Healthcare Assistants (HCAs) gathered outside the hospital before seeking to present their concerns directly to trust leaders.

While plans to march on the trust’s board offices were deemed a health and safety risk, protesters were met by Chief Nurse Tyrone Roberts, who came out to listen to their concerns.

The dispute centres on claims that many HCAs employed on Band two contracts are routinely carrying out duties associated with the higher-paid Band three role without receiving the corresponding pay.

Unison branch organiser Ryan Quick said similar campaigns had already been successful at NHS trusts across the North West.

He said: “Lots of the HCAs at Bolton Hospital are Band Two but they’re expected to do Band Three duties and they’re not paid for it, that’s not been recognised for a long time.

“Across the North West there’s about 17 trusts that we’ve ran this campaign in and it’s been successful.

“We’ve recently just signed with Lancashire Teaching Hospitals to agree to back pay since 2018 and that all HCAs at Band 2 would be upgraded to the top of Band 3 because ultimately that’s the job that they’re doing.

“If they’re expected to do it then they should be paid to do it, it’s only fair.”

Mr Quick warned that while staff had chosen to protest rather than strike, further action could follow if an agreement cannot be reached.

He added: “They have to agree to it, otherwise the potential is that this escalates, which we don’t want to do, but it might escalate which would include industrial action.”

Staff gathered in their uniforms as they came out on breaks, while others came to the hospital in their non-working hours to join the march.

Healthcare Assistant Kiana Ogunewu-Symonds said she joined the protest because she believes HCAs are not being fairly recognised for the work they do.

Kiana Ogunewu-Symonds (middle) said she joined the protest to demand better pay (Image: NQ)

She said: “I’ve decided to come out because I feel like we’re not treated fairly in terms of our job role and the pay.

“We are the closest to the patients that need us the most.

“Some of these patients are dying, some of these are in a very vulnerable position and we are the ones, the HCAs, that are closest, that do the personal care, that do the feeds, that need to look after these patients.

“This is why I’m here today, to fight not only for me, but for the patients to get the best care that they are able to get.”

Protesters claim Bolton NHS Foundation Trust is now the remaining trust involved in the North West campaign that has not yet agreed to regrade affected HCAs or provide backdated pay to 2018.

The group gathered opposite the main entrance where they were met by Chief Nurse Tyrone Roberts (Image: NQ)

Responding to the concerns, James Mawrey, Chief People Officer and Deputy Chief Executive at Bolton NHS Foundation Trust, said healthcare assistants play a vital role across the organisation and that discussions would continue with staff and union representatives.

He said: “Our Healthcare Assistants are a vital and valued part of our workforce, delivering outstanding personal care for patients and service users in hospital and across our communities every single day.

“We recognise that some Healthcare Assistants have concerns about pay arrangements and we are committed to listening to those concerns and engaging in constructive discussions with staff and their representatives.”

Both sides of the dispute say they remain engaged in discussions over the issue.

A study has raised a question that many women would understandably want answered: could hormone replacement therapy (HRT) protect against dementia? The research found that women who had used HRT were less likely to receive a dementia diagnosis during follow-up, particularly if they had undergone surgery involving their reproductive organs. But the results do not establish that HRT caused the difference.

The researchers analysed data from 183,450 postmenopausal women in the UK Biobank, followed for an average of 13.3 years. During that period, 3,948 received a dementia diagnosis, including 1,993 diagnosed with Alzheimer’s disease.

Women who reported using HRT for at least a year, or who were still taking it when they joined the study, had a 10% lower relative risk of dementia than non-users after researchers accounted for factors including age, education, smoking, deprivation, blood pressure and diabetes.

The difference was larger among women the researchers classified as having had “surgical menopause”, meaning surgery involving removal of the womb or ovaries. HRT use was associated with a 26% lower relative risk of dementia in this group. There was no statistically clear association among women who had undergone natural menopause.

