Ransomware attacks: 29,000 infections in China as working week begins - live updates

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Businesses and NHS brace for fresh impact as minister blames Labour for UK’s cyber-security failings

• Did you pay money as a victim of ransomware?

1.32pm BST

Russia had nothing to do with a massive global cyberattack, President Vladimir Putin said Monday, criticising the US intelligence community for creating the original software, AFP reports.

“As for the source of these threats, Microsoft’s leadership stated this directly, they said the source of the virus was the special services of the United States,” Putin said.

1.15pm BST

Three hospitals in Ireland have been targeted by the cyber attack.

Health chiefs blocked external communication to servers until Wednesday to stop the spread of the “ransomware” virus as officials confirmed that up to 20 computers had been affected.

1.08pm BST

The health secretary, Jeremy Hunt, has broken his silence on the cyber- attacks after pressure to comment.

He said there has not been a second wave of cyber attacks after the NHS was struck by ransomware attacks on Friday, PA reports.

1.06pm BST

Thousands of NHS computers were still using the old Windows XP operating system, the government has revealed, though a Number 10 spokesman insisted other Windows’ systems were also affected.

The prime minister’s spokesman said the NHS had updated the vast majority of its systems but just under 5% were still operating Windows XP.

1.06pm BST

Health trusts across England were sent details of an IT security patch that would have protected them from the crippling ransomware attack, NHS Digital said.

NHS Digital, the arms-length body of the Department of Health that provides information, data and IT systems for the NHS, said it had made health trusts aware last month of IT protection that could have prevented the attack.

12.01pm BST

The French government cyber security agency ANSII knows of “fewer than 10” French companies that have fallen victim to a global hacking attack that hit car factories, hospitals and other organisations in about 100 countries, an ANSII spokesman said on Monday.

11.39am BST

The Prime Minister’s official spokesman has defended health secretary Jeremy Hunt’s lack of public statements or appearances since the cyberattack on Friday.

“This is an international cyber crime, committed on an unprecedented scale.

11.15am BST

Theresa May has rejected claims the government ignored warnings the NHS was vulnerable to a possible cyber security attack.

The Prime Minister said warnings had been given to hospital trusts.

11.15am BST

If you paid money as a victim of ransomware we’d like to hear from you. How much were you asked to pay? Why did you decide to pay the ransom? What happened afterwards? We’d also like to hear the experiences of those who paid in other recent attacks.
You can share your stories with us – anonymously if you wish – by filling in our form here.

11.04am BST

Few major problems have been reported in India with the hea of the government response team saying “everything seems to be normal, so far”, AP reports.

Experts estimated 5% of affected computers were in India, with the Computer Emergency Response Team of India issuing a red-colored “critical alert”.

10.42am BST

Microsoft’s top lawyer has called on governments around the world to treat the international cyber attack as a “wake-up call” as he laid part of the blame at the door of the US administration, PA reports.

Brad Smith, the technology firm’s president and chief legal officer, criticised US intelligence agencies the CIA and the National Security Agency (NSA) for “stockpiling” software code which could be exploited by hackers.

10.29am BST

“Hundreds of thousands” of Chinese computers at nearly 30,000 institutions including government agencies have been hit by the global ransomware attack, a leading Chinese security-software provider has said.

The enterprise-security division of Qihoo 360, one of China’s leading suppliers of anti-virus software, said 29,372 institutions ranging from government offices to universities, ATMs and hospitals had been “infected” by the outbreak as of late Saturday, AFP reports.

10.16am BST

Blackpool Teaching Hospitals NHS Foundation Trust, NHS Blackpool Clinical Commissioning Group (CCG) and NHS Fylde and Wyre CCG are still experiencing some IT problems.

They said services are open and operating “as best as possible” but asked patients only to attend A&E in life-threatening and urgent cases.

9.58am BST

The Royal Liverpool and Broadgreen University Hospitals Trust reported their IT system had not been attacked and was operating normally.

Likewise the Pennine Acute Hospitals NHS Trust, which runs hospitals in Manchester, Oldham and Rochdale, said they had not been affected by the attack but had taken precautionary measures to protect their IT systems.

9.58am BST

The Southport and Ormskirk Hospital NHS Trust said patient safety is being “maintained” but difficulties are continuing.

Patients scheduled to have operations today have been asked not to attend hospital unless they have been contacted directly.

9.53am BST

European governments and companies appeared early Monday to have avoided further fallout from a crippling global cyberattack, the police agency Europol said.

“The number of victims appears not to have gone up and so far the situation seems stable in Europe, which is a success,” senior spokesman for Europol, Jan Op Gen Oorth told AFP.

9.40am BST

No patient data has been lost in the ransomware attack on Scottish NHS computer systems, Nicola Sturgeon has said.

Eleven health boards as well as NHS National Services and the Scottish Ambulance Service were affected Friday’s attack, PA reports.

9.30am BST

Foreign Secretary Boris Johnson, arriving in Brussels for a meeting of EU foreign ministers, said the cyber-threat was not on the agenda.

He said: “Cyber-security is a huge issue for all of us in all our countries.

9.13am BST

Three days on from the initial outbreak, fewer than a hundred victims of the WeCry malware appear to have given in and paid the ransom, according to analysis of the two bitcoin addresses to which the software demanded payment.

In order to restore encrypted files, the malware demands a payment of $ 300 in the cryptocurrency, sent to one of two addresses hardcoded into the software. Yet the contents of the addresses, which like all bitcoin wallets are publicly viewable, shows just under 14 bitcoin has been sent to them in total. At current exchange rates, that is worth slightly under $ 25,000, suggesting just 82 victims have paid the ransom.

8.46am BST

Jeremy Hunt was warned last summer that the NHS was failing to prioritise cybersecurity and continued to use obsolete computer systems, the Times reported.

The Care Quality Commission and Dame Fiona Caldicott, the national data guardian, wrote to the health secretary to point out a worrying “lack of understanding of security issues” and that “the external cyberthreat is becoming a bigger consideration”.

8.23am BST

York Teaching Hospital NHS Foundation Trust, which was hit by the attack on Friday, said some out-patient appointments had been cancelled on Monday – especially at Selby War Memorial Hospital – but most were not affected.

The trust said bone scan appoints had been cancelled in Scarborough and in Selby: “All outpatient appointments are cancelled except blood-taking and MSK physiotherapy.”

8.22am BST

The British cybersecurity researcher described as an “accidental hero” for halting the global spread of the ransomware attack has spoken of his fears for his safety after a number of media outlets revealed his identity.

The 22-year-old, who tweets as @malwaretechblog, told the MailOnline: “In future someone might want to retaliate – they could find my identity within seconds.

8.15am BST

Meanwhile in Japan, AP reports the ransomware attack hit computers at 600 locations but appeared to cause no major problems as Japanese started their workday Monday even as the attack caused chaos elsewhere.

Nissan Motor Co. confirmed some units had been targeted, but there was no major impact on its business.

8.12am BST

As the UK wakes up on Monday braced for fresh impact as NHS returns to work, Chinese state media say more than 29,000 institutions across China have been infected by the global “ransomware” cyberattack, AP reports.

Xinhua News Agency reports that by Saturday evening, 29,372 institutions had been infected along with hundreds of thousands of devices. It cited the Threat Intelligence Center of Qihoo 360, a Chinese internet security services company.

8.10am BST

Welcome to live coverage of the fallout from last Friday’s ransomware attack.

Ben Wallace, UK security minister has been on BBC Radio 4’s Today programme defending its record on investment in cyber-security.

Continue reading…

Ransomware attacks: 29,000 infections in China as working week begins - live updates

Quarter of adults in England "get less than half hour of exercise a week"

One in four adults in England get less than 30 minutes of exercise a week, with women more likely to be inactive, a report shows.

NHS Digital’s annual review of obesity in England also found high levels of obesity among adults and children, with only around a quarter of adults eating the recommended five portions of fruit and vegetables a day.

Twenty six per cent of all adults were classified as inactive (undertaking fewer than 30 minutes of physical activity a week), with women more likely to be inactive (27%) than men (24%).

People who are long-term unemployed or who have never worked are most likely not to take exercise (37%), compared with 17% of those in professional and managerial jobs.

