CHAMPION HURDLE RESULT: The grey claimed her biggest success at Cheltenham where she had already won the Mares’ Hurdle twice and the Triumph Hurdle in 2023

Willie Mullins’ star mare Lossiemouth sealed her place in the history books when she landed the Unibet Champion Hurdle to record her fourth win at the Cheltenham Festival.

The grey was undefeated at the fixture, landing the Mares’ Hurdle two years running after victory in the Triumph Hurdle in 2023 and had appeared to be headed for a Mares’ Hurdle hat-trick until connections made their minds up at the weekend to take a different path.

One of three Mullins-trained runners and the choice of stable jockey Paul Townend she never looked in any sort of trouble, in first-time cheekpieces, as she inflicted a six-and-a-half-length defeat on Brighterdaysahead as The New Lion came home in third.

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A year ago in the same race Townend had approached the last hurdle with the Champion Hurdle apparently in the bag on State Man only for that horse to take a dramatic fall and hand victory to Golden Ace.

“Lossiemouth deserves it,” said Townend. “She travelled much better, sweeter and kinder today. She tries so hard that you know very early in the race whether she’s going or not.

Mullins said: “She’s a star mare to come back four years on the trot, never mind win. That puts her in a league of her own. She’s nearly getting into Quevega territory.

“It was an open race, and when I put cheekpieces on the other morning, I thought, Wow, that’s the old Lossiemouth and Paul felt the same.

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“How quick was she to flip her front feet out and get away from the hurdle with so much momentum, and then quicken up the hill as well. I mean, she is just so good, and we’ve all sort of worried two miles is really too sharp for her, but her jumping today was as quick as we’ve ever seen it.

“To win the Champion Hurdle definitely outranks everything else she’s done. But to come back here with four years in a row is an achievement in itself but then to win four years is, she’s gone Triumph, Mares’ twice and then this and it’s been superb.

“Just 12 months ago State Man would have left her for dead.”

East Riding of Yorkshire Council said its animal health officers had been involved with Malcolm Metcalfe, 64, since 2021.

When they visited the farmer’s lands together with officers from the Animal and Plant Health Agency (APHA) between July 9, 2024, and September 3, 2024, they repeatedly found decomposing animal remains, sheep carcasses, sheep lying down and inadequate water supplies.

The problems continued despite Metcalfe being served with legal orders compelling him to remove the carcasses and get a vet to investigate the high mortality of his stock.

A post‑mortem examination on one lamb found severe parasitic gastroenteritis, which a vet said a “competent stockkeeper should have recognised and acted upon the condition sooner”, a council statement said.

Checks also identified multiple unconfirmed sheep movements recorded on the national database.

Metcalfe’s mitigation was that he was sorry for his actions, which were out of character and linked to his health.

His defence team said sheep farming was all he has known and remains his only source of income, but he now recognises he is no longer able to keep sheep.  All the sheep now belong to his sister.

Malcolm Metcalfe, 64, now of Sledgate Garth, Rillington, pleaded guilty to eight animal health and welfare offences at Beverley Magistrates Court.

He was given a six-month prison sentence suspended for two years and banned for five years from owning, keeping, transporting, participating in the keeping, and being party to an arrangement under which he is entitled to control or influence the way in which sheep are kept, for five years. He was also ordered to pay £1778.01 in prosecution costs and a £154 statutory surcharge.

Cllr Lyn Healing, East Riding of Yorkshire Council cabinet member for communities and public protection said: “Everyone responsible for keeping livestock must uphold the highest standards without exception. Anything less puts animal welfare and public health at risk and undermines the integrity of the livestock sector.”

“Our animal health officers will rigorously investigate incidents of this kind, and East Riding of Yorkshire Council will not hesitate to take formal enforcement action wherever it is required.”

Welsh Rugby Union CEO Abi Tierney says she is determined to see through the radical restructuring of the professional game as she warned legal actions against the union risk “destroying” the game.

The WRU is under fire from all angles due to its plans to cut the number of professional men’s clubs from four to three. As part of their plans the WRU is also in the process of selling Cardiff Rugby to Ospreys owners Y11 Sports & Media.

According to Swansea Council, which has launched legal action against the WRU, such a scenario would see the Ospreys becoming a semi-professional Super Rygbi Cymru outfit.

