Risk of baby abduction revealed in one of worst NHS watchdog reports ever published

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Britain’s biggest NHS trust was today shamed as “inadequate” as it received some of the worst criticism ever levelled by the NHS watchdog.

Barts Health, which runs five east London hospitals including the £650 million Royal London in Whitechapel, was ordered to make an unprecedented 65 immediate improvements by the Care Quality Commission.

It was castigated for having “not enough doctors and midwives to deliver safe care” to women in labour, “significant risks” due to a lack of paediatric nurses, and security failings that created a risk of newborn babies being abducted.

A shortage of beds at the Royal London – the biggest stand-alone hospital in Europe, with 671 beds on 31 wards – meant operations were repeatedly cancelled and patients were shuffled between wards for non-medical reasons.

A “them and us” culture exists between a “very committed” workforce and the trust board, while a “culture of blame” and bullying meant some staff were afraid to speak to CQC inspectors.

The trust, which posted a £79.6 million debt in the last financial year, was placed in special measures by the Trust Development Authority in March after the CQC found Whipps Cross hospital, in Leytonstone, to be inadequate.

The CQC’s concerns led it to investigate the flagship Royal London – rebuilt under a controversial private finance initiative (PFI) deal three years ago – and Newham.

It found these too to be inadequate, with only the major trauma unit at the Royal London – which saves twice as many patients as the national average – and the trust’s stroke services among the few services attracting praise.

Professor Sir Mike Richards, the CQC’s chief inspector of hospitals, said “too little attention was paid to safety” across the trust. There were nine “never events” – medical blunders so bad they should never occur – in 14 months, including eight cases of surgery in the wrong area and 1,253 serious incidents.

Sir Mike said: “Barts Health NHS Trust is the largest NHS trust in England, serving a population of well over two million people, and home to some world-renowned specialities. So it is all the more disappointing to report the extent and level of our concerns in all three hospitals, particularly in safety and leadership.

“It is clear that the leadership issues we found at Whipps Cross were replicated at the other hospitals. It is three years since the merger which formed the trust – but there is still a lack of engagement with the staff, low morale, high levels of stress, even confusion among the workforce about who is in charge.”

The report, based on inspections in January followed by unannounced visits, could increase pressure to break up the trust. Its chief executive, chairman, chief nurse and finance director have all quit in the past months.

One patient told the CQC that it was so difficult to contact staff at Whipps Cross that he had to visit the hospital in person after making 79 phone calls without success.

Another patient had their surgery cancelled five times – but the head of surgery, head of cancer, hospital director and head matron were all unaware.

Security tags had not been fitted to the ankles of newborn babies for six months because of a series of false alarms, despite the high number of unknown visitors to the Royal London’s maternity unit. Two of the floors at the Royal London remain mothballed because of a lack of cash, but there are plans to use one floor for private patients to reduce the trust’s deficit.

Royal College of Nursing London Operational Manager Sue Tarr said: “Barts Health has faced a series of problems over recent years, driven in part by an unsustainable PFI debt. However the decision in 2013 to try to save money by cutting and down banding hundreds of nursing posts has proved disastrous. Barts now has the biggest deficit and the biggest agency nursing bill of any trust in England.

“The CQC suggests that staffing shortages went further than those reported at board level. The trust urgently needs a realistic and sustainable plan to get enough nursing staff in post to safely deliver the care needed by the millions of East Londoners who rely on Barts for their healthcare needs.”

Steve Ryan, the Barts Health NHS Trust Chief Medical Officer, said: “These CQC reports describe some services that fall short of what we aspire to. We are very sorry for the failings identified by the CQC in some of our services at Newham and The Royal London hospitals. We know we have a big challenge ahead but we are determined to rise to that challenge.

“We are already making rapid and dramatic improvements in key areas. We welcome the targeted help the special measures regime provides. We firmly believe in Barts Health as an organisation and we recognise the need for improvement.”

How rogue HGV driver destroyed many lives: devastating victim impact statement of cyclist’s widow

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The widow of a cyclist killed instantly after being run over by a rogue driver’s tipper truck has told in heartbreaking detail how she was torn apart by the trauma of his death.

