1 hour agoShareSaveDivya Talwar & Natalie TruswellBBC News InvestigationsShareSaveGetty ImagesThere are “significant” concerns about the safety and quality of maternity services at an NHS trust, a new report has revealed.Issues with staffing, a “challenging” culture and a lack of learning from previous incidents were identified at Leeds Teaching Hospitals (LTH) NHS Trust.NHS England published its findings following a visit to the trust in March this year. It made 101 recommendations to improve the quality of care and ensure the “wellbeing” of mothers and babies.In response, LTH said making urgent improvements was a “priority”.Over the past six months, the BBC has spoken to 67 families who said they experienced inadequate care at the trust, including parents who said their babies suffered avoidable injury or death. We also talked to five whistleblowers who have raised safety concerns.Two months after our initial report, NHS England placed the trust under its national Maternity Safety Support Programme (MSSP). Its teams work to improve services where serious concerns have been identified.Areas of concerns the MSSP report highlighted included:Staff describe safety concerns being de-escalated without resolution, and learning from incidents was not robust which meant there was a continuation on previously identified themes.Lack of cardiotocography (CTG) machines to enable women to be effectively and safely monitored.Issues with escalation process especially out of hours with no clinical or midwifery management on call.Challenge in responding to families who have experienced harm and poor outcomes.Poor communication and staffing issues with maternity leadership needing improvement.An NHS whistleblower told the BBC there were “still huge concerns about the lack of progress” on some of the recommendations in the MSSP report, as some of the points had already been identified in January during a Rapid Quality Review Meeting, which the NHS holds to profile risk and make action plans.The whistleblower said “many areas of concern had not been rectified” since January and that the trust would also have seen the MSSP report before it was published, as early as May.A group of Leeds bereaved families said the MSSP report, which also highlights good practices, is “truly shocking and horrifying reading”.”As bereaved and harmed families this most recent report, yet again, totally vindicates what we have been saying for years. The culture of denial, the failure to listen and the absence of real accountability are systemic and persistent,” a spokesperson said.MARTIN MCQUADE / BBCThe MSSP report comes a month after LTH’s maternity services at two hospitals were downgraded from “good” to “inadequate” by the Care Quality Commission.Fiona Winser-Ramm, whose daughter Aliona died in 2020 after what an inquest found to be a number of “gross failures”, is among dozens of families calling for an independent inquiry into the maternity services to ensure accountability for the deaths or injuries of their babies.The trust’s CEO Phil Wood announced this month, just days before the report was published, that he would retire at the end of the year.He has led the trust since February 2023, but has been at LTH for more than a decade, including as chief medical officer from May 2020 until his appointment as CEO.Bereaved families said the timing of Mr Wood’s departure was “concerning” given the ongoing issues with maternity services and worried there was a lack of accountability given that he was at the trust when dozens of mothers and babies faced potentially avoidable harm.Rabina Tindale, chief nurse at LTH, said: “This report has highlighted significant areas where we need to improve our maternity services, and my priority is to make sure we urgently take action to deliver the recommendations.”I would like to apologise to all the families who have received maternity care with us which has fallen short of the high standard we aim to provide.”The trust was committed to delivering the “highest standard of care” to everyone, she added, and was taking steps to deliver “safe”, “high-quality” and “compassionate” care.Mr Wood said: “My intention was to retire in the next 12 to 18 months, but with the changes taking place within the NHS nationally, this feels like the right time for me to hand over to a new leader.”I am committed to making sure our robust maternity improvement plans, already developed with the CQC and NHS England, are fully embedded, and that we engage constructively with the Rapid National Investigation into Maternity and Neonatal services as it develops.”Do you have more information about this story?You can reach Divya directly and securely through encrypted messaging app Signal on: +44 7961 390 325, by email at divya.talwar@bbc.co.uk, or her Instagram account.Related internet links

