Michael Simmons

The NHS has a crisis every winter, but this year’s is on a different scale. Before a wave of strikes puts patients and care at risk, stats released by NHS England this morning show a health service already on the brink. Last month, the number of 12-hour waits in A&E departments in England exceeded 37,800, having hit almost 44,000 the month before: a decrease, but a worrying number still. Waiting lists for consultant-led treatment have grown by 74,000 cases and now stand at 7.2 million. Ambulance waiting times are still far higher than they should be too: now at 48 minutes. All of this before the going really gets tough. Here’s what this morning’s monthly NHS statistical release tells us: 1.

Ian Blackford has resigned after five years as Westminster leader of the SNP. In a statement he said the time was right for ‘fresh leadership’ and that he will not be standing for reelection at the group’s AGM next week. The announcement comes just a fortnight after the Ross, Skye and Lochaber MP survived an attempted coup. He is continuing as an MP. Just weeks ago Blackford survived a challenge from the Aberdeen South MP, Stephen Flynn, who attempted to overthrow him. SNP backbenchers had grown unhappy with Blackford’s leadership after several scandals during his tenure. Flynn had been on manoeuvres against Blackford for months.

For Scotland to stay at its current levels of health in 20 years’ time it would have to entirely eradicate cancer. That’s according to the Burden of Disease study published this morning by Public Health Scotland.   The report found that although the country’s population is projected to fall in the next two decades, its annual ‘disease burden’ – the impact of morbidity and mortality on population health – is forecast to increase by some 21 per cent. ‘In order to achieve a similar level of disease burden as 2019’, they say it would need to be reduced by 17 per cent by 2043 – ‘which is equivalent to eradicating the entire disease burden of cancer in 2019.

Last night was shaping up to be a night of the long sgian dubhs for the SNP’s Westminster leader Ian Blackford. SNP backbenchers have grown unhappy with Blackford's leadership after several scandals during his tenure. Yesterday a challenge briefly emerged from Aberdeen South MP Stephen Flynn, though Blackford has managed to survive the attempted coup.  Flynn has reportedly been on manoeuvres against Blackford for months. Yesterday he made his move, informing the party’s compliance officer Ian McCann he planned to challenge Blackford at the Westminster group's AGM in December. The next step of the plan was for a gang of so-called men in grey kilts, led by culture spokesman Brendan O’Hara, to tell their leader he had to go before the meeting.

More people are dying every week than during Covid’s peak years. Last month there were 1,482 more deaths than average each week – known as excess deaths – compared with just 315 two years ago and 1,322 last year. In the week to 21 October (the most recent week of data) ONS figures reveal there were some 1,646 excess deaths alone. As has been reported before, excess deaths are most stark at home: with deaths in private homes nearly a third above average. Meanwhile in hospitals and care homes they’re just 15 and 10 per cent above average. The shift to dying at home, and the health service ceasing to function, continues.  What’s causing these deaths? It isn’t Covid: just 27 per cent of excess deaths in England for the most recent week have Covid as the underlying cause.

Gone in a flash, Liz Truss becomes the shortest serving prime minister in British history. As it stands, she’s 75 days short of George Canning, who lasted some 119 days in office before dying from tuberculosis. If Truss’s successor wants to avoid joining her and Canning at the lower ends of the Wikipedia, they’ll need to keep a close eye on these seven metrics: 1. The value of the pound Kwasi Kwarteng’s (and Liz Truss’s) mini-Budget caused the pound to fall to its lowest ever level at just above $1.03. At the time there were fears it may even pass parity with the dollar. Since then it regained its losses and stands at $1.13. Much of the pressure against the pound was really due to a strengthened dollar.

NHS waiting lists have exceeded seven million people for the first time since records began. That means nearly 12 per cent of people in England are waiting for consultant-led treatment. A&E waiting times broke records too: nearly 33,000 people waited more than 12 hours from decision to admit to admission. The target is four hours. This all adds to a difficult week for the health service. Staff shortages affecting the whole economy – a record 2.5 million people are not working due to long-term sickness – are now being felt in the NHS too. Recently some hospitals have experienced a shortage of blood because of donation centres having to close due to problems getting enough staff.

Britain will make it through the winter without the lights going out. That’s the view of the National Grid, which is responsible for Britain's energy system. You'd be forgiven for thinking otherwise based on the BBC's headline: 'Homes face winter power cuts in worst-case scenario, says National Grid'. But Fintan Slye, executive director of the grid, offered some words of reassurance:  ‘Under our Base Case we are cautiously confident that there will be adequate margins through the winter period.’  In other words: the lights won’t go out. In the scenario considered most likely, we’ll be left with a small margin of six per cent – or just under four gigawatts (GW) of unused capacity.

Kwarteng’s £45 billion tax cuts will have given Nicola Sturgeon a headache. She has power over income tax and has indicated that she won’t replicate his cuts (especially for the best paid). Which means that Scots could end up paying hundreds of pounds more in income tax next year. Already, there is talk about Scottish tax exiles heading to London (with a particular focus on Edinburgh’s financial service industry.) The Chartered Institute of Taxation has run the figures. If the 1p cut to the basic rate isn’t passed on in Scotland, anyone earning more than £14,732 will pay more tax than those in the rest of the UK. Those earning £30,000 will pay nearly £200 more each year.

What's the link between long Covid and mental health? A study just published in the Journal of the American Medical Association suggests it's a significant one. The paper looked at more than 3,000 people who tested positive for Covid in the US. Of those who went on to develop ‘long Covid’, it found many of them already experienced mental distress before catching the virus. The study looked at 3,193 people – mostly women – who reported Covid symptoms continuing four weeks after first falling ill. They found that those reporting long Covid were more likely to have already experienced a range of symptoms including ‘depression, anxiety, worry about Covid, loneliness and stress’ before they tested positive. The risk increased between 1.3 and 1.5 fold.

In Britain, the damage of lockdown was easily covered up by grade inflation: with 45 per cent of A Level students being given A or A*. In the United States, there are large-scale independent studies published today. It’s pretty devastating. Educational performance scores for nine-year-olds have fallen to levels last seen in 1999: so two decades of progress wiped out. It’s the first time on record that performance in maths has fallen at all, and reading ability fell further than it has at any point in the last 30 years.  The National Assessment of Educational Progress, released today, measures the long term ability of 14,800 nine-year-olds in the US in core reading and maths skills. Average scores fell five points in reading and seven points in maths compared with 2020.