Millions 'Should Not Be In A&E' - Exclusive

By Thomas Moore, Health Correspondent

Up to 6.5 million patients every year should avoid going to A&E and be treated by GPs, paramedics and even chemists instead, the doctor leading the review of NHS emergency services claims today.

Around one third of all people who visit A&E each year could be diverted away from hospital under plans to be unveiled shortly by NHS chiefs.

In an exclusive interview with Sky News, the doctor in charge of re-shaping emergency services in England said family doctors, ambulance staff and pharmacists could treat them instead to relieve the pressure on A&E.

Indicating for the first time how he hopes to radically reform A&E, Professor Keith Willett, the national director for Acute Episodes of Care, said: "We know that 15% to 30% of people who turn up to be treated at A&E could have been treated in general practice.

"They did not know that because the system did not obviously make itself available to them."

He said patients with routine medical problems are going to A&E because they cannot get a quick enough appointment with their GP. Others are frustrated by out-of-hours services.

Prof Willett says a long-term solution is needed

"We can look at the way primary care is available to people," he said.

"By changing the way we deliver services we can start to address the demand. We can do the same thing in terms of the ambulance services and how much, how many patients they treat, at the scene, rather than transfer and that's about them having the right information.

"We would look to the public to understand the issues and when the situation does get difficult, to take the advice that I've suggested about phoning first, to get the right advice, to go to the right place, to think of using your general practitioner or indeed your pharmacist, (who) give a lot of advice for minor ailments."

Professor Willett and the medical director for NHS England, Professor Sir Bruce Keogh, will publish their plan for reforming emergency services later this autumn. It is expected to be implemented two years from now.

The plan will acknowledge that demand for care will continue to rise with an ageing population. But it will set out a series of measures for reducing pressure on A&E departments.

They are expected to include:

:: A&E units will have to ensure a consultant is available seven days a week

:: Other senior doctors, such as elderly care specialists, will be expected to help assess and treat patients arriving at A&E

:: Paramedics will treat more patients at home or by the roadside so they don't need hospital care

:: Patients will be encouraged to 'ring first', using the NHS111 helpline to be directed towards appropriate care.

Health Secretary Jeremy Hunt wants GPs to be more proactive

Health Secretary Jeremy Hunt has also said GPs must take on a bigger role. Next week he will call on GPs to do more to prevent patients with chronic conditions, such as diabetes, from suffering emergency complications.

In an interview for State Of Emergency, Sky News' 24 hours of live coverage from Nottingham's Queen Medical Centre which begins today at 5pm, Mr Hunt said: "The role of GPs in caring for older people needs to be proactive - checking up on people, finding out how they are, heading off problems before they happen - rather than reactive.

"GPs are busy, so to make that happen we have to find ways of getting more capacity in the system and that is a big challenge.

"But we have to address that. In the end, if the NHS is to be sustainable, it has to be about prevention as much as cure."

But GPs say they are already doing what they can.

Professor Mike Pringle, president of the Royal College of General Practitioners, said: "They are overwhelmed by the workload they are expected to deliver.

"We have got to start to build general practice, not blame it, not victimise it.

"We have to invest in it if we are going to solve these problems. And I am sure the Secretary of State recognises that."

England's A&E departments were under severe pressure last winter.

Waiting times reached their worst in nine years between January and March 2013, with more than 300,000 patients waiting more than four hours for treatment.

The Government has given the NHS an extra £500m over two years to find short-term solutions to the likely rise in demand for emergency care in the winter months.

Hospitals could bring GPs into A&E departments to see patients with more minor problems and more locum A&E doctors are likely to be employed to fill vacancies.

Only half the training posts for emergency medicine have been filled in the last two years, and more than a third of hospital trusts have vacancies for A&E consultants.

Professor Willett said a long-term solution is required.

"We do have to address the emergency medicine workforce," he said.