Almost a third of people in South Tyneside, Leicester, Barking and Dagenham and Rochdale are deemed to be inactive, while the lowest rates of inactivity were found in Wokingham (13%) and Brighton and Hove (14%), the report said.

In 2015, 58% of women and 68% of men in England were overweight or obese. Obesity has risen from 15% of adults in 1993 to 27% in 2015.

The prevalence of morbid obesity has more than tripled since 1993, affecting 2% of men and 4% of women in 2015.

The report also revealed high numbers of overweight children, with more than one in five in reception class (aged four to five) being overweight or obese in 2015-16, rising to more than one in three for children in year 6.

On Thursday, Public Health England (PHE) published new voluntary targets for the food industry to reduce sugar levels by 20% by 2020 in nine categories of food popular with children.

The NHS Digital report found that only 26% of adults ate the recommended five portions of fruit or vegetables a day in 2015: 47% of men and 42% of women ate fewer than three portions a day. But 52% of 15-year-olds said they hit the recommended five a day.

The data also showed there were 525,000 hospital admissions in England in 2015-16 where obesity was recorded as a factor. Two in three patients, or 67%, were female.

The data revealed, too, that 6,438 weight-loss surgical procedures were carried out.

A spokesman for the Obesity Health Alliance, a coalition of more than 40 health charities, campaign groups and medical colleges, said: “As waistlines increase, so do the chances of developing life-threatening conditions like Type 2 diabetes, heart disease and cancer, putting further strain on our already overstretched health service.

“This data is a stark reminder of exactly why we need measures like the sugar reduction programme and the soft drinks industry levy to help create a healthier environment for all.”

Dr Justin Varney, Public Health England’s national lead for adult health and wellbeing, said: “We need many more adults and children to be more physically active. Little and often makes a big difference – just 10 minutes extra walking each day can improve a person’s health and their overall quality of life.”

Chris Allen, senior cardiac nurse at the British Heart Foundation, said: “Being inactive can dramatically increase your risk of having a deadly heart attack or stroke.

“But the good news is that it’s never too late to start being more active, which can help you control your weight, reduce blood pressure and cholesterol and improve your mental health.

“The recommended 150 minutes of physical activity a week may seem like a lot, but you can break it down into 10-minute sessions and gradually build up.”

Quarter of adults in England "get less than half hour of exercise a week"

World Glucoma Week 2017 – Discover and Confront Your Glaucoma

Glaucoma is an eye disease which if left untreated can ultimately lead to vision loss. Approximately 11-67 million people worldwide suffer from this disease. In the UK alone, about 300,000 people have undetected glaucoma. To bring awareness to people about this disease and help them fight it, NRS Healthcare has prepared an educational guide and an infographic. The guide has been launched during the World Glaucoma Week 2017. This guide mostly contains information about the disease, its causes, symptoms and treatment. It is not only useful for Glaucoma patients, but also for others, so that they understand the disease and know how to avoid it.

The guide also included interview of an 81-year old lady, who has been fighting glaucoma for the past 9 years It serves as a source of inspiration for other people. Her experience with the disease and survival tactics will help other patients to live a hassle-free life.

Glaucoma is globally known as the silent thief of sight, because most Glaucoma types do not have any symptoms. It is a disease caused due the impairment of optic nerve, which usually happens when fluid builds up in front of the eye causing extra pressure in the eye, thus damaging the optic nerve. The condition if not treated properly can slowly lead to blindness over a period of time. Old people are mostly prone to this disease. Besides, people with eye injury, diabetes, migraines, and those with family history of Glaucoma are more likely to get this disease. After cataracts, Glaucoma is the second most common cause of blindness in people.

The most appropriate way to diagnose Glaucoma is to get your eyesight checked and do it regularly. However, merely checking the eye pressure won’t be enough. Your ophthalmologist should perform a complete eye exam to find any abnormality in your eye. Unfortunately, if you get diagnosed with the disease, you have to take regular medicine to prevent your vision from deteriorating. The medication is mostly in the form of eye drops and should be taken as prescribed.

To generate awareness of Glaucoma among people, NRS Healthcare is working effectively for the cause. They will also be sharing their Glaucoma guide on their blog and social media channels during the World Glaucoma Week 2017 with the aim to educate more and more people about this disease.

Zeeshan is a health journalist who writes for various health care & fitness blogs. He recently covered World Glucoma Week 2017 and worked to generate awareness about Glucoma.

World Glucoma Week 2017 – Discover and Confront Your Glaucoma

Over half of NHS staff work unpaid overtime every week, survey finds

This past year has sent shockwaves through an already challenging working environment in the NHS. From the withdrawal of nursing bursaries and junior doctors’ strikes to the uncertain impact of Brexit on 58,000 EU nationals currently working in the health service, workforce pressures continued to build for an already overstretched service.

So what do the findings of the latest NHS staff survey, released on Tuesday, tell us about how staff are coping? Covering 316 participating NHS organisations, the survey is the biggest in the world, capturing the experiences of more than 423,000 healthcare professionals across the country.

The good news is that despite the tremendous pressures the NHS faces, nearly three quarters of staff remain enthusiastic about their job, while 70% said they would be happy with the standard of care provided by their organisation if a friend or relative needed treatment. The proportion of staff who reported feeling unwell due to work-related stress is at its lowest since 2012, down to 37%.

Responses addressing another key aspect of staff motivation – feeling empowered to contribute suggestions for improving work practices – also signalled positives. More than 70% of staff said that there are frequent opportunities to show initiative in their role, and 75% reported making suggestions to improve the work of their team or department. The survey did indicate room for improvement, however. Only a small majority of staff (56%) stated that these suggestions were actually acted upon – staff feedback does not appear to always translate into tangible change.

As is to be expected in such a pressured working environment, the survey does highlight some challenges for the NHS. More than half of staff (56%) report having attended work in the last three months despite feeling unwell, due to pressure from either their manager, colleagues or themselves. This is, however, a significant improvement since 2012, when 64% attended work despite illness. Most of this pressure comes from staff themselves (92%), rather than from managers (26%) or other colleagues (20%).

Generally, staff report feeling that managers are invested in their health and wellbeing. Most say that their immediate manager takes an interest in their health and wellbeing (67%) and that their organisation more broadly takes positive action on the health and wellbeing of staff (90%). These figures are on a par with those from last year’s survey and describe a workforce committed to working together and supporting one another to deliver high quality care – one that struggles more with heavy workloads and external pressures.

A key aspect of wellbeing is maintaining a healthy work-life balance and this is another area that contains some worrying figures. Staff report being satisfied with the opportunities to work flexibly – but 59% are, on average, working additional unpaid hours each week. Overall, the proportion of staff working additional hours is 72%, indicating that not enough has been done to alleviate workloads in light of similar results in recent years. The steady increase in both paid and unpaid overtime since 2012 is concerning as research repeatedly suggests that relying on tired and over-worked staff can lead to poorer standards of care.

The results of the 2016 staff survey suggest NHS staff are showing remarkable resilience despite the huge pressures that have been placed on the system. However, with external pressures such as Brexit likely to exacerbate existing problems in future years, a concerted effort is required from the government and NHS England to ensure that the positives to be found in staff motivation and engagement this year are not lost. NHS staff are subject to immense pressures that are unlikely to ease without significant support.

• Rory Corbett is a senior research associate at Picker, a charity that co-ordinates the NHS staff survey on behalf of NHS England
  

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Over half of NHS staff work unpaid overtime every week, survey finds

Sobbing teenagers, angry staff and threats: my week in NHS payroll

Monday

I arrive at my desk just as our manager approaches a colleague suffering from back pain and asks how she’s doing. She replies that she is in a lot of pain. Our manager responds: “I’m not interested; I’m asking if you’re going to meet your deadline. If you don’t complete your work by 10am you can explain to 5,000 people that they haven’t been paid due to your failure to do your job properly.”

I am personally responsible for the distribution of millions of pounds of public money: I pay domestic, portering, maintenance, clerical, nursing and medical staff, senior managers, chief executives and apprentices. My in-tray is brimming with timesheets, expenses claims and new starters to set up.

Among the 43 emails that have arrived over the weekend, there are queries about sickness entitlements, reports of unpaid enhanced hours, and a request for a salary advance “because I’ve spent all my money”.