Deputy head teacher Penny Johnson wrote emails to Alan Neve telling him she loved him – and sent replies from his email account to her own – slept with his pyjamas and looked in vain for him on the Tube and as she drove around London.

Alan Neve: "In every way the finest and most decent of men", said Judge Daniel Worsley

Alan Neve: “In every way the finest and most decent of men”, said Judge Daniel Worsley

“My live used to be vividly and richly coloured,” she said. “Now it’s black and white. “It’s hard to accept that such a gentle, kind, sensitive man had such a horrible death.”

Penny Johnson 1

Penny Johnson 2

Tipper truck driver Barry Meyer, 53, of Walthamstow, was last week [Thursday 14] jailed for three-and-a-half years and banned from driving for 10 years after admitting causing the death by careless driving of Mr Neve, 55, a music industry auditor from Poplar.

Barry Meyer: had a "wretched disregard" for the rules of the road

Barry Meyer: had a “wretched disregard” for the rules of the road

Judge Daniel Worsley said Meyer, who had previously been banned from the road five times and was driving without a HGV licence and insurance at the time of the morning rush-hour collision at Holborn on July 15, 2013, had a “wretched disregard for the safety of road users”.

In a victim statement to Blackfriars Crown Court, read by prosecutor Allison Hunter, Ms Johnson said she had suffered “traumatic” loss as Mr Neve’s death came without warning.

She said: “I could not fully comprehend that Alan was not still here. I had not said goodbye. He was there and then he wasn’t.

“When the police told me that Alan had been taken to St Pancras mortuary, I remember thinking he would be cold and that I should take him some warm clothes and a blanket.”

They met in 1984 when she was 21 and he was 26. They became a couple in 2000 and married in 2008. She became step-mother to Mr Neve’s teenage daughter Matilda.

“I loved Alan with all my heart and he made me happier than anyone else in the world,” she said.

“I felt like the luckiest woman in the world to have him as my husband. It’s impossible to fully convey how Alan’s death has affected me.

“I so very much want the life back that I had, rather than the one I am living now. I long for Alan constantly.

“Matilda has said: ‘I think about dad every day and miss him deeply. I thought of him as a best friend as well as a father. He was truly an inspiration.’”

Penny Johnson 3

Penny Johnson 4

Judge Worsley told Meyer the harm he caused to to Mr Neve’s family and to Alexander Smith, a lorry driver who had tried to help Mr Neve, was “devastating beyond all measure”.

Mr Neve was wearing a cycle helmet but died from massive head injuries when the lorry’s front and rear wheels ran over his head. Mr Smith was so traumatised that he had a mental breakdown, lost his job and his marriage almost fell apart, the court was told.

Neil Corre, defending, said Meyer had never served a prison sentence despite his series of bans, some of which were flouted. He said there was a “very limited opportunity” for Meyer – who had driven through a red light – to spot Mr Neve as he weaved through traffic.

Despite the fact that it was Mr Neve’s right of way, Mr Corre said: “It has to be said with sadness that Mr Neve put himself in a position of danger by riding into the closing gap between Mr Neve’s vehicle and the vehicle driven by [a colleague].

‘The staff love her': Paramedics launch unprecedented campaign to win top job at London Ambulance Service for interim boss

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Dr Fionna Moore: The most popular boss in the NHS?

Dr Fionna Moore: The most popular boss in the NHS?

Paramedics have launched an unprecedented public campaign to have their “loved” medical director given the top job at the London Ambulance Service.

More than 450 have signed an online petition calling on bosses to appoint Dr Fionna Moore as chief executive of the world’s largest emergency service.

Click here to see the full petition backing Dr Moore.

It comes as the NHS watchdog prepares to carry out a major inspection of the London Ambulance Service – and has urged Londoners to share their views of its performance.

Dr Moore has been interim LAS chief executive since Ann Radmore quit in January amid concerns at an exodus of staff and as the Prime Minister was forced to defend 999 response times that fell to the slowest in the country.

Latest figures show it reached 64.8 per cent of the most serious 999 calls within eight minutes last month – below the NHS target of 75 per cent.

Applications closed on Monday for the chief executive’s job, with “UK or international” candidates sought.

