Galleri screening test for cancer trial by NHS

On the 13th September 2021 the NHS began the world's largest trial of a revolutionary new blood test that can detect more than 50 types of cancer before symptoms appear.

Patients whose cancer is found early at stage one or two typically have a broader range of treatment options available, which can be curative and are often less aggressive. Diagnosis at the earliest stage has typically between five and ten times the survival rate with those found at stage four.

The Galleri test

This simple blood test looks for the earliest signs of cancer, especially those that are usually difficult to identify early or for which there are no NHS screening programmes, such as lung, pancreas and stomach cancers. The test was developed by the firm of Grail, California and is is already in use in the USA.

The test works by finding chemical changes in fragments of genetic code (cell-free DNA or cfDNA) that leak from tumours into the bloodstream. Finding these changes does not mean someone actually has cancer, just that they might have cancer and will need follow up tests.

The Trial

The NHS aims to recruit 140,000 volunteers in eight areas of England to see how well the test works. Participants must not have already had a cancer diagnosis in the last three years.The first people to take part will have blood samples taken at mobile testing clinics in retail parks and other convenient community locations. They will then be invited back to give further samples after 12 months and again at 2 years.

The study is a randomised control trial (RCT). Half the participants will have their blood screened with the test immediately. The other half will have their sample stored and may be tested in the future. This will allow scientists to compare the stage at which cancer is detected between the two groups.

People will only know if they are in the test group if they are among the small minority whose test detects potential signs of cancer in their blood. They will be contacted by a trial nurse and referred to an NHS hospital for further tests. All participants will be advised to continue with their standard NHS screening appointments, and contact their GP if they notice any new or unusual symptoms.

Initial results of the study are expected by 2023 and, if successful, NHS England plans to extend the testing to a further one million people in 2024 and 2025.

Source: Various news sites in 2021.

The Queen has died - Long live the King

Queen Elizabeth II died on the 8th September 2022, but what happens next?

Succession

Her eldest son, Charles, became king immediately. The new monarch chooses the name they will be known as - in this case Charles III.

An Accession Council, by custom held at St James's Palace, is usually convened within 24 hours of the death of the monarch and the accession of the successor to the throne. The Council should be held before Parliament meets, and Parliament should meet as soon as practicable after the death.

The Accession Council comprises certain Privy Counsellors, Great Officers of State, the Lord High Mayor and High Sheriffs of the City of London, Realm High Commissioners, some senior civil servants and certain others invited to attend, but without the new Sovereign. This meeting formally announces the death of the monarch and proclaims the succession of the new sovereign. The Accession Proclamation is signed by those members of the Royal Family who are Privy Councellors, the Archbishop of Canterbury, the Lord Chancellor, the Archbishop of York, the Prime Minister, the Lord Privy Seal, the Lord Great Chamberlain, the Earl Marshall and the Lord President of the Council

Following this the Sovereign holds their first Privy Council, which is attended by Privy Counsellors only.

Funeral

The funeral will be held at Westminster Abbey on Monday 19th Sept. King Charles III has approved a bank holiday on the day of the funeral.

The Queen's coffin was first laid to rest in the ballroom at Balmoral to allow the Royal Household to pay their respects. On Saturday 10th Sept. her coffin will then be driven via Ballater, Aberdeen, Dundee and Perth to the Palace of Holyroodhouse in Edinburgh. On Monday a procession will march up the Royal Mile St Giles' Cathedral in Edinburgh, where a Vigil of the Princes is expected to take place with members of the Royal Family. The public may be able to file past her coffin while she lies in state. On Tuesday she will be flown to London, and be driven from Buckingham Palace to Westminster Hall, where people will be allowed to file past over a period of four days' lying in state. Her coffin will be draped with the Royal Standard and once in Westminster Hall it will be topped with the Imperial State Crown, orb and sceptre.

The Queen's coffin will then be taken to Westminster Abbey for the funeral service. Following the funeral service, her coffin will be drawn in a walking processions from the abbey to Wellington Arch, at London's Hyde Park Corner before heading to Windsor by hearse. The Queen's coffin will make its final journey that afternoon to St George's Chapel in Windsor Castle for the committal service. Her coffin will be lowered into the Royal Vault, before being interred in the King George VI memorial chapel, located inside St George's Chapel.

Mourning

A period of national mourning is now in place and will last until the day of the state funeral.

The period of Royal Mourning by the Queen's family will continue for seven days after the funeral.

Other events

The union flag will be flown at half mast on government buildings until the morning after the funeral. Flags will return to full mast for a 24-hour period beginning at 13:00 BST on Saturday to mark the proclamation of Charles as King, before returning to half mast.

There will be a remembrance service at St Paul's Cathedral on Friday (9th Sept.?) attended by the prime minister and other senior ministers.

On Friday 9th Sept. bells will toll in tribute to the Queen at Westminster Abbey, St Paul's Cathedral and Windsor Castle. Around the country parish churches with bells will also be tolled in tribute. Gun salutes of 96 rounds to mark each year of her life will be fired in Hyde Park and elsewhere.

Many sporting fixtures have largely been cancelled, as have the final three of the BBC Proms concerts. Theatre performances are expected to continue, observing a minute's silence. Strikes for industrial disputes have also been cancelled.

Changes of title

The Duke and Duchess of Cambridge automatically became Duke and Duchess of Cornwall and Cambridge. The title of Prince of Wales is the gift of the sovereign and is not automatically passed on. However, King Charles has bestowed the title of Prince of Wales on Prince William and his wife Catherine becomes Princess of Wales.

The children of the Duke and Duchess of Sussex could now be titled Prince Archie and Princess Lilibet as on the death of the Queen they are now the children of sons of the sovereign. It is not known whether Harry and Meghan will use the titles for their children. The Duke of Sussex is now 5th in line for the succession, with his brother William 1st in line and then William and Kate's children George (2nd), Charlotte (3rd) and Louis (4th).

Currency, stamps and passports - and more

The money and coins currently in circulation will be replaced with the face of King Charles III. A new portrait of Charles will be commissioned, from which millions of pounds worth of new currency will be printed by the Royal Mint and distributed across the UK. The old currency featuring the Queen's face will be gradually fazed out.

As with coins, new stamps featuring Charles will simply be slowly brought into circulation. Any current stamps you own with the Queen on will still be eligible for use.

All British passports are issued in the name of Her Majesty, and are still valid for travel. The wording in the inside of the front cover of new passports will be updated to His Majesty.

When a monarch dies, royal warrants they issued become void and a company has two years to stop using the royal arms. The warrants Charles issued as Prince of Wales will continue because they go with the household, not the title.

Police forces in England and Wales will have to change the royal cypher of Queen Elizabeth II in the centre of helmet plates.

Leading barristers have become King's Counsel (KC) instead of Queen's Counsel (QC).

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