Tuesday

A team member announces her pregnancy. We are happy for her but it means extra work for the rest of us. Any absences for maternity, paternity, sickness, career breaks and in many cases leavers, are dealt with by sharing out the workload among those of us still present.

I check reports, set up new starters and calm a sobbing teenager who thought she’d be paid the living wage rather than apprentice rate. I have four overpayments to calculate, all due to failure by departmental managers to inform us of two leavers, a reduction in someone’s contract hours and a member of staff suspended. I have to produce a report for each to pass to NHS fraud investigators. The managers apologise to me for the extra work, but leave me to deal with their upset and angry staff.

Wednesday

I plough through a huge report detailing changes to employee records made by HR and departmental managers. To do this thoroughly would take several days but I have an hour so a perfunctory scan and crossed fingers will have to suffice.

I receive a beautiful handmade thank you card from a grateful payee I arranged an urgent payment for after her manager forgot to send us her timesheet for a whole month of night shifts. It is the second one I have received in over 20 years in the job and it will be treasured. I am happy all day.

Thursday

An angry man calls and tells me his expenses payment is wrong again; he insists his claim detailed an overnight stay in a hotel and several hundred business miles. I fax him a copy which displays 22 miles and a 60p parking ticket. He tells me his sister-in-law works in HR at our trust and will have me fired.

Not speaking my mind when my managers and people are rude to me is difficult. Senior managers tell us we are there to support them, middle managers focus on their next promotion and the line managers carry their workload. Their frustration is not reported due to a culture of fear and blame, and is instead directed at us.

A colleague has the flu but is afraid to stay off as it will trigger a sickness review: three short absences in a year, or just one long-term can lead to job loss. I make her hot drinks and cover her work for her.

Friday

An electrical fault has affected our telephone line and for once it is quiet. The peace is short-lived. When the line is repaired, people accuse me of switching off my phone to stop them getting through. I calm each one down and deal with their problems and queries. I notice it is 6.30pm and I have been working for free for the last hour – again.

Some details have been changed

If you would like to contribute to our Blood, sweat and tears series which is about memorable moments in a healthcare career, please read our guidelines and get in touch by emailing sarah.johnson@theguardian.com.

Join the Healthcare Professionals Network to read more about issues like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

Sobbing teenagers, angry staff and threats: my week in NHS payroll

Fifty-two NHS hospitals sent patients elsewhere in busiest week yet

The NHS experienced the busiest week in its history last week, with record numbers of hospitals having to send patients elsewhere or declare a major alert.

Fifty-two hospital trusts had to send ambulances elsewhere between 8 and 15 January, up from 39 the previous week and 27 in the second week of January last year, NHS England figures show.

Hospitals activate “A&E divert” plans when their emergency department is struggling with the number of patients turning up seeking care.

Sixty-eight trusts – 45% of the 152 in total in England – declared an alert last week, up from 65 the week before, in another sign that some hospitals can no longer meet demand.

NHS England said the rise was partly due to a change in how it records data, but doctors said last week was the most challenging and relentless they had ever faced.

On Monday 9 January 61 trusts issued an alert, which is thought to be the highest number ever on a single day.

Fifteen trusts were on alert continuously for 11 days in a row between 3 and 13 January. They included trusts in Stoke-on-Trent and in Copeland, Cumbria, where two parliamentary byelections are due.

Overall, England’s 152 acute NHS trusts – which between them run about 250 hospitals – recorded bed occupancy rates of 95.8% last week, well above the 85% considered safe. That was up slightly on the 94.8% in the week after the new year holiday weekend.

On Tuesday 10 January bed occupancy across England hit 96.4%, 15 trusts were full and another 24 had five beds or fewer free for patients who needed to be admitted as an emergency.

Fifty-two NHS hospitals sent patients elsewhere in busiest week yet

Digested week: Trump showers satirists with gifts

Monday

Even if it was primarily intended as a diversionary tactic to stop people asking her about Brexit for a few days, it was good to hear Theresa May talking about making mental health a priority. Though I couldn’t help thinking her words might have sounded a little more sincere if she had offered a little more than the £1bn for mental health services that David Cameron had promised, but never delivered, in an almost identical speech the year before. Under the Conservative and coalition governments there have been 4,000 fewer nurses and 600 fewer doctors working in mental health. I consider myself fortunate to have been able to pay for my all-too-frequent visits to psychiatrists and therapists over the past 30 years; without that ability, I dread to think what would have happened to me. Or if I would still be around. But I’m all too aware that many people aren’t that lucky, and either have to struggle on alone or wait a long time to get help. By which time for some it will have been too late.

Tuesday

The last that I – and most others – saw of Dominic Cummings, the eccentric former special adviser to Michael Gove and passionate advocate for Brexit, was at his remarkable appearance before the Treasury select committee during the EU referendum campaign. He got things off to a bad start by telling the chair, Andrew Tyrie, how busy he was and that he had to get away early. He then refused to engage with the committee’s concerns about the accuracy of Vote Leave’s figures. “It’s only a couple of decimal points,” he shrugged petulantly. “There’s quite a few decimal points between £33bn and £16bn,” Tyrie observed. At which point Cummings started muttering about Tyrie chatting to his wife in his slippers, just in case he hadn’t been offensive enough already. But now Cummings has partially re-emerged, having written a detailed blog about the Vote Leave campaign. Much of it is very entertaining but, perhaps not surprisingly, some of it doesn’t ring entirely true. He insists that both Boris Johnson and Gove could barely contain their excitement the morning after the referendum. That doesn’t quite square with the impression left with those of us who attended their joint press conference. Johnson acted like a mute zombie while Gove looked like someone who had come down off a bad trip to discover he had murdered his best friend.

Wednesday

Fifa has come in for a lot of criticism for expanding the World Cup from 32 to 48 countries from 2026. Having just under a quarter of all the world’s countries qualifying for the finals does seem rather excessive – though maybe not if you’re Scottish as your team will probably still struggle to make the cut. I suspect the increase in numbers has more to do with lining Fifa’s pockets than making football more inclusive. But at least one good thing should come out of it – the 2026 Panini sticker album should be the biggest yet. Panini began making sticker albums for the 1970 World Cup and it was rather a low-key affair. For a start only 16 teams appeared in the finals and Panini didn’t even bother to print stickers for all the players; teams like Israel and Peru were designated a squad of just 11 players. Still, if you’re like me, you’re sitting on a completed 1970 album your nerdiness has paid off to the tune of about £1,500. By Rio 2014, the number of stickers had expanded well into the 600s and for 2026 we might even get past the 1,000 mark.

Thursday

What with the coalition, the Scottish referendum, the 2015 general election and Brexit it’s been a good few years to be a political sketch writer. Scarcely a week has gone by without at least one politician managing to embarrass themselves. This week we had Theresa May slagging off the Red Cross and Jeremy Corbyn contradicting himself at least three times on the same day of what was supposed to be his relaunch. But part of me would love to be in the US right now. Donald Trump may not be great for the US but he’s a gift to satire. The president-elect’s Twitter feed is a goldmine in itself. With Trump there is no filter; he just wakes up in the night and tweets the first thing that comes to mind. No British politician would dare having a pop at Judi Dench the way Trump went for Meryl Streep. More’s the pity. Then there was THAT press conference. If a British politician was caught up in a sex scandal – made up or not – he or she would first try to ride it out in silence and when pushed make a brief two-minute statement with no questions. Trump went for it big time. On and on he went, shit-bagging any member of the press who happened to have upset him and trotting out “germaphobe”’ – a word that once heard can never be forgotten. It was the best of times, it was the worst of times.

Friday

There’s no part of an MP’s life that goes unrecorded these days. A new organisation, Polimonitor, has taken to counting the number of swear words used by MPs on Twitter. Excluding retweets MPs swore 256 times in 2016, with Labour taking up six of the top 10 places. Perhaps that’s a sign their opinion poll ratings are getting to them. The sweariest MP was Jamie Reed, who has already announced his resignation, with 20. Mike Dugher was second equal with 17. The top Tory was Nicholas Soames, also with 17. It was Brexit that did it for him. Labour’s Jess Phillips – the only woman on the list – will be disappointed to have only made it to fourth place, but not many would bet against her making a concerted effort for top spot in 2017. Perhaps the most surprising entrant was Douglas Carswell who finished in seventh place: the Ukip MP is one of Westminster’s more sensitive souls and usually takes to blocking anyone who doesn’t understand his brilliance rather than swearing at them. I got blocked by him long ago. Still, Carswell’s language might be severely tested if Nigel Farage contests and wins the Stoke byelection following Tristram Hunt’s resignation to become director of the V&A. Carswell and Farage hate each other far more than they do the Tories or Labour and won’t be pleased at having to sit next to each other in Westminster.