Tom Lynch, who founded the LAS cycle response team, called for Dr Moore to be given the job permanently, saying she had a “truly magnificent” level of support from staff.

He said: “The public show of support from our staff on recent gatherings has been very real and emotional, the staff love her, we just wish you could package that up and show the recruitment team.

“This sort of support and belief in her would never come across in any recruitment process. Fionna as our medical director for over 15 years has always led from the front and still does as our interim CEO.”

Inspectors from the Care Quality Commission want Londoners to help them target their inspection of the service, which will begin at the start of June.

CQC chief inspector, Professor Sir Mike Richards, said: “We need to make sure that ambulance services are safe, caring, responsive, effective and well led.

“This inspection will provide people with a clear picture of the quality of their local ambulance service, exposing poor or mediocre service if its exists as well as highlighting where the trust provides good and excellent services.

“If you have recently needed to call out an ambulance in emergency, or have experience of using the service – we would like to hear from you.”

LAS director of nursing and quality, Zoe Packman, said: “We hope our patients will come forward to share their experiences with the CQC team. We welcome feedback and look forward  to using their findings to further improve our service to Londoners.”

Barts Heart Centre ‘could save the lives of 1,000 Londoners a year’

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The lives of more than 1,000 Londoners a year could be saved by the opening of the UK’s biggest heart centre, its executive director claimed today.

Professor Charles Knight said the merger of three cardiac units into the £234 million Barts Heart Centre, in Smithfield, would lead to huge advances in care due to the number of specialists under one roof.

Heart disease is the UK’s number one killer, accounting for one in four deaths – 160,000 Britons a year. “In the East End, rates of heart disease are very high,” Professor Knight said.

“If we look at the three million population of east London, we estimate that if we brought the rate of heart disease death down to the UK national average, that would save us 1,000 deaths a year. That is why we exist as a heart centre – to try and achieve that.”

More than 150 patients suffering a heart attack – a blockage in a heart artery – or a more serious cardiac arrest (where the heart stops beating) have been treated since the heart centre received its first emergencies on April 14.

Formed from the merger of services at the London Chest Hospital, the Heart Hospital and those already on the St Bartholomew’s site, it is one of seven heart attack centres in London credited with a “revolution” in cardiac survival since their formation in 2010.

Research last year found that 66 per cent of patients taken to a heart attack centre survive – more than double the rate for those taken to a conventional A&E unit.

As a centre of excellence for congenial heart disease, Barts Heart Centre will treat 80,000 patients a year, from emergency interventions to multiple heart bypass and aortic valve surgery. It has 10 theatres, 10 catheter labs, 250 general cardiac beds and 58 critical care beds.

“This is the first time we have got the opportunity for a proper cardiac arrest centre,” Professor Knight said. “At the London Chest Hospital, we just had people like me – coronary interventionists. We didn’t have specialists in electrical rhythms of the heart. Now we have cardiac surgeons, anaesthetists, electrophysiologists and interventionists all under one roof.”

Director of cardiac nursing Louise Crosby said: “It’s brilliant. The building is just fantastic. I feel really, really lucky to be working here. We have got a great team. I think we can make this really good.”

Patient Barbara Boswell, 83, from Woodford Green, was being released six days after undergoing a heart bypass. “I was given the option: have the operation or a heart attack,” she told me. “I didn’t realise I was one of the first patients. It’s quite an honour – it’s a marvellous place.”

In its first three weeks, it has met the NHS target of performing coronary angioplasty – the insertion of a balloon in a blocked artery – within 150 minutes from a 999 call on about 85 per cent of occasions.

A second “door to balloon” target – from the patient arriving at the door of the hospital to undergoing the procedure within 90 minutes – has been met in 100 per cent of cases. Professor Knight believes this can be cut to 60 minutes in some cases.

London to Barcelona bike ride to raise £100,000 to fight ‘silent killer’

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A top surgeon is cycling to Spain with the son of one of his patients to raise £100,000 for research into the cancer known as the “silent killer”.

Professor Nigel Heaton, from King’s College hospital, volunteered to join James Lane on the 900-mile ride from London to Barcelona to raise awareness of the increasing threat posed by liver cancer.