"But that will not produce new consultants for several years. So we have to manage the situation and take away from emergency medicine teams those patients who could be managed by other parts of the system.

"Defaulting to seeing an emergency medicine consultant is not necessary for many of those patients and it is frustrating to wait."

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Buckingham Palace Break-In: Two Arrested

Security Scares For Royal Family

Updated: 6:27am UK, Saturday 07 September 2013

The break-in at Buckingham Palace is the latest in a series of security scares involving the Royal Family.

:: In March 2011, a car carrying the Prince of Wales and the Duchess of Cornwall was mobbed by demonstrators who had split from a protest against higher university tuition fees.

Camilla was visibly distressed after being poked in the ribs with a stick through an open window in the distinctive Rolls-Royce Phantom VI as she and Charles travelled to the Royal Variety Performance at the London Palladium.

:: In 2003, comedian Aaron Barschak managed to get into Prince William's 21st birthday party at Windsor Castle.

The self-styled "comedy-terrorist" set off a series of alarms and was caught on CCTV before he joined 300 guests at the bash and was removed.

:: In 1994, student David Kang charged at Charles while firing a starting pistol during a ceremony in Sydney, Australia.

Kang was wrestled to the ground by New South Wales premier John Fahey and another man, while Charles was praised for his calm reaction.

:: In 1981, six blank shots were fired from the crowd while the Queen rode during the Trooping the Colour ceremony.

The Queen's horse was startled but she managed bring it back under control while police rushed to grab the shooter.

:: In 1974, Princess Anne was the target of an apparent kidnap attempt in The Mall near Buckingham Palace.

Four people, including her bodyguard, Jim Beaton, were injured after shots were fired when their car was forced to halt by another vehicle which blocked their route.

A police officer chased the driver, Ian Ball, and brought him to the ground before arresting him.

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Winter Wonderland: 'Unbelievable' Hail Storm

A freak hail storm left part of a Cornish town looking like a winter wonderland.

After the hottest summer in the county for seven years, residents in Boslowick, Falmouth could have been left wondering if it was already nearing Christmas with the scenes in their streets.

Hail and flash flooding in Falmouth (Pic: Pirate FM)

Resident Tommy Matthews filmed the snowy-like conditions on Friday morning.

He said they were "the likes of which I don't think I've ever seen before".

Mr Matthews added: "You can see the hail just mounting up everywhere and there are rivers of water just pouring down between it.

"It's absolutely unbelievable".

The hail then thawed and coupled with torrential downpours brought flash flooding to the town on Friday night.

Fire crews were scrambled to help pump water away as roads turned to rivers.

Heavy rain and cooler temperatures have led to a major change from summer heat to autumnal weather across much of the UK.

Sky's weather forecaster Isobel Lang said: "Last week's mini heatwave came to an abrupt halt on Friday with heavy, thundery downpours.

"Durham recorded 63mm in just 24 hours which lead to the Environment Agency issuing two flood warnings on the River Esk.

"Parts of Falmouth in Cornwall were transformed into a winter scene after a thunderstorm left a blanket of hail which proceeded to thaw bringing local flooding.

"Storms of this nature are not unusual at any time of the year, although after the week's sunshine and heat, it was a bit of a shock."

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'Devoted' Mum Killed In Holiday Boat Tragedy

A British mother has been killed in a boating accident during a dream holiday with her family in Brazil.

Gillian Metcalf, of Tenterden, Kent, was travelling with her husband and two daughters when their boat was struck at high speed by another vessel.

The 50-year-old died instantly from head injuries during the collision on the Rio Negro river on September 5.

It is believed the other boat did not stop to help.

It was "an accident that should never have happened", her husband Charlie told the Daily Mail.

Daughter Alice, 18, added "she died happy, painlessly and with her family around her".

Friend and colleague Richard Locke said he was "devastated" by the death and paid tribute to Mrs Metcalf, saying "we have all lost a very special person".

