new punishments should remind all offenders that, under this government, crime does not pay.
“Rightly, the public expect the government to do everything in its power to keep Britain safe, and that’s what we’re doing.”
The proposals are part of the Labour government’s efforts to tackle overcrowding in prisons.
Back in June, it emerged that prisoners were to be transferred to lower security jails in an effort to ease overcrowding, as part of a new measure quietly unveiled by the government.
Sky News reported earlier this month how the prison system was close to collapse on a number of occasions between autumn 2023 and summer 2024, according to an independent review by former chief inspector of prisons, Dame Anne Owers.
The report said there was a systemic problem which has led to recurring prison capacity crises over the last 18 years.
Protesters have gathered across the country as groups demonstrated against asylum seeker housing and were met by anti-racism campaigners.
Demonstrations under the Abolish Asylum System slogan were held in England, Scotland and Wales, including in Bristol, Exeter, Tamworth, Cannock, Aberdeen, Mold, Perth, Nuneaton, Liverpool, Wakefield, Newcastle, Horley and Canary Wharf.
Counter-protests were also organised by campaign group Stand Up to Racism.
Image: Police officers scuffle with demonstrators during protests at Castle Park in Bristol. Pic: PA
In Bristol, mounted police separated the two groups in the Castle Park, with officers scuffling with protesters.
Police kept around 200 anti-immigration protesters draped in English flags away from roughly 50 Stand Up to Racism protesters in Horley, Surrey.
Image: People take part in a protest outside the Sheraton Four Points Hotel in Horley, Surrey. Pic: PA
One man, wearing a West Ham United football shirt, was held by police as he yelled: “You’re not welcome here, you’re not welcome here, you’re not welcome here” at anti-racism protesters.
Anti-immigration protesters also chanted: “Tommy, Tommy, Tommy, Tommy Robinson” in support of the far-right activist, whose real name is Stephen Yaxley-Lennon.
Image: A confrontation between a protester and a counter-protester outside the Sheraton Four Points Hotel in Horley, Surrey. Pic: PA
The anti-racism protesters chanted “say it loud, say it clear, refugees are welcome here” and held signs calling for solidarity and to “stop deportations”.
The Stand Up to Racism protesters were shepherded into a smaller area as they continued to chant: “No hate, no fear, refugees are welcome here”, which was met with “No they’re f****** not” from the other side of the street.
Image: People inside the hotel look at protesters outside the Radisson Hotel in Perth. Pic: PA
In Perth, protesters gathered outside the Radisson Hotel.
The anti-migration protesters held up signs with slogans such as “Perth is full – empty the hotels” and “get them out”.
Image: People take part in a counter-protest outside the Radisson Hotel in Perth. Pic: PA
Stand Up to Racism Scotland said it had achieved “victory” in Perth, with more than 200 gathering to oppose the Abolish Asylum System demonstration.
In Liverpool, a dispersal order was issued to try and contain the protests.
Saturday’s events come amid continued tension around the use of the hotels for asylum seekers.
Regular protests had been held outside the Bell Hotel in Epping, Essex, which started after an asylum seeker housed there was charged with sexually assaulting a 14-year-old girl on 10 July.
Hadush Gerberslasie Kebatu, 38, was charged with trying to kiss a teenage girl and denies the allegations. He is due to stand trial later this month.