Mr Lane’s father Christopher died aged 67 in July 2011, eight months after being diagnosed. He had been “very fit and active” and his family was devastated at his sudden decline.

“There seemed to be very little that could be done,” Mr Lane, 40, a lawyer at Ricoh’s head office in Euston, said. “I wanted to try to make some good out of bad.

“I watched my father deteriorate at a rapid rate over such a short period of time and it was absolutely soul-destroying. It absolutely knocked his friends and family for six.”

The pair will be joined on the 11-day ride, beginning on Saturday [May 16] by 32 riders, many from Ricoh’s offices across the globe. Mr Lane, a married father of two from Henley, said his father would have been very proud of his efforts – but would have thought him “mad”.

More than 5,000 people die each year from liver cancer. The number of cases of liver cancer in men has increased by 70 per cent in a decade.

Less than a third of patients survive a year after diagnosis, and only around 12 per cent live for five years. Rising obesity rates have fuelled the incidence of liver cancer, which often has no symptoms in its early stages.

Professor Heaton said: “It is one of the few cancers which is rapidly increasing in frequency. If you went back 20 years it was relatively rare. Now we are seeing at King’s 500 new patients a year.

“If you can recognise it early then cure rates are high. The majority of patients present late. Often then, we have relatively few treatments to manage them.”

A total of 243 liver transplants were performed at King’s, in Denmark Hill, last year – including 42 in children. The hospital has 180 patients on a transplant waiting list.
The funds will used on research projects at the Institute of Liver Studies at King’s, the leading centre in Europe for the treatment of liver cancer, to find new treatments.

“If we can recognise cancer early, we can treat it effectively and avoid such expensive treatments as liver transplantation,” Prof Heaton said.

* www.ricohimaginechangechallenge.com

Labour secures victory in Hampstead and Kilburn and Holborn and St Pancras 

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Tulip Siddiq claimed victory for Labour in the most marginal seat in England – Hampstead and Kilburn – while former Director of Public prosecutions Sir Keir Starmer doubled the party’s majority in neighbouring Holborn and St Pancras.

Green Party leader Natalie Bennett came third in Holborn and St Pancras after seeing her vote increase five-fold.

  
Ms Siddiq, who turned Glenda Jackson’s 42-vote majority from 2010 into a comfortable 1,000-plus votes, brought her husband and family onto the podium to thank them for their part in her success.

Sir Keir, who was visibly strained at the catastrophic performance of his party outside London, vowed to fight against High Speed 2 in his role as MP for Holborn and St Pancras, where he replaces former Labour health secretary Frank Dobson.

Ms Bennett looked to the Green performance nationally as an indication of its success, claiming it now had more members than the Lib-Dems and UKIP and had earned a place at the centre of British politics.

Two-year-old girl died after doctor failed to order brain scan, coroner rules

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Keira Lee

The failure of a doctor to order a 15-minute scan on a two-year-old girl displaying signs of a brain tumour “contributed to her death”, a coroner has ruled.

Dr Andrew Harris said there had been a “gross failure to provide medical care” by consultant paediatrician Dr Majeed Jawad in his treatment of Keira Lee (pictured above) on October 26, 2013, at the private Spire Gatwick Park hospital in Horsley, Surrey.

She died six weeks later, on December 5, 2013, in King’s College hospital, Denmark Hill, after undergoing an operation to remove the 5cm tumour – surgery that may never have been needed if it had been spotted earlier.

Dr Harris, in a narrative verdict last Thursday [April 30] at Southwark coroner’s court, said: “The failure of the paediatrician to refer for a scan at the end of October contributed to her death.”

Keira’s parents, Tim and Kirsty Lee, who live near Horsley, told the Standard: “The death of our beautiful daughter Keira is obviously totally devastating for us as a family.

“Whilst the inquest was emotionally very difficult, we hope that it has in some way helped to raise awareness of childhood brain tumours and maybe save lives in the future. The coroner’s verdict supports our belief that if Keira had been diagnosed sooner then she would be with us today.”

During his evidence, Dr Jawad apologised to the family for failing to diagnose the tumour. “I feel very, very sorry,” he said.