The UK government will soon be asking lots of cat and dog owners to collect and send their pet’s poo for laboratory testing. Experts worry that some domestic animals might carry hard-to-treat superbugs – bacteria that have become resistant to common antibiotics. These can spread to people through close contact with pets, such as kissing and stroking, as well as handling poo, research suggests.In many cases the bacteria do no harm, but some can lead to serious issues, including bloodstream infections or sepsis.The world-first study will monitor healthy pets, not just those that are ill. Over half of UK adults own pets and live with them in a shared environment, meaning that bacteria, including resistant bacteria, can spread easily between animals and people, says the goverment’s Veterinary Medicines Directorate.Several studies have shown pets and owners can potentially swap pathogens, including the hospital ‘superbug’ MRSA.Scotland’s Royal College will run the study over four years. Prof John Berezowski, who is one of the researchers, said they would work with pet owners and their vets to explore how best to collect all the poo samples.”This initiative is critical for a better understanding of the transmission and maintenance of antimicrobial resistance in our pets,” he said. The World Health Organization classes antibiotic resistance as one of the greatest public health threats facing humanity. Drug-resistant infections kill more than 1.2 million people a year globally, with the figure projected to rise to 10 million by 2050 if no action is taken, it says. To prevent transmission, experts recommend owners practise good hygiene, including washing their hands after petting their dog or cat and after handling their waste.If a pet is unwell, owners might consider isolating them in one room to prevent the spread of bacteria throughout the house, and clean other rooms thoroughly. Antimicrobial resistance (AMR) arises when organisms that cause infection evolve ways to survive treatments.Without effective antibiotics, even minor surgery and routine operations, such as caesarean sections when giving birth, could become high-risk procedures if serious infections can’t be treated.

Regular walking is widely recognized for its significant benefits to overall health and well-being. Previous research has primarily focused on middle-to-high-income White populations. Now, a novel analysis using data from the Southern Community Cohort Study, involving 79,856 predominantly low-income and Black individuals across 12 southeastern US states, confirms the benefits of regular walking, especially at a faster pace, within a crucial, underrepresented group. The new study appearing in the American Journal of Preventive Medicine, published by Elsevier, underscores the importance of promoting walking, particularly at a brisk pace, as an effective form of physical activity for improving health.
Lead investigator Wei Zheng, MD, PhD, Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, School of Medicine, Vanderbilt University, and Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, says, “While the health benefits of daily walking are well-established, limited research has investigated effects of factors such as walking pace on mortality, particularly in low-income and Black/African-American populations. Our research has shown that fast walking as little as 15 minutes a day was associated with a nearly 20% reduction in total mortality, while a smaller reduction in mortality was found in association with more than three hours of daily slow walking. This benefit remained strong even after accounting for other lifestyle factors and was consistent across various sensitivity analyses.”
Participants reported the average amount of time per day (minutes) they typically spend “walking slowly (such as moving around, walking at work, walking the dog, or engaging in light exercise)” and “walking fast (such as climbing stairs, brisk walking, or exercising).” Information regarding vital status and cause of death was obtained by linking the cohort to the National Death Index.
The protective effect of fast walking extended to all causes of death but was most pronounced for cardiovascular diseases. Importantly, the benefits of fast walking were independent of overall leisure-time physical activity levels (LTPA). Even for those who are already engaged in slow walking or some LTPA, adding more fast walking further reduced mortality.
According to the study the benefits of fast walking related to cardiovascular health are: Boosts heart efficiency: As an aerobic exercise, fast walking improves cardiac output, increases oxygen delivery, and enhances the efficiency of the heart’s pumping action, leading to better overall cardiovascular health. Manages cardiovascular risk factors: Regular fast walking helps control body weight and composition, reducing obesity and related risks like hypertension and dyslipidemia. Highly accessible: Fast walking is a convenient, low-impact activity suitable for individuals of all ages and fitness levels.Low-income populations often face economic constraints and are more likely to reside in impoverished, highly polluted communities with limited access to safe walking spaces. Additionally, these populations tend to have a higher prevalence of lifestyle behaviors that may increase disease risk and mortality, such as lower quality diet, cigarette smoking, and heavy alcohol consumption. At the same time, there are other challenges for individuals with low income such as lack of access to health insurance or healthcare that may also increase mortality. These factors collectively contribute to an increased mortality among low-income individuals and may potentially elucidate the racial disparities observed in longevity. By demonstrating the benefits of fast walking in this study, this research provides direct evidence to inform targeted interventions and policies to improve health equity.
