‘You spit, we hit’: Trump takes over Washington DC with vow to stop ‘thugs’

Monday marked the beginning of a Trump takeover of Washington D.C.’s law enforcement capabilities and what many Democrats fear could be step one of full federal control over the District of Columbia.

At the White House, Donald Trump was flanked by top officials including FBI Director Kash Patel and Attorney General Pam Bondi as he announced that the Metropolitan Police Department (MPD), the city’s main police force, would be brought under federal control.

From behind the podium, the president recalled images of police officers facing abuse by protesters he’d watched on TV screens over the years, clearly evoking anger in him and leaving a city braced for Trump to fulfill a long-awaited desire to “send in the troops.”

He then passed around images of individuals arrested over the weekend, and promised that, going forward, police officers would be unhinged in their treatment of criminals and, likely, dissenters: They’ll be able to do “whatever they want”, Trump vowed. “You spit, and we hit.”

It was about as explicit a lean into the “strongman” image as one could ask for. But the president’s fixation on clashes between protesters and law enforcement has one glaring exception: January 6.

The violent siege of the U.S. Capitol by Trump supporters in 2021 lasted for several hours. In the end, protesters left the building after police officers from neighboring counties in Maryland and Virginia arrived to quell the chaos.

A deployment of more than 6,000 National Guard troops was finally authorized at 6 p.m., hours after the chaos began and hours after the worst of it ended.

Dozens of officers were injured, several died after the attack including one who sustained injuries during it, Brian Sicknick. Survivors recounted vicious abuse from protesters, especially Black officers who recounted racial slurs and threats of violence.

But the Capitol is not where the January 6 story ends.

As Trump supporters left the Capitol that day, they fanned out across the entire District of Columbia, some returning to homes and hotels in the region and others spreading mayhem across the city. Businesses were boarded up as far as southeast D.C. and scattered evidence of vandalism was seen around residential areas and various neighborhoods the next day.

It was the city’s most violent day in decades. But on the campaign trail last summer, Trump vowed his first act would be to pardon all of them.

True to his word, and despite the pleas of even some Republican supporters, on the day Trump was sworn in he pardoned some 1,500 people who participated in the siege on the U.S. Capitol and were either convicted or facing charges.

MPD officers were part of the initial response as well. Some of the officers who responded that day are now under the command of the same administration that pardoned hundreds of Jan. 6 offenders, including some charged with violence against MPD and Capitol Police officers.

One of those rioters, Julian Khater, was charged with spraying officer Sicknick with a chemical repellant during the attack; a colleague later testified that Sicknick looked “ghostly pale” afterwards.

Even so, the MPD’s union chief told Fox News on Monday that his outfit “completely agree[s]” with Trump that crime in D.C. is “out of control.” He and union officials pointed to an MPD commander under investigation for allegedly falsifying crime data, and claimed that it was a lie that crime in the District of Columbia was decreasing. The Justice Department touted that data as recently as January, days before Trump took office.

For Trump, Monday was “Liberation” day. “Crime, Savagery, Filth, and Scum will DISAPPEAR. I will, MAKE OUR CAPITAL GREAT AGAIN!” he wrote on Truth Social ahead of the press conference he’d teased all weekend.

But city officials are adamant that the trends mapped by the data are real, and that all types of crimes including some of the most stubborn categories such as carjackings were dropping in frequency across the board.

“Any comparison to a war-torn country is hyperbolic and false,” D.C. Mayor Muriel Bowser told MSNBC on Sunday. “There are very specific things in our law that would allow the president to have more control over our police department. None of those conditions exist in our city right now.

“We had one of the lowest crime levels and shootings that we’ve had in a July in recent history. So, not only are we going down year to year, we’re seeing the trends go in the right way in every crime category.”

There’s no question: Trump has been looking for an excuse to do this.

A Rolling Stone investigation published earlier this year cited two sources with knowledge of the president’s conversations as saying that Trump was speaking to aides just after taking office in January about identifying the earliest possible moment when it would be appropriate to send in federal troops for crime suppression efforts.