Mrs Metcalf was a partner at the affordable housing law firm Sharratts, which she helped set up in 1999.

In a statement on the firm's website, he said: "As you will imagine this news has hit us all very hard.

"Gill was a marvellous lawyer, a generous friend and most of all a loving wife and devoted mother to her two girls."

Mrs Metcalf counted skiing, golf, cinema and reading among her hobbies.

A Foreign Office spokesman said: "We are aware of the death of a British national in Manaus on September 5.

"We are providing consular assistance to the family at this difficult time."

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Immigration: Official Data 'Poor' Leak Reveals

Immigration A Toxic Issue In UK

Updated: 4:07pm UK, Saturday 07 September 2013

By Anushka Asthana, Political Correspondent

Leaked Government documents always cause a stir of interest among Westminster's media pack, not least when they are labelled "sensitive" and "should not be forwarded".

The latest, from the Department for Education, is all about the looming crisis in school places.

A baby boom matched by a surge in immigration is loading pressure onto primary schools, with reports last week of children packed in like "sardines". This memo suggests that the pressure will soon mount on secondarys, too, with 35,000 extra places needed by 2015.

So why the controversy?

What makes this story political is the reason behind the mess and - crucially - who is to blame. After all, immigration is a toxic issue in Britain, with concerns of its impact thrown regularly to MPs when they doorstep their constituents.

For Conservatives it is seen as key to retain a strong stance in the face of the growing threat of UKIP to the right.

That is why Tory sources typically point the finger at Labour to explain the surge in immigration. And it is certainly the case that this internal analysis points to a "threefold increase in net long-term migration since the mid-1990s".

But what is interesting is another line that raises questions about current Government policy, warning that data on immigration is "poor" and it is unclear if current policies will be effective. Whitehall officials are admitting that things are not back on track inside a document that was never meant to be seen outside their own offices.

For a Prime Minister who has promised to bring net immigration down to the "tens of thousands" this conclusion is a problem because it adds fuel to the warnings of critics that his promise is unrealistic.

The freedom of movement within the EU makes it very difficult to take action. Moreover, limiting visas for students or high-level workers from elsewhere could damage the UK economy.

Already this issue has led to a clash between the Conservative Home Secretary Theresa May and Lib Dem Business Secretary Vince Cable, who thinks restricting certain types of immigration could be bad for industry.

Whatever the reason, one thing is clear: Schools are at the sharp end.

According to the memo, some local councils are facing a situation in which demand outstrips supply even when only taking into account the children of migrant workers.

Tories will promise that free schools will help ease the pressures - but can they really be opened quickly enough?

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Alps Murder Suspect Denies Involvement

By Martin Brunt, Crime Correspondent

Alps murder suspect Zaid al Hilli has denied any involvement in the shooting of his brother Saad and other family members.

Speaking on the first anniversary of the massacre, the accountant said: "I have no idea who killed them. Absolutely no idea."

He refused to discuss any details of his questioning by Surrey police after his arrest in June on suspicion of conspiracy to murder. He is currently on bail.

But French prosecutor Eric Maillaud has accused Mr Hilli, 54, of not co-operating with investigators.

M. Maillaud said: "He doesn't co-operate, which is even more intriguing. Saad was scared of his brother. It's for this reason he changed the locks of the house."

Saad al Hilli was shot dead with his wife and mother-in-law

The house is Saad al Hilli's £1m family home in Claygate, Surrey, which the prosecutor believes was part of a bitter inheritance dispute between the two brothers in the months before the murders.

However, Mr Hilli said before his arrest that he had loved his younger brother Saad and could not understand the murder. He denied they had had a row over money.

Saad al Hilli, 50, was shot dead in his car parked in a lay-by in a mountain road near Lake Annecy in France. Also killed were his wife Iqbal, 47, her mother Suhaila al Allaf, 74, and a French cyclist Sylvain Mollier.