However, the surgical group included both women who had undergone a hysterectomy, which removes the womb, and women whose ovaries had been removed. Removing both ovaries causes an abrupt fall in oestrogen, while removing the womb alone does not necessarily affect hormone production in the same way. Grouping these women together makes it harder to determine whether HRT protects against dementia after a sudden loss of oestrogen.

Why the findings need care

Women who take HRT may differ from those who do not in ways that also affect dementia risk. Education, income, general health and access to care can influence both the decision to seek treatment and later health. Researchers can adjust for measurable differences, but observational studies cannot account for everything.

An early study found that women who later chose to take HRT were already healthier and at lower risk of dementia eight years before starting treatment. They tended to have more education, lower blood pressure and diabetes risk, were more active and were less likely to be overweight. These factors are themselves associated with dementia risk.

The new study also could not distinguish between women using oestrogen alone and those using oestrogen combined with a progestogen, or compare doses and ways of taking HRT. Oestrogen-only HRT is generally prescribed after hysterectomy, while a progestogen is usually added for women with a womb to protect its lining against cancer.

In a review of national registry studies that I worked on, longer use of combined hormone therapy was associated with a small increase in Alzheimer’s risk. The same pattern was not seen with oestrogen-only treatment. Those studies were observational too, so they cannot prove treatment caused the increase.

Results from the same UK Biobank data have also varied. An earlier analysis reported an association between lifetime HRT use and higher dementia risk in women whose natural menopause occurred after 50. The studies asked different questions and analysed different groups, so they cannot be compared directly. Their differing results do, however, show why one new association cannot settle the debate.

The new paper also suggested that timing may be important. Lower dementia risk appeared among women who started HRT between their late forties and mid-fifties, but the pattern was less convincing among those who started younger. This makes it difficult to argue that replacing hormones as early as possible protects women whose menopause occurs particularly young.

Researchers also examined women with the APOE ε4 genetic variant, which increases Alzheimer’s risk. Although the association appeared stronger among carriers, statistical testing did not establish that HRT affected them differently from non-carriers. Previous studies have also produced conflicting results.

What does this mean for someone taking HRT?

Trials in women closer to menopause have not shown consistent improvements in cognition after several years of HRT. Some short-term trials have reported benefits, including among women with substantial menopausal symptoms, but these findings have not established that HRT prevents dementia.

A trial involving women aged 65 and over found an increased incidence of dementia among those taking a form of combined HRT commonly used at the time. That does not answer every question about treatments used today or about women who undergo early surgical menopause. However, trial evidence does not currently support using HRT to prevent dementia in women who undergo menopause at the usual age of around 50 or 51.

That is reflected in Nice guidance, which says HRT should not be offered specifically to prevent dementia or cardiovascular disease. It does recommend HRT for menopausal hot flushes and night sweats. Those benefits should remain central to treatment decisions, alongside medical history and the risks of the particular treatment.

Women who have their ovaries removed at a young age deserve particular attention because early loss of hormones may have different health effects from menopause at the usual age. This study gives researchers a reason to investigate that group more closely. For now, it provides no sound reason to start, stop or change HRT solely in the hope of preventing dementia.

At a Treasury briefing in 1997, Ed Balls, then Gordon Brown’s economic guru, sidled up to me. He wanted to tell me why his boss was so determined to keep government borrowing under control.

Every pound spent servicing the national debt, he rightly explained, was money wasted – money that could instead be spent on public services.

Only a decade later, Balls’s rare kernel of economic wisdom had been forgotten. Brown was forced to borrow heavily to shore up Britain’s collapsing banking system – and ever since then, the principle Balls outlined to me that day has been callously abandoned by his party. And you and I are paying for it.

Earlier this week, it was revealed that, in August alone, our spendthrift Government squandered an eye-watering £8.8billion on servicing the national debt. Meanwhile, the country is facing ever-surging borrowing costs – expected to reach at least £130billion by the end of this year.