Lead author of the article Lili Liu, MPH, Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, School of Medicine, and Vanderbilt University, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, concludes, “Public health campaigns and community-based programs can emphasize the importance and availability of fast walking to improve health outcomes, providing resources and support to facilitate increased fast walking within all communities. Furthermore, the findings of the reduced mortality associated with fast walking pace were supported by previous studies conducted in middle- and upper-middle-income populations. Individuals should strive to incorporate more intense physical activity into their routines, such as brisk walking or other forms of aerobic exercise.”

High levels of a hormone found in cells in the gut could underlie many cases of chronic diarrhea and help explain up to 40% of cases of patients with irritable bowel syndrome with diarrhea, according to a new study led by scientists at the University of Cambridge.
The research, published in the journal Gut, could help in the development of a blood test and points towards a potential new treatment.
When we eat, the liver releases bile acid to break down fats so that they can be absorbed into the body. Bile acid is released into the top end of the small intestine and then absorbed back into the body at the lower end.
However, around one person in every 100 is affected by a condition known as bile acid diarrhea (also known as bile acid malabsorption), whereby the bile acid is not properly re-absorbed and makes its way into the large intestine (colon). It can trigger urgent and watery diarrhea, and patients can risk episodes of incontinence.
Bile acid diarrhea can be difficult to diagnose as there are currently no routine clinical blood tests. Many individuals are given a diagnosis of irritable bowel syndrome (IBS), an umbrella term for a range of conditions. As many as one in 20 people is thought to have IBS, of which an estimated one in three patients with diarrhea as their main symptom have undiagnosed bile acid diarrhea.
Studies in mice have previously suggested that the gut hormone known as Insulin-Like Peptide 5 (INSL5) – present in cells at the far end of the colon and rectum – may play a role in chronic diarrhea. INSL5 is released by these cells when irritated by bile acid.
Researchers at the Institute of Metabolic Science, University of Cambridge, have been exploring whether this hormone might also underlie chronic diarrhea in humans. This has been possible thanks to a new antibody test developed by pharmaceutical company Eli Lilly, with whom the team is collaborating, which allows them to measure tiny amounts of INSL5.

A study at the University of Adelaide looking at ways to trigger release of the gut hormone GLP-1 – the hormone upon which weight-loss drugs are based – previously found that giving a bile acid enema to healthy volunteers triggered release of GLP-1, but had the unintended consequence of causing diarrhea. When the Cambridge team analyzed samples from this study, they found that the bile acid enema caused levels of INSL5 to shoot up temporarily – and the higher the INSL5 levels, the faster the volunteers needed to use the toilet. This confirmed that INSL5 is likely to play a role in chronic cases of diarrhea.
When the team analyzed samples obtained from Professor Julian Walters at Imperial College London, which include samples from patients with bile acid diarrhea, they found that while levels of INSL5 were almost undetectable in healthy volunteers, they were much higher in patients with bile acid diarrhea. In addition, the higher the INSL5 level, the more watery their stool samples.
Dr Chris Bannon from the University of Cambridge, the study’s first author, said: “This was a very exciting finding because it showed us that this hormone could be playing a big part in symptoms of this misunderstood condition. It also meant it might allow us to develop a blood test to help diagnose bile acid diarrhea if INSL5 levels are only high in these individuals.
“When you go to the doctor with chronic diarrhea, it’s likely they’ll test for food intolerances, rule out an infection or look for signs of inflammation. There has been significant research interest in the microbiome, but gut hormones have been neglected. But it’s becoming increasingly clear that gut hormones play an important role in things like gut health and weight management.”