Under questioning from the coroner and cross-examination from the Lee family’s barrister Bridget Dolan, Dr Jawad admitted he had been ignorant of Royal College of Paediatrics and Child Health guidelines on treating brain tumours, and failed to order neurological checks despite Keira displaying “red flag symptoms” of different-sized pupils and facial palsy.

Mr Harris told him: “That wasn’t very confusing, was it? It couldn’t be clearer, if you had examined her, that she had two abnormal focal signs.”

Dr Jawad replied: “At that time, Keira didn’t have the classical symptoms that are part of a brain tumour.”

Dr Harris expressed concern at the lack of specialist paediatric nurses in the post-operative area at King’s, which is a regional centre for neurosurgery. He is to demand immediate action from hospital bosses as he fears the shortage of nurses means there is a risk of future deaths.A prevention of future deaths report will be issued in due course.

Joanna Hunter, divisional head of nursing for critical care at King’s, admitted to the hearing that the hospital remained in breach of Royal College of Nursing guidelines 16 months after Keira’s death. She said she was trying to recruit two specialist nurses but admitted five were needed to ensure 24/7 cover.

King’s College hospital said there was a national shortage of paediatric nurse specialists. “Until these posts are filled permanently, we have a paediatric nurse seconded into the department to help treat children after their operations,” a spokeswoman said after the inquest. “Recovery also has access to a 24-hour rota system, which means there is always a paediatric nurse on-call should they be needed.”

In a statement afterwards to the Standard, Dr Jawad said: “This is a very sad and tragic case and I would again like to extend my deepest sympathy to Keira’s family. I accept the findings made by the coroner and sincerely hope that the inquest process has provided Keira’s parents with the answers to their questions.”

Keira Lee

On the first day of the inquest, Mrs Lee told how she feared Keira would “internally combust” after reacting badly to an operation to treat a brain tumour.

She became anxious that doctors at King’s College hospital were unable to ease her daughter’s post-operative distress after emergency surgery on December 3, 2013.

The child “with a beaming smile and heart-melting giggle” died two days later after a “catastrophic stroke” caused by a brain stem hernia.

Ms Lee told Southwark coroner’s court: “I felt it was out of control. My feeling at the time was that she had just had brain surgery. The way she was behaving with her heart rate, her body just seemed in far too much distress.

“In my opinion, the only words I can find is that it felt if it continued the way it did and she wasn’t put to sleep or helped to relax in some fashion, she would internally combust.”

Keira, the fourth child of Mr and Mrs Lee, had been transferred to the specialist neurology department at King’s after being rushed to her local A&E on November 27, 2013.

A CT scan ordered by doctors at East Surrey hospital, in Redhill, had uncovered a 5cm tumour in the centre of Keira’s brain – explaining what lay behind her deteriorating condition that had gone undiagnosed by doctors at the Spire hospital.

Her parents had become increasingly concerned during the preceding two to three months as Keira lost her appetite, vomited more frequently and became lethargic.

She was seen on three occasions in October and November 2013 by Dr John Brookes, an ear, nose and throat consultant at Spire Healthcare.

He admitted in court that he failed to order neurological tests that mighty have detected the tumour, saying he believed she had a nasal problem but was reassured when she smiled.

The coroner  said Mr Brookes had failed to react adequately to the Keira’s history of gagging and vomiting and the concerns of a “reliable and experienced mother”.

Mr Brookes was shown photographs of Keira taken in October and November 2013 and admitted they showed different pupil sizes and a weakness on the side of her face.

Mr Brookes told the hearing: “I would like to say to Mr and Ms Lee how sorry I am that I missed the diagnosis.”

* The Lee family is raising awareness of brain tumours at: loveukeira.co.uk

Edited versions of this story have been published in the Evening Standard:

http://www.standard.co.uk/news/health/doctor-failed-to-order-scan-that-could-have-saved-twoyearold-girls-life-10225324.html

http://www.standard.co.uk/news/health/doctor-at-private-hospital-apologises-to-surrey-girls-parents-for-missing-tumour-which-killed-her-10197553.html

http://www.standard.co.uk/news/health/doctor-failed-to-order-scan-that-could-have-saved-twoyearold-girls-life-10225324.html

Lorry driver flees inquest as details revealed of fatal collision with cyclist

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A lorry driver involved in the death of a cyclist fled an inquest in tears as details of the fatal collision were revealed.