Sensible people would look at these figures and conclude that the only remedy is to reduce our borrowing by keeping the current budget (spending and tax receipts) in balance.

Our Labour Government, however, is not sensible. And the fundamental tenet, familiar to every household, of ‘living within your means’ is alien to them.

As such, while we fritter away billions on servicing our debt, the cost of running Britain’s pensions and welfare system is out of control.

The Government has locked the nation in a doom loop of spending and higher taxes, from which there can be no painless escape. It is a socialist approach that paralyses enterprise and, as I have previously written, is driving top taxpayers overseas.

Worse, it means that our Government is so mistrusted by the bond markets that Britain is forced to pay the highest interest rates of all our international competitors in the Group of Seven (G7) richest countries.

So what should our recently installed Chancellor John Healey do to start limiting the nation’s monstrous interest rate bill ahead of his October 28 debut Budget?

Well, there’s one policy announcement that would send a monumental signal to the bond markets that this Government is set on fiscal responsibility: dismantling the ‘triple lock’.

Every economic think-tank in Britain knows that, thanks to our ageing population, the state pension triple lock – an election-winning gambit (a bribe, in other words) introduced by former Tory Chancellor George Osborne in the distant days of 2010 – is an unsustainable burden.

Under the triple lock, Britain’s happy silver surfers, me included, can look forward every year to an increase in their state pensions by whichever is the highest of average earnings growth, the consumer prices index (CPI) or a 2.5 per cent uplift.

It was manna from heaven when introduced, back when the basic pension for a single person (paid at 65 for men and 60 for women) was £97.65 per week and £156.15 a week for a married couple – among the meanest pensions in the industrial world.

Some 16 years later, the state pension (paid at 66) has jumped to £241.30 a week or £12,547.60 a year and we are no longer lagging behind our European competitors.

The Daily Mail is committed to supporting Britain’s pensioners and their lifelong contribution to the nation’s economic wellbeing. But it’s undeniable the cost of maintaining the triple lock – projected to cost £15billion per year by 2030, more than three times what was originally anticipated – is far too high.

Doing away with it might seem like an act of electoral suicide to Labour MPs with fragile majorities – but it is the opposite.

What should our recently installed Chancellor John Healey do to start limiting the nation’s monstrous interest rate bill ahead of his October 28 debut Budget, Alex Brummer asks

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It would show that Andy Burnham’s Government understands the economic maelstrom Britain faces. And it’d be hard for opposition parties, in the face of ever-higher borrowing and interest rates, to oppose scrapping it. But if the annual state pension rise is to be ‘unlocked’, there must be a quid pro quo: changes to the way working-age welfare payments are uprated; reforms to disability benefits; and an overhaul of the extraordinarily generous pension arrangements enjoyed by public sector employees.

As matters stand, more than 24million people in Britain – around 35 per cent of the population – receive some form of welfare payment. Remarkably, payouts to these citizens, some of whom have never worked, increase each year automatically in line with average earnings.

The Office for Budget Responsibility calculates that if the annual uprating was based on CPI inflation, rather than earnings, the projected cost could be slashed from 6 per cent of national output to just 3 per cent, saving tens of billions of pounds for the Exchequer in future years.

Then there is the public sector. Since Labour took office, the public payroll has swollen with 270,000 new employees. Of course, these government jobs come with gold-plated, defined-benefit pensions (meaning the amount paid in retirement is guaranteed, determined by salary and how long someone was employed) – increasingly rare in the private sector.

That disparity is grotesquely unfair. Thanks to Gordon Brown, millions of private-sector workers are automatically enrolled into defined-contribution pensions, in which their eventual retirement income depends on how much they and their employers put aside and how those investments perform – despite their taxes funding far more generous, guaranteed public pensions.

Bringing public sector pension provision closer to the arrangements faced by the workers who ultimately pay for it could deliver substantial long-term savings – making the system considerably fairer.

