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One million NHS Scotland waiting list backlog projections branded ‘terrifying’

Nearly one million people are set to be on a NHS waiting list in Scotland by next year, analysis has revealed, in projections that have been described as “terrifying”.

The analysis produced by Edinburgh University shows NHS Scotland must treat at least 20 per cent more non-emergency hospital cases over the next three years to eliminate the backlog caused by the Covid-19 pandemic. And the research revealed the number of referrals waiting to be treated in Scotland topped 667,000 at the end of December 2023, covering an estimated 10 per cent of the population.

Researchers warned that, without any increase in capacity, the waiting list will increase to nearly one million people by December 2026.

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Source: The Scotsman, 10 January 2024

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Hospital wards face ‘pandemic-level’ strain with soaring flu cases triggering winter crisis

Around 20 hospital trusts across England have declared critical incidents with staff facing ‘mammoth demand’ due to the cold weather and flu.

England’s top doctor has warned staff in hospitals are facing conditions similar to the “height of the pandemic” amid a national surge in flu cases on wards. NHS figures reveal there were an average of more than 5,400 patients with flu in hospitals each day last week, up 21 per cent from the previous week and more than three times the level seen at the same point last year.

Visits to A&E also rose to an unprecedented level for December, making last year the busiest ever year for emergency departments.

Professor Stephen Powis, the national medical director for NHS England, said: “It is hard to quantify just through the data how tough it is for frontline staff at the moment – with some staff working in A&E saying that their days at work feel like some of the days we had during the height of the pandemic.”

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Source: Independent, 9 January 2024

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‘We took too long’: Jeremy Hunt offers apology to families of Letby’s victims

Former health minister says medical examiners, who spot cases of intentional harm, could have been in place earlier. Jeremy Hunt has said ministers took “too long” to introduce medical examiners to investigate deaths in the NHS, as he apologised to the families of Lucy Letby's victims.
 
Giving evidence at the Thirlwall inquiry on Thursday, the former health secretary said he had “ultimate responsibility” for the NHS at the time Letby committed her “appalling crime” of murdering babies at the Countess of Chester hospital in 2015 and 2016. Hunt, who was health secretary from 2012 to 2018, said his government took “too long” to introduce independent medical examiners to the NHS after they were first proposed in 2004, six years before the Conservatives came to power.
 
Medical examiners are senior doctors who carry out independent scrutiny of deaths that are not investigated by coroners. They were introduced widely last September, 20 years after they were first proposed as a result of the Harold Shipman inquiry in 2004, then again by the Francis inquiry into the Mid-Staffordshire scandal in 2013.
 
 
Source: Guardian, 9 January 2025
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Ambulance handover delays hit record high

Long ambulance handover delays hit record levels in the past week as the winter crisis in the NHS reached its height. There were an average of 2,834 hour-long handover delays every day in the week to 4 January, according to the latest NHS winter sitrep data released today. That was the highest since records began.

The previous record was at the start of January 2023—a time of intense and high-profile pressures on services, due to a very high flu peak and ongoing Covid-19, when many patients were harmed.

At that time a daily average of 2,682 hour-long delays were reported. Since then, cutting handover delays has been a high priority of government and NHSE.

On Monday, HSJ reported long ambulance handover delays were surging in the Midlands and northern regions, which have recorded more of them than in the 2022-23 winter.

Sir Stephen Powis, NHS England’s national medical director, said: “It is clear that hospitals are under exceptional pressure at the start of this new year, with mammoth demand stemming from this ongoing cold weather snap and respiratory viruses like flu—all on the back of 2024 being the busiest year on record for A&E and ambulance teams."

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Source: HSJ, 9 January 2025

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What you need to know about HMPV as China sees rise in cases

Chinese health officials are reportedly monitoring an increase in cases of human metapneumovirus (HMPV). There is currently no evidence that the outbreak is out of the ordinary or that a new respiratory virus or illness has emerged in China. HMPV is a virus that can cause upper and lower respiratory disease, according to the CDC. It was discovered in 2001 and is in the Pneumoviridae family along with respiratory syncytial virus, or RSV, the CDC said.

A spokesperson for the World Health Organization (WHO) said data from China indicates "there has been a recent rise in acute respiratory infections" but that "the overall scale and intensity of respiratory infectious diseases in China this year are lower than last year."

