Don MacKechnie

[Royal College of Emergency Medicine @RCollEM]

#ICYMI No sign of winter pressures easing. A&Es bear the brunt of a gridlocked system.

Hospitals are running dangerously close to capacity, thousands of people each day remain in hospital when they could go home and the system is grinding to a halt.

Full article: https://t.co/nyzPk6FG5s

[Ian Higginson @RCEMpresident]

https://t.co/PCsQOAvufy. I never expected @RCollEM to end up in @hellomag 😳 #rcemasc

[Jo Rowe @joanneerowe]

Well done to all the team! 👏👏👏

[Heather Ryan @DrHFRyan]

The #PhysicianAssociates @rcgp paper has been leaked. As a Council member I can't really discuss the paper publicly, as despite the leak it is still officially confidential. But I believe that PAs have no role in General Practice, & I plan to say as much at #RCGPCouncil tomorrow.

[Rob Galloway @DrRobgalloway]

I tweet quite a bit - but this one is different and perhaps the most important I’ve ever written

I hope it gets shared as much as possible, so new parents don't make the same mistake I nearly made (even as a dad of five, having worked in A&E for 23 years and someone who teaches about not missing a diagnosis because of cognitive biases).

Our 6 week old baby is getting discharged today from @TheAlexBrighton @UHSussex after receiving the best possible care for meningitis.

She is doing really well and as a family we can't begin to express our gratitude to all involved.

The day she came in, she was not herself but nothing which particularly worried us. But my wife did her temperature, and it was over 38C.

As she was under 3 months, it meant she needed to be seen in A&E ASAP. By the time we got to A&E she was really quite sick even though it was only 30mins after taking her temperature.

I initially dismissed her signs and initially even questioned why my wife did her temperature. I had a cognitive bias, twisting my thinking to believing she was ok because that is what I wanted her to be, when she wasn't- a positivity bias.

Please if you are worried about your new baby - be like my wife and not me, check their temperature, use your gut instinct and don't delay getting the help your baby needs. @M_R_F

[Lawrence Dunhill @LawrenceDunhill]

Then National performance chiefs weighed in - telling trust leaders to sign declaration forms committing to hit 76% on the four-hour standard in March. Very odd for this to happen in relation to a single month's performance

2/

https://t.co/TdvlWwF8WS

[Lawrence Dunhill @LawrenceDunhill]

There's a sudden & unusual desperation from NHS Eng to meet the A&E target in March....

First it came through regional teams - telling trusts to focus energy on quick-win A&E cases to help improve 4hr performance %

🧵1/

https://t.co/FgfwbfoQ6A

[Lawrence Dunhill @LawrenceDunhill]

& now Finance chiefs make late late offer of £millions to deliver strong March %

Thats a lot of energy into A&E performance in a single month

Points to Govt pressure to deliver *something, anything* for GE campaign
(could it even be coming in May?)

3/3
https://t.co/COSL30jNlW

[Den Langhor @DLGDen]

What an absolute crock of shit. I was oncall last night looking after patients waiting > 50 hours for a bed. Quick wins should not be the focus. Not when you’ve got multiple sick people on corridors desperately needing care. I’m sorry but Barry and his stubbed toe can wait.

[Ian Higginson @RCEMpresident]

Yep

[Don MacKechnie @donmack210]

@AlistairBurtUK @BeingScots Law has clearly changed since I played, Alistair. Needs to be underground now rather than on the ground for a try to count 😏

[Kath @kathlh1]

It’s good to know when you arrange a study day for your colleagues they get something good out of it. We have a great team of ACP’s @NMGHED @Paeds_ED_NMGH @kazpotier @donmack210 @COSMakin

[Dr Linda Dykes has moved to Bluesky @DrLindaDykes]

I am not liking the look of this. As a med student and young doctor in the 1990s UK we still saw people living with after effects of RhF, TB & polio from 1920s-1950s. Covid shaping up to do far worse.

[Don MacKechnie @donmack210]

@LawrenceDunhill @NorthMcrGH_NHS @RCEMpresident

[Lawrence Dunhill @LawrenceDunhill]

Bit more on the massive improvement in ambulance handovers at @NorthMcrGH_NHS

Gone from 228 handover delays of >2hrs in six-month period last yr, to zero this yr.

++ front door capacity
++ senior clinicians in rapid assessment unit
++ medical wards & bays
++ 'power hours'

[katherine potier @kazpotier]

@clifford0584 @COSMakin @LawrenceDunhill 3rd dept in GM with 12 hr target YTD at 5%, just behind RMCH and Tameside. Again whole site approach