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Hospital leaders have expressed serious concerns about how they will maintain patient safety as the health service enters “unchartered territory” during “unprecedented” strike action next week.

Junior doctors who are training in England will stage their longest walkout so far between 11 and 15 April.

The 96-hour strike is likely to be the most disruptive in the history of the health service due to the length of the action and the fact doctors have chosen to stage it directly after a long bank holiday weekend.

The bank holiday traditionally causes disruption to the NHS even without the prospect of strike action.

The walkout also coincides with the Easter school holidays, which means many consultant staff who provided cover during the first round of strikes will be unable to do so again due to pre-planned holidays and childcare commitments.

NHS Providers, which represents NHS trusts, said the timing of the strike and its duration present a “range of challenges over and above the disruption seen from the industrial action in recent months”.

It said that during the strike, the NHS will focus resources on emergency treatment, critical care, maternity, neonatal care and trauma.

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But even in these areas, there are “real concerns of a raised risk to safety”, NHS Providers said.

The strikes could lead to delays for some patients starting treatment – for instance, if a new cancer patient needed to start weekly rounds of chemotherapy, the start of their treatment may be delayed until after the strike action to ensure continuity.

Last month’s 72-hour walkout led to about 175,000 hospital appointments and operations being postponed.

Hospital leaders have raised concerns with NHS Providers about the impact of the strike.

“This is less about what planned routine work gets pulled down and everything about maintenance of safety in emergency departments, acute medicine and surgery,” one hospital trust chief executive said.

“Concerned doesn’t begin to describe it.”

Another said: “I am not confident this time that we can maintain patient safety as we will not be able to provide the cover.”

“Many of the consultants who stepped up to do nights last time are not available or are more reluctant this time,” a third said.

While another added: “Those with families almost certainly won’t as [they] can’t rearrange out of school holidays.”

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Sir Julian Hartley, chief executive of NHS Providers, said: “It’s clear from our extensive dialogue with trust leaders that we are in uncharted territory.

“Yet again we are seeing colleagues pull out all the stops to minimise disruption and ensure patient safety. But the challenges here are unprecedented.”

Dr Latifa Patel, workforce lead for the British Medical Association, said: “No one understands better than us, the doctors who care for them, that patients are getting a substandard experience 365 days a year from an overstretched and understaffed NHS.

“In this brutal work environment, patient care is at risk every day due to chronic staff shortages and years of underinvestment in equipment and services.

“Junior doctors have no desire to strike, they been pushed into this action by long-term government inaction and now want to bring this dispute to an end as quickly as possible.

“We hope the health secretary will come to the table immediately with a meaningful pay offer so doctors can avoid more strike action and instead return to doing what they want to be doing: caring for their patients.”

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Why are doctors quitting the NHS?

A department of health and social care spokesperson said: “Four days of strikes by junior doctors will risk patient safety and cause further disruption and postponed treatment.

“The BMA’s demand for a 35% pay rise is totally unreasonable and unaffordable.

“We urge them to come to the table with a realistic approach so we can find a way forward, as we have done with other health unions, which balances fairly rewarding junior doctors for their hard work with meeting the prime minister’s ambition to halve inflation.

“We are working with NHS England to put in place contingency plans to protect patient safety.

“The NHS will prioritise resources to protect emergency treatment, critical care, maternity and neonatal care, and trauma.”

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Widow has ‘no regrets’ over assisted suicide of husband despite ‘ongoing’ police investigation

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Widow has 'no regrets' over assisted suicide of husband despite 'ongoing' police investigation

A woman who is under police investigation after assisting the suicide of her husband at Dignitas in Switzerland has told Sky News she has no regrets.

Louise Shackleton has spoken publicly for the first time since her husband’s death in December, as parliament prepares to vote again on legislation to introduce assisted dying in England and Wales.

Mrs Shackleton surrendered herself to police after returning from Switzerland having seen her husband Anthony die. He had been suffering with motor neurone disease for six years.

“I have committed a crime, which I have admitted to, of assisting him by simply pushing him on to a plane and being with him, which I don’t regret for one moment. He was my husband and I loved him,” she said.

“We talked at length over two years about this. What he said to me on many occasions is ‘look at my options, look at what my options are. I can either go there and I can die peacefully, with grace, without pain, without suffering or I could be laid in a bed not being able to move, not even being able to look at anything unless you move my head’.

“He didn’t have options. What he wanted was nothing more than a good death.”

The law in the UK prohibits people from assisting in the suicide of others, but prosecutions have been rare.

For Greg Milam story. Copy and pictures submitted via email. A woman who is under police investigation after assisting the suicide of her husband at Dignitas in Switzerland has told Sky News she has no regrets. Louise Shackleton has spoken publicly for the first time since her husband’s death in December. Mrs Shackleton surrendered herself to police after returning from Switzerland having seen her husband Anthony die. He had been suffering with Motor Neurone Disease for six years.
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Louise Shackleton has spoken publicly for the first time since her husband Anthony’s death

In a statement, a North Yorkshire Police spokesman told Sky News: “The investigation is ongoing. There is nothing further to add at this stage.”