Anger felt by some city residents (among whom Trump supporters are still a slim minority) on Monday was embodied by restauranteur José Andrés, who tweeted at the president: “[Y]ou didn’t have the power to call the National Guard on January 6 but now you do? Washington DC is not only our nation’s capital…it’s a beautiful city that 700,000 people call home. I’m proud to run a business and raise a family here. DC doesn’t need federalized troops…it needs leaders who respect our fundamental founding principles of democracy, dignity, and respect.”

Trump finally got his opportunity with the July attack on a man whose online nickname — “Big Balls” — propelled him to both mockery and notoriety. The former DOGE staffer, who is still a federal employee, named Edward Coristine, was attacked while allegedly intervening during a carjacking attempt. According to police reports, Coristine was mobbed by a large group of teens during the attack and had his iPhone stolen in addition to being viciously assaulted.

Groups of teenagers have become a major problem for city officials in recent weeks, with residents reporting large numbers of young adults and school-aged children attacking people on city streets, neighborhoods such as Navy Yard (where many congressional staffers live) and the Metropolitan Branch Trail, a paved route across the northeastern part of the city used by pedestrians and cyclists. In some cases, groups have numbered as high as hundreds of people and have required massive police responses.

The only questions for Trump now are how far he takes this, and how much punishment he’ll dole out on D.C. elected officials. Even as Bowser continues to avoid a public confrontation, Trump aimed harsh rhetoric at the city council on Monday.

And it remains to be seen whether he’ll try and take this effort national once again, after being largely stymied in his efforts to impose a sustained presence on the city of Los Angeles over ICE protests.

A compliant Congress will likely make any Trump takeover of D.C., no matter how broad, a smooth process. But that same dynamic won’t be found if the president tries to reimpose his will on America’s blue states, where governors are raring for the chance to show that they have the backbones which their voters are demanding they show.

Amber heat health alert for England amid warning over rise in deaths

An amber heat health alert has been issued for large parts of England, with authorities warning soaring temperatures this week are likely to cause a rise in deaths.

The UK Health Security Agency (UKHSA) has issued alerts in London, the West Midlands, the East Midlands, the East of England and the South East, which are due to come into effect at 9am on Tuesday.

It warns that there could be a rise in deaths particularly among those aged 65 and over or with health conditions. However, it added that there may also be impacts on younger age groups, with a likely increase in demand for health and social care services.

The amber alerts are set to remain in place until 6pm on Wednesday, with yellow alerts in place for the remainder of England at the same time.

It comes as the UK is set for its fourth heatwave this summer after temperatures are forecast to soar over the coming days.

Those under amber warnings have been told temperatures in care settings such as hospitals and care homes may exceed recommended threshold for clinical risk assessment, with overheating increasing the risk to vulnerable people living independently in community and care settings.

The heat could also lead to issues managing medicines, and cause an increased demand for power exceeding capacity. The UKHSA has also warned that it may affect the ability of the workforce to deliver services, and that there could also be travel delays.

Temperatures are expected to peak in the mid-thirties in the south of England this week, according to the Met Office, with London marking 32C on Tuesday.

It is set to remain warm in other parts of the country, with Manchester clocking temperatures of 28C on both Tuesday and Wednesday.

Met Office Deputy Chief Meteorologist Tom Crabtree said: “Warmth is the focus in the forecast in the first half of this week, with temperatures likely to peak on Tuesday around the mid-30s, but remaining above average in the second half of the week, particularly further to the southeast.

“The exception to the widely warm conditions will be northwest Scotland on Monday, where showers will be more frequent. Warmth will develop there from Tuesday with temperatures peaking in the mid to high 20s.”

In addition to high daytime temperatures, warm nights are also likely in southeastern parts of the UK early in the week, with even a chance of a tropical night in a few places, which is where temperatures do not drop below 20°C overnight.

A heatwave is identified when a location records maximum temperatures exceeding a designated value across at least three consecutive days, according to the Met Office. For most of the UK, this is 25C, but rises to 28C in London and the surrounding areas where temperatures are typically higher.