Cases of HMPV have been steadily increasing in the U.S. since November 2024 with 1.94% of weekly tests positive for HMPV as of Dec. 28, 2024, according to data from the Centers for Disease Control and Prevention (CDC). By comparison, 18.71% of weekly tests were positive for flu and 7.10% were positive for COVID during the same week, the data shows.

Public health experts told ABC News that HMPV is well-known to health care professionals and commonly circulates during respiratory virus season.

MORE: Cases of RSV, flu ticking up among young children in US as respiratory virus season begins
"This is that winter respiratory virus season, indeed," Dr. William Schaffner, a professor of preventive medicine at Vanderbilt University Medical Center in Nashville, told ABC News. "So, all of these respiratory viruses -- influenza, COVID, RSV, human metapneumovirus -- they all increase this time of the year, in part because we get so close to each other."

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Source: ABC News, 7 January 2025

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Black men in England more likely to be diagnosed with late-stage prostate cancer, analysis shows

Black men in England are more likely to be diagnosed with late-stage prostate cancer than their white counterparts, while being less likely to receive life-saving treatment, analysis by the National Prostate Cancer Audit has found.

The analysis found that black men were diagnosed with stage three or four prostate cancer at a rate of 440 per 100,000 black men in England, which is 1.5 times higher compared with their white counterparts, who had a diagnosis rate of 295 per 100,000.

Furthermore, the research also found that black men in their 60s who had a later diagnosis were 14% less likely to receive life-saving treatments that have been approved by the National Institute for Health and Care Excellence for use on the NHS.

The research was conducted by analysing new prostate cancer diagnoses by ethnicity in England from January 2021 to December 2023, using data from the Rapid Cancer Registration dataset and the National Cancer Registration dataset.

Prostate cancer is the most common cancer among British men, with about 52,300 new cases and 12,000 deaths recorded in the UK each year. Black men are twice as likely to be diagnosed and 2.5 times more likely to die from the disease compared with white men.

Prostate Cancer UK is calling for the government’s guidelines to be updated as, under current guidance, it is an individual’s responsibility to find out his risk and decide if he would like to request a blood test.

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Source: The Guardian, 9 January 2025

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Trust orders external review into medical training ‘concerns’

University Hospitals Birmingham has ordered an independent review into a major international medical training programme, after concerns the scheme may be routinely underpaying overseas doctors.

The foundation trust confirmed to HSJ it was “now in the process of commissioning an independent review” into its three international medical training programmes. A spokesman said the decision to order an external review had been sparked by an earlier internal review of its medical training, which itself followed “concerns raised by clinical and non-clinical colleagues”.

And a bulletin sent to UHB staff today from chief medical officer Kiran Patel, seen by HSJ, said “pay parity” issues had come to light through the internal reviews. It follows previous reports that overseas doctors were being paid substantially less than domestic peers working at a comparable level.

Details about who will carry out the external review, how long it will take, and the terms of reference are yet to be confirmed.

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Source: HSJ, 9 January 2025

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Robot-guided ‘smart biopsy’ technique tested on patients in UK first

A robot-guided “smart biopsy” technique has been tested on UK patients for the first time, with researchers hopeful it could spell the end of invasive procedures for those with suspected cancer.

Medics used advanced MRI scans to identify different areas of tumours and take multiple samples at once to better understand their biology.

This could potentially help personalise cancer treatment, they suggest, with hopes that patients could one day forego biopsy completely as doctors would be able to study tumours from scan images the same way they would under a microscope.

For the study, led by a team at the Royal Marsden NHS Foundation Trust, 12 patients with suspected etroperitoneal and pelvic sarcomas (RPS) – a rare group of soft tissue tumours that develop in the pelvis and the back of the abdominal cavity – were given smart biopsies.

Dr Edward Johnston, consultant interventional radiologist at The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, London, told the PA news agency: “Current biopsy just involves sampling one region rather than multiple regions. Secondly, it doesn’t have a very detailed MRI acquisition beforehand. So we want to make it a lot more thought out.”

The team is now exploring expanding the technique for other tumour types.

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Source: The Independent, 9 January 2025

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'Patients are collapsing in the waiting room': A&E nurses speak out

The NHS is experiencing intense winter pressure, with critical incidents declared at a dozen hospitals across the UK by Wednesday.