Digested week: Snow and showers.

Digested week: Trump showers satirists with gifts

NHS crisis: 40% of hospitals issue alert in first week of new year

More than 40% of hospitals had to declare an alert in the first week of January because they were experiencing major problems caused by having too many patients and too few spare beds.

Figures released by NHS England on Friday also show that 32 people have died from flu so far this winter and scores of others had to be treated in intensive care last week alone.

The data reveals that hospitals in England came under huge pressure in the first week of the new year. Serious levels of overcrowding worsened to levels generally regarded as dangerously high.

Overall, 95% of hospital beds were full from 2-8 January, up from 91% the week before.

A&E units became so busy they had to divert patients to other emergency departments 39 times, slightly fewer than the 42 a week earlier.

Bed shortages were exacerbated by outbreaks of norovirus, the diarrhoea and vomiting bug, forcing hospital managers to close 933 beds that were occupied and another 164 that were empty, making a total of 1,197 – almost one in 100 of the NHS’s total supply of 130,000 beds.

In that week, 58 of England’s 153 acute hospital trusts had to go on to what NHS England calls an Opel 3 alert and eight on to the highest form of alert, Opel 4. Both mean trusts are struggling to cope with the weight of demand.

Both take their name from NHS England’s Operating Pressures Escalation Levels framework. It sets out what steps trusts should take to manage the large numbers of patients.

The 58 trusts that went on Opel 3 alert did so because, according to guidance form NHS England, they were “experiencing major pressures compromising patient flow” – their ability to get patients in and out quickly enough – and needed to take “urgent actions” to keep functioning.

Eight went on Opel 4, also known as black alert, after becoming so stretched they were “unable to deliver comprehensive care” and there was “increased potential for patient care and safety to be compromised”.

A total of 375,687 people sought help at an A&E unit in the first week of January, up from 371,599 the week before. However, the number of people who needed to be admitted as an emergency fell from 92,480 to 89,712.

The Guardian reported this week that close to 30 trusts had been forced to declare a black alert since Monday, suggesting that already severe pressure on the NHS intensified this week.

NHS England has warned that the current spell of freezing weather could trigger a rise in the number of people falling seriously ill and also interfere with the running of services.

“This weather could increase the health risks to vulnerable patients and disrupt the delivery of services,” it said.

Prof Paul Cosford, Public Health England’s director for health protection and medical director, said people should keep their homes heated to at least 18C (64F), wear lots of thin layers rather than fewer thicker ones, and wear footwear with a good grip to cope with the snow and ice in many part of the country.

NHS crisis: 40% of hospitals issue alert in first week of new year

"The worst conditions in memory": NHS doctors describe their week in A&E

The Guardian asked a number of doctors working in A&E departments across the country to explain how their departments have coped over the past seven days, said to have been the worst week ever for NHS emergency departments. These are some of their responses:

‘We are devastated by underemployment’

It’s been like an absolute war zone recently. The government at the moment, not to mention my regulatory bodies, are ignoring the worst hospital conditions in my memory. We have a brilliant team, but are devastated by underemployment and underinvestment. We have two permanent registrars on a rota of seven places.

On a recent shift, I walked in to patients waiting four and a half hours to see a doctor. This means every patient has failed the “breach” target by the time they’re seen. A diligent staff nurse asked me to take a look at a patient she was a ‘bit worried about’. The woman was devastatingly ill with a perforated bowel, and could have easily become fatally unwell. She survived thanks to the observational diligence of my colleague, and later our excellent surgical team.

The London ambulance service is similarly overwhelmed. They couldn’t provide me with a transfer ambulance for another emergency case, and 11-year-old with a sight-threatening infection, in less than 70 minutes. The target is eight minutes. It is a miracle the child didn’t lose an eye.”

‘Nothing can be done’

Our hospital is crumbling and is unsafe on a daily basis. On Thursday, there were 75 patients in an department that has 18 majors’ beds. Thirty-five of those were medical patients awaiting beds, 20 hadn’t been seen as there was nowhere to see them or no staff to triage them.

We have expressed our concerns verbally, via formal emails to trust, incident reports etc, but nothing can be done as it can’t elsewhere either. Medical professionals are talking about quitting as they believe soon someone will die on our watch … [It is] completely out of control. Maybe it has already happened and we just don’t know. I’m talking about a cohort of 11 doctors. God knows what people feel nationally. It scares me what we are heading for.

When a family member got admitted last weekend I panicked, not because it was that serious but I actually felt they may not be safe in hospital.

I am angry that it is being ignored and swept under the carpet. I am angry that we are left to pick up the pieces and apologise for a system we’ve put our hearts and souls into, but now have no control over.

‘It’s not acceptable to practise medicine in this way’

This past week in A&E has been horrendous. There are no beds in this busy teaching hospital. There are more than 20 patients queueing in the corridor at any given time. We’re seeing, treating and discharging patients in the queue. It’s undignified to ask a miscarrying pregnant woman about her blood loss in a queue, never mind in one filled with loud drunks. It’s just not acceptable to have to practise medicine in this way, but what choice do we have?

Patients in the queue have a substandard quality of care. Fact. So much for calling 999 in an emergency, then waiting an age for the crew to arrive because they’re all waiting in the corridors of A&E to unload patients. Even once you arrive at the department with said emergency, you’ll be waiting hours for any sort of assessment or treatment. My collusion in this depravity is solely in an attempt to keep my patients as safe as possible, but mistakes are being made and this is not sustainable.

‘We were truly swamped’

I was on call at night for the last week at a small district general hospital. We had to put the hospital on divert. There were 15 ambulances waiting for entry and consultants doing their assessments in the back of them. On surgery, despite phenomenal work from the registrar on call, we were truly swamped.

‘These are just some of my experiences this week in A&E …’

A four-bedded resus unit expected to make capacity for eight patients; leaving a shift to come back 24 hours later and finding some of the same patients still in resus; being in charge of the emergency department [ED] overnight with rota gaps; and requesting a divert for a few hours to allow us to catch up, only to be told that the policy has changed and capacity issues now had to be dealt with internally.

‘Everybody is terrified’

In the accident and emergency department where I work there is provision to keep up to 12 people overnight in case the wards are too full. On Tuesday night there were 27 sick patients all requiring hospital treatment who were kept on corridors and in the laundry room, being cared for by three nurses and one doctor.

It’s normal at the moment for 20 to be there overnight. We are having to send patients home we would rather admit, with little to no access to social care. Everybody is terrified. Everybody is waiting for something terrible to happen, because no matter how hard you work, there are too many cracks that are widening for patients to slip through. Stafford is where everything went down a few years ago. It seems the same situation is now happening on a nationwide level. I hope desperately that nobody I love or care about needs to be admitted to hospital right now. I just can’t believe how bad it is compared to last year.

‘The entire system is crumbling’

There are not enough staff and 12 ambulances regularly sitting in the corridor. There are designated corridor nurses. In this ED the patients can wait for eight hours. The emergencies do get seen first, as do the strokes, and the triage nurses pull the sickest out the corridor but sometimes they are seen in the corridor. A consultant is designated for the corridor to ensure safety.

A consultant has been staying overnight often lately due to the safety concerns, but that is unsustainable and they are burning out. No one is bothered about breaches anymore, it’s the 12-hour trolley waits because the CCG [clinical commissioning group] has to know then and trust board get involved. The entire system is crumbling. On New Year’s Eve our hospital asked for a divert when the wait was eight and a half hours with only 14 ambulances left on the roads in Merseyside. This is not uncommon. The divert was denied because the wait was not the longest, and every other department was in the same situation.