The hottest day of the year so far saw 34.7C recorded at St James’s Park in central London on 1 July. As it gets hotter once again, Britain is expected to see its fourth heatwave after one in June and two in July.

Nurses facing ‘abhorrent’ violence levels while in A&E

Nurses are facing “abhorrent” levels of violence in A&E departments including being punched, spat at and even having a gun pointed at one of them.

And long waits in A&E are also leading to anger among patients who are not prone to violence, the nursing union said.

The Royal College of Nursing (RCN) said more must be done to protect NHS staff.

Without action to tackle long waits, corridor care and “chronic” staffing problems, then rates of violence will continue to rise, the RCN warned.

It comes after it found rising rates of violence towards staff after sending freedom of information (FOI) requests to NHS hospitals with accident and emergency departments.

Figures from 89 hospital trusts, out of a possible 129, revealed there were 4,054 cases of physical violence against A&E staff recorded in 2024, up from 2,093 in 2019, the RCN said.

One senior A&E nurse based in east London told the RCN she has seen colleagues punched and kicked and described how a colleague had a gun pointed at them.

She herself had been spat at by a patient and threatened with an acid attack.

A senior charge nurse from the East Midlands, Rachelle McCarthy, told the RCN that “even patients you would expect to be placid are becoming irate because of just how long they have to wait”.

“You can only imagine the behaviour of those who are already prone to violence,” she added.

Ms McCarthy also told the union she was punched “square in the face” by a “drunk, six foot two bloke”.

Another nurse said: “It’s not going to help with our retention and recruitment if you think you’re going to be clobbered every shift.”

Sarah Tappy, a senior sister in an A&E in east London, was knocked unconscious after being punched in the head by a patient.

“The violence is awful,” she said. “And it’s just constant. Nurses, doctors, receptionists – none of us feels safe.”

RCN general secretary and chief executive Professor Nicola Ranger said: “Nursing staff not only go to work underpaid and undervalued but now face a rising tide of violence.

“It leads to both physical and mental scarring, lengthy time off and sometimes staff never returning.

“Measures to keep staff safe day-to-day are crucial, but the stark reality is that unless the Government does something about lengthy waits, corridor care and understaffed nursing teams, more nursing staff will become victims of this utterly abhorrent behaviour.

“Left unaddressed, this could see plans to reform the NHS fail completely.”

Health and Social Care Secretary Wes Streeting said: “I am appalled by these findings.

“Nurses dedicate their lives to helping others and deserve to go about their jobs free from violence or intimidation.

“Anyone who violates this core principle will feel the full force of the law.

“I met with the Royal College of Nursing recently to reaffirm our commitment to standing with frontline workers, working together to stop violence against NHS staff and improving their working conditions.

“Just yesterday I announced a new graduate guarantee to get more nurses into our NHS, and I have also committed to shining a light on the extent to which corridor care plagues our NHS, as the first step to eradicating it.

“We are strengthening vital support for victims, including security training and emotional support for staff affected by violence, so no NHS worker has to suffer in silence.”

The Liberal Democrats have called for A&E staff to be given access to a panic button which would give them a “direct line” to the police.

The party’s health spokesperson Helen Morgan said: “Violence against hospital staff is utterly abhorrent and those committing it should feel the full force of the law. Those working in hospitals often do so under incredibly difficult conditions to look after us when we are most in need.

“The Conservatives’ shameful neglect left our hospitals understaffed and patients left at risk. If this Labour Government thinks it can turn that around without addressing this shocking violence, they are badly mistaken.

“The Government must urgently ensure all A&E units have a direct line to their nearest police station through a panic button – to protect patients and staff and ensure these violent criminals are swiftly arrested.”

Two girls arrested after hotel destroyed in suspected arson attack

Two girls aged 13 and 14 have been arrested after a major fire gutted a historic former hotel.

West Mercia Police said the teenagers had both been released on bail as part of its inquiry into damage caused to the Grade II-listed Raven Hotel in Droitwich Spa, Worcestershire.

Hereford and Worcester Fire and Rescue Service said it responded swiftly to the fire at 4.45pm on Sunday, with the first fire engine arriving on scene within two minutes of the initial emergency call.

