NHS bosses are aiming to keep nearly all services running as resident doctors begin a five-day walkout in England.

The strike – the 13th by British Medical Association members in the long-running pay dispute – starts at 07:00 GMT and lasts until 07:00 Wednesday.

Resident doctors – the new name for junior doctors – will walk out of both emergency and non-urgent care.

Hospitals will come under the most strain, with resident doctors making up about half the medical workforce. But NHS England said patients should still attend appointments unless advised otherwise.

It said it wanted to keep 95% of non-urgent work, such as hip and knee operations, going.

The NHS aims to do this by re-deploying and offering overtime to consultants and and other senior doctors as well as relying on those not striking – around a third of resident doctors are not BMA members.

But this will come at significant cost with the NHS estimating the five-day walkout is costing £240m to cover.

'I'm furious'

Despite the attempt to keep services going, patients like Colette Houlihan, 68, have still had to face postponements.

She was due to have a pre-surgery appointment on Monday, but this has now been pushed back to late December.

Ms Houlihan, from Cambridgeshire, who is waiting for a benign tumour in her neck to be removed, said she had had to put up with two cancellations already, but could understand those as she was told patients who were higher priorities needed to be seen.

"They could have had cancer. I didn't mind that, but this is different.

"I am furious. By striking they ignore the Hippocratic Oath - first and foremost do no harm.

"Striking causes harm by way of delaying procedures, taking senior doctors from their posts and causing chaos within the system," she said.

Challenging

NHS England medical director Prof Meghana Pandit said it was frustrating and disappointing that there was another round of industrial action at a challenging time for the NHS, with flu cases rising earlier than usual.

"Despite this, staff across the NHS are working extremely hard to maintain care and limit disruption," he added.

But BMA leader Dr Tom Dolphin said keeping most services running would be "challenging".

He said doctors had a legal right to strike and should not be "bullied or coerced" into working.

And he warned his members would only leave the picket line if there was a major emergency – such as a mass casualty event.

The latest walkout comes after Health Secretary Wes Streeting launched arguably his strongest attack on the BMA.

Addressing a conference of health managers this week, he called the union "morally reprehensible" and accused it of acting like a cartel, attempting to hold the public and government to ransom.

He said doctors had received generous pay rises over the past three years – worth nearly 30%, bringing average basic salaries to just over £54,000.

Talks between him and the union broke down last week after the BMA turned down a fresh offer to end the dispute.

Streeting has maintained throughout the year that he could not negotiate on pay, but he proposed a deal that would see out-of-pocket expenses like exam fees and membership fees covered, along with a boost in speciality training places.

But the BMA has argued that, despite the pay rises, resident doctors' pay is still a fifth lower than it was in 2008, once inflation is taken into account.

The union has also warned doctors are struggling to find jobs at a key stage of their training – between years two and three when they start speciality training.

This year there were more than 30,000 applicants for 10,000 jobs at this stage, although some will have been doctors from abroad.

A transport enthusiast, a beauty advocate and a mum teaching people how to raise an autistic child were among the winners of the second annual TikTok awards.

Hosted by TV presenter Aj Odudu at Magazine London, awards were handed out in 12 categories including fashion, travel, food and education.

And taking home the coveted prize of creator of the year was Max Klymenko, who is best known for his career ladder series, which he says is the most popular non-animated show in the world.

In case you've not seen it, Max sets up his stepladder in various public spaces and invites passers-by to join him standing on the ladder while he tries to guess their career with a series of yes/no questions.

Max came to the UK from Ukraine 14 years ago and said the reason he started creating content was because he found it impossible to get a job to get his own career going.

"I had a lot of anxiety and stress around finding a job so I created videos helping people know what jobs were available to them." Gold ladder in hand, Max, who has 8.5 million followers on TikTok, dedicated his award to his grandma in Ukraine who "has no electricity to follow along".

"I'm calling her right after this," he said, explaining that she used to log-in from different TikTok accounts when he first started creating content so it looked like he had more views.