The BBC has spoken to nurses dealing with demand in A&Es. "Patients are collapsing in the waiting room. It's just hectic," Lorraine, a nurse in Birmingham, told BBC Radio 5 Live on Tuesday.

"There's women that are 90 that have been waiting for a bed for 24 hours," she said. "We try our best but if there's no beds what can we really do? We just make the old lady as comfortable as she can, just make sure that she's okay. But there's no beds."

She said she felt sorry for paramedics who due to the lack of space in hospitals are being forced to hold patients on board for a long time. "And then when we do get them in they need a bed and there isn't one. It is really bad."

Prime Minister Sir Keir Starmer visited a hospital in London's south-east on Monday, revealing a new plan involving the private healthcare sector to help reduce waiting times for appointments.

But nurses like Lorraine say he needs to witness the reality of emergency wards currently. "The prime minister should actually sit in the waiting room, see the abuse that we get, the poor old ladies and pensioners, the young people that are trying to kill themselves, people collapsing, people having cardiac arrests in the waiting room," she said.

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Source: BBC News, 8 January 2025

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Mum told to give seriously ill son painkillers amid ambulance delay

The mother of a Belfast man, who collapsed outside a hospital, said she was shocked when a 999 call handler told her he should take painkillers as they would have to wait hours for an ambulance.

Brian Rooney, 35, suffered a heart attack outside the Royal Victoria Hospital's emergency department after his bowel had perforated at home.

He is now in an induced coma following emergency surgery, which resulted in the removal of his intestine.

The Northern Ireland Ambulance Service (NIAS) apologised to Mr Rooney and his family "for not meeting their expectations in terms of the care provided to him".

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Source: BBC online, 8 January 2025

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Breakthrough drugs herald ‘new era’ in battle against dementia, experts predict

Pills that prevent Alzheimer’s disease or blunt its effects are on the horizon, as the fight against dementia enters a “new era”, experts have said.

Scientific advances were on the cusp of producing medicines that could be used even in the most remote and under-resourced parts of the world, thereby “democratising” care, said Jeff Cummings, professor of brain science and health at the University of Nevada.

An estimated 50 million people live with dementia globally, more than two-thirds of them in low- and middle-income countries.

In 2024, the first drugs that can change the course of Alzheimer’s disease entered the market. Eisai and Biogen’s lecanemab and Eli Lilly’s donanemab were approved by medicine watchdogs in many western countries, including the UK and US.

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Source: Guardian, 8 January 2025

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Patients facing two-day waits in A&E

Patients at Royal Liverpool University Hospital's accident and emergency unit have been facing waits of up to 50 hours.

Liverpool University Hospitals NHS Foundation Trust has declared a "critical incident" due to "exceptionally high demand" on services and urged people to only go to A&E in a genuine medical emergency.

The hospital said it was "extremely busy" amid a rising number of patients with flu and other respiratory conditions, prompting Liverpool Riverside Labour MP Kim Johnson to call on the government to immediately come up with a plan to increase NHS funding.

Critical incidents have also been declared in the East Midlands, Birmingham, Devon, Cornwall, Northamptonshire and Hampshire.

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Source: BBC online, 7 January 2025

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Private sector’s role in cutting NHS waiting lists in England to rise by 20%

Private hospitals will provide NHS patients in England with as many as a million extra appointments, scans and operations a year as part of the government’s drive to end the care backlog.

Keir Starmer unveiled the NHS’s growing use of private healthcare in a major speech on Monday in which he set out his new elective reform plan to address a waiting list for planned care on which 6.4 million people are waiting for 7.5m treatments.

Private operators will receive an extra £2.5bn a year in government funding, taking the total to almost £16bn, if they deliver the uplift in care and treatment the prime minister outlined. The initiative is a key element in a plan intended to ensure that patients no longer have to wait more than 18 weeks for non-urgent hospital care by spring 2029.

Starmer said in his speech that he would not let critics of NHS privatisation stop him relying more heavily on the independent sector, because people’s health needs must come first.

“When the waiting lists have ballooned to 7.5m, we will not let ideology or old ways of doing things stand in the way of getting people’s lives back on track.

“It would be a dereliction of duty not to use every available resource to get patients the care they so desperately need,” he said.

But the co-chair of Keep Our NHS Public, Dr Tony O’Sullivan, said the private sector was a parasite that was damaging the health service and that it would lose out as a result of the deal because its own staff would provide most of the expansion of private care.