Despite the vociferous criticism and an upcoming extraordinary general meeting of the WRU, Tierney is adamant the plans are the right ones.

“Yes, I am absolutely committed to that being the right thing to do,” said Tierney.

“I think the consultation, the level of engagement and the depth in which we went through that process.

“The other bit for me is none of the vocal minority have come up with an alternative either.

“Four clubs not funded to the level to be competitive and not being able to do the investment into the pathway.

“So, basically the alternative feels like it is continuing as we are which I didn’t think was the right answer.

“If people agree that we need to do something different then let’s go through this.

“It is going to be really painful going through it but we will come through the other side in a much stronger place as a result and let’s get some stability because that’s the other thing we need in Welsh rugby.”

Tierney revealed the current legal actions the governing body is facing, from Swansea Council and the Scarlets, are draining money, time and energy out of the game.

“I just think we risk destroying ourselves,” she said. “And actually, if we could put all of that energy and all of that money into pulling together and being a stronger union, because we are union, we’re a union of clubs, then to me, all that passion and all of that kind of hurt and anger could go into making rugby better.”

Here is every word from WalesOnline’s wide-ranging interview with Tierney.

What is the latest on Y11 buying Cardiff?

“So we’re still in a period of exclusivity with Y11 and in the process of assessing that. No decisions have been made yet.”

If Y11 do succeed in buying Cardiff would that mean an end to the Ospreys?

“We have made it clear they are two separate processes and we have to make a decision on Cardiff from a Cardiff perspective.

“We will do that. We are dealing with the Cardiff deal separately.

“We did an open, transparent bid process for Cardiff. Y11 was the best bid based on what we received when going through the process of looking at that. Once we know that outcome, there’ll be two outcomes.

“One is either we recommend to the board that we proceed with Y11 buying in Cardiff, or we say we don’t. And then at that point, we’ll make a decision on what happens next, but there’ll be a separate process.

“So just by Y11 buying Cardiff, doesn’t mean that off Ospreys go.”

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You are facing an EGM in the near future with your chair Richard Collier-Keywood facing a vote of no confidence. What are your thoughts on that?

“Firstly, the EGM is a process that as a national governing body we respect. We’re currently putting in place the process to allow the EGM to happen, so it will happen.

“We consulted on this plan for Welsh rugby. The current way of doing what we’re doing isn’t sustainable.

“We can see that in terms of performance on the pitch nationally and the performance of our regional teams. And so therefore, if the EGM motion was to be carried, and you get a new chair as a result of that, and that chair doesn’t support this plan, then you know you’d have to come up with an alternative plan.

“Is that keeping four teams where you don’t have the funding to fund them at the level that enables them to be competitive and produce the players we need for a strong national team? That’s the alternative.

“Having been here for two years now, having developed the plan that we developed, and did that through one of the biggest consultations in Wales, I believe it is the best plan.

“It’s hard. It’s really difficult.

“And I know it’s difficult and it has impacts that people are upset about, but it is the best plan for Welsh rugby.

“I think we’d be back doing it in two or three years’ time, if it was delayed now. We’d continue to see a deterioration in performance over that time.”

Is there a way of keeping four teams and putting the necessary investment (28m over five years) into the pathway?

“You wouldn’t be able to do that, and you wouldn’t be able to put the investment into the teams either.

“The £28million of investment that we’ve talked about in the pathways and in the national academy, we wouldn’t be able to afford to do that.”

The WRU have come under intense scrutiny from politicians over your plans. Has that put any doubts in your mind?

“It’s difficult. This was always going to be difficult.

“So, you can have support, a general support that we need to change. Everybody said that as part of the consultation that we couldn’t keep doing what we were doing.

“There was a view that going to three teams was the best answer as part of that.

“At the point, when actually then people start to realise what that might mean for their team or their location, that’s when it gets really difficult.

“It doesn’t mean it’s not the right answer. But to reiterate, we haven’t made a decision on what the three teams are going to be.

“We just need to take each step at a time to work out. There’ll be an east, a west and a central licence.”

Richard Collier-Keywood recently said there is no plan B. Is that true?

“It’s got headlines. It was over an hour-and-a-half’s discussion.

“We’ve got a plan A which is four to three teams. Do we constantly look at the risks involved in that and think about what contingency plans are? We absolutely do.