The 29-year-old, who accepted his award from last year's winner Kyra-Mae Turner added that he was grateful his content was being recognised because "everything you see when you scroll on the toilet or in bed takes hours to make".

The nominees have a combined follower count of more than 83 million and the winners were voted for by five million people on the app.

Winning the award for video of the year was Bemi Orojuogun, better known as bus aunty.

Often seen smiling silently on TikToks as she stands at the side of a road or a depot – while a passing double-decker appears to narrowly miss hitting her – Orojuogun has turned her lifelong love of the London's transport network into a viral celebration of city life.

Her winning video has been viewed almost 50 million times and she now has collaborations with Burberry and Ikea.

The mental health nurse has become one of TikTok's most unexpected success stories and she admitted: "It's slightly overwhelming that everyone recognises me," but said is she is proud of what she's achieved.

She thanked Transport for London and Stormzy, saying that he propelled her to fame after re-posting one of her videos.

The 56-year-old grandma had a wonderful night making friends - including Nikki Lilly, the winner of the fashion and beauty creator of the year.

Nikki, who has 10 million TikTok followers, told the BBC that fashion, beauty and lifestyle content can be seen as "skin deep" but her content challenges those perceptions.

"I don't want to only make my social media a highlights reel," the 21-year-old said. "It's also me having surgeries, a chronic illness and me having a facial difference."

After being diagnosed with an arteriovenous malformation, a rare life-threatening medical condition, at age six, she has used her platform to raise awareness and inspire others.

"As someone with a facial condition, I've never felt fully embraced in this space," she said while accepting her award. But she added, she has now found "so much safety" in the TikTok beauty world.

Another advocate creator is Tola and Kevin who won the "voice for change" award.

Tola and Kevin are a mother-son duo behind an account that posts candid videos of what it's like to raise a young adult with autism, striving to create content that raises awareness and promotes acceptance.

In tears, Tola said she was so grateful for the award and explained she started the account because she felt isolated when her son was first diagnosed with autism 16 years ago.

She's since built an "amazing community who love and support Kevin" which has helped the both of them immensely.

One of the most recognisable winners of the night was Charley Marlowe, a Radio 1 presenter, who won entertainment creator of the year.

If you don't know her, you're likely to know her famous cackle which has become her trademark.

On the red carpet earlier in the night she told me "Win or lose, we're on the booze, so I'm having a good night anyway."

She was in shock to have won the award and dedicated it to "every northern, working-class diva."

Full list of winners

Creator of the year - Max Klymenko

Entertainment creator of the year - Charley Marlowe

Food creator of the year - Kieran Monlouis

Sport creator of the year - Lissie Mackintosh

Fashion and beauty creator of the year - Nikki Lilly

Travel creator of the year - Phil Carr

Books & learning creator of the year - Gabriel Astorga

Voice for change creator of the year - Tola and Kevin

Storyteller of the year - Morgan M James

Rising star creator of the year - Joy Anokwuru

Video of the year award - Bemi Orojuogun

Artist of the year - Olivia Dean

The special educational needs and disabilities system for children in England faces "total collapse" and the government must not "keep ducking" reforms, council leaders have warned.

The County Councils Network, which represents some of England's largest local authorities, said councils had deficits which will reach £4.4bn a year by the end of this parliament in 2029, as they struggled to cope with increased demand.

The government has put off planned reforms to the SEND system until next year, and a white paper setting out those reforms was delayed recently.

But ministers face pressure from Labour MPs who warn there would be political danger in watering down support for children.

The number of Education Health and Care Plans (EHCP) - the legal document entitling children to support from local authorities - have increased, according to the Department for Education.

There were 638,745 EHCPs in place in January 2025, up 10.8% on the same point last year. The number of new plans which started during 2024 also grew by 15.8% on the previous year, to 97,747.

The County Councils Network (CCN) says one in every 20 children in England could end up needing this kind of support by the end of the decade.