Lee Norfolk temporarily left the hearing at Southwark coroner’s court last Friday as it considered how Richard Muzira, 61, (below), died in Camberwell on November 18, 2013 – the last of six cyclists killed in London in a fortnight.

Richard Muzira: "A very cautious cyclist"

Richard Muzira: “A very cautious cyclist”

Terence Dixon, who was driving a van immediately behind the lorry, told how he sounded his horn to try to alert Mr Muzira to the fact it was turning left.

“He was like he was in his own little world,” Mr Dixon said. “He was sat up straight and was enjoying his day. It looked like he enjoyed cycling.”

He said Mr Muzira “swerved” in an apparent attempt to undertake the lorry. “It looked like he was about to hit it [the lorry], and that was when the lorry caught the bike.”

Mr Muzira fell under the vehicle and suffered massive pelvic and chest injuries. He died at the scene.

Collision investigator PC Steven Gilbert told the inquest that Mr Norfolk, a HGV driver with 30′ years experience, would have been “unlikely” to have seen Mr Muzira on his inside as his tipper truck turned left from Camberwell Road into Albany Road.

Mr Gilbert said: “Mr Muzira would probably have [needed to have] been at least another 2m away from the side of the lorry before he would have been visible to the driver looking out through the side window.”

The lorry, belonging to Roll On Off Services, of Erith, had moved off from traffic lights and turned the corner at 9mph. Mr Muzira was travelling at a “slowish cycling pace” of about 5.5mph.

Jane Henderson, Mr Muzira’s ex-wife, told the court: “He wasn’t a risk-taker in his cycling. He was a very cautious cyclist.”

The lorry had moved into the right-hand lane to give it extra space to make the tight turn into Albany Road. Mr Norfolk, asked by coroner Andrew Harris if he had seen a cyclist, replied: “Not that I can recall, no.”

He said he had been aware of the spate of cyclist deaths at the time. “You are aware of it because it’s all over the media,” he said. “You hope you will never be involved in it.”

He said that the firm’s HGVs were now fitted with sensors that sound an alarm if anything was detected nearby. The lorry had CCTV cameras at the time of the collision.

Police told the court there were no grounds to consider a prosecution against the driver.

The coroner said it was clear from evidence that the lorry had been indicating left and the driver had checked his mirrors.

He recorded a narrative verdict that Mr Muzira’s death was caused by road traffic collision. He said: “The cyclist would appear not to have noticed the lorry turning left and failed to stop.”

He rejected a request from the family’s solicitor to issue a prevention of future deaths report, saying he understood that Southwark council was already taking action to improve safety at the junction.

After the inquest, Mr Norfolk was given a consoling hug by a friend of Ms Henderson’s.


* What has happened in relation to the other cyclist deaths?

A prosecution is ongoing in the case of the first of the cyclists to die, Brian Holt. Crossrail contractor Anthony Howsego will stand trial at Wood Green crown court on June 16, charged with causing death by careless driving. Background here: https://rosslydall.wordpress.com/2014/11/14/crossrail-driver-expresses-sorrow-for-death-of-cyclist-as-he-pleads-not-guilty/

Francis Golding inquest report: http://www.standard.co.uk/news/london/coroner-slams-slow-response-over-triple-cycle-death-junction-in-camden-9246280.html

Roger de Klerk inquest report: http://www.standard.co.uk/news/london/cyclist-killed-at-croydon-station-slipped-on-tram-tracks-and-fell-into-path-of-a-bus-inquest-hears-9771861.html

Venera Minakhmetova inquest report: http://www.standard.co.uk/news/london/dont-jump-red-lights-coroner-warns-cyclists-at-bow-roundabout-lorry-death-inquest-9250220.html

Khalid Mohamed Wallyd al-Hashimi inquest report: http://www.standard.co.uk/news/london/cyclist-killed-in-spate-of-london-road-deaths-was-twice-the-drinkdrive-limit-9250699.html

Constituency profile: Will wheels come off UKIP bandwagon in Rochester and Strood?