“Just as in the 2000s, the NHS could provide those million appointments and build sustainable capacity if funding was invested to reopen theatres, provide equipment, support more NHS GPs, community and hospital staff,” he said.

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Source: The Guardian, 6 January 2025

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UK cut health aid to vulnerable nations while hiring their nurses, research finds

The UK cut health aid to some of the world’s vulnerable countries at the same time as recruiting thousands of their nurses, in a “double whammy” for fragile health systems, new analysis has found.

The Royal College of Nursing (RCN), which carried out the research, said Labour had a “duty to fix” aid cuts imposed by the previous government, and to work on increasing the UK’s domestic supply of nurses.

Between 2020 and 2023, direct UK aid for health-related projects in “red list” countries – those with the most severe workforce shortages – fell by nearly 63%, from £484m to £181m.

Spending on projects designed to strengthen the healthcare workforce in those countries fell by 83%, from £24m to £4m.

At the same time, the number of nurses from these countries on the UK’s national register rose sharply. There were 11,386 registered in September 2020, and 32,543 in September 2024.

Professor Nicola Ranger, RCN general secretary and chief executive, said: “Cuts to aid may have been the previous government’s idea, but it is now this government’s duty to fix it.

“Recruiting heavily from the same countries from which we have deprived aid is a double whammy for some of the world’s most fragile healthcare systems. But it is also a damning indictment of successive governments’ unwillingness to properly fund and grow our own domestic nursing profession.”

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Source: The Guardian, 6 January 2025

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More breast cancer cases found when AI used in screenings, study finds

The use of artificial intelligence in breast cancer screening increases the chance of the disease being detected, researchers have found, in what they say is the first real-world test of the approach.

Numerous studies have suggested AI could help medical professionals spot cancer, whether it is identifying abnormal growths in CT scans or signs of breast cancer in mammograms.

However, many studies are retrospective – meaning AI is not involved at the outset – while trials taking the opposite approach often have small sample sizes. Important, larger studies do not necessarily reflect real-world use.

Now researchers say they have tested AI in a nationwide screening programme for the first time, revealing it offers benefits in a real-world setting.

Prof Alexander Katalinic, a co-author of the study from the University of Lübeck in Germany, said: “We could improve the detection rate without increasing the harm for the women taking part in breast cancer screening,” adding the approach could also reduce the workload of radiologists.

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Source: The Guardian, 7 September 2025

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Elderly patients' five-day wait in 'intolerable' A&E

Two elderly patients have been in the emergency department (ED) of the Royal Victoria Hospital (RVH) in Belfast for more than five days, BBC News NI can reveal.

This comes after more than 500 patients were unable to be discharged from Northern Ireland's hospitals on Sunday night, despite being medically fit.

With no suitable care for them in the community, it meant they remained in beds preventing other sick people from being admitted to hospital wards.

Lead nurse Claire Wilmont said that staff in the RVH were "treating the most vulnerable elderly sick patients in an intolerable environment".

At 17:00 GMT on Monday, 1,052 people were in Northern Ireland's nine EDs, up from 797 on Sunday night.

There were 349 people who had waited more than 12 hours.

The Department of Health said longer-term solutions required sustained investment and reform.

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Source: BBC News, 6 January 2025

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Cases double in NHS trust death and injury investigation

A police investigation into allegations of preventable deaths and injuries at an NHS trust has doubled the number of cases it is looking at, BBC News can reveal.

The claims centre on care and treatment provided by University Hospitals Sussex NHS Trust between 2015 and 2021.

Sussex Police started looking in 2023 into an initial 105 cases, but BBC File On 4 Investigates has learned that number is now more than 200.

The force says the investigation is "active and ongoing", but it will "not be providing specific details around case numbers at this time".

Police became involved after two whistleblowers raised allegations of medical negligence at two of the trust's departments - neurosurgery and general surgery, including concerns about at least 40 deaths.

The increase in cases is linked to more families having contacted the police.

Separate to this investigation, the BBC have spoken to the family of a patient who allege they were "lied" to by a senior surgeon in the trust's general surgery department, before he carried out an operation that left her with life-threatening injuries.

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Source: BBC News, 7 January 2025

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Royal Liverpool Hospital declares critical incident over soaring flu cases

A major hospital has declared a critical incident following a surge in flu and other respiratory illnesses across the region.