‘We have a daily lack of beds’

I’m a registrar in one of the busiest emergency departments in the country. This past week saw our busiest day on record with nearly 200 people waiting in our department at one point. There was a five-hour wait just to be seen, and a 14-hour wait for beds. I have people queuing to get a space in resuscitation and it regularly becomes dangerous. We have a daily lack of beds due to poor flow of patients out of hospital backing up to the emergency department. Patients are coming to harm and there are undoubtedly deaths arising from the current state of emergency medicine.

"The worst conditions in memory": NHS doctors describe their week in A&E

Eat This Cancer-Fighting Salad Every Week (Spinach superfood salad)

Eat This Cancer-Fighting Salad Every Week (Spinach superfood salad)

The week in TV: Westworld; A World Without Down’s Syndrome; The Apprentice; Real Time With Bill Maher

Westworld (Sky Atlantic/Now TV)
A World Without Down’s Syndrome? (BBC2) | iPlayer
The Apprentice (BBC1) | iPlayer
Real Time With Bill Maher (Sky Atlantic/Now TV)

The much-vaunted Westworld, HBO’s grandiloquent bid to sew our carcasses ever more tightly into a cocoon of weekly fantasy – Game of Thrones officially runs out of breasts and dying heroes some time in 2018 – arrived with low-key splendour. Muted title sound, yet an opening sequence of such technical magnificence it looked as if it had been beamed back to us from about 2048. The fetlocks of horses were being 3D-modelled with filigree’d and granular precision, as were the noses of crooked barmen (as if there’s any other kind) and doughty sheriffs, and the very ivories of nags’ teeth and of pianolas, and suddenly we were into Westworld, a panorama of haughty big skies, aching beauty and spitefully small human dreams.

A world, in case you missed all the media hype (and where on earth were you? Possessing a life?), in which guests will pay handsomely for a week or so in a wild west in which they can go riotously tootsie: sleep with every perfumed whore, gut-shoot every sweaty dog-breath hoodlum. Even, if addled and bourbonned enough, shag the bandit and gun the girl. They’re all robots, programmed to hurt and bleed like us, but also to wake the next day mended and with no memories.

It’s an intriguing premise, of course, and, of course it will all go wrong: a sudden aberrant line of source code will risk not only the lives of the guests but, more crucially, the psyches of the androids in the park, who suddenly have twitches of memories. For the moment, we care more about the robots, who seem more human than the visitors, who cannot be physically harmed in the park: a depressing number have chosen to go all black hat with their moneyed freedom, murdering and fornicating at any whim: be advised that this is often nasty viewing.

[embedded content]

Watch a trailer for Westworld.

It could have been just another tricksy CGI fantasy. But it came from the pen of Michael Crichton, responsible for Jurassic Park, which also asked pertinent questions about humanity and technology. I would happily class Crichton with Ray Bradbury and Philip K Dick, because they also wrote wisely about ourselves: even when it might have been spuriously about robots, or dinosaurs, it was always about us. What might we do? Are we happy with discovering the people we truly are or only happy with the people we want to be? And if you can’t tell the difference between the humans and the androids, should it matter?

This is existentially and morally mired, in that it raises questions not of the narrative in itself but of us, the reader/viewer. This opener was tremendously, deliberately confusing: the good guy is a robot, the bad guy (a tremendous Ed Harris, playing the part he was born to play) a veteran vicious tourist on the hunt for darker levels, to assuage all he lacks in real life, which is shaping up as a howdy-doody lot of a lack. It’s all rather scintillating, not least because if features Borgen’s Sidse Babett Knudsen as the searingly blue-eyed head of quality assurance, off stage and chain-smoking high on the controllers’ gantry, intent not on money but simple control: of robots, the “livestock”, but also of every human around her.

Could it be a worthy successor to GoT? Absolutely. HBO has another global heavyweight on its hands, thanks to the authors: I’m hooked, in a way I never was with early Thrones. Again: this is not about robots: it’s about us. Yet every time I am tempted to worry about robots taking over the world any time before about 2416 I simply think of self-service tills. Smile my usual smile.

Most winning programme of the week was undoubtedly A World Without Down’s Syndrome?, in which Sally Phillips, with quizzical wit and just the right salting of lip-trembling anger, asked whether we’re right to hail with such a blizzard of approbation a new non-invasive test for pregnant mothers.

Halldóra, one of the few people in Iceland with Down’s, and actor Sally Phillips. Photograph: Not Known/BBC/Dragonfly

Some of the statistics were frightening. In Iceland, where they have had the test for a while, every positive diagnosis for Down’s has resulted in termination: 100% in the past five years. There are now fewer than 40,000 people with Down’s in Britain. Phillips, whose dear son Olly is one, made a passionate yet refreshingly unsentimental case for the right to have Down’s extant in this world. It’s not a disease, it’s a set of characteristics (and ones that, actually, genetically predispose the child to happiness).

Hugely set against this comes the understandable set of fears of any mother: of an inability to cope, of a child’s being bullied, even of their own prejudices. Yet Down’s remains the one disability it has become socially acceptable to “cleanse” and Sally was more than troubled (as was I) by medical professionals’ universal embracing of one and only one tenet: Down’s is always bad, choice is always good. This lucid and strangely uplifting programme should be only the very beginning of a debate we should have been busily having for about 30 years.

“I’m the business equivalent of a diamond. I can sparkle, and light up a room, but if you’re not careful I can cut you.” Was this contestant perhaps confusing “a diamond” with “scissors”? I can’t think of anyone in the history of ever who has actually been cut by a diamond. Just by the people who wear them.

The women’s team discuss how to turn a whelk stand into a pig’s ear in The Apprentice. Photograph: BBC

Yes, The Apprentice is back, complete with ol’ Lord Bearded Man-Stoat and the usual basket of deplorables. And back this year to guys v gals, an intriguing reversion that shouldn’t in an ideal world work, but does. It might be my imagination but some of the candidates seem a little more sympathetic than in recent years. Some, and it’s all relative, of course, and they managed as usual to turn a whelk stall into a pig’s ear with their first task. The women called back into the boardroom made a masterclass only of being able to turn viciously, wheel and blame each other, and regroup in nanoseconds to re-blame another other: bitchy death by scuffed Louboutin heels. Bring it on.

For those not yet driven forlorn by attemping to make sense of America, I cannot recommend highly enough Real Time with Bill Maher. Like a Democrat version of PJ O’Rourke, Maher is suave, angry, pithily funny and possessed of a fine foul mouth when necessary.

He makes no secret of his loathings for Mr Trump, the most badass black hat of this and most other years. “Welcome to another week of ‘yes, this is really happening,’” he began a more than usually confrontational show. It’s not perfect: some humour strains in the translation and I wish these shows wouldn’t always rely on visual gags that always flash up for about six seconds longer than it has taken to get the often negligible “joke”. Yet Maher, and John Oliver, proves that there’s space to manage both satire and deadly serious within the very same hour, and I wonder anew why we don’t quite have the equivalent here: a TV version of Private Eye. Eddie Mair for the job.

The week in TV: Westworld; A World Without Down’s Syndrome; The Apprentice; Real Time With Bill Maher

UK workers consume 800 extra calories a week while commuting

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Royal Society for Public Health study finds snacking on junk food largely to blame for additional consumption on work journeys

The average UK commuter consumes nearly 800 additional calories a week while travelling to and from work, often as a result of unhealthy snacking, a study has found.

The Royal Society for Public Health (RSPH), which commissioned the research, said longer commutes are potentially shortening lives by increasing stress, limiting sleep and physical activity, and encouraging unhealthy eating.

Related: Meet the supercommuters: how to survive five hours of travel every day

Continue reading…

UK workers consume 800 extra calories a week while commuting

"I prick my finger while taking blood": my first week as a junior doctor

Monday

I’m shadowing the junior doctors, whom we will replace on Wednesday. It feels very alien to answer calls with “FY1 doctor here” after being a medical student for so long. Given the recent events in the NHS over the past year regarding the junior doctors’ contract, my morale towards starting my first job is low. Today I am working on the wards along with another junior doctor. It is not too busy and we get to go home at 5.30pm. I spare a thought for our colleagues on other wards, who do not make it home until 7pm or 8pm.

Tuesday

There are normally three FY1s on call but due to sickness and annual leave there are just two of us. A lot of patients are anxious as we do not yet know what is wrong with them, when they can go home or if they need an operation. To make things worse, there are not enough slots for all of them to have their CT scans done today.