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If Kelly Tolhurst has her way, Rochester and Strood will be where the wheels come off the UKIP bandwagon.

The personable small-business owner, 36, has been given a second crack at defeating UKIP’s Mark Reckless, after doing better than expected in last November’s by-election.

Then, Mr Reckless became UKIP’s second MP, following Douglas Carswell in Clacton, after defecting from the Tories last September at the start of their party conference.

But his majority was cut from 9,953 to 2,920. With turnout in the General Election expected to be markedly higher, and without the media circus that accompanies a by-election, he openly admits that defeat is a possibility.

Concerns mounted when private UKIP polling earlier this month reportedly predicted that Mr Reckless was likely to be defeated.

“I think it’s going to be tight,” he told the Standard. “I have got a good fighting chance. I might win. I might lose. It’s an uncharted situation.”

Six months of campaigning have meant that both candidates are recognised on the street. At Dot Cafe on Rochester High Street, owner Sandy Chattendon jokes with Ms Tolhurst that her non-stop canvassing means she barely finds time to stop for a coffee.

She likes the fact Ms Tolhurst runs her own local business, a marine surveying firm, and says she plans to vote Tory. “Last General Election, I think I voted Tory,” Ms Chattendon said. “I will probably stick. If Labour force me to pay the living wage of £8 an hour, I would be straight out of business.”

Ms Tolhurst appears reluctant to see herself on the frontline of the battle to stop UKIP, preferring to talk about benefits of a recovering economy under the Tories, and who deserves the keys to 10 Downing Street.

But such is the strategic importance of Rochester and Stood that it was the location for Samantha Cameron’s first solo campaign visit, with Ms Tolhurst at a special needs school. Tory chief whip Michael Gove has been to the constituency, and the Prime Minister is also expected.

“It’s about standing up for local people,” Ms Tolhurst said, declining to indulge in a verbal sparring match with UKIP. “For me, it’s very much about being able to represent the area and the people I know and I’m part of. I would never try and be a candidate anywhere else. I only want to represent Rochester and Strood.

“People on the doorstep are talking to me about the economy. They are talking about benefits. They are talking about housing. They are talking about immigration. People are thinking about who is going to run the country in May.”

She was a community campaigner who was encouraged to become a councillor in 2011. She was fast-tracked as a parliamentary candidate following Mr Reckless’s defection.

She claims Mr Reckless’s defection bosted membership of the local Tory association. “Effectively we were left without representation for six weeks,” she said. “For the local people, it was very, very difficult.”

Rochester and Strood have increasingly become London commuter towns, boosted by the arrival of the Olympic Javelin trains on the High Speed 1 route that link the north Kent and Medway area to St Pancras. Earnings are around the national average while unemployment is low.

Ms Tolhurst says its dockyard history has meant immigration had been a fact of life for centuries, and it was no UKIP heartland. “People have always come to Medway for work,” she said. “We have always had a transient community.”

She said UKIP decided not to stand a candidate against Mr Reckless in 2010 as it knew of his Eurosceptic views. His near-10,000 majority was over Labour, which came second. Its by-election candidate Naushabah Khan, who works in public affairs in London and whose hobbies include kick-boxing, is standing again.

UKIP rosettes 3

Further down the High Street, the front window of Mr Reckless’s office is displaying UKIP merchandise. He said sales of UKIP-branded high-visibility vests, “Genuine Belgian Damp Rag Herman Van Rompuy” tea towels (£2) and rosettes (£1) were boosting party coffers, but declined to model the purple UKIP baseball cap for the Standard’s photographer.

UKIP teatowel 4

On the streets, Jennifer Curno said she would continue to vote for Mr Reckless. “Where he goes, we go,” she said. “He is from Rochester and he knows how people feel.”

An undertaker also pledged his vote, recognising the seat was on a knife-edge. “It’s close, Mark,” said the man.

Canvassing in Strood, Danielle Wynne, 24, opens the door to Mr Reckless and instantly recognises him – he helped get her and husband Michael re-housed and she is full of gratitude.