Of course, the burden of Labour’s spend-and-tax bonanza should not fall solely on the nation’s elderly. As Kemi Badenoch argued yesterday, those living on welfare and those working for the state must also shoulder some of the sacrifice if Britain is to have any prospect of digging itself out of its fiscal hole.

Indeed, Labour’s biggest failure as keeper of the public purse has been its shameful refusal to get to grips with the alarming surge in Personal Independence Payments (PIP), which are not means-tested, to people with disabilities.

The attempt by Keir Starmer and Rachel Reeves to trim the burgeoning welfare bill was sabotaged by Labour backbenchers – a rebellion that catalysed that odd couple’s political downfall.

Anyone arriving from Mars might have imagined ministers were proposing to snatch benefits from the most severely disabled people in the country. The reality, as ever, was different.

Spending on disability payments has soared in real terms from £14billion in August in 2020 to £25billion in the last fiscal year.

The number of under-30s claiming the benefit has rocketed to 689,000 at a cost of £5.5billion a year.

It would be grossly inequitable to take the triple lock away from pensioners, who’ve earned their retirement, simply to subsidise this group of welfare recipients.

Since William Beveridge’s landmark wartime report laid the foundations of the modern welfare state, successive governments have accepted that Britain should provide a social safety net for the elderly, the sick and disabled, the destitute and those who lose their jobs.

But neither Beveridge nor the politicians who constructed the post-war settlement envisaged today’s system: a state pension almost guaranteed to rise unsustainably, alongside a disability benefits system so generous it discourages work.

Unless these issues are confronted with urgency by Andy Burnham’s Government, the decision will be made for us.

The markets will wrestle us into emergency cuts to the size of the state and benefits – and millions will be even worse off.

Bob Mortimer and Andy Dawson announced the decision in a statement yesterday (Wednesday, September 23), telling listeners: “After over a decade and almost 200 episodes, it is time to bring Athletico Mince to an end.

“We’d like to thank all of you for the huge amounts of love and support you’ve given us over the past ten years as we all went up, up, up into the podcast sky together.”

The statement also revealed what’s next for the duo.

Mortimer will work on a new series of Gone Fishing and a fresh novel, while Dawson joked that he’ll be “mostly focusing on his Type 2” — with plenty of room for fun along the way.

Launched in March 2016, the podcast became one of the UK’s most successful and distinctive comedy shows.

Billed as a football podcast, Athletico Mince soon became something far stranger, blending surreal comedy, songs, improvised sketches and recurring characters with occasional football references.

The show built a devoted following with its bizarre fictional universe, featuring exaggerated versions of Steve McClaren, Peter Beardsley and Mark Lawrenson alongside characters created by Mortimer and Dawson.

Its success led to UK-wide live tours and Club Parsnips, a subscription service offering bonus content and exclusive episodes.

Middlesbrough author Mortimer, 67, is one of Britain’s best-known comedians and rose to fame as one half of double act Reeves and Mortimer alongside Vic Reeves.

He has since enjoyed success with television programmes including Would I Lie To You? and the award-winning BBC series Mortimer & Whitehouse: Gone Fishing.

Middlesbrough-born author and TV personality, Bob Mortimer. (Image: Ian West/PA)

Sunderland-born Dawson is a writer, broadcaster and podcaster who has built a large following through comedy writing and podcasts.

He co-created Athletico Mince with Mortimer after the pair connected through their shared love of football and comedy.

Over the years, Athletico Mince attracted tens of millions of listens and earned a reputation as one of Britain’s most influential comedy podcasts.

By 2018, it had passed 30 million listens and regularly drew more than 200,000 listeners per episode.

While Athletico Mince may be ending, fans can still revisit hundreds of episodes from the podcast’s decade-long run.

Mortimer and Dawson signed off with one final nod to a favourite listener in-joke: “Please raise your next glass of blue drink to us.

“Dog dirt.”

Not even a teeny little bite?

In a feat of sensational restraint, a customer at one of Greater Manchester’s most-loved bakeries waited for the entirety of an agonising 4,700-mile trip to the US before tucking into a tray of custard tarts.