In the afternoon, I get a bleep from my registrar, asking me to come and assist in theatre. Later, my colleague and I are handed an ECG from a patient with chest pain and he goes to assess if she’s had a small heart attack. I offer to finish some more jobs for him as he is very busy with this sick patient. It has been a long day but I have felt appreciated by all members of staff I have worked with, and I am a little less nervous about tomorrow.

Wednesday

The stabilisers are off. It is the first day I am officially an FY1, along with 28 others in the hospital. My anxiety is eased by my supportive registrars who emphasise that I can call them whenever I have questions. In the midst of a high-pressure moment, I accidentally prick my finger with a needle while taking blood. Not only am I embarrassed, I have to go to occupational health and I feel guilty about leaving my colleagues with one less doctor for 45 minutes. The to-do list keeps growing so I stay an extra hour to avoid handing over too many jobs to the evening on-call team.

Related: The secret junior doctor’s diary: ‘After 40 minutes of chest compressions, we stop’

Thursday

The night on-call FY1 hands over a very sick patient on the ward as soon as I arrive. Today tests our teamwork and delegation skills, as our sick patient requires discussions with various other departments and we are all nervous about approaching senior doctors whom we are not familiar with. While we review the patient, her family arrives and my colleague and I update them on their relative’s situation. As I go to inform another patient that he needs to be started on a drip to correct some abnormal blood results, he is upset to learn he cannot go home today and I, too, wish he could be at home, without the endless intrusion of doctors and nurses.

Friday

As I am on a week of night shifts from Monday, I have today off. I may not physically be at the hospital but I can’t stop thinking about one of my unwell patients from yesterday. I take some time at home to update my online portfolio, which is a requirement for us to progress past this year and in our careers. I can’t help texting my colleague to check on the patient from yesterday. I am happy when she replies to tell me he is much better and even walking around the ward.

Before Monday, the NHS had been sold to me as an overstretched, uncaring and outdated body. It may be busy, and there may be a very steep learning curve, but I have genuinely enjoyed my first week. Among other things, the level of support I have received from my peers as well as my seniors has restored my faith in our healthcare system, and I would urge everyone to take the sensational headlines about its failures with a pinch of salt.

If you would like to contribute to our Blood, sweat and tears series which is about memorable moments in a healthcare career, please read our guidelines and get in touch by emailing sarah.johnson@theguardian.com.

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

"I prick my finger while taking blood": my first week as a junior doctor

Any Insurer Angst On Obamacare Subsidies May possibly Emerge This Week

If there is any nervousness from the overall health insurance sector in regard to the potential for specific Americans who signed up for health-related coverage on the federally-run exchange to lose coverage, it could emerge later this week.

A parade of publicly-traded overall health insurance firms are expected to report their second-quarter earnings this week and numerous of them are expected to update Wall Street analysts and investors on their expansion plans. Previously, UnitedHealth Group UnitedHealth Group has mentioned it will be doubling the number of markets the place it ideas to provide ideas on government run exchanges.

At issue is a three-judge federal appeals court panel’s ruling late week that explained insurance coverage premium subsidies paid to Americans who bought coverage under the Inexpensive Care Act through a federally-run in exchange in 36 states was illegal. The panel stated a ruling from the Inner Income Services that permits subsidies to be paid in states relying on the federal exchange was basically illegal.

Though an additional federal appellate court in Virginia contradicted the U.S. District Court of Appeals for the District of Columbia on the exact same day and there is no fast impact on these who purchased coverage through the federal exchange currently, the rulings could result in turmoil in the marketplace as well being programs are choosing in which to offer coverage and the place to broaden and industry their plans going forward.

“In the close to phrase, we expect these selections to create substantial confusion about the validity of subsidies for plans currently obtained on exchanges in the 36 states with federally run exchanges,” Fitch Ratings stated in a report final week on the contradicting court rulings. “Offsetting appeals court choices … raise uncertainty close to overall health insurance exchanges. In the close to phrase, Fitch Ratings expects current benefits to be questioned and confusion about them to lead to lower enrollment in exchange plans in 2015.”

Five main U.S. health strategies report earnings last this week. Aetna Aetna (AET) will be the first to do so when it reports its 2nd-quarter earnings on Tuesday followed on Wednesday by Humana Humana (HUM) and Wellpoint (WLP), a main operator of Blue Cross and Blue Shield programs. Cigna (CI) and Molina (MOH) also are scheduled to announce their earnings this week. UnitedHealth reported its second-quarter earnings and expansion plans earlier this month and hasn’t however announced any strategies to alter these expansions.

Most publicly-trade well being insurance firms have either raised earnings or income projections in current quarters as 8 million men and women signed up for coverage on a health insurance exchange in the course of the initial open enrollment period October 1, 2013 by way of March of this year.

Just 16 states and the District of Columbia operate their personal exchanges. Therefore, permitting the D.C. appellate court ruling to stand would eradicate subsidies and hike premiums for millions of Americans.

“Without action from the federal government almost 5 million Americans would receive an common premium improve of 76 % if the courts ultimately rule that shoppers in the federal exchange cannot obtain premium subsidies,” Elizabeth Carpenter, director at Avalere Health, a research and advisory companies firm on health policy problems monitoring the Cost-effective Care Act in a statement following final week’s court rulings.

“If the ruling is ultimately regarded and upheld by the Supreme Court, individuals purchasing insurance in states with federally-facilitated exchanges will be impacted,” Avalere’s Carpenter mentioned. “While it stays somewhat unclear how states implementing state-based exchanges but relying heavily on the federal government for exchange operations ( e.g. Idaho, New Mexico, Oregon, and Nevada) would be taken care of, customers in a bulk of states would be at chance.”

Questioning how Obamacare will influence your wellness care? The Forbes eBook Within Obamacare: The Repair For America’s Ailing Wellness Care Method answers that question and more. Available now at Amazon and Apple.

 

Any Insurer Angst On Obamacare Subsidies May possibly Emerge This Week

Can I afford a 4-day week?

Individuals must function 4 days a week, not five. That was the suggestions from one of Britain’s major physicians last week, who declared that we are working also difficult and it’s negative for our overall health. “We need to be moving towards a 4-day week, since the issue we have in the world of perform is you’ve acquired a proportion of the population who are doing work as well difficult and a proportion that have not got jobs,” said Professor John Ashton, the president of the United kingdom Faculty of Public Overall health.

Sarah Butler switched to a 4-day doing work week at the sixth-form school in which she teaches although she was studying for her master’s. She intended to make the lower in working hours – and pay – for a yr, but has now dropped to two-and-a-half functioning days since getting her son, Indie. She says she will by no means go back to a five-day week. “There is no sum of cash you can place on getting that extra day off,” she says. “I was making an attempt to do way as well considerably prior to.”

Butler is amongst individuals reducing their working hrs to enhance their good quality of daily life. Their primary factors have a tendency to be to gain a lot more time with young children to research or learn other abilities poor well being or, possibly increasingly, to minimize tension. But how sensible is dropping a day?

How hard will your finances truly be hit?

Undoubtedly, the greatest single query dealing with anyone contemplating of dropping a day (or far more) at work is, can you afford the resulting 20% shell out reduce? For a good deal of folks the drop in salary will be too considerably, but for other people, particularly these who would see their childcare and commuting bills drop, the salary cut can operate out greater than anticipated.

A lower in salary may mean you turn out to be eligible for kid advantage, which is slowly eliminated when 1 individual in the home earns more than £50,000 a yr. You could also be entitled to doing work tax credits.

“The economic implications were manageable,” says Jack Currie, a secondary college instructor who in 2010 dropped from five days to four. “My wife functions, so when I went to 4 days the fiscal drop was not disastrous – less than 10% of our mixed soon after-tax earnings.” The couple saved one particular day’s childcare fees and the alter meant that they qualified for kid advantage.

“And, of program, the tax consider on the final twenty% of your earnings is greater than on the initial twenty%, so the reduction was 20% of my gross salary, but not twenty% of my net consider-residence pay,” says Currie. “The loss to disposable earnings when the financial savings, advantages and earnings reduction had been worked out, was £200 to £300 per month. Not meaningless by any indicates, and if we would been on a single income, that could have been a demonstrate-stopper.”