The couple's daughter Zainab, seven at the time, recovered after being shot and pistol-whipped and her sister Zeena, who was four, was found unhurt hiding beneath her mother's body.

French investigators and Surrey detectives have explored several theories, including Saad al Hilli's Iraqi background and his work as a satellite design engineer, but have failed to establish a firm motive.

Saad al Hilli's family home in Claygate, Surrey

The apparent lack of progress in the investigation has angered friends of the family.

Engineer James Matthews said: "At Saad's house they dug up the garden, ripped up his book shelves, cut into his safe and took away his music.

"I thought Saad was the victim, but the police were treating him as though he was responsible for his own death."

Mr Matthews also said that Saad had asked him to be a witness for him if the dispute with his brother Zaid went to court.

Surrey police still have 40 officers working on the case on behalf of the French authorities. They revealed they have seized 5,000 documents, taken 560 witness statements and collected 1,600 other pieces of evidence.

Detective Superintendent Nick May said: "The tragic events of a year ago left four people dead in appalling circumstances.

"We remain committed to finding answers to what happened that day on behalf of their families, particularly for the two young girls who lost their parents.

"This remains a complex enquiry and we continue to have a team of officers dedicated to supporting the investigation."

The prosecutor and Surrey detectives are due to hold a news conference in Annecy on Friday, but are not expected to reveal any breakthrough in the case.

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Teachers To Stage New Strikes Over Pay Row

Teachers are planning a fresh round of strikes in October in a move that will affect thousands of primary and secondary schools.

Members of two teaching unions will walk out in eight areas of England next month in a long-running row over pay, pensions and workload.

A national walkout is likely to follow before Christmas.

The new strikes, on two days in October, are the latest move in the campaign by the National Union of Teachers (NUT) and the NASUWT over Government education reforms.

They said teachers were "angry, frustrated and concerned" by Education Secretary Michael Gove's plans, accusing him of being "reckless and irresponsible".

Mr Gove hit back, declaring there was "no excuse" for the action and accusing union leaders of undermining the teaching profession by suggesting it was in crisis.

Michael Gove insists he is trying to defend teachers from cynics

The union's members in the East Midlands, West Midlands, Yorkshire and Humberside and the Eastern region will walk out on October 1.

Those in the North East, London, the South East and the South West will follow on October 17.

There are no strike dates for Wales because the government there has tried to engage with teachers about their complaints, the NUT and NASUWT added.

There is anger that teachers' pay is being linked to performance, with schools setting salaries themselves instead of following a national framework.

Changes have also been made to public sector pensions.

Unions accused Mr Gove of failing to agree to talks, which they claimed had left them no choice but to strike.

NUT general secretary Christine Blower claimed Mr Gove had left teachers facing a "brick wall".

NASUWT general secretary Chris Keates added: "This is not a reckless rush to strike action. We have been trying to engage with Mr Gove since he came to office.

"No one wants to be disrupting children's education. Our experience is parents understand that if you attack teachers' pay and conditions you are putting at risk children's education.

"Since June Mr Gove has taken to going from one public platform to another using megaphone diplomacy rather than sitting down and engaging frankly. It is a reckless and irresponsible way for a Secretary of State to behave."

The Association of School and College Leaders (ASCL), which historically does not take part in industrial action, said it shared the organisations' "frustration".

General Secretary Brian Lightman said: "While ASCL and the teacher unions have different views on the best way to resolve disputes with the Government, we all are united in campaigning for the fairest working conditions and remuneration for teachers and school leaders."

Mr Gove appeared baffled by the row, insisting teachers' pensions were still far better than most deals and that pay reforms would see good performers receive more.

"I fear the reason is that there are people within the executive and leadership of the teaching unions who are for ideological reasons on some sort of kick," he said.

He insisted he was willing to meet with the union bosses for talks "any time, any place, anywhere, to get them to see the error of their ways."

A Department for Education spokesman added: "It is disappointing that the NUT and NASUWT are striking over the Government's measures to allow heads to pay good teachers more.