INSL5 also provides a potential target for treatment. Dr Bannon and colleagues obtained further samples from Professor Robin Spiller at the University of Nottingham, who had given the anti-sickness medication ondansetron – known to block the action of INSL5 in mice – to patients with IBS. Analysis of these samples by the Cambridge team showed that around 40% of these patients had raised levels of INSL5, even though they had had bile acid malabsorption ruled out, and these patients responded best to ondansetron.
Exactly why ondansetron is effective is currently unclear, though a known side effect of the drug is constipation. The team will now be investigating this further, hopeful that it will allow them either to repurpose the drug or to develop even better treatments. Bile acid diarrhea is usually treated with so-called bile acid sequestrants, but these are only effective in around two-thirds of patients.
Dr Bannon added: “I often get asked why we would have a hormone that gives you diarrhea. I think of it as a kind of poison sensor. Bile acids aren’t meant to be in the colon – they’re an irritant to the colon and they’re toxic to the microbiome. It makes sense that you would have something that detects toxins and helps the body rid itself of them. But a problem develops if it’s always being triggered by bile acid, causing very dramatic symptoms.”
Dr Bannon is a clinical fellow in the group led by Professors Fiona Gribble and Frank Reimann at the Institute of Metabolic Science, University of Cambridge.
The research was supported by the Medical Research Council and Wellcome, with additional support from the National Institute for Health and Care Research Cambridge Biomedical Research Centre.

Patients in the East of England have been encouraged to attend their appointments as resident doctors’ strikes continue.Industrial action over pay will continue until 07:00 BST on Wednesday 30 July, but patients should still attend their appointments unless contacted to reschedule, said NHS England.Adam Cayley, the chief operating officer for NHS England in the East, thanked staff for their “hard work over the weekend” and “continued efforts in the days ahead”.The latest series of strikes began on Friday and patients who need emergency medical care have been told to use 999 or go to A&E as normal.Hospitals and local NHS teams throughout the region said they were working together to minimise disruption to patient care.Mr Cayley said: “Whilst it is inevitable that strikes mean some appointments and procedures cannot go ahead as planned, it’s thanks to the huge efforts of NHS teams in the region that we are continuing to provide as many as we can.”Our advice remains to please attend your appointment unless you have been contacted directly to reschedule.”If it’s an emergency, you should dial 999 or attend your A&E as normal. Otherwise, you should use 111 online as your first port of call, or your local pharmacist or GP.”It is the 12th strike from resident doctors since March 2023, which NHS England said had resulted in 49 days of disruption to its services, equivalent to about 10 working weeks of industrial action over that period.Resident doctors, previously named junior doctors, make up about half of all doctors in the NHS.They had anywhere up to eight years’ experience working as a hospital doctor or up to three years in general practice.Since strikes began at the end of 2022, the cumulative total of hospital appointments rescheduled in England was close to 1.5 million across the NHS, the public body said.

Researchers from Columbia Engineering have established a framework for the design of bioactive injectable hydrogels formulated with extracellular vesicles (EVs) for tissue engineering and regenerative medicine applications.
Published on July 25 in Matter, Santiago Correa, assistant professor of biomedical engineering at Columbia Engineering, and his collaborators describe an injectable hydrogel platform that uses EVs from milk to address longstanding barriers in the development of biomaterials for regenerative medicine. EVs are particles naturally secreted by cells and carry hundreds of biological signals, like proteins and genetic material, enabling sophisticated cellular communication that synthetic materials cannot easily replicate.
In this study, Correa and colleagues designed a hydrogel system where EVs play a dual role: they act as bioactive cargo but also serve as essential structural building blocks, by crosslinking biocompatible polymers to form an injectable material. Using an unconventional approach that leveraged milk EVs from yogurt, the team was able to overcome yield constraints that hinder the development of EV-based biomaterials. The yogurt EVs enabled the hydrogel to both mimic the mechanics of living tissue and actively engage surrounding cells, promoting healing and tissue regeneration without the need for additional chemical additives.
“This project started as a basic question about how to build EV-based hydrogels. Yogurt EVs gave us a practical tool for that, but they turned out to be more than a model,” said Correa who led the study with Artemis Margaronis, an NSF graduate research fellow in the Correa lab. “We found that they have inherent regenerative potential, which opens the door to new, accessible therapeutic materials.”