Councils have a statutory duty to provide support to children with an EHCP, depending on what the document outlines.

The CCN also says demand for EHCPs alone is not the only factor driving spiralling expenditure, with "over-reliance on higher costs placements and special provision" also a factor, including "expensive private school places".

There are now record numbers of pupils in special schools. In England, there are around 194,000 pupils, compared with 109,000 in 2014/15 according to the CNN.

The CCN has projected that councils could be spending £8bn on these placements by the end of the decade.

While the government wrestles with provision for children, many families continue to struggle.

Amanda Quick, who has a 12-year-old son with ADHD and autism, really appreciates the support at her local Taunton café, set up specifically for parents to bring their children with special educational needs.

Amanda's son Ezra attends a specialist school, but Amanda says she had a long fight with their local authority in Somerset to get him the support he needs.

"My mental health took a hit. I couldn't cope with all the paperwork so I ended up getting a solicitor, which is about £200 an hour," she said.

Claire Naylor, who owns the café, said she felt "dismissed" in trying to get support for her six-year-old son MJ, who has non-verbal autism.

"The EHCP process became a real fight and a real battle to get those provisions put in place. We ended up having to go to court which took us over a year," she says.

"We had to spend thousands of pounds on private reports just to prove what we already knew.

"We needed him to fail to be able to prove [he needed support] which is a really really sad way of basically being heard and it affected a whole family. We lost friendships, we've lost a lot of money and a lot of time."

Budget deficits

The CCN has called for the council deficits incurred by SEND provision to be written off and for changes to the law to focus EHCPs on those "most in need".

Councillor Bill Revans, Lib Dem leader of Somerset County Council and SEND spokesman for the CCN, said spiralling demand is fuelling the crisis and better inclusion in mainstream schools should be a priority.

"The whole system needs looking at, including EHCPs," he said.

"That pressure is unsustainable and it will make the system collapse within this parliament.

"All councils that have responsibility for special educational needs and disabilities carry a deficit on their budget which isn't included on their accounts.

"We will have no way of paying that off unless there is a solution from government."

But changing EHCPs is a political battleground and campaigners have warned against watering down legal protections for families.

Education Secretary Bridget Phillipson has refused to say whether the government would change or abolish EHCPs.

Labour chair of the Education Select Committee, Helen Hayes, has joined campaigners saying this entitlement must stay in place.

Rachel Filmer, a parent of children with special educational needs, set up Save our Children's Rights campaign in direct response to the government refusing to commit to these plans.

"Without [EHCPs] children have no legal right to any support so things could be catastrophic," she said.

Keeping EHCPs in place but diluting them into a more generalised format that offers less tailored support is also a concern amongst campaigners, and some MPs have suggested the delay to the government's reforms are due to tension over whether to change or scrap these plans.

One said the pushback to changes to EHCPs would be "serious and significant" and would endanger already low levels of trust families have.

The Conservatives have said the delay in publishing the white paper had been "seriously damaging".

Tory MP Saqib Bhatti said: "SEND provision is vital to so many children and that's why we all need the government to get its reforms right."

He added: "Speculation that the government may scrap EHCPs has caused further anxiety to families that already face a struggle to get their children the support they need."

Reform UK are expected to set out its own plans for the SEND system soon.

The party's deputy leader, Richard Tice, recently suggested some parents were "abusing" the system – limiting support for those in "genuine need".

Phillipson favours an approach of earlier intervention, something that is welcomed by campaigners and MPs.

Schools Minister Georgia Gould, who recently inherited the SEND brief, has been visiting constituencies on a "listening" tour exercise.

A Department for Education spokesperson said the government inherited a SEND system "on its knees".

"We're determined to put that right by improving mainstream inclusion so every child can thrive at their local school," they said.

"We've held over 100 listening sessions with families and will continue engaging parents as we deliver reform through the Schools White Paper."

