Hello,

I hope you're all surviving this Baltic weather. As temperatures drop, my colleague Nicole Wootton-Cane has the latest on the worsening wave of flu facing the NHS.

It's also been a big week for patient safety, with several important investigations published by The Independent. One revealed a deeply troubling situation at a mental health trust, where a new report makes serious allegations about patient care.

Another uncovered fresh concerns from the Care Quality Commisson (CQC) watchdog over surgical services at a major hospital — and why the problems run much deeper, which I explore in Behind the Headlines.

And on the global front, Rachel Schraer reports on how Trump's aid cuts are giving cover to evangelical groups pushing attacks on human rights.

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This story about surgical services may have flown under the radar a little last week, so I want to take some time today to highlight it.

Northern Care Alliance is a large NHS trust based in Manchester, serving a population of more than one million. It has had a complex history as the result of a merger of smaller hospital trusts.

Several sources have revealed that the trust has received a warning over its surgical department at Salford Royal Hospital from the CQC.

A letter, yet to be published, warns that patients are being left in pain, wards are constantly short-staffed, and staff are exhausted.

Surgical patients left in pain amid staffing crisis at major NHS trust

Surgical staff have reported feeling burnt out and overwhelmed, while others have claimed that staffing levels are unsafe

These issues are not new. Last year, we exposed the horrific story of Martin Wild – you can read what happened to him here. Mr Wild, who has sadly died since, was subjected to awful care, including being left in agony for so long that he was forced to call 999 from his hospital bed.

Speaking with concerned sources, the problems at the trust appear to run deep, with a senior clinician telling me there is a "disconnect" between the leaders and frontline staff, who feel "abandoned".

If you're a patient or a staff member who would like to talk about the situation, email me in confidence at rebecca.thomas@independent.co.uk.

What is the biggest threat to the NHS?

As MPs warn that HS2-style mismanagement could hit vital services, I want to know where readers think the real pressure on the health service comes from. What is the bigger threat to the NHS? Is it privatisation, or political interference? Vote here.

Last week, I asked if you were worried about the most severe flu outbreak in decades this winter. As a new strain threatens to put even more pressure on the NHS, 59% of Health Check readers said they more concerned than usual about catching the virus.

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