“I think what we’re saying is we’re not running parallel plans here. We’re absolutely focused and determined on Plan A. Yeah.

“We’ve got a risk register. We look at all the different things.

“If we end up with four teams, you know what that means in terms of finance and performance etc. There’s 20 or 30 different scenarios you constantly work through.”

Were you expecting an injunction and legal action from Swansea Council?

“I think the hard bit of it is that we haven’t made a decision yet. Therefore, a lot of it has pre-empted a decision.”

Are the politicians just electioneering ahead of the Senedd elections in May?

“I couldn’t possibly comment. I don’t know.

“I haven’t asked them that question, so you’d have to ask them that question.”

How damaging is all of this legal action to Welsh rugby?

“I’m a historian by training. I look at the last 20 years in Welsh rugby and the fighting that’s gone on.

“I just think we risk destroying ourselves. And actually, if we could put all of that energy and all of that money into pulling together and being a stronger union, because we are union, we’re a union of clubs, then to me, all that passion and all of that kind of hurt and anger could go into making rugby better.

“Then, of course, you’re absolutely right. So yes, it is damaging, and it’s money, but it’s also time.

“It’s the energy it takes of teams to do it, when, while we’re doing that, we’re not focusing on rugby. I won’t comment on the costs.

“You’ll see them in the annual report. But they’re very significant. That isn’t going into rugby.”

Yourself, Richard Collier-Keywood and Dave Reddin have been criticised for not understanding Welsh rugby because you were born and reside England. How do you respond to that?

“I’ve been really clear I’ve considered myself Welsh. I’ve always considered myself Welsh.

“So I don’t think it’s actually from my perspective, not necessarily factually correct. But also, I just think actually, you should recruit people based on their ability to do a job.

“But I think what’s really important is, as part of that, that you understand, value and live and breathe the culture that you work within.

“And that is important, and that can be done whether you’re whatever nationality you are.

“So, it’s about appreciating, valuing and being passionate about culture. And I think that’s what’s important, not about personality or about where you were born.”

Did you expect the job to be as hard as this?

“You do this job, and you know that people care passionately about rugby in Wales. You know that if you take on the job at a time when things are difficult, then you’re going to have to make difficult decisions.

“I know that’s part of my job. I accept challenge, but I think when it goes as far as it has with some of the players at the moment in terms of the level of abuse they get, then it’s not acceptable.”

What has stopped you from just walking away from Welsh rugby?

“I ask myself every day am I doing the right thing?

“I have Welsh rugby in my blood and I loved it. The privilege of this job still outweighs all of that.

“Do I believe we are doing the right thing for Welsh rugby now to put it on a sustainable footing? Yes.

“If I was to go and they brought somebody else in, you end up with that delay.

“I look at myself and ask are we doing the right thing for the right reasons even though it’s really difficult and do I have the courage to keep doing it? I do.”

How do you go about rebuilding trust and getting people on board with your plan?

“I agree with what you’ve just said and it is something I think a lot about.

“As a governing body if you don’t have the trust to deliver that’s really really difficult.

“So how do you go about rebuilding it? All you can do is just keep being honest, talking to people, answering the challenges, front up and have those difficult conversations.

“You just have to keep focused on building it.

“We need to remind people why we are doing this.

“I think it is by having the difficult conversations not just with the people who agree with what you are doing but the people who don’t agree.

“We need to do that every day but it takes time to do that.

“There will absolutely be an opportunity at some point where we can win some hearts and minds to try to win back some of that trust.”

How would you sum up how tough the last year has been for you?

“Simon (press officer) asked me a question earlier where he said: if you were going to sell this job to someone else what kind of person would do this job?

“I said ‘well, actually one of the hardest bits is you actually have to be thick skinned and you have to be…

“I’m somebody who is really open and I lead from my heart as well as my head. It has been the hardest part because I care so much about it and that’s actually why I do the job.

“That’s what gets me up in the morning because actually I do care passionately about it. It then makes it so much harder when it is as hard as it is.

“To sum it up I’m going to use an analogy and I’m not trying to be flippant here.

“Have you ever watched that programme on an assault course over water.

“They are climbing up some inflatables but when they get to the top a lot of oil gets poured on and you fall off it.

“You walk across planks and somebody comes and pours oil over you. Every day feels like I am on that gameshow

“They are fighting on quite a lot of different fronts which is quite tiring.