The next vote on the assisted dying bill for England and Wales has been delayed by three weeks to give MPs time to consider amendments.

The legislation would permit a person who is terminally ill with less than six months to live to legally end their life after approval by two doctors and an expert panel.

‘He was at total peace with his decision’

Mrs Shackleton says she saw her husband “physically and mentally” relax once on the flight to Switzerland.

She said: “We had the most wonderful four days.

“He was laughing. He was at total peace with his decision.

“It was in those four days that I realised that he wanted the peaceful death more than he wanted to suffer and stay with me, which was hard, but that’s how resolute he was in having this peace.

“I was his wife, we’d been together 25 years, we’d known each other since we were 18. I couldn’t do anything else but help him.”

For Greg Milam story. Copy and pictures submitted via email. A woman who is under police investigation after assisting the suicide of her husband at Dignitas in Switzerland has told Sky News she has no regrets. Louise Shackleton has spoken publicly for the first time since her husband’s death in December. Mrs Shackleton surrendered herself to police after returning from Switzerland having seen her husband Anthony die. He had been suffering with Motor Neurone Disease for six years.

‘We need to safeguard people’

She said the hardest part of the journey came after her husband’s death.

“There was this panic and this fear that I was leaving him,” she said. “That was a horrific experience.

“If the law had changed in this country, I would have been with family, family would have been with us, family would’ve been with him. But as it was, that couldn’t happen.”

Opponents to the assisted dying bill have raised concerns about the safety of vulnerable people and the risk of coercion and a change in attitudes toward the elderly, seriously ill and disabled.

They say improvements to palliative care should be a priority.

“I think that we need to safeguard people,” said Mrs Shackleton. “I think that sometimes we need to suffer other people’s choices, and when I mean suffer I mean we have to acknowledge that whilst we’re not comfortable with those, that we need to respect other people, other people wishes.”

For Greg Milam story. Copy and pictures submitted via email. A woman who is under police investigation after assisting the suicide of her husband at Dignitas in Switzerland has told Sky News she has no regrets. Louise Shackleton has spoken publicly for the first time since her husband’s death in December. Mrs Shackleton surrendered herself to police after returning from Switzerland having seen her husband Anthony die. He had been suffering with Motor Neurone Disease for six years.

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Anthony, who died aged 59, was a furniture restorer who had earned worldwide recognition for making rocking horses.

“I think the measure of the man is that nobody has ever said a bad word about him in the whole of his life because he was just so caring and giving,” his widow said.

‘This is about a dying person’s choice’

She said she had chosen to speak publicly because of a promise she had made him.

“I felt that my husband’s journey shouldn’t be in vain. We discussed this on our last day and my husband made me promise to tell his story.

“He told me to fight and the simple thing that I’m fighting for is people to have the choice.

“This is about a dying person’s choice to either follow their journey through with disease or to die peacefully when they want to, on their terms, and have a good death. It’s that simple.”

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Feminists ‘feel braver about speaking out’ after gender ruling – but critics say it ‘stokes culture war’

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Feminists 'feel braver about speaking out' after gender ruling - but critics say it 'stokes culture war'

A former Labour MP who quit the party over Sir Keir Starmer’s leadership has welcomed the landmark Supreme Court ruling on the definition of a woman as a “victory for feminists”.

Rosie Duffield, now the independent MP for Canterbury, said the judgment helped resolve the “lack of clarity” that has existed in the politics around the issue “for years”.

She was speaking to Ali Fortescue on the Politics Hub on the same day the UK’s highest court delivered its verdict on one of the most contentious debates in politics.

Politics latest: MPs respond to Supreme Court ruling on gender

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How do you define a woman in law?

The judges were asked to rule on how “sex” is defined in the 2010 Equality Act – whether that means biological sex or “certificated” sex, as legally defined by the 2004 Gender Recognition Act.

Their unanimous decision was that the definition of a “woman” and “sex” in the Equality Act 2010 refers to “a biological woman and biological sex”.

Asked what she made about comments by fellow independent MP John McDonnell – who said the court “failed to hear the voice of a single trans person” and that the decision “lacked humanity and fairness” as a result, she said: “This ruling doesn’t affect trans people in the slightest.

“It’s about women’s rights – women’s rights to single sex spaces, women’s rights, not to be discriminated against.

“It literally doesn’t change a single thing for trans rights and that lack of understanding from a senior politician about the law is a bit worrying, actually.”

However, Maggie Chapman, a Scottish Green MSP, disagreed with Ms Duffield and said she was “concerned” about the impact the ruling would have on trans people “and for the services and facilities they have been using and have had access to for decades now”.

Susan Smith and Marion Calder give a statement, as the Supreme Court rules on an appeal by For Women Scotland about whether a person with a full gender recognition certificate which recognises that their gender is female is a woman under British equality laws, outside the Supreme Court in London, Britain, April 16, 2025. REUTERS/Maja Smiejkowska
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Susan Smith and Marion Calder, directors of For Women Scotland celebrate after the ruling. Pic: Reuters

“One of the grave concerns that we have with this ruling is that it will embolden people to challenge trans people who have every right to access services,” she said.