"In a recent poll, 61% of respondents supported linking teachers' pay to performance and 70% either opposed the strikes or believed that teachers should not be allowed to strike at all."

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Sheppey Crash: 100 Cars Collide On Bridge

A 100-vehicle pile-up on the New Sheppey Crossing Bridge has left hundreds of people injured in a crash witnesses described as "mayhem".

Nobody is believed to have died in the crash around 7.15am, but police say "there could be people trapped" in their cars.

Chief Inspector Andy Reeves, from Kent Police, said it was "truly miraculous" that there were no fatalities from the crash.

"From my perspective, it's truly miraculous. It's very fortunate."

A Kent Police spokeswoman said visibility was a problem at the time, and witnesses say there was "very, very thick" early morning fog hovering over the bridge.

Five people have been cut free from their cars. Pic: Chris Buckingham

There are reports of some motorists driving "like idiots" in the conditions before the crash that closed the A249.

Witnesses told Sky News that some motorists were driving without headlights.

At least eight people have suffered serious injuries, and another 60 people suffered minor injuries.

Lives were probably saved by a quick-thinking lorry driver who used his truck to block the entrance to the bridge and stop more cars piling into the crash.

A driver involved in the incident, Chris Buckingham, told Sky News: "He was going the other way and ... he's gone down to the end of the carriageway, gone across the roundabout and actually blocked off the road so no more cars could actually enter the dual carriageway before the emergency services got there.

Fog across south-east England around 8am today. Pic: MeteoGroup

"Whoever that guy is I'd like to shake his hand because he's probably saved lives."

Up to 30 medical response vehicles were on the scene and motorists have been warned to avoid the area.

The bridge was clogged with buckled cars, lorries and even a car transporter as people waited at the side of the road to receive help from the emergency services.

A witness to the pile-up, Martin Stammers, told Sky News: "I was very, very, lucky. I was the last car out of it, if you like. As I came to the top of the hill, there were about five cars already smashed up, one was across my carriageway.

"I had to hit my brakes hard as well, I just had enough space to get through.

The crash occurred on the New Sheppey Crossing bridge in Kent

"From then on, all you could hear was the screeching of car tyres and the thudding, which was endless.

"It must have been going on for five to 10 minutes. You could hear the screeching, you could hear the lorries thudding into cars, you could hear glass breaking, there was nothing we could do.

"Even after the police turned up, you still heard further down the bridge – a quarter of a mile, half a mile away - cars still going into the back of each other. It was horrendous."

Student Jaime Emmett, 19, was driving through the fog when she became involved in the pile-up.

"There was a man at the side of the road saying to stop. I stopped in time but a van smashed in to me and I smashed in to the car in front," she said.

Some 30 medical response vehicles are on the scene

"I was lucky I was not injured. It was all quite surreal when it happened."

Another witness, David Ingram, described the scene of the crash as "mayhem".

"People were going quite fast, too fast. We were about 50 to 60 cars back. Luckily people coming on to the island were flashing their lights and waving their arms like mad (to warn us).

"It's carnage, it really is. The fog was very, very thick today. You could not see a vehicle in front of you as you came on to the bridge.

"We managed to stop .. the people in front of us weren't that lucky. It was mayhem."

Witnesses say the fog was very thick at the time of the crash

Valentine Elad, a 46-year-old teacher whose car was struck from behind in the crash, told of the eerie aftermath of the pile-ups.

He said: "There were cars upside-down on other cars. There was a black four-wheel-drive Mitsubishi upside-down on a small white car, and an Audi upside-down on the bonnet of another car. It was horrible."

A statement from the Kent Fire and Rescue Service said: "There are no fatalities but ambulance crews are dealing with a large number of walking wounded casualties.

"Firefighters have used hydraulic cutting equipment to release five people from their vehicles."

AA president Edmund King said the pile-up may have been caused by "stupid driving".