Correa directs the Nanoscale Immunoengineering Lab at Columbia University, where his research focuses on drug delivery and immunoengineering. He is also a member of the Herbert Irving Comprehensive Cancer Center and collaborated on this project with Kam Leong, a fellow Columbia Engineering faculty member. The study was further strengthened through international collaboration with researchers from the University of Padova, including Elisa Cimetta (Department of Industrial Engineering) and graduate student Caterina Piunti. By combining Padova team’s expertise in agricultural EV sourcing with the Correa lab’s experience in nanomaterials and polymer-based hydrogels, the team demonstrated the power of cross-disciplinary, global partnerships in advancing biomaterials innovation.
By using yogurt-derived EVs, the team defined a design space for generating hydrogels that incorporate EVs as both structural and biological elements. They further validated the approach using EVs derived from mammalian cells and bacteria, demonstrating that the platform is modular and compatible with diverse vesicle sources. This could open the door to advanced applications in wound healing and regenerative medicine, where current treatments often fall short in promoting long-term tissue repair. By integrating EVs directly into the hydrogel structure, the material enables sustained delivery of their bioactive signals. Because the hydrogel is injectable, it can also be delivered locally to damaged tissue.
Early experiments show that yogurt EV hydrogels are biocompatible and drive potent angiogenic activity within one week in immunocompetent mice, demonstrating that agricultural EVs not only enable fundamental biomaterials research but also hold therapeutic potential as a next-generation biotechnology. In mice, the material showed no signs of adverse reaction and instead promoted the formation of new blood vessels, a key step in effective tissue regeneration. Correa’s team also observed that the hydrogel creates a unique immune environment enriched in anti-inflammatory cell types, which may contribute to the observed tissue repair processes. The team is now exploring how this immune response could help guide tissue regeneration.
“Being able to design a material that closely mimics the body’s natural environment while also speed up the healing process opens a new world of possibilities for regenerative medicine,” said Margaronis. “Moments like these remind me why the research field in biomedical engineering is always on the cusp of something exciting.”

Getty ImagesCiaran VarleyBBC Sport JournalistEmma MiddletonBBC Sport journalist28 July 2025Can a professional footballer play with a fractured leg?Following Sunday’s Euro 2025 final win over Spain, England defender Lucy Bronze revealed she had done just that, saying: “I actually played the whole tournament with a fractured tibia, but no-one knew.” Mum Diane Bronze said the Chelsea full-back suffered the injury in June but she still started all six of the Lionesses’ games in Switzerland and was a key reason for their success.”We’ve known all the time. We knew the medics had checked it, and they knew what they were doing,” Diane Bronze told BBC Radio 4’s Woman’s Hour.”I think a lot of the girls knew and not a whisper got out.”What is a tibia fracture?Dr Mark Bowditch, President of the British Orthopaedic Association told BBC Sport that a tibia is, “the shin bone and the main weight bearing bone from the knee to the ankle”.”Fractures of the tibia range from partial break, such as a stress or fatigue split, through to a complete break and separation,” the consultant knee and sports surgeon added.”A complete break is the high-energy sudden injury from a fall from a height, twist or direct blow, such as a studs-up tackle. You cannot continue to play on or even walk on a complete break.”Stress/fatigue fractures – which is likely to be the type Lucy Bronze has – are low-energy repeated injury and usually seen in athletes or army personnel. “They normally present with pain after activity, rather than a sudden incident.”Following Sunday’s final, England manager Sarina Wiegman said that Bronze, “had some issues with her tibia so of course we tried to manage that”.Nick Worth, who was England men’s under-21 team physiotherapist between 2000-2003, told BBC Sport that Wiegman’s comments further corroborate the view that the defender’s injury was a stress reaction, rather than a clean break.But BBC Sport do not yet know the full extent of the injury.How could Bronze play with a fracture?The 33-year-old played 598 minutes across the tournament, with only Keira Walsh, Alex Greenwood and Hannah Hampton playing more for Wiegman’s side. Dr Bowditch called it, “remarkable” Bronze was able to play so much tournament football. “She probably has had to reduce the amount of training she has done in between games or train in a low weight-bearing environment such as a swimming pool or anti-gravity trainer,” he suggested.”It’s a great tribute to Dr Ritan Mehta and Lionesses medical team that they have managed to keep Lucy going.”Worth believes that Bronze’s decision to play through her injury would have been based on a calculation of risk vs reward, made in collaboration with the Lionesses’ medical team.”No doubt she’s been exceptionally brave, you can’t underestimate the mentality and resilience to do that,” he added. “But it must be a manageable injury to enable her to do that.”