Phillipson has had praise from MPs for being accessible and ready to hear their thoughts, and they point to this as evidence that Downing Street has learned lessons from the summer, when numerous Labour MPs rebelled against the government's proposed cuts to welfare.

Ministers favour setting up more specialist provision in mainstream schools, but MPs have warned that there cannot be a half-hearted approach to giving schools and councils what they need.

"If SEND reform is about saving dough rather than improving the system then it's not headed in the right direction," said Labour MP Neil Duncan-Jordan.

Labour MP Rachael Maskell said that if the upcoming budget does not show that the government is adequately equipping schools and councils - such as increased workforce funding for roles such as speech therapists, health visitors and physiotherapists - then she will not be supporting reforms.

And Jen Craft, a Labour MP who has a disabled daughter, says the approach of groups like the CCN may not be the right one.

"I don't think you should be coming at it from a position of these children, these families cost too much money," she said.

Writing off billions in council deficits would be challenging for a government already facing what's widely expected to be a difficult budget, with warnings about the existing pressure on public finances.

Ministers have signalled that reform of the SEND system will focus on increasing and improving inclusive mainstream provision and early intervention, but that would require extra resource for schools.

Either way it is a challenge ministers are trying to carefully navigate, conscious of the consequences if they don't get this right.

When Rebecca Middleton became pregnant, she had no idea that she would end up in a wheelchair for the final three months before she gave birth.

Rebecca had had a difficult first trimester dealing with nausea and sickness, and began to develop pelvic pain four months into her pregnancy.

"I could hardly walk, I'd always had some problems with lower back pain in my life. But nothing that significant and it escalated quite quickly," she says.

After complaining about the pain, she was referred to an NHS physio, and eventually diagnosed with an extreme case of pelvic girdle pain (PGP), also known as symphysis pubic dysfunction.

Problems with your pelvic joints are a common symptom of pregnancy, affecting one in five expectant mothers to some degree.

"I was terrified, would I ever walk again? How would I have my baby, how would I care for it?"

After giving birth, Rebecca was in less pain, but she still struggled with basic things like walking, lifting her son or pushing a pram.

"I was disabled for seven months and had to have someone helping me all the time," she says.

"I just couldn't do the things that you should be able to do in looking after a baby, it was a really challenging time."

Prior to becoming pregnant, it was an issue Rebecca was unaware of and since her experience she volunteers for The Pelvic Partnership, a charity which helps raise awareness and support women with this condition.

It says the condition is treatable with the right action.

As soon as your symptoms start, the charity advises you get hands-on individualised treatment, including manual therapy, and ask for a referral for NHS physiotherapy from your GP or midwife.

If you aren't offered this support initially, the charity suggests going back to your GP or midwife and asking for a second opinion.

They can also refer you to maternal mental health support to help you manage the emotional impacts of living with PGP.

Dr Nighat Arif, a women's health specialist, says higher awareness and early assessment could prevent patients like Rebecca needing wheelchairs or crutches.

"Without that early identification based on a really good understanding of the female body, we leave some of these women with negative effects for life," she says.

Gynaecologist Dr Christine Ekechi says the lack of research around the condition means it is less likely to be identified and suitably treated, particularly post birth.

"We don't necessarily see them unless they then come back into a gynaecology clinic presenting with pain.

"So we don't have a great understanding as to the proportion of women that have persisting pain that has started off during pregnancy."

Victoria Roberton, co-ordinator at the Pelvic Partnership, is an example of how awareness can help.

Like Rebecca, she didn't know what PGP was when she began experiencing the condition during her first pregnancy.

She tried to stay as active as possible as advised and was referred to NHS physio sessions online and by phone, but found the pain worsening as her pregnancy progressed.

"They gave us exercises, stretches to do. By this point I couldn't do any of them. It was too painful," she says.

It got to the point where even sitting became uncomfortable for Victoria, and she was largely homebound until her baby was born.

The pain lessened after the birth of her daughter, but she began experiencing the same problem when she became pregnant with her second child.