“You need to be incredibly resilient to then want to get up in the morning after a day where you’ve been whacked, metaphorically, and then you get up the next morning and go at it again.”

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Did you know how bad this job could get before taking it on?

“This is a conversation I was having last night with the chair of the IRFU. He’s worked in really difficult circumstances.

“He took on Bank of Ireland as chair post the financial crash and he said the stakeholder management in rugby is the hardest he’s ever had to deal with.

“I think it is harder in Wales because there is even more passion around it.

“There are so many complex stakeholders. You’ve got your politicians, you’ve got your players, your participants, your sponsors and your fans.

“It’s a really complex set of stakeholders so trying to move all of them, manage them and engage with them is hard because they’ve all got different agendas.

“I mean agendas in a positive way. They all care about different things and want different things so it is a very complex stakeholder.

“I think I underestimated just how complex the stakeholders are when I took on the job.”

Do you ever wake up and wish you’d never taken this job?

“Yes, there are times.

“I’m going to be really honest there are times when I think that but it doesn’t last very long because something will happen that is so inspiring that has happened in the community game.

“One of the clubs will win and you remember why you do it.

“I’d be a really hard nosed person if I said there hasn’t been times where I ask myself whether it was the right decision.”

If Richard Collier-Keywood loses his vote of no confidence does that automatically mean your restructuring plans stop?

“Well because one of the recommendations is to pause the restructure of the professional game.”

But it isn’t one of the motions put forward?

“No, it isn’t. We are talking about going to four to three over a period of time.

“We are not doing it overnight so if you think that a new chair comes in we still wouldn’t be at a point where we’ve completed the restructuring.

“So, they still would have the ability to stop it at that stage.

“Also, because the board all voted unanimously for it I would imagine some of them would consider their positions as well.”

Where are you with the licences and the control debate?

“We are still talking to the clubs about that at the moment.

“We’ve got meetings in a week or two’s time to keep going on that. There’s no definitive answer yet but we are aiming to get that agreed for the next season.”

Where are you with the URC?

“We’ve got to go through the process but they are being supportive and constructive.

“They are looking at different ways they would support us to put in an alternative team.”

But you are sticking with 4 teams for the 2026/27 season?

“Yeah, we’ve always said that. We are committed to having four sides for next season and it may even be until 2028 because it may take that long.”

You are 100% committed to the plan to go to three sides in the long-run and won’t change your minds?

“Yes, I am absolutely committed to that being the right thing to do.

“I think the consultation, the level of engagement and the depth in which we went through that process.

“The other bit for me is none of the vocal minority have come up with an alternative either.

“Four clubs not funded to the level to be competitive and not being able to do the investment into the pathway.

“So, basically the alternative feels like it is continuing as we are which I didn’t think was the right answer.

“If people agree that we need to do something different then let’s go through this.

“It is going to be really painful going through it but we will come through the other side in a much stronger place as a result and let’s get some stability because that’s the other thing we need in Welsh rugby.”

What is your view on amateur clubs having such a big say over the professional game? Would that happen anywhere else?

“Firstly, I wouldn’t call them amateurs. If you look at the volunteers at the clubs most of them are professionals.

“When I meet them and talk to them they are hugely passionate about Welsh rugby and care about Welsh rugby.

“I respect this process. I think it is really important that our shareholders, our clubs, have the ability to… it includes the regional clubs.

“We’ve got to listen but I’m confident we go through the EGM process, we use it as a chance to reiterate why this plan works and that we get a vote of confidence out of that and we keep going.”

In his unmissable column our ace tipster has scoured the second day of the Cheltenham Festival for the best value and has three recommendations

Bring out your Beastly side for the Debenhams Johnny Henderson Grand Annual. RELEASE THE BEAST (4.40) looks well suited to the demands of this competitive 2m handicap chase. He had some useful novice form last season and kicked off this term with a decent effort when runner-up at Wexford in October.

The 2m3f distance and lack of race fitness probably cost him the victory and he ran even better when second behind Addragole in a competitive Leopardstown contest on Boxing Day. There’s no doubting his potential and it’s interesting his trainer Paul Nolan puts a hood on him for the first time. Have 1pt each-way at 10-1. Sky Bet is paying out on six places.