The brigade said eight fire engines and multiple specialist vehicles were deployed to tackle the blaze, which did not lead to any casualties but “totally destroyed” the building.

In a statement issued on Monday, the West Mercia force said: “Police attended a large fire at the Raven Hotel on St Andrews Street in Droitwich.

“It was believed the fire had been started deliberately but thankfully nobody has been injured.

“Two girls, 13 and 14, were arrested on suspicion of arson and have since been released on bail.”

Officers remain at the scene, the force said, and are asking that the public stay away from the area at this time.

Scaffolding was put up around the privately-owned building by Wychavon District Council after an incident in September 2024 where guttering and debris fell into the road.

The incident also prompted an urgent inspection by the authority, which found that the condition of the disused structure, part of which dates back to the 16th century, posed risks to the public.

Fire service Group Commander Simon Cusack said: “This was a challenging incident, and I want to commend the professionalism and dedication of our firefighters and partner agencies.

“The rapid response and teamwork ensured that the fire was quickly contained and extinguished without injury. We appreciate the public’s support and will continue to work with the local authority and business owner to secure the site.”

The district council said it shared the community’s upset and anger at the “devastating” fire.

The council said in a statement: “We understand completely the strength of feeling and affection for this historic building and the significance it has for the town.

“Over the last six months we had been working hard to ensure that urgent works were carried out to protect the building in line with the court order we secured late last year. These works were due to finish this week and we will still invoice the owner for payment.

“We are working closely with the fire service and our building control officers were visiting the site this morning to review the building and advise of the next steps.

“We will issue a further statement very soon, once we have an update regarding the state and safety of the structure.”

Three children arrested on suspicion of murder after man dies in Kent

Three teenagers have been arrested following the death of a man on the Isle of Sheppey in Kent.

Kent Police officers were called to the Warden Bay Road area in Leysdown-on-Sea shortly after 7pm on Sunday to reports of an altercation and a serious assault on a man.

Paramedics also attended, and a man in his 40s was confirmed dead.

His next of kin has been informed.

A 16-year-old girl and two boys, aged 14 and 15, have since been arrested on suspicion of murder.

They remain in custody pending further inquiries, police said.

On Monday, a police cordon could be seen in a large clearing behind the beach in the Leysdown-on-Sea resort, in front of a caravan park.

One local resident was surprised that her afternoon walk was disrupted, as she thought the helicopter sent last night was the coast guard which they “get a lot” at this time of year.

A crew of Kent police officers remained at the scene on Monday.

Detectives are appealing for witnesses and anyone with information should call Kent Police on 01622 690690 quoting 10-1384.

Jet, Set, Glow: How to turn pre-flight time into a wellness ritual

The airport might not be the first place you think of when you think about wellness, but believe me, you can hone healthy habits just about anywhere. Feeling well is about small incremental changes that are easy to manage and I’ve got plenty of tips on how to apply these ahead of a holiday.

Part of my job is travelling to health retreats around the world so there are a few things I do when I arrive at Heathrow to prepare me for this. Read on for my tips on how to transform waiting at your gate into a wellness ritual.

There are great wellness wins to be found in Duty-Free if you know where to look. Discounted skincare? Yes please. I’ll always head to the World Duty Free stores to stock up on my flight favourites to hydrate, protect and soothe stressed out skin and wellness tools to fight jet-lag and keep my healthy habits up on the other side.

Don’t believe what you see on TikTok – you don’t want to be putting on a load of skincare and facemasks on a plane. Dermatologists agree that less is more, so I pick up one of Aesop’s simple Venturer kits and use it as soon as I’m on the plane. The mouthwash and deodorant contain no nasties and the natural scents soothe the nervous system.

I also head to the Charlotte Tilbury counter to make the most of the deals there. The Magic Cream is gentle and hydrating so I use it on the plane once I’ve taken any make up off to stop my skin drying out in transit. I also usually pick up an In-Flight Hydrate, Protect and Glow kit, which contains a hydrating travel-sized mist, primer and lip oil.