Royal Liverpool Hospital declared the incident due to “exceptionally high demand” over patients being admitted to emergency services wards.

It comes after it was reported patients were facing waits of up to 50 hours at the hospital’s emergency department.

A critical incident is declared after a hospital temporarily or permanently loses the ability to deliver critical services or where patients have been harmed - requiring support from other agencies, according to NHS England.

A University Hospitals of Liverpool Group spokesperson said: “We have seen an increasing number of people with flu and respiratory illnesses in our emergency departments in recent weeks.

“Given the exceptionally high demands on our Emergency Department, especially with flu and respiratory illnesses, and the number of patients, we have taken this action to support the safe care and treatment of our patients, which is our absolute priority.”

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Source: The Independent, 7 January 2025

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The shocking scale of bed-blocking in NHS hospitals - and it is costing the NHS billions

The drive to cut NHS waiting lists is being hampered by bed-blockers who now cost taxpayers more than £2billion a year, a study reveals.

More than 12,000 hospital beds every day are occupied by patients who no longer have a medical need to remain but are unable to leave.

The huge scale of the crisis - equivalent to closing 26 entire hospitals - is forcing managers to cancel operations and fuelling ambulance delays as there are so few beds for new admissions.

A total of 15.7million bed days have been lost to bed-blocking over the past three-and-a-half years, according to new analysis of NHS figures.

This averages 12,008 beds per day over the study period but the problem has significantly worsened during this time - soaring 59% from an average of 8,039 per day in April 2021 to 12,772 in April 2024.

Many of those stuck on wards are waiting for a place in a care home or for a package of care to be arranged in their own home.

Charities warn the longer elderly people remain in hospital the more they deteriorate and the greater they risk they will never regain independence.

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Source: The Daily Mail, 31 December 2024

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GPs to be paid to seek consultant opinion before referring

New payments for GPs to incentivise a significant reduction in referrals are among a range of measures being announced by the prime minister in a “radical” new plan to slash the elective waiting list.

As well as a major expansion of “advice and guidance”, which involves GPs discussing cases with specialist consultants to try to avoid a referral, the government has claimed new “elective reform plan” will include ramping up activity in community diagnostic centres and “elective hubs”, and ensuring more patients are offered a choice of provider.

However, many of the details of how these changes will be achieved have yet to be revealed. Most of the planned improvements also involve initiatives which have been under way for some time, or have been previously announced. The full plan is not set to be released until Monday afternoon.

Trusts will be ordered to put “non-clinical frontline staff like receptionists on compulsory ‘customer service’ training [to ensure the NHS delivers] a new gold standard retail offer”, the Department for Health and Social Care said on Saturday.

There will also be extensive upgrades to the NHS app, including direct booking of diagnostics, to improve access, choice, and the options available while waiting.

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Source: HSJ, 5 January 2025

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Ten-year plan development ‘lacking diversity’

Government must “move quickly” to address a lack of diversity in responses to its 10-year plan consultation, an adviser on the work has warned.

Health and social care secretary Wes Streeting admitted last month that several groups have been heavily under-represented in the high-profile online engagement exercise, which began in October.

Just 1% of responses are from Black African, Caribbean and Black British groups, who make up 4% of England’s population, while 3% are from an Asian background, who represent 10% of the population.

Mr Streeting, acknowledging these “disparities and inequalities” to the Commons health and social care committee last month, said: “I want to nail [them] in the rest of this consultation period.”

Jacob Lant, CEO of service user group National Voices and lead of one of the 10-year plan policy workstreams, said: “The public engagement exercise has been very ambitious in both its scale and speed, and it is good to see the [Department of Health and Social Care] actually investing in this sort of activity to ensure policy decisions are based on what matters most to patients.

“It’s also encouraging the [health and social care secretary] is in reflective mode and is acknowledging the groups who have not had their say so far. It’s vital the process moves quickly now to fill those engagement gaps, and with the right support the VCSE sector can play a vital role in helping the government reach key communities over the next few months as the 10-year plan takes shape.”

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Source: HSJ, 3 January 2025

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Ambulance handover delays in England may harm 1,000 patients a day

More than 1,000 patients a day in England are suffering “potential harm” because of ambulance handover delays, the Guardian can reveal.