“I think my vote is with you,” she said, his UKIP status neither counting for or against him. “After everything you have done to help me in the past, I have got no issue with you at all.”

UKIP cap 4

Mr Reckless says UKIP’s ambitions are merely to win “at least a handful” of seats, but won’t be pinned down on a number. He predicts a “reasonably clean fight” with his old party – after a court action ended in his favour.

Medway Conservatives had attempted to recoup “several thousands of pounds” it spent promoting Mr Reckless. The claim was thrown out of court, and it was ordered to pay his £1,850 legal fees. “It was like leaving your job and having to reimburse your employer for unused business cards,” Mr Reckless said.

He claimed he was garnering most support from the 45 to 65 age group, in particular disillusioned Labour voters. “We are challenging the cosy consensus of Establishment parties,” he said. “Part of how they keep others out is to demonise those who challenge them. UKIP is a decent party with decent mainstream people fighting for Britain. I’m happy to add my weight to that fight.”

* An edited version of this article appeared in the Evening Standard yesterday: Rochester

Woman runs marathon to fund heart checks for young Londoners after boyfriend’s shock death

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Fiona T-shirt for James

The girlfriend of an Olympic architect who died during a half-marathon is running the London marathon to raise awareness of sudden cardiac death in young people.

Fiona Barnes, 27, told how “my world was obliterated” when her boyfriend of five years James Phillips, 27, collapsed and died near the finish line of the Reigate half-marathon last September.

She has used the training for the London race on April 26 to overcome the “indescribable pain and loss” of Mr Phillips’ death. She and best friend Suzy Kerton, who is also running the marathon, aim to raise £15,000 to fund hundreds of free heart checks for young Londoners.

Ms Barnes, from Amersham, recalled how she and Mr Phillips spent hours cheering on runners at last year’s London marathon. “I’ll never forget James turning to me and saying, ‘Let’s do this together before we are 30,’” she told the Standard. “Then Reigate happened and my world was obliterated.”

James, Fiona and Suzy

James, Fiona and Suzy

The three were part of a group of about 40 friends who ran the half-marathon and who looked on in horror as paramedics tried in vain to save Mr Phillips’ life. Ms Barnes followed Ms Kerton in being accepted to run London for the charity Cardiac Risk in the Young (CRY) in his memory.

“It all fell into place, from James saying ‘let’s do this race together’, to the fact that CRY is such a fantastic, life-saving charity I’d never known existed before, and I found this drive to raise both money for them and awareness of the work they do,” Ms Barnes said.

“Training for the marathon has definitely helped me to cope with the impact of James’ death. It’s given me a huge goal and a real focus which – along with the amazing love and support of my friends and family – I honestly think has got me through the past six months.

“I love the freedom of running, I love how it clears my head, I love how I can escape the grief and sadness of losing James and find a place where I don’t really feel anything other than a bit of physical pain towards the end of a long run.”

CRY estimates 16 young Britons die each week from sudden cardiac death. About 90 per cent of victims are like Mr Phillips and display no symptoms.

Mr Phillips, who lived in Battersea, was an accomplished architect whose firm Make helped design the London 2012 athletes’ village. The BBC, where Ms Barnes works in human resources, has helped raise more than £3,000, with sports presenter John Inverdale hosting a pub quiz.

She and Ms Kerton, hope a silent disco at Mahiki nightclub on May 9 will help them reach their fundraising target. Each heart check offered by CRY costs £35.

“What happened to James was so untimely, so unnatural and there is no explanation for those of us left behind,” Ms Barnes said. “James deserved to have the full and happy life he was looking forward to and he would have continued living it to the full every day. To lose him in such a shocking way at such a young age has been absolutely devastating.

“If we can raise enough money in James’ memory to fund 300 heart checks then I will feel like I have saved a life, and I’ll have stopped one family going through the indescribable pain and loss that James’ family, friends and I are going through.”

Fiona, Suzy and James in Sydney

Fiona, Suzy and James in Sydney

Ms Kerton, 27, from East Acton, said: “If someone had done it for us, maybe James would still be here.”

* An edited version of this article appears in today’s Evening Standard.

* To donate, visit: http://uk.virginmoneygiving.com/team/jamesyp

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