The pastries were picked up from Loafi Bakehouse in Ramsbottom by a regular customer called Ryan, just before he travelled to the airport. According to the bakery, their speciality tarts then travelled with him more than 4,700 miles to Portland, Oregon, where they were eventually shared with friends.

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Loafi Bakehouse wrote in a post on Instagram on Thursday (September 24): “Last week one of our ace regulars Ryan asked Stuart to box up four custard tarts for collection at 8.10am. A rather specific time but it turns out it was just before he got his taxi to the airport.

“Under Ryan’s stewardship they arrived safely 4,741 miles away in Portland, Oregon and were later shared with friends. Mega!”

One person commented on the social media post: “That is self control beyond belief!”

Loafi is a micro-bakery on Square Street in Ramsbottom, which opened after chef Rich Sharples took over the former Levanter site.

Rich spent a decade as executive chef of Gary Usher’s Elite Bistros collection, overseeing kitchens including Hispi in Didsbury and Kala in Manchester city centre. He has also worked alongside chefs including Darren Rowe at The Bay Horse in Roughlee and Mary-Ellen McTague at Aumbrey in Prestwich.

Loafi’s hugely popular offerings include freshly baked bread, sandwiches, sweet treats and coffee, as well as their famous custard tarts.

Loafi is on 10 Square Street, Ramsbottom, BL0 9BE. It is open from Tuesday to Saturday, from 8am to 2pm.

Reports suggest the large fire can be seen for miles away, with North Yorkshire Fire and Rescue crews expected to be dealing with the incident throughout the night

A fire has broken out overnight at the UK’s largest military barracks with crews expected to battle the blaze throughout the night.

Crews were called on Thursday evening, September 24 to the fire at an accommodation block in Catterick Garrison – reports suggest the blaze has broken out at the Gaza Barracks Accommodation building.

Catterick Garrison is located near the town of Richmond, North Yorkshire, is the largest British Army garrison in the world. As of 2021, the barracks had a population of around 14,000 and covered over 2,400 acres.

According to reports, smoke can be seen for miles away as a result of the blaze.

A spokesperson for North Yorkshire Fire and Rescue said: “North Yorkshire Fire and Rescue Service have multiple appliances in attendance an accommodation block fire.

“An appliance from County Durham and Darlington along with their Ariel Ladder Platform are also in attendance. This incident is expected to be ongoing throughout the night.”

Hipswell and Colburn councillor Kevin Foster told the Northern Echo : “At this stage, details are limited, and I am awaiting further information.

“My immediate concern is for the safety and wellbeing of everyone at the camp, including our military personnel, their families and the emergency services responding to the incident.

“I would like to thank our emergency services for their response and hope that everyone involved is safe.

“As North Yorkshire Council’s Armed Forces Champion, I will continue to monitor the situation and offer any support I can to our Armed Forces community.

“My thoughts are with everyone affected, and I hope to hear positive news as further details emerge.”

A study by family holiday specialist Ski Famille analysed ratings for 97 motorway service areas across the UK and found that Moto’s Southwaite Services and Lancaster Services were among the poorer-performing sites.

Southwaite Services, on the M6 in Cumbria, narrowly avoided appearing in the UK’s 10 lowest-rated service areas, receiving an average score of 3.71 stars from 11,455 Google reviews.

Meanwhile, Lancaster Services was ranked as the sixth-lowest rated motorway service station in the UK, with an average rating of 3.65 stars from 12,798 review.

The findings were published as part of a wider ranking which also saw Cumbria’s Tebay Services and Killington Lake Services named among the country’s top 10 best-rated motorway stops.

Tebay had an average of 4.34 stars from more than 39,000 reviews, and Killington Lake Services had average rating of 4.22 stars from 4,640 reviews.

Responding to the results, a spokesperson for Moto said customer experience remains a priority for the company and argued that other research paints a more positive picture.