READ MORE: Jockey hit with suspension over incident in horse race as stewards issue statementREAD MORE: Sir Alex Ferguson backed for Cheltenham Festival glory as Dan Skelton gives top five tips

QUILIXIOS (4.00) hasn’t run since falling at the last in the BetMGM Queen Mother Champion Chase 12 months ago. He was the only danger to Marine Nationale when he came down and he would have probably finished a gallant second if he had stayed on his feet.

It might not seem a good preparation to miss the whole of the last year but Henry de Bromhead’s hope has a superb record when returning from a break. He beat Marine Nationale at Naas on his first start of last season and he’d made a successful chase debut off the back of a 20-month gap the previous year.

With serious question marks against the main contenders, it is worth chancing that he can perform to his best today. He’s also got plenty of other crucial Festival form having also won the 2021 Triumph Hurdle. Have 1pt each-way at 10-1.

BECKETT ROCK (2.40) hasn’t really taken to fences this season and he should be happier returned to hurdles in the BetMGM Cup. He was a creditable sixth in this race last year despite having to pick his way through traffic turning into the home straight.

That was a decent effort to run so well in this competitive handicap on just his sixth race and he should be coming to his peak now. He’s also lower in the weights this time due to his disappointing spell chasing. Have 1pt each-way at 25-1. Plenty of firms are offering six places.

UK warship HMS Dragon has left its naval base in Portsmouth for the eastern Mediterranean to protect Cyprus, the government has announced.

The vessel left Portsmouth Harbour after 4pm on Thursday, a week after its deployment was announced.

The Type 45 destroyer is capable of shooting down drones and ballistic missiles fired by Iran and its proxies as the Middle East crisis continues.

Crew were seen lining the deck as the ship moved out of Portsmouth Harbour.

Officials insisted the ship had been prepared as quickly as possible for deployment, with six weeks’ worth of work squeezed into six days.

The announcement of the deployment of the ship came in response to a drone attack which hit the RAF Akrotiri base in Cyprus on the night of 1st March.

The drone strike forced the UK to reconsider its hands-off approach to America’s war with Iran.

In a recorded TV address earlier that evening, Sir Keir Starmer said he had agreed to a US request to use British military bases for “defensive” strikes on Iranian missile sites, adding “British lives” had been put at risk. By Tuesday, the government decided it would scramble a warship, HMS Dragon, to the eastern Mediterranean.

Under the 1960 Treaty of Guarantee, which handed independence to Cyprus, the UK has a legal obligation to ensure the island’s security. But the Cypriot government has said it was “disappointed” in Britain’s response to the strike and has been forced to draft in help from France.

The HMS Dragon is one of the Royal Navy’s six Type 45 Destroyers, which make up the fleet’s first line of defence against aerial threats such as aircraft, missiles and drones.

Normally based in Portsmouth, with a crew of around 200 sailors, it’s capable of protecting an area up to five times the size of Cyprus. It can also track hundreds of targets simultaneously, the MoD says.

Its Sea Viper missile system can launch eight missiles in under 10 seconds, and can direct up to 16 missiles onto their targets simultaneously, firing at four times the speed of sound.Last year, HMS Dragon became the first British warship to destroy a missile travelling at supersonic speed during an international exercise off Scotland.

Now a second British ship could be sent to the eastern Mediterranean if the Middle East crisis continues.

Landing ship RFA Lyme Bay is being prepared for a potential deployment to the region, according to the Ministry of Defence.

The vessel has aviation and medical facilities allowing it to assist in any evacuation effort.

A Ministry of Defence spokesman said: “As part of prudent planning, we have taken the decision to bring RFA Lyme Bay to heightened readiness as a precaution, should she be needed to assist in maritime tasks in the eastern Mediterranean.”

Markets calmed after US President Donald Trump suggested the military action would be a “short-term excursion” rather than a more prolonged war and threatened “death, fire and fury” against Iran unless vessels were allowed through the Strait of Hormuz, a vital maritime oil and gas route.

However, there was still a concern that energy prices could increase and the UK’s budget watchdog warned inflation this year could be higher than it had previously estimated.

Professor David Miles, a member of the Office for Budget Responsibility (OBR’s) budget responsibility committee, told MPs: “Right now, if prices don’t change from where they are – both the spot prices and market expectations for futures prices, which is particularly important for the Ofgem price cap – we think the inflation rate would end the year not near 2 per cent, but nearer 3 per cent.”

