invasion of ukraine. and the lengths people will go to to get around schemes that are supposed to reduce coming up on bbc news the fallout from the grand national is the death of three horses across the three day meeting, protest and arrest part of the best spark debate. good evening. the nhs in england said it had to cancel almost 200,000 operations and appointments last week during the four day strike by junior doctors, heaping four day strike byjunior doctors, heaping yet more pressure on the health service. over the past five months, almost half a million appointments have had to be rescheduled, and the nhs national medical director says with each strike, it becomes harder. and he wants the impact on patients and staff will continue to worsen. he warns. our health editor hugh pym reports. trying to get back to normal. are you comfortable as you are, lying on the bed? they are assessing patients who have come through this hospital s emergency department. fully staf