Hello everyone,

This month, I revealed that the NHS has been delivering unexpected diagnoses to patients by text message. Since then, more people have come forward to share how they received shock diagnoses through the NHS App.

With NHS England announcing that the app will soon become the main way patients are contacted, it's important to recognise the potential unintended consequences of that shift.

It's also that time of year again – winter is coming – and doctors have warned The Independent that this could be the most challenging one yet. Dr Vicky Price, president of the Society of Acute Medicine, told me: "This winter, I'm more scared than I've ever been. We are in a state of dread."

But it doesn't have to be winter for the NHS to feel under strain. Case in point: my colleague Andrew Grice reported on his shocking 18-hour wait following a mini-stroke. This telling quote about sums it up: "I didn't close my eyes all night. I was worried I would fall asleep and miss my turn with the doctor."

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Living Well

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Every winter, we see the same headlines warning that this will be the one to end them all.

The same concerns are being raised this year – but what's behind them?

A multitude of issues is impacting the NHS's performance ahead of this winter. These include an earlier flu season, a Covid-19 peak expected in November, increased staff sickness, and hospitals that have had no respite over the summer.

Usually, the summer gives hospitals time to get back on track with elective care and provides a slower period. However, this year there appears to have been no let-up.

Crucially, this means staff have been working on overdrive without any pause.

Inside looming NHS winter crisis as hospitals face 'armageddon'

Every winter is a challenge for the NHS. But doctors fear this year could be one of the worst yet...

On top of this, other infections are circulating, such as measles, while children are being particularly affected by flu. Readers may remember the year when scarlet fever ran riot in December.

Amid all this, NHS services are facing tough financial targets, with recruitment freezes and cuts to shifts – even in A&E, according to one consultant.

With all this in mind, if you have recently attended A&E or been admitted to hospital and would like to share your experience, please email me in confidence at rebecca.thomas@independent.co.uk.

How many steps do you average a day?

This week, I want to know: how many steps are you averaging each day?

Walking remains one of the most accessible ways to boost your weekly activity levels. But the science around how many steps we actually need is evolving all the time.

Do you regularly hit 10,000 steps, or are you more focused on the quality of your exercise rather than the quantity? Vote here.

Last week, I asked whether you'd ever considered giving up alcohol – and to mark the (almost) end of Sober October, here are the results.

42 per cent said they'd already gone sober, while 32 per cent said they'd thought about it but hadn't yet taken the plunge.

Ten per cent said there was no need to give it up, and a further 16 per cent said they simply enjoyed drinking in moderation.

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