In the last year, 414,137 patients are believed to have experienced some level of harm because they spent so long in the back of ambulances waiting to get into hospital. Of those, 44,409 – more than 850 a week – suffered “severe potential harm”, with delays causing permanent or long-term harm or death.

In total, ambulances spent more than 1.5m hours – equivalent to 187 years – stuck outside A&Es waiting to offload patients in the year to November 2024, the Guardian investigation found.

Experts said the figures were “staggering” and showed how the NHS was in a more “fragile” state than ever before, amid a “perfect storm” of record demand for A&E, soaring numbers of 999 calls, and an increasingly sicker and ageing population.

The analysis of NHS data by the Guardian and the Association of Ambulance Chief Executives (AACE) highlights the huge scale of the challenge facing Keir Starmer as he prepares to set out how he plans to rescue the NHS.

Anna Parry, the managing director of AACE, which represents the bosses of England’s 10 regional NHS ambulance services, said the data “speaks for itself”.

She added: “These figures underline what the ambulance sector has been saying for a long time – that thousands of patients are potentially being harmed every month as a direct result of hospital handover delays.”

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Source: The Guardian, 5 January 2025

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NHS App upgrade to give patients more choice over treatment

Plans for an upgraded NHS App to allow more patients in England to book treatments and appointments will be part of a package of measures unveiled by the government on Monday.

The changes will allow patients who need non-emergency elective treatment to choose from a range of providers, including those in the private sector.

But the British Medical Association (BMA) said there was a risk the policy would "discriminate or alienate" patients who did not have access to digital technology.

Health Secretary Wes Streeting told the BBC on Sunday: "The NHS needs investment, but it also needs reform, otherwise we will not break this cycle of annual winter crises."

The plan will set out how the government intends to meet one of its key election pledges - for more than 9 in 10 patients to have their treatment or be signed off within 18 weeks of a referral by the end of this parliament.

Announcing the plan, he said the move would shift the NHS "into the digital age" and help cut waiting times "from 18 months to 18 weeks".

The app would "put patients in the driving seat and treat them on time", and they would be "put in control of their own healthcare", the health secretary said.

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Source: BBC News, 5 January 2025

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Government unveils plan to cut NHS waiting list backlog

The government has unveiled a new pledge to cut the list of patients waiting more than 18 weeks for NHS treatment in England by nearly half a million over the next year.

The plan will expand access to Community Diagnostic Centres and surgical hubs, alongside reforms designed to enhance patient choice and tackle inefficiencies.

Prime Minister Sir Keir Starmer said it would create millions more appointments and "deliver on our promise to end the backlogs".

A key Labour election pledge, now included in the government's six main priorities, is for 92% of patients to begin treatment or be given the all-clear within 18 weeks by the end of this Parliament.

This has been an official NHS target for some time, but has not been met since 2015. Currently, only 59% of patients meet the 18-week target, with three million people waiting longer.

The latest promise is to reach 65% by March 2026, which, according to the government, would reduce the backlog by more than 450,000.

A network of Community Diagnostic Centres, which provide appointments such as scans and endoscopies in local neighbourhoods, will extend their opening hours to 12 hours a day, seven days a week.

GPs will also be able, where appropriate, to refer patients directly to these centres without requiring a prior consultation with a specialist doctor.

More surgical hubs will be created to focus on common, less complex procedures, such as cataract surgeries and some orthopaedic work. These hubs are ring-fenced from other parts of the hospital to ensure operating theatre time is not lost if there are emergency cases.

The new plan says that one million unnecessary appointments per year will be freed up for patients who need them. This will be made possible by abolishing automatic review appointments after treatment and only offering them to patients who request them.

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Source: BBC News, 5 January 2025

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Wes Streeting to scrap over a million ‘pointless’ hospital appointments

Wes Streeting has vowed to scrap more than a million “pointless” NHS hospital appointments as he seeks to cut waiting lists.

The Health Secretary said that “waste of time” hospital check-ups could be scrapped, which would free up consultants to carry out more operations.

Officials say that around half of these routine check-ups could be phased out by making greater use of smart watches and wearable tech to monitor patients’ blood pressure levels remotely.

The NHS plans will increasingly scrap the use of routine follow-up appointments after elective surgery – putting the onus on patients to decide if they need further checks.

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Source: The Telegraph, 5 January 2025

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