Self-employed folks may well not encounter a spend minimize at all when moving from 5 to four days a week, based on the nature of their enterprise and how nicely established it is, says independent monetary adviser Martin Bamford, of Informed Selection. “A day a week spent outdoors a business can be incredibly beneficial for strategic and creative considering, major to greater results when you are back in the workplace or sitting in front of clientele.”

Will your pension and function positive aspects be impacted?

If you are reducing your operating hours and for that reason pay out, you will also take a corresponding cut in the quantity being paid into any workplace pension scheme.

“Men and women who decrease their functioning week will have less disposable earnings so are possibly much less in a position to contemplate conserving and investments,” says Patrick Connolly, an independent economic adviser at Chase de Vere. “Even so, a lessen in contributions to your pension will have the knock-on result of taking longer to develop an adequate pot for your retirement – so you do need to have to search at this and no matter whether you can do anything about it.”

Connolly suggests very first obtaining a written projection from your company pension provider, which he says is essential to appear at in today’s terms with inflation taken into account.

“The most logical issue to then do is to improve your contributions into that pension fund if you need to, rather than start up a separate individual pension. This is, of course, only if you can afford it,” he says.

Other factors that may possibly be impacted could be any existence insurance coverage or revenue-protection insurance you get from your employer. As these are based mostly on multiples of your salary, the volume that would be paid out will minimize.

The truth that you are doing work component-time doesn’t imply you need to be treated much less favourably than your colleagues. Your rights are the exact same and you need to nevertheless receive the identical rewards, this kind of as bonuses, functionality-related pay out, car parking, childcare provision, healthcare and so on.

What about travel expenses?

If you commute to operate, either by car or train, then carrying out so much less will conserve you income. If you drive, cutting your working week will conserve you petrol, and may well decrease your vehicle insurance fees, as well, if you can declare a decrease yearly mileage when applying for a policy.

For rail season-ticket holders, the picture is not usually as clear. At existing, component-time staff who commute by train have to either purchase a season ticket and drop funds on the days they don’t use it, or acquire personal peak-time tickets, which are more pricey.

At the second, 1 of the only ways to decrease peak-time rail fares is to pay by carnet tickets, which normally give you ten journeys for the cost of nine and are valid for three to 6 months. Train organizations do not always promote these, however, so it is well worth calling the firm that operates your train line to request regardless of whether your route is eligible.

An additional selection, open to some, is to alter your times of travel. “I do twenty hours’ function spread more than 3 days, so I start off function at 10.45 now as an alternative of 9am,” says Butler. “As I commute to London from Kent that has saved me a substantial quantity of cash.”

What will your employer say when you request to perform less?

The great news for these wanting to drop a day of work is that the principles on the appropriate to request flexible working changed last week, which means that now any person is entitled to apply. The proper had only been awarded to carers, or individuals who appear following young children, but from final Monday it was extended to all staff – even if you want to get time off to, say, stroll the dog.

Employers can turn down a request on any of eight grounds, nevertheless, and this includes arguing that the alter would affect on the business’s consumer base or that it would add extra fees to the company.

WHEN Significantly less CAN BE A lot more

‘Every minute is valuable’: Ryan Carson of Florida-based mostly technology schooling business Treehouse is a convert to the 4-day week.

British employers are identified for imposing longer operating hrs than people of most other EU nations, but elsewhere some companies claim that they have found that significantly less function is a lot more.

Treehouse, a technology education organization primarily based in Orlando, Florida, operates a 4-day week as normal. Its founder, Ryan Carson, pictured, says he was “working himself into the ground” working a preceding company when his wife suggested they should function significantly less.

“I responded angrily at 1st, as I currently felt like I didn’t have enough time to comprehensive all my tasks. Working less would just make it worse,” says Carson. “Nevertheless, some thing sparked inside me that wanted to show the traditional wisdom wrong – that you have to function long, hard hrs to generate a profitable firm.”

A day later, the couple (then the company’s only employees) made a decision to get each and every Friday off. Two years later, they hired their first employee and manufactured the 4-day week organization policy. “We would pay complete salaries, supply great advantages, 18 paid days of holiday and but only function 32 hrs a week,” says Carson. The organization now has 72 total-time workers and is set to earn much more than $ 15m (£8.75m) in revenue this 12 months.

Carson believes the method performs due to the fact he, and co-founder Alan Johnson, believe in their staff. “We see individuals taking that believe in and undertaking amazing items, not abusing it. It massively increases retention – in which else can you go and get 50% much more cost-free time with your loved ones?”

1 factor that may possibly be surprising for a technology organization is that e-mail is banned internally at Treehouse, “because it is a huge time-suck” – equipment like forums are utilised rather.

“The week is extreme because you have to work really effectively to get all your operate carried out,” says Carson. “There isn’t that feeling of taking a extended lunch on a Friday and tuning out. Each minute is beneficial.”

Can I afford a 4-day week?

Would Uk staff stick to a four day week?

The Uk wants a four-day working week to combat tension, according to the president of the Uk Faculty of Public Wellness, Prof John Ashton.

Denis Campbell reported Ashton as saying:

When you appear at the way we lead our lives, the tension that individuals are under, the stress on time and sickness absence, [perform-associated] psychological wellness is obviously a major concern.

We should be moving towards a four-day week simply because the difficulty we have in the globe of work is you’ve received a proportion of the population who are operating as well hard and a proportion that haven’t got jobs

He also talked about that the lunch hour had been eroded, with individuals basically taking sandwiches at their desk. However, we cannot get statistics on the percentage of lunches taken in front of a personal computer screen, but we can find both the averages for the hours folks have agreed to work and the sum of time total-time staff actually invest operating in their major job.

Operating hour reality in the EU

The United kingdom regular demonstrates that the variety of hours truly worked is 3.one hrs larger than the common for the amount of hours collectively agreed – a bigger gap than anyplace else in Europe.

The average gap for the EU28 is one.four hrs. The majority of EU countries are investing much more time than the average collectively agreed time for doing work. The United kingdom is only 1 of only 3 in which the gap exceeds two hrs.

The information comes from the latest Developments in collectively agreed functioning time report by the European Industrial Relations Observatory (EIRO).

Chart should be study alongside this annex. Does not incorporate countries where the actual numbers of hours worked is provided but not the contractually agreed hrs (such as Luxembourg).

Remarkably there are 3 countries where the volume of time spent functioning is lower than the regular for collectively agreed hours: Ireland, Malta and Hungary.

In terms of real time spent doing work, the Uk at 40.8 hrs comes third after Luxembourg (41) and Romania (41.two). But, when it came to collectively agreed hours, the United kingdom was much more or significantly less on par with the EU15 common of 37.six.

Hungary, Greece, Romania, Croatia and Malta had the joint-longest average collectively agreed doing work week at 40 hrs.

European functioning law geeks will be unsurprised to see France at the bottom of the checklist for each agreed working hrs and actual hours worked. This is at least in element due to the Aubry law, implemented in 2000, which imposed a statutory 35 hour operating week.

United kingdom: one particular of the 48 hour states

The big framework for doing work hours across the union is the Working Time Directive, introduced by the European commission in 1993 – but it only came into force in the United kingdom in 1998 following a lost court battle two many years earlier.

Workers in the United kingdom in specific sectors can select to opt-out of the principles, which need highest working hours to not exceed an average of 48 hrs. In the latter respect , the nation is joined by Denmark, the Netherlands, Ireland and Malta although none of the nations described in this paragraph come close to the regular total-time week. In that respect the limit acts more as a safety net.

Elsewhere the image is fairly fuzzy, with plenty of country-distinct rules and regulations. For illustration, some nations have a statutory working week of 40 hours but these 40 do not incorporate overtime.

Which is not to say the guidelines in the first batch of countries are straightforward, the report explains how the Netherlands law operates:

The limits referred to may be exceeded in several nations exactly where doing work time flexibility schemes allow weekly hours to be varied around an common in excess of a reference period, as permitted by the Functioning Time Directive.

Weekly optimum functioning time beneath this kind of hours-averaging schemes might itself be topic to a ceiling, this kind of as 60 hours. In the Netherlands, for example, weekly doing work time – which includes overtime – could not exceed 48 hrs, on common, more than a sixteen-week reference period, or 55 hrs per week on regular more than a 4-week reference time period, unless otherwise agreed by the employer and trade union or operates council, topic to an absolute weekly restrict of 60 hrs.