‘She’ll not let the pain get in the way’Bronze’s aunt, Julie Tough, told BBC 5 Live: “Lucy wouldn’t damage her body but she’ll play through pain if she thinks she’s not going to do anything worse to it. “She’ll not let the pain get in the way.”Painkillers and anti-inflammatories may have helped Bronze manage her pain during games, as well as perhaps using different insoles in her boots to enable her to offload weight on the injured leg.Bronze’s mum Diane added: “The medics had checked it and they knew what they were doing, and so does she because she did a sports science degree.””She reads research papers and things. She knows about injuries. That’s how she can keep going.”The defender, who was England’s oldest player at the tournament, managed 105 minutes in Sunday’s showpiece final, before leaving the pitch in tears as she was forced off with a separate injury to her right knee.Wiegman praised her attitude afterwards, saying: “The whole team has a great mentality but she has a crazy mentality, it’s unbelievable.”Worth told BBC Sport that pain is experienced subjectively.”What Lucy has shown is that bit extra – she’s an exceptional individual, and not everyone would do that,” he said.”She knows her own body, and I have no doubt she would speak up if something isn’t right.”During the quarter-final against Sweden, Bronze was shown on camera self-strapping support around her right leg during a break in play. Worth suggested that this is unlikely to be related to her fractured tibia.What could Bronze’s recovery look like?It is difficult to say, without knowing the full extent of the injury.Dr Bowditch told BBC Sport that the worst thing that could have happened was that, “the partial break progressed into a full break and the bone effectively snapped.” “This fortunately hasn’t happened,” he said. “It may need a prolonged time off to allow it to heal itself or she may need surgery to try to help the bone heal properly”Worth suggested that Bronze should hopefully not face any long-term consequences after playing during the tournament, and the most important thing now will be rest.While she will need to offload the tibia a little bit, Bronze should be able to continue with work in the gym and the pool, and that weight-bearing can help the healing. “Bones heal in the lines of stress, so in a converse way, putting weight on a fracture at the right time can help with healing.”This article is the latest from BBC Sport’s Ask Me Anything team.What is Ask Me Anything?Ask Me Anything is a service dedicated to answering your questions.We want to reward your time by telling you things you do not know and reminding you of things you do.The team will find out everything you need to know and be able to call upon a network of contacts including our experts and pundits.We will be answering your questions from the heart of the BBC Sport newsroom, and going behind the scenes at some of the world’s biggest sporting events.Our coverage will span the BBC Sport website, app, social media and YouTube accounts, plus BBC TV and radio.More questions answered…’No plans’ for bank holiday if England win EurosFrom ball girl to England hero – who is rising star Agyemang?When will the WSL and WSL2 fixtures be released?Get in touchSend us your questionsContact formContact formRelated topicsEngland Women’s Football TeamUEFA Women’s EUROFootballWomen’s Football

NHS bosses have criticised the British Medical Association for its “increasingly hardline” approach in rejecting emergency requests for striking doctors in England to return to work.A system known as ‘derogation’ is in place whereby the NHS can ask for resident doctors, who are taking part in a five-day walkout, to cross the picket line where patient safety is at risk.As of Sunday evening, 18 requests by hospitals for derogations had been rejected in this strike – the twelfth in the long-running pay dispute – with nine accepted.The BMA said while it was ready to respond to emergencies, poor planning and the push to continue non-urgent care in this strike had stretched staffing too much.However, NHS England accused the doctors’ union of putting safety at risk, criticising a “remote BMA panel” for “second-guessing” doctors on the ground who were trying to look after patients.A central committee of senior BMA doctors makes decisions on each derogation request.NHS England said it was