If you’re concerned about your circulation on a flight, you can find incredible ayurvedic massage tools and neurocosmetic oils from Mauli Rituals to give the brain and skin a boost while you’re waiting to board and in flight. The brand’s bath salts are great for jet lag recovery too.

I slather hand cream on to prevent dryness while I’m in air conditioned spaces so I also make a beeline for L’Occitane products while I’m in the World Duty Free store – the minis are great for travelling and there are some cute travel exclusives available, such as the Shea Travel Must Have’s Set. Elemis also does a great selection of minis. If you don’t want to bring your entire skincare routine on holiday, opt for the whole Elemis protocol in minis in a travel exclusive set for a gentle hydrating pro‑collagen fix.

You can reserve your products online up to 30 days before your trip, so rather than stressing about what’s in stock or turning up without a clue, I recommend pre-ordering and heading straight to the desk for what you need. Then enjoy a bit of a browse. Stress isn’t great for you at any time, let alone when you travel so don’t stress yourself out by spending too long looking for what you need and having to run to your gate.

I recommend pre-ordering the Aesop kit, Charlotte Tilbury skincare or Mauli Rituals’ travel-size oils. It’s also worth looking for travel-exclusive offers and sets. The Charlotte Tilbury, Elemis and Clinique travel sets are often much better value than high street versions

There are a host of other stores I like to visit for essentials when I arrive at Heathrow and Boots is obviously one of them. This is where I find all my supplements – magnesium for sleep and muscle tension, electrolytes to maintain hydration while travelling and probiotics or digestive enzymes to keep my gut happy.

I also head to the Rituals store for more aromatherapy goodness but usually I’ll have already stocked up in World Duty-Free. One thing I won’t have found in Duty-Free is clothing, so I go to Lululemon for buttery-soft comfies to wear on the plane. Of course, no airport visit is complete without popping into WH Smiths for a book – next on my list is Genius Gut by Dr Emily Leeming.

Did you know that Terminal 2 and Terminal 5 both offer quiet areas for stretching? This is a must if you’re going to be sitting down for ages on your flight. A quick stretch or yoga session helps to alleviate tight hips, back and neck pain and avoid swelling – especially if you do it before you board and after you land.

Compression socks can also help with swelling and improve your circulation but it’s great to wake the body up too. Try ankle rolls, neck rotations, legs up the wall and cat-cow stretches. You can also use this time to use your Mauli Rituals massage tools to boost circulation and get your muscles nice and relaxed before having to sit still for an extended period.

Even if you’re flying economy, you can also book into lounges like Plaza Premium or No1 Lounge for a fee. Many include quiet zones, hot food, showers and complimentary herbal teas. Terminal 5 also has a spa inside some lounges like the Sofitel Heathrow if you’re really in need of some downtime whilst passing through the airport, perhaps for a connecting flight.

There are so many eateries and shops I recommend at Heathrow, you just have to know where to look for the healthiest finds. Eating high protein and fibre options will mean you stay fuller for longer and feel comfortable on your flight. You might also want to think about whether you plan to sleep on the plane or not, and either go for foods and drinks that will relax you, or give you an energy boost, depending on your plans.

I’ll always go for a high protein breakfast from Pret over a fry up at ‘spoons. I also love their ginger shots for an extra immunity boost before breathing in aeroplane air.

If I want to feel awake and invigorated, I’ll go for a juice and a matcha from Joe and the Juice. Leon is a great shout if you want something more filling that won’t leave you feeling sluggish – think fast, fresh options including quinoa bowls, grilled chicken, and veggie pots.

For a sit-down meal, head to Giraffe for global-inspired meals with veggie options, smoothies and herbal teas. My all-time favourite spot is Itsu for sushi, miso soup, edamame and gut-friendly options that won’t leave me feeling bloated or uncomfortable during the flight.

Then I’ll stock up on snacks from M&S food for the plane – fresh fruit, nuts and coconut water for hydration. Eating mineral-rich food like this and staying hydrated can help lessen jet lag.