“We know that over the last few years… their [trans people’s] lives have become increasingly difficult, they have been blocked from accessing services they need.”

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‘Today’s ruling only stokes the culture war further’

Delivering the ruling at the London court on Wednesday, Lord Hodge said: “But we counsel against reading this judgment as a triumph of one or more groups in our society at the expense of another. It is not.

Campaigners for For Women Scotland (FWS) celebrate outside the Supreme Court in London after terms "woman" and "sex" in the Equality Act refer to a biological woman and biological sex, the Supreme Court has ruled. Picture date: Wednesday April 16, 2025.
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Campaigners celebrate outside the Supreme Court. Pic: PA

“The Equality Act 2010 gives transgender people protection, not only against discrimination through the protected characteristic of gender reassignment, but also against direct discrimination, indirect discrimination and harassment in substance in their acquired gender.

“This is the application of the principle of discrimination by association. Those statutory protections are available to transgender people, whether or not they possess a gender recognition certificate.”

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Asked whether she believed the judgment could “draw a line” under the culture war, Ms Chapman told Fortescue: “Today’s judgment only stokes that culture war further.”

And she said that while Lord Hodge was correct to say there were protections in law for trans people in the 2020 Equality Act, the judgment “doesn’t prevent things happening”.

“It may offer protections once bad things have happened, once harassment, once discrimination, once bigotry, once assaults have happened,” she said.

She also warned some groups “aren’t going to be satisfied with today’s ruling”.

“We know that there are individuals and there are groups who actually want to roll back even further – they want to get rid of the Gender Recognition Act from 2004,” she said.

“I think today’s ruling just emboldens those views.”

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Arsenal reach Champions League semi-final with dramatic win over Real Madrid

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Arsenal reach Champions League semi-final with dramatic win over Real Madrid

Arsenal have reached the semi-finals of the Champions League after a dramatic victory over holders Real Madrid in Spain.

The north London side, who became the first English team to win twice at the Bernabeu following their triumph there 19 years ago, will face Paris Saint-Germain in the last four after the French side beat Aston Villa on Tuesday.

It is the third time the Gunners have made it through to the semis of the top club football tournament in Europe, and the first since 2009.

Arsenal went into the second leg of their quarter-final clash on Wednesday with a 3-0 lead.

Backed by a raucous home crowd, Madrid tried to get off to a strong start and Kylian Mbappe scored after two minutes. However, the goal was disallowed for a clear offside.

Arsenal had the chance to go ahead in the 13th minute but winger Bukayo Saka missed a penalty.

The Spanish hosts were awarded a penalty of their own about 10 minutes later when Mbappe stumbled under pressure from Declan Rice in the box – but the decision was overturned by VAR.

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Saka atoned for his tepid penalty as he chipped the ball past Madrid’s keeper Thibaut Courtois when put through on goal by auxiliary striker Mikel Merino in the 65th minute.

But Arsenal were pegged back just two minutes later as Vinicius Junior caught William Saliba dawdling on the ball and fired Real Madrid level.

Arsenal’s resolute defending kept the home side at bay until Gabriel Martinelli made a late break through the home side’s defence to put his side 2-1 ahead three minutes into injury time, as the Gunners made it 5-1 on aggregate.

(L-R) Arsenal's Declan Rice and Mikel Merino celebrate after the defeat against Real Madrid. Pic: AP
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(L-R) Arsenal’s Declan Rice and Mikel Merino celebrate after the defeat against Real Madrid. Pic: AP

‘We knew we were going to win’, says Rice

Arsenal midfielder Declan Rice has insisted his team are intent on winning the Champions League after their victory in Madrid.

Speaking to TNT Sport, Rice, who was named player of the match, said: “It’s such a special night, a historic one for the club. We have the objective of playing the best and winning the competition.

“We had so much belief and confidence from that first leg and came here to win the game. We knew we were going to suffer but we knew we were going to win. We had it in our minds, then we did it [in] real life. What a night.

“I knew when I signed, this club was on an upward trajectory. It’s been tough in the Premier League but in this competition we’ve done amazingly well.

“It’s PSG next, who are an amazing team.”

‘We have to be very proud of ourselves’, says Arteta

Arsenal boss Mikel Arteta told TNT Sport: “One of the best nights in my football career.

“We played against a team with the biggest history.

“To be able to win the tie in the manner we have done, I think we have to be very proud of ourselves.”

He added: “The history we have in this competition is so short. The third time in our history of what we have just done and we have to build on that. All this experience is going to help us, for sure.”

Real Madrid were seeking their third Champions League title in four seasons.

Mbappe twisted ankle

Their forward Mbappe twisted his right ankle during the game and was jeered by part of the crowd when his substitution was announced after a lacklustre performance.

The French star, who is still looking for his first Champions League title, was replaced by Brahim Diaz in the 75th minute following his injury. He was able to walk off the pitch by himself, but was limping slightly.

The other semi-final will be between Barcelona and Inter Milan.

The first legs are set to be played on 29 and 30 April, with the second legs on 6 and 7 May.

The final will be on 31 May.

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