It's not an option for many mothers, but Victoria said given her medical history she decided to pay for a private physio as the NHS wait for referral was long.

The physio gave her a full assessment and hands-on treatment including joint mobilisation, and taught her different ways to move her body to not aggravate her hip joints, which helped ease the pain.

Victoria still struggles with a degree of PGP today, four years on, but her second pregnancy was much easier to manage because she understood her condition and how to handle it.

Rebecca's second pregnancy has been similarly a much more positive experience.

This time round she knew she was at risk of PGP and was able to have it treated throughout her pregnancy before it became debilitating.

She has made a full recovery from PGP, just two months post birth compared to two years for her first child.

"I'm probably in better shape now than I was before either of my children because I now know what caused that pelvic girdle pain, and have had it fully treated and resolved with manual therapy," she says.

"It was five years of hell because of the pain I was in because of a lack of knowledge and understanding about the subject."

Bangladesh's former prime minister Sheikh Hasina has denied committing crimes against humanity during a deadly crackdown on last year's uprising that ousted her, days before the special tribunal trying her is due to deliver a verdict.

Hasina is accused of being the main architect behind hundreds of killings during the mass protests against her autocratic rule - an allegation she denies.

In her first interview with the BBC since she fled the country on 5 August 2024, she said her trial in absentia was a "farce" orchestrated by a "kangaroo court" controlled by political opponents.

Prosecutors are seeking the death penalty for Hasina if she is found guilty on Monday.

Hasina claimed the trial was destined to deliver a "pre-ordained guilty verdict".

Security has been tightened in and around the tribunal in the capital Dhaka ahead of Monday's verdict.

It will mark a significant moment for the country as well as for the relatives of those killed during the student-led anti-government protests that ousted Hasina.

UN human rights investigators have said up to 1,400 people were killed when Hasina and her government used systematic, deadly violence against protesters in the failed bid to hold onto power.

The former prime minister has refused to return from India to attend the trial.

She has been accused of personally ordering security forces to fire at protesters in the weeks before she fled.

In an email interview, Hasina told the BBC she "categorically" denied such allegations.

"I'm not denying that the situation got out of control, nor that many lives were lost needlessly. But I never issued any order to fire on unarmed civilians," she said.

Leaked audio of one of her phone calls verified by BBC Eye earlier this year suggested that she had authorised the use of "lethal weapons" in July 2024. The audio was played in court during the trial.

Hasina was formally indicted along with two others in July this year. They are former home minister Asaduzzaman Khan Kamal and former inspector general of police Chowdhury Abdullah Al-Mamun.

Prosecutors have sought the death penalty for the former, who is in hiding. The latter pleaded guilty in July but has not been handed a sentence.

Speaking about the trial, Hasina said she hadn't been able to defend herself or appoint her own lawyers.

She added her political opponents had gone after her in an attempt to "liquidate" her Awami League party as a political force.

Lawyers representing her issued a statement on Monday saying they had filed an urgent appeal to the UN raising serious fair trial and due process issues at the International Crimes Tribunal in Bangladesh.

The Awami League is already banned from standing in general elections due in February.

The BBC interview also covered other serious allegations of abuses committed during Hasina's 15-year rule, which will be heard in another case at the special tribunal. Hasina denies charges of crimes against humanity in that case too.

After Hasina was ousted from power, a number of secret jails were discovered holding prisoners who had been detained for years without any legal process. Many other critics and opponents of Hasina who had been abducted or held in these prisons are alleged to have been killed unlawfully.

Asked who was responsible for this, Hasina said she "did not have knowledge" of them.

She also denied her involvement in alleged extra-judicial killings and disappearances, which rights group say she was responsible for as the head of government during her leadership.

"This is denied in terms of my own involvement, but if there is evidence of abuse by officials, let us have it examined properly in an impartial, depoliticised process," she said.

Hasina and other senior members of her former government are also facing trial for corruption in a separate court, charges they deny.

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