A similar principle applies in the United kingdom, with individuals who do not opt-out of 48 hour weeks allowed to invest a lot more time than that operating on a given week, so extended as their average over 17 weeks stays under the restrict. We invite commenters to try out and work out their common doing work time more than that time frame.

No EU state has a 4 day doing work week

If we get a day of work in neat segments as 7 hours a day, 5 days a week then no nation is shut to meeting that, even France.

Taking individuals two days out then the regular operating day in each country is at least 7.48 hours (France). On common, an employee in the United kingdom is doing 8.16 hrs as can be witnessed in the chart beneath.

So to conclude, if the Uk was to stick to Professor Ashton’s tips, it would be a reasonably unprecedented phase amongst EU countries. Even though, there is no doubt that substantially much less time might be invested removing crumbs from laptops.

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Would Uk staff stick to a four day week?

Would functioning a four-day week relieve tension? | Poll

A major medical doctor has advised that the Uk switch to a four-day working week to combat growing anxiety and permit people to devote more time with their families. Prof John Ashton stated that the Uk has a maldistribution of work, with lunch breaks disappearing, and individuals functioning increasingly long hrs. He also highlighted the issue of inequality, with numerous functioning too tough while other individuals are out of work. Would a shorter functioning week lessen anxiety in your life?

Would functioning a four-day week relieve tension? | Poll

Dr Michael Mosley"s Quick Seaside 5:2 diet plan: Week Six update

D1: Consume. Breakfast: One particular slice toast with peanut butter. Lunch: smoked salmon on rye bread, minimal fat crisps, an Consume All-natural bar. Supper – 1 tiny bowl of pasta with house-produced tomato sauce, plus salad and a slice of bread. Fresh fruit salad and normal yoghurt. 1 square chocolate and two glasses white wine. Cals: two,000

D2: Rapidly. Miso soup, and then smoked salmon salad at property. Drank elderflower cordial at a party Cals: 500.

D3: Consume. Breakfast: scrambled eggs and sourdough toast Lunch: packet of nuts on a plane. Supper: salads and gnocchi. Watermelon chunks. 1 glass of white wine. Cals: one,600

D4: Eat. Breakfast: museli and yoghurt. Rye toast. Lunch: falafel sandwich. Snack: muesli bar. 7pm: supper: Baked beans on toast. Two glasses white wine. Cals: one,900

D5: Eat. Breakfast: Slice toast and a boiled egg. Lunch: salad and cold salmon, bread roll. Snack: Slice of cake. Supper: pasta and veggies. Glass of white wine. Cals: two,000

D6: Eat. Breakfast. Slice of toast and peanut butter. Half a banana. Lunch: sandwich with smoked salmon pate and salad. Consume Normal bar. One particular apple. Supper: Vegetable chilli with bulgar wheat. Stewed fruit and organic yoghurt. Cals: 1,900

D7: Rapidly. Black coffee /tea. Miso soup. Pea soup. Cals: 500

End result: Reduction 1lb.

VERDICT:

That was a quick week – fasting is getting easier and feels far more versatile. Nonetheless not acquiring adequate exercise and consuming also much white wine on days ‘off’ though.

I like the way that my physique doesn’t crave snacks as considerably – it’s less difficult to handle awkward schedules and company trips like a single to Germany this week when you know you can control hunger, and resist corporate hospitality and cake trays.

A sore knee is still placing paid to fast workout, but I’m hoping walking is toning me up nevertheless.

But how did I do all round? See the new me with muse Mimi Spencer in following week’s Telegraph.

For details on how to do the Rapidly Seaside 5:two diet plan, click right here

The Fast Seashore Diet program by Mimi Spencer (Short Books, RRP £6.99) is accessible to order from Telegraph Books at £3.99 + £1.ten p&ampp. Call 0844 871 1514 or go to books.telegraph.co.uk

Dr Michael Mosley"s Quick Seaside 5:2 diet plan: Week Six update

United kingdom requirements four-day week to fight pressure - prime medical doctor

Professor John Ashton said a 4-day week could help ease mental and bodily wellness difficulties. Photograph: Souvid Datta for the Guardian

One of Britain’s foremost medical professionals has called for the nation to switch to a 4-day week to help fight high amounts of function-related pressure, allow men and women spend far more time with their households or doing exercises, and reduce unemployment.

Bringing the regular doing work week down from 5 to 4 days would also aid tackle medical conditions, this kind of as substantial blood pressure and the mental unwell-wellness associated with overwork or lack of perform, Professor John Ashton explained.

The president of the United kingdom Faculty of Public Health explained the 5-day week must be phased out to end what he named “a maldistribution of perform” that is damaging numerous people’s well being.

“When you appear at the way we lead our lives, the tension that people are below, the stress on time and sickness absence, [perform-relevant] mental wellness is plainly a major concern. We ought to be moving in the direction of a 4-day week since the problem we have in the planet of work is you’ve acquired a proportion of the population who are doing work also challenging and a proportion that haven’t acquired jobs”, Ashton mentioned.

“We’ve acquired a maldistribution of function. The lunch-hour has gone folks just have a sandwich at their desk and carry on functioning,” additional the leader of the UK’s three,300 public-overall health authorities operating in the NHS, local government and academia.

The Faculty of Public Health’s members operate on concerns this kind of as obesity, poor diet, alcohol misuse and smoking, often related to poverty, unemployment or poor housing, and also to consider to narrow widening overall health inequalities between the rich and bad. Ashton is utilizing his 3-yr presidency of the organisation to raise awareness of the fact that psychological wellness difficulties, this kind of as anxiousness and depression, can be either a result in or result of a lot of public overall health troubles.

“We require a 4-day week so that people can appreciate their lives, have a lot more time with their families, and perhaps lessen large blood stress simply because individuals may possibly start off exercising on that extra day.

“If you have received two men and women in a couple operating, they require to be capable to function in this kind of a way that they can invest time with each other with their kids. It really is a nightmare,” said Ashton, who worked in the NHS for 42 years right up until he retired final yr.

He cited the instance of a 4-day week offering mother and father the time to acquire their young children from school.

Britons work some of the longest hrs in Europe, which surveys have linked to tension, rest difficulties, decreased productivity and the taking of sick depart.

“My concern is that also several individuals are functioning as well lengthy hrs and also challenging and too many men and women are not working at all. A massive quantity of folks are working crazy hours and a considerable amount of people cannot get perform,” Ashton explained.

A YouGov survey in April identified that 57% of staff assistance the thought of a four-day week, and that 71% feel it would make Britain a happier spot.

“It would imply that people may smile a lot more and be happier, and enhance standard well being,” Ashton stated.

Workers struggling to cope with working also a lot can end up stressed or with higher blood strain or issues in their partnership, and even resort to alcohol or medication, he stated.

His feedback, in an interview with the Guardian, come a day after the government extended the proper to request working versatile hrs to all employees. Till Monday, only carers and individuals seeking following youngsters had been able to make this kind of a request.

“It [a 4-day week] is viable. We need to have an ambition in the up coming 10 to 20 many years to move to that on a European level. We’ve had the European doing work time directive. Why could not we have the ambition to move to a four-day week? The fifth day could be a local community exercise day, a giving back day. This is how you operationalise the huge society,” he said.

The Trades Union Congress stated several workers would welcome moving to a four-day week.

“Too few people in the Uk are in a position to operate the hrs they want and require. Far as well several even now operate part-time when they want a total-time work, leaving them struggling to make ends meet,” stated Frances O’Grady, the TUC general secretary.

“But there’s also a growing problem with excessive functioning hours, with hundreds of thousands of staff below real pressure as they try to stability perform with their daily lives. And in spite of this week’s modify in the law it’s nevertheless also straightforward for employers to block flexible doing work requests, even so nicely a employee asks.

“A 4-day week will not operate for absolutely everyone, but at the second it’s way beyond the grasp of many who would like to alter the hours they operate. The new proper to request versatile operating should be strengthened so that those who need shorter hours have a greater possibility of obtaining it.”

United kingdom requirements four-day week to fight pressure - prime medical doctor