particularly worried about a number of requests relating to cancer care being turned down.And it said the BMA was sitting on some requests for hours – there are another 20 waiting for decisions to be made.And the source said some had been rejected because hospitals would not pay striking doctors premium rates to come back in.Before this strike started, the BMA had only agreed to five derogations during the whole dispute.Resident doctors, the new name for junior doctors, are the largest group of medics in the NHS, representing half the doctor workforce. They include everyone from those fresh out of university through to doctors with up to 10 years experience. It comes as the Royal College of Nursing is due to announce the results of its vote on pay with members expected expected to call for more than the 3.6% increase they are being given.The BBC understands there will be an “overwhelming” rejection after the RCN previously described the rise as “grotesque” as nurses got a lower increase than doctors.This does not block the pay award, but raises the prospect of the union running a formal strike ballot later in the year.Among the derogation requests agreed by the BMA was a doctor to work at Nottingham City Hospital’s neonatal intensive care unit over the weekend.Three BMA members were also brought in to work an emergency department night shift at the Northern General in Sheffield.But the BMA rejected a request by Milton Keynes Hospital for a doctor to carry out prostate cancer checks. In that case the BBC understands a doctor did return to work under their own volition.BMA resident doctor co-leaders Dr Melissa Ryan and Dr Ross Nieuwoudt said: “Patient safety remains our highest priority during strike action. This agreement – called a national derogations process – is there to strictly to be used should a safety-critical, urgent event occur. “It is deeply irresponsible for hospitals to use it to facilitate non-urgent care or cover for poor planning on their part.”They said the BMA was working round the clock to assess the requests, but some were “confusing, inappropriate or provide insufficient information”.King’s College Hospital in London had a derogation agreed and then revoked for its radiology department after what the BMA said was a “false submission” about staffing levels.But the hospital said it acted in good faith and during the time it took the BMA to assess the request it had managed to find cover from elsewhere.NHS England sources said it was particularly disappointed with the rejections as the national organisation was now vetting every request from hospitals to ensure a consistency in approach between different places.Every request, they said, was based on “rigorous assessment”.”We absolutely recognise the legal right for people to strike, but we also recognise that it’s essential to maintain as many services for patients as possible,” they added.The five-day strike by resident doctors is due to run until 07:00 BST on Wednesday.

Frailty is a medically defined condition in older adults that increases vulnerability to everyday stresses, leading to a higher risk of falls, hospitalization and loss of independence. Warning signs of frailty include: Unintentional weight loss Moving slowly Feeling weak Persistent tiredness Low levels of physical activityBecause most of these signs have a direct link to how active someone is, walking is a particularly effective way to help older adults improve their overall health and quality of life and maintain independence for longer.
But a common question remains: How fast should older adults walk to see real benefits? Traditionally, the “talk test” has been used to guide walking intensity: people are encouraged to walk at a pace that makes it difficult to sing but still allows for comfortable conversation. However, this method is subjective and difficult to apply consistently.
A new study led by researchers at the University of Chicago Medicine found that walking slightly faster — 14 steps per minute more than a person’s usual pace — led to meaningful improvements in physical function among older adults who were frail or at risk of becoming frail. In a second study, the researchers developed and tested a smartphone app designed to accurately measure walking pace, making it easier to integrate this beneficial practice into daily life.
Why study walking pace?
Walking cadence — the number of steps taken per minute — is an intuitive and pragmatic way to measure walking intensity. Daniel Rubin, MD, an anesthesiologist at UChicago Medicine, became interested in cadence because of his clinical experience evaluating older patients preparing for surgery.
“Older adults have a high risk of complications associated with surgery,” he said. “Traditionally, surgical teams have relied on physical function questionnaires to risk stratify patients, but I thought there must be a way to develop more objective metrics.”