More to follow…

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After a phone call with Vladimir Putin, Donald Trump announced the US could ease oil sanctions on some countries to combat the rise in prices brought about by the Iran war.

It wasn’t clear whether Russia would be included, but such a move could signal a significant shift for the country, which has been isolated since the start of the war with Ukraine.

Could Russia be finding its way back to the world stage – after years as a global pariah?

Jayne Secker is joined by Sky’s Moscow correspondent, Ivor Bennett.

Have you got a question for us? Email the show – why@sky.uk

Over two months, I put nine different hot brushes through daily testing to see how each performed beyond the promise of glossy marketing claims. My hair type is wavy, of medium thickness and mid-length, so it can be a challenge to style.

The models varied in both price and purpose: some were designed specifically for use on dry hair, others performed best on damp strands, and a few included multiple attachment heads for added versatility.

Each brush was scored across several metrics, beginning with design. This included how well it felt in hand, the quality of build and how intuitively the buttons and settings could be used. Usability and convenience were judged by timing how long it took to heat up, how easily it glided through sections of hair, and how quickly it created a salon-worthy finish.

Safety on the hair was tested through repeated styling sessions, noting any signs of dryness or damage. I also assessed how straightforward they were to use straight from the box, without relying on manuals, and how much technique was required to achieve a smooth blow-dry or soft curl. For those hoping to maintain results overnight, check out our guide to the best silk pillow cases.

Why you can trust Telegraph Recommended

Our thorough, real-world tests will always help you find the best product. No manufacturer ever sees Telegraph Recommended reviews before publication and we don’t accept payment in exchange for favourable reviews, nor do we allow brands to pay for placement in our articles.

All reviews are based on independent expert opinion and our hands-on testing. Visit our Who We Are page to learn more.

Best hot brushes of 2026

The victim suffered a broken bone in his neck in 2024

A man is wanted in connection with a crash that left a pedestrian injured in 2024. Suffolk Police were called to a crash between 11.15pm and 11.30pm on August 12, 2025 in Ehringshausen Way, near the Esso filling station, in Haverhill.

The incident involved a red Nissan Micra and a pedestrian. The car failed to stop at the scene.

The pedestrian, a man in his 30s, was taken to Addenbrooke’s Hospital for treatment. It was revealed he sustained a broken bone in his neck.

The man was discharged from hospital three days later. However, the incident has left the man with permanent pain, and has had a significant psychological impact on him.

Suffolk Police are trying to find Dzhemal Dzhemal, 29, who they would like to speak to in connection with the incident. A police spokesperson said: “Dzhemal Dzhemal, aged 29, had been residing in Haverhill but is understood to have moved elsewhere shortly after the collision.

“Officers have made numerous enquiries to locate Mr Dzhemal, both within the UK and abroad. It is now thought that he may be living in London.”

Anyone with information should call police on 101 or report it online and quote reference 37/45772/24.

Do you want more of the latest Cambridgeshire news as it comes in from across the county? Sign up to our dedicated newsletter to make sure you never miss a big story from Cambridge or anywhere else in the county. You can also sign up to our dedicated Peterborough, Traffic and Crime newsletters for the latest updates on the topics you are most interested in.

The police said they are aware of social media posts appearing to pit Cambridgeshire schools against each other

Police are stepping up patrols in Cambridgeshire after concerns about social media posts that appear to pit schools against each other. Cambridgeshire Police said that they are working closely with local schools after the social media posts, which discuss gatherings of young people.

CambridgeshireLive has been made aware of social media posts circulating that divide schools into ‘red’ and ‘blue’ categories. They appear to pit schools in different categories against each other.

Cambridgeshire Police are aware of the posts. A spokesperson said that there is nothing to suggest gatherings in Cambridgeshire will take place.

A spokesperson for Cambridgeshire Police said: “We are aware of social media posts circulating online concerning gatherings of young people from local schools.

“There is nothing at this stage to suggest these gatherings are going to take place, but our officers are working closely with schools concerning content and reassurance patrols will be put in place.”

Joint pain is often dismissed as ageing, overuse or a minor injury. But for some people it is the first sign of inflammatory arthritis, a group of immune-driven conditions that can damage joints and other organs if not treated promptly.