"It's really bad to travel too close to the car in front in good conditions and if you do it in foggy conditions it's an absolute recipe for disaster.

"In dense fog you cannot see the brake lights ahead. By law, you don't have to have fog lights on, although it's recommended.

"Unfortunately many people don't know how to turn their fog lights on. You may only need them once a year but it's vital they get used."

A statement from Kent Police said: "Emergency services are currently at the scene dealing with the incident.

"Officers are urging motorists to avoid the area but if a journey to the Island is essential, the old Kingsferry Bridge remains open but expect long delays."

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Michael Le Vell 'Devastated' By Rape Claims

Coronation Street actor Michael Le Vell has told a court he's "devastated" and "like a lost soul" after being accused of child sex abuse.

Giving evidence on the fourth day of his trial at Manchester Crown Court, he said: "I am lost. I don't know where this has come from. It has left such a hole in my life. I am like a lost soul."

He added: "I'm fighting for my life."

Asked about the rape allegations he said: "I promise you, never in a million years would I do anything like that ever."

Le Vell said the alleged victim had a "tendency to lie" after the court heard him describe her in police interviews as a "silly girl" who is "seriously deluded".

"I think it was one of those lies that just escalated and she couldn't stop it," he said.

Earlier the court had been hearing details of four interviews the star, who plays car mechanic Kevin Webster in the ITV soap, gave to police after his arrest.

After the actor was accused of rape by the alleged victim's mother, he told police: "When she told me you could have just blew me over. My legs just went to jelly."

The 48-year-old continued: "I just said to the girl's mother, 'Please tell me you are f****** joking. Please, this has got to be a joke'. I was in total shock."

Later in the police interview the officer said Le Vell said: "This is a life changing thing. It will cost me my job."

During the interviews, he said the alleged victim's mother "thinks I am the devil reincarnated".

Le Vell is accused of 12 charges in all - five counts of rape, three of indecent assault, two counts of sexual activity with a child and two of causing a child to engage in sexual activity.

The alleged offences relate to one complainant and are said to have taken place between September 2002 and September 2010.

Le Vell told the court he had never been arrested or cautioned before.

Asked about his drinking, Le Vell said he had the "working-class mentality" of a "bloke" - working, then drinking to unwind - and went to the pub most nights.

"I know it sounds a bit chauvinistic but that's the way I was brought up," he added.

He admitted he was "an alcoholic" and had twice tried Alcoholics Anonymous without success.

Earlier in the trial, the court heard Le Vell was alleged to have raped the girl while she clutched a teddy bear during one attack.

The girl, who cannot be named for legal reasons, wept as she told the court that Le Vell told her it was their "little secret".

But Le Vell told police: "I did not rape her and I certainly did not try to smother her."

The 48-year-old, who lives in Hale, Cheshire, is charged under his real name of Michael Turner.

He denies all the charges and has called the claims "an absolute pack of lies".

:: A man has been arrested and bailed over publicly identifying Le Vell's alleged victim in a tweet.

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Father Jailed For Son's Cancer Charity Theft

A man who stole hundreds of thousands of pounds from children's cancer charities - including one he set up to help his own son - has been jailed for five years.

Kevin Wright stole a total of £171,500 from the Bobby Wright Cancer Fighting Fund, with the cash used to fund his "interests, investments and personal lifestyle".

The 49-year-old was found guilty of 10 counts of theft and two of fraud by false representation following a trial at Nottingham Crown Court last month.

He also stole cash and credit balances from appeals he set up to raise money for cancer treatment for three-year-olds Callum Kaye and Armani Mohammad.

Jurors were told he gave £20,000 to a friend who ran a used-car business and that he put £60,000 into Premium Bonds.

Another £30,000 was used to buy the Toad In The Hole restaurant in Exeter, Devon, while a further £30,000 was invested in the Royal Oak pub in a village close to his home.

More follows...

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