Walking faster is healthier

In a secondary analysis of a randomized controlled trial, Rubin and his colleagues studied older adults classified as frail or prefrail. Participants were enrolled in structured walking programs within their retirement communities, guided and assessed by clinical research staff, and cadence was measured by a device fitted to their thigh. One group was encouraged to walk “as fast as safely possible,” while another group walked at their usual comfortable pace.
The study’s results showed clear benefits: those who increased their cadence by at least 14 steps per minute above their usual pace (to roughly 100 steps per minute) experienced substantial improvements in their functional capacity, demonstrated by their ability to walk longer distances in a standardized test.
“People who haven’t experienced frailty can’t imagine how big a difference it makes to be able to not get tired going to the grocery store or not need to sit down while they’re out,” Rubin said.
An intuitive walking app
Building on these findings, Rubin’s team created a smartphone app called “Walk Test,” which they designed specifically for measuring walking cadence accurately.
“We didn’t necessarily trust smartphones’ built-in analytics,” Rubin said. “Instead, we built an app that uses a novel open-source method to analyze the data measured by the phone and lets us actively engage users in brief, deliberate walking tests, ensuring accurate measurement.”
Validation testing showed that the app counts steps per minute with exceptional accuracy, closely matching specialized, research-grade accelerometers. Rubin noted that Walk Test was designed for accessibility and user-friendliness in addition to accuracy.

“We wanted to make it as low-barrier as possible so it’s easy for older adults to use without additional equipment,” he said. “The people who need the most help are usually the least well-equipped to get started.”
Practical advice for daily life
The research highlights walking as a widely accessible exercise with substantial health benefits.
“Even casual walking had positive effects on our study participants,” Rubin said. But for those who are able, increasing their walking pace judiciously can yield even greater results.
To use cadence to guide your walking intensity, start by measuring your usual walking pace in steps per minute to establish a baseline. From there, try increasing your pace slightly to find a level that still feels comfortable but brisker.
To maintain a steady and elevated cadence, Rubin recommends using a metronome app to match your steps to a consistent beat. While the Walk Test app developed by the research team is not yet available to the public, metronome apps are a simple alternative that can help walkers stay on pace and track progress over time.
These methods can help integrate faster-paced walking into daily routines, offering a simple yet effective strategy to people who want to stay healthier and more independent as they age.

From poached to panfried, when it comes to eggs, it’s all sunny side up, as new research from the University of South Australia confirms that this breakfast favourite won’t crack your cholesterol.
Long blamed for high cholesterol, eggs have been beaten up for their assumed role in cardiovascular disease (CVD). Now, UniSA researchers have shown definitively that it’s not dietary cholesterol in eggs but the saturated fat in our diets that’s the real heart health concern.
In a world-first study, researchers examined the independent effects of dietary cholesterol and saturated fat on LDL cholesterol (the ‘bad’ kind), finding that eating two eggs a day – as part of a high cholesterol but low saturated fat diet – can actually reduce LDL levels and lower the risk of heart disease.
CVD is the leading cause of death worldwide, responsible for nearly 18 million deaths each year. In Australia, one person dies from CVD every 12 minutes, accounting for one in four of deaths nationwide.
Lead researcher, UniSA’s Professor Jon Buckley, says it’s time to rethink the reputation of eggs.
“Eggs have long been unfairly cracked by outdated dietary advice,” Prof Buckley says.
“They’re unique – high in cholesterol, yes, but low in saturated fat. Yet it’s their cholesterol level that has often caused people to question their place in a healthy diet.

“In this study, we separated the effects of cholesterol and saturated fat, finding that high dietary cholesterol from eggs, when eaten as part of a low saturated fat diet, does not raise bad cholesterol levels.
“Instead, it was the saturated fat that was the real driver of cholesterol elevation.
“You could say we’ve delivered hard-boiled evidence in defense of the humble egg.
“So, when it comes to a cooked breakfast, it’s not the eggs you need to worry about – it’s the extra serve of bacon or the side of sausage that’s more likely to impact your heart health.”