A Moto spokesperson said: “A great customer experience is hugely important to us and we continually listen to feedback to understand where we can make improvements across our sites.

“While this particular ranking is based on publicly submitted Google reviews, which can vary considerably in volume and over time between individual locations, broader independent customer research provides a different picture.

“The in-depth Transport Focus Motorway Services User Survey found that 94 per cent of respondents were either satisfied or fairly satisfied with their experience at Moto sites.

“We nevertheless take every piece of customer feedback seriously and will continue investing in our facilities and working with our teams to give motorists the best possible experience when they stop with us.”

The original ranking was compiled using Google review scores from motorway service stations across the UK, with separate ratings combined where sites had different scores for each side of the motorway.

The UK’s 10 lowest-rated motorway services, according to the study

1. Bridgwater (Moto), M5, Somerset: 3.05 stars from 9,994 reviews
2. Leeming Bar (Moto), A1(M), North Yorkshire: 3.26 stars from 2,151 reviews
3. Severn View (Moto), M48, South Gloucestershire: 3.60 stars from 2,252 reviews
4. Bothwell (Roadchef), M74, South Lanarkshire: 3.63 stars from 1,257 reviews
5. Frankley (Moto), M5, Worcestershire: 3.64 stars from 9,466 reviews
6. Lancaster (Moto), M6, Lancashire: 3.65 stars from 12,798 reviews
7. Gordano (Welcome Break), M5, North Somerset: 3.66 stars from 9,218 reviews
8. Sedgemoor Northbound (Welcome Break), M5, Somerset: 3.68 stars from 4,994 reviews
9. Scotch Corner (Moto), A1(M), North Yorkshire: 3.71 stars from 6,599 reviews
10. Knutsford (Moto), M6, Cheshire: 3.71 stars from 10,500 reviews

Portugal captain Bruno Fernandes praised Wales after their narrow win, admitting Craig Bellamy’s side showed they have plenty of quality

Manchester United captain Bruno Fernandes said he was “not impressed” by Wales’ performance because Portugal knew what they were capable of after the Dragons pushed the European giants all the way in Lisbon.

Portugal edged to a 1-0 victory at the Estadio Jose Alvalade in the opening game of Wales’ Nations League campaign, with Joao Felix’s deflected first-half strike proving enough to settle a hard-fought contest.

Craig Bellamy’s side had their moments, particularly after the break, and came within inches of an equaliser when Brennan Johnson’s effort clipped the crossbar before Portugal cleared the resulting scramble off the line.

Fernandes, who captained Portugal after Cristiano Ronaldo was substituted, insisted Wales’ performance had not come as a surprise to the hosts.

“No, we were not impressed,” he said to the BBC post-match when asked whether Wales had surprised Portugal with their performance.

“We knew they were good. We know that they have a lot of good players.

“I’ve played against many of them. If they play in the Premier League they need to have quality. They need to have a certain high level.

“So I think we knew they could cause us problems. But we created a lot of chances and we could have scored more goals.

“Unfortunately today it was not the case but we scored one and didn’t concede and that’s amazing.”

Wales’ performance was made all the more impressive by the absences Bellamy had to contend with, with Harry Wilson, Joe Rodon, Nathan Broadhead, Dylan Lawlor and starting goalkeeper Karl Darlow among those unavailable.

The result means Wales begin their return to Nations League A with a defeat, but they showed enough to suggest Portugal will face another difficult assignment when the sides meet again later in the campaign.

The reverse fixture takes place on November 17, when Portugal will travel to Wales and face a very different atmosphere.

Fernandes is expecting the hosts to feel the full force of their home support.

“Yes, probably even more pressure, playing with your fans against us,” he said.

“We know the atmosphere you can create there.

“We expect a lot of pressure and moments where fans will push the team to go forward and we need to be aware of that.”

Wales’ next fixture sees them take on Denmark on Sunday, while Portugal will take on Norway in the other match in Nations League A Group 4.