John Shirley

Family Radiology Rugby Sailing Music Labradors Outdoors

[Dr Rachel Clarke @doctor_oxford]

The whole point is that these two topics are inextricably linked. If social & palliative care are inadequate, then patients with a terminal diagnosis could “choose” AD because we, society, have not given them the care they need for life to still feel like it’s worth living. As a palliative care doctor I witness this so depressingly frequently - patients whose suffering is avoidable, preventable, if only they received decent care.

[UEFA @UEFA]

Statement on behalf of UEFA and its 55 National AssociationStatement on behalf of UEFA and its 55 National AssociationStatement on behalf of UEFA and its 55 National AssociationStatement on behalf of UEFA and its 55 National Associations

[Dr Tony Goldstone @goldstone_tony]

URGENT SCAM ALERT: If you get an email like the one below, its not from ESR, and it is a scam. If you hover over the URL (!!dont click it!!) you can see its from a known scamming URL

Delete it and move on. Please share / RT

[Please can @NHSEngland spam emails linking scams]

[The BMA @TheBMA]

Consultants in England voted in favour of industrial action on the 4th July. We are now on to a new health secretary, but still no meeting in with BMA reps. Yvette, it's time to get round the table.

[Tim Ricketts @timricketts_]

If I were Nick Clegg, I would keep my mouth very shut on this issue.

I have a plan 2 and a post graduate loan, with the terms that his government established, my deductions this month are below.

I can’t believe his gall

[Dr Steve Taylor @DrSteveTaylor]

The disconnect here is that the minimum requirement to be a GP is 10years of training to be a ‘newly qualified GP’

They will be more qualified, better suited & safer consulting patients than a PA with 10years experience

The lack of understanding of what it takes is the problem

[Emma @MrsEmmaWebber]

❗️Here it is. Please RT 🙏
The major piece of news I have been waiting to share
⬇️
@NHSNotts UNDER CRIMINAL INVESTIGATION FOR CORPORATE MANSLAUGHTER.

@thetimes
‘Detectives (@northumbriapol ) have informed the trust’s bosses and told them to preserve all records related to the June 2023 attacks.
The trust said that it would co-operate with the inquiry.
The move is likely to send ‘shockwaves’ through the NHS as it shifts the case against the trust from treatment failures to the question of whether it was directly responsible for the killings’.

COMMENT:
As a trust we hold you to account for the loss of our son, for Grace and for Ian.
Yes - YOU.
To all of the negligent, inept and failed clinicians, practitioners and managers.
TOP DOWN.
You WILL be held to account.
You (alongside the Calocane family, the @nottspolice, @leicspolice and @CPSUK ).
You have blood on your hands. You know it, I know it, and now the country will know it.

Whatever it takes, you will be held to account.
I will post in full tomorrow….
@Fhamiltontimes 🫶

https://t.co/xcHMWZ7JP3

[Dr Asif Qasim MA PhD FRCP @DrAsifQasim]

When duty cardiologist for the week the number of Advice and Guidance requests we receive has more than doubled - >50 every day due entirely to non-doctor requests - PAs, nurses, pharmacists with no discussion with the GP. Frequently incomplete and often unnecessary.

Expensive and high risk

@DrSteveTaylor @drmattuk @trishgreenhalgh @Parody_RCGP @Xeon4f145d96s1 @Dr_Done_ @djnicholl @martinmckee @DrEilidhMaria @Doc_IonaCollins

[Louella Vaughan @DrLKVaughan]

@valhumphreys51 @jabberwock951 @Anisocyte Val, in this instance, my integrity and reputation are now in conflict with needing to keep my job.

And the rules don't allow me to do my job properly.

Catch 22 and a carte Blanche for trusts to get of anyone they view as troublesome.

[John Shirley @jshirl007]

@BeckyHall016 @Melissa_S_Ryan @jamesmurray_ldn Yes

[Devan Sinha @DevanSinha]

Afaics

Illegal to teach, professionally develop or maintain personal quality assurance by following up patients previously provided a diagnosis or differential.

Our mandatory auditing of outcomes or care/procedural standards is illegal.

Classic NHS answer.

[Dr Robert Laurenson @RobLaurensonD4P]

The most contentious issue of the latest NHSE guidance is the explicit mention about looking back at an episode of care one was previously involved in to see how things developed for professional "curiosity".

Curiosity is a very poor word to use for multiple reasons not least because professional curiosity is the bedrock of holistic medicine and their phrasing comes across as a loaded word to diminish care, reflection, and professional development.

Many have argued that "it is just common sense" however one of the problems that is inextricable from the concept of common sense is the trust placed in those who judge how the language used in guidance is interpreted.

If no one trusts NHSE