Heathrow has water refill stations in every terminal after security. Staying hydrated is one of the easiest ways to reduce jet lag, boost focus, and support digestion—especially important if you’re flying long haul. I fill mine up with filtered water and then drink it before I go through security. On the other side it’s easy to refill your bottle or buy a new bottle of filtered water.

You can also bring your own herbal tea bags, electrolytes and soothing adaptogenic drinks from home. Most come in travel-size sachets and all you have to do is politely ask any coffee shop or restaurant for hot or cold water in a takeaway cup or your reusable cup to mix them up.

I always create a personal ritual to feel grounded whilst I’m in an airport. They can be busy frenetic places and you might already feel tired from an early start. I like to do a guided meditation (there are plenty of free ones on Spotify) with my headphones on while I’m sitting down paired with some box breathing exercises. I also do it again once I’m in my seat on the plane. This relaxes the nervous system and gets you into a more positive mental state. It’s great for alleviating any stress, preparing you for any stressful or challenging situations or calming your nerves if you happen to be a nervous flyer.

You can also use your aromatherapy oils, a rollerball or a spray to soothe your senses and reset. Just be mindful of other people around you if you’re spraying something. I also try to use the opportunity of time spent waiting at my gate to read a book, instead of doom-scrolling on my phone. If I’m doing this, I pop my earplugs in to drown out the noise around me – my favourites are from Loop. If you prefer to take in your surroundings, pop your headphones on and listen to a soothing or uplifting playlist. I like to curate these before I head to the airport to help me get into the right headspace when I need it.

If you do suffer with anxiety around crowds, feel nervous about flying or just want to feel more grounded, you can practice saying a few affirmations and mantras for confidence and calm. This could be something as simple as: “I am safe and I travel with ease”.

Armed with all these tips you’ll hopefully be able to board your flight feeling relaxed, prepared and excited to travel to destinations far and wide. Though the unknown can be stressful, there are plenty of ways to feel more optimistic and resilient if we know how to take better care of ourselves, wherever we are.

Find out more about Heathrow’s Redefine Your Beauty campaign, including treatment menus, participating brands and exclusive offers here.

Kemi Badenoch suggests putting asylum seekers in ‘migrant camps’

Kemi Badenoch appeared to suggest the setting up of migrant “camps” when speaking about possible alternatives to using hotels to house asylum seekers – comments which have been dubbed “deeply troubling” by refugee campaigners.

As she met members of the community in Epping, Essex, the Conservative Party leader said: “We’ve got to turn things around very quickly. We cannot use rules from 1995, or 2005, or even 2015 for 2025.

“Our world is changing very quickly, and we need to adapt to it.”

Ms Badenoch, who is attempting to persuade voters that the Tories can be trusted on the issue of migration in the face of a growing threat from Reform UK, added: “Is it possible for us to set up camps and police that, rather than bringing all of this hassle into communities?

“As a party, we need to also hear from the community about what you think the solutions are. We don’t have all the answers; it’s important that we make sure that the community is part of the problem solved.”

Responding to her remarks, Refugee Action’s Tim Naor Hilton told The Independent: “It’s deeply troubling that our political leaders appear to be in a race to the bottom for who can treat people seeking asylum the most cruelly.

“It is creating an incendiary atmosphere in our communities that is emboldening dangerous far-right groups and leading to racist attacks on people seeking asylum.

“Hostile policies and rhetoric must stop now. People must be treated with dignity and housed properly in our communities so they can rebuild their lives in peace.”

It comes amid mounting tensions over asylum seekers housed in hotel accommodation in recent days, with protests taking place across the UK.

Meanwhile, the government is ramping up its efforts to bring down migration amid growing public anger over the issue, announcing on Friday that the new “one in, one out” returns deal with France was up and running.

The Home Office has also expanded its “deport now, appeal later” scheme, which sees foreign criminals deported before their appeals have been heard.

But Ms Badenoch said the fresh government effort to deport foreign national offenders was “the sort of stuff that they should have been doing on day one”.

Asked about the recent announcements, she told broadcasters: “When we were deporting criminals, Keir Starmer was writing letters trying to stop our deportations, so I’ll believe it when I see it.

“This is the sort of stuff that they should have been doing on day one. The fact that they tried to stop deportations before means that I don’t really believe it.