Inflammatory arthritis can take years to diagnose and receive treatment, with some forms taking an average of nine years. During that time, persistent inflammation can lead to irreversible joint damage, fatigue and reduced mobility.

Although there is no cure, advances in medication over the past 15 years mean many people can live full and active lives. Outcomes are best when treatment begins quickly, ideally within the first three months, often described as a critical “window of opportunity”.

Inflammatory arthritis is less common than osteoarthritis and is managed in different ways. It occurs when the immune system mistakenly attacks the body’s own tissues, particularly the lining of joints. The exact cause is often unclear.

It can begin at any age, including in childhood, and often starts in the hands and feet. Some forms affect just the spine and pelvis. Other parts of the body such as the skin, eyes, heart and lungs may also be involved. Joints can become swollen, warm and tender, and many people experience morning stiffness that lasts for hours and improves with movement rather than rest.

Early symptoms can be subtle and easy to overlook. Stiffness may be blamed on sleep, swelling on overuse and fatigue on stress or ageing. This can contribute to delays in referral and specialist assessment.

How inflammatory arthritis differs from osteoarthritis

Osteoarthritis is different. It is strongly associated with age and most often affects people from midlife onwards, particularly in the knees, hands and hips. It usually develops gradually and becomes more common with advancing age.

Inflammatory arthritis, by contrast, is driven by the immune system and often causes prolonged morning stiffness, visible swelling and fatigue that do not improve with rest or simple activity. Although osteoarthritis is far more common globally, affecting more than 600 million people, over 18 million people live with rheumatoid arthritis, the most widely recognised form of inflammatory disease.

Despite these differences, early-stage arthritis can be difficult for healthcare professionals to distinguish. Symptoms often overlap, and no single test confirms the diagnosis. Blood tests and imaging can support assessment, but results are not always definitive. Because treatment varies depending on the type of arthritis, accurate and timely diagnosis is essential.

Medications for inflammatory arthritis aim to control the immune response and reduce inflammation. These include steroids, which are generally not suitable for long-term use, and disease-modifying anti-rheumatic drugs (DMARDs). When introduced promptly under specialist care, these treatments can reduce symptoms and slow disease progression. Some people reach remission: inflammation is well controlled and symptoms are minimal or absent. A small proportion are even able to stop medication under specialist supervision.

Treatment for osteoarthritis focuses on managing pain and improving function. There are currently no medications that reverse the condition or target its underlying cause. Paracetamol, anti-inflammatory drugs such as ibuprofen, and steroid injections may help relieve symptoms. Non-drug approaches are important for both inflammatory arthritis and osteoarthritis. These include exercise, walking aids where needed, heat and cold therapies and some complementary approaches. Lifestyle also plays a key role. Maintaining a healthy weight, stopping smoking and staying physically active can all improve outcomes.

Why early assessment matters – and who to see first

Reaching specialist care quickly can make a significant difference. In the UK, new roles in primary care are helping people be assessed sooner. First contact physiotherapists (FCPs) working in GP surgeries can recognise early symptoms of inflammatory arthritis and refer patients to rheumatology specialists to begin appropriate treatment. They assess people with joint and muscle problems, request tests where appropriate and provide advice on treatment and long-term outlook. If specialist care is needed, they arrange referral directly.

First contact physiotherapists have been part of UK primary care for more than a decade. Evidence suggests the role is safe, cost effective and beneficial to patients, with patients reporting high satisfaction and doctors expressing confidence in physiotherapists’ expertise.

Arthritis is a leading cause of pain, stiffness and disability worldwide. For people with inflammatory forms of the disease, delayed recognition remains one of the biggest barriers to effective treatment. Symptoms can resemble more common joint problems, slowing referral to specialist care at the point when treatment would be most effective.

If you notice persistent joint swelling, warmth or morning stiffness that lasts more than an hour or improves with movement, assessment is important. There are UK-based websites that include symptom checkers to help people understand when to seek advice. Many GP surgeries in the UK offer appointments with first contact physiotherapists, which can usually be requested directly.

Joint pain is common and often harmless. But when symptoms persist, involve visible swelling, or do not behave like typical “wear and tear”, they should not be ignored. Prompt assessment and appropriate referral give people the best chance of protecting their joints, preserving mobility and maintaining quality of life.