“The government has released 26,000 prisoners since they came to power, released them early, [and] there are now more criminals on our streets, that’s what I’m really worried about.”

The “deport now, appeal later” scheme has been expanded to include offenders from another 15 countries including India, Bulgaria and Australia, bringing the total to 23 countries.

It allows the UK to deport offenders who have had a human rights claim against their removal rejected, with any appeals heard from abroad over a video link.

Thousands with prostate cancer facing unnecessary treatment – experts

Up to 5,000 men every year could be facing unnecessary overtreatment for prostate cancer due to ‘outdated’ guidelines, a charity has warned.

Overtreatment of the disease can lead to side effects such as erectile dysfunction or incontinence, according to Prostate Cancer UK.

Patients whose cancer is unlikely to progress may only need close monitoring. But experts say out-of-date guidance from the National Institute of Health and Care Excellence (Nice) has created a “wild west” of what is implemented in the NHS.

The warning comes as the government is currently awaiting advice on a national screening programme for prostate cancer, which was launched following Sir Chris Hoy’s call for more men to be screened after he revealed in February 2024 that he had been diagnosed with stage four prostate cancer.

Around one in four men diagnosed with prostate cancer will have a cancer that is so slow-growing it is unlikely to ever cause them harm.

NICE guidance currently only advises active surveillance as the preferred approach for men who have the lowest-risk cancer. But these guidelines have not been updated since 2021, and the Prostate Cancer UK argues they do not take into account advances in testing and diagnosis.

Professor Vincent Gnanapragasam, professor of urology at the University of Cambridge, said: “Active surveillance is the best treatment option for men whose cancer is unlikely to progress or cause them problems in their lifetime.

“But NICE’s outdated guidelines have created a deeply concerning wild west on how surveillance is implemented by different health care teams. This inconsistency is resulting in a lack of confidence from patients in surveillance, who may instead opt to have treatment they may not have ever needed, risking harmful side effects.”

According to the charity, overtreatment rates in England range from 2 to 24 per cent, and it warns that this results in a “postcode lottery” in which some men receive treatment unnecessarily while others receive monitoring as they should. It also found 35 hospitals have created their own guidelines on what to do.

Michael Lewis, 63, was diagnosed with prostate cancer in 2020. The nurse, from Dudley, said: “My doctors told me my cancer was ‘low-risk’ and not likely to spread quickly, so I was put on active surveillance until 2024, when my PSA level started to rise again, so I had surgery to remove my prostate.

“Being on active surveillance meant I didn’t have to have treatment until I needed to. I was able to continue my everyday life with no side effects. I’m glad I was able to get treatment when I needed it, but having the time without it was so valuable.”

Amy Rylance, assistant director of health improvement at Prostate Cancer UK, said: “Thanks to advances in research, we can now tell which prostate cancers require immediate treatment, and which men would be better off being monitored with blood tests and scans – enabling them to delay treatment or even avoid treatment altogether.”

She said the treatments for prostate cancer, such as radiotherapy or surgery, can lead to “life-changing side effects, like incontinence or erectile dysfunction, which can have a huge mental and physical impact on men”.

“NICE’s outdated guidance is increasing the likelihood of men experiencing these life-changing side effects,” she added. “It is causing confusion and inconsistency between hospitals in how active surveillance is implemented across England, leading to a postcode lottery of overtreatment.”

The charity is now repeating its call for Nice to update its guidance on active surveillance, claiming this could help up to 5,000 men a year avoid overtreatment.

The UK’s National Screening Committee is currently assessing whether a national screening programme for prostate cancer should be rolled out.

A NICE spokesperson said: “We are committed to ensuring our guidelines continue to reflect the best available evidence and give patients the best possible outcomes. They are developed by an independent committee, including NHS clinical experts, and are kept under review to ensure they remain current.

“We are updating our prostate cancer guideline, including a review of the recommendations around active surveillance, and will be assessing whether our suspected cancer guideline recommendations around age-related thresholds for PSA tests for prostate cancer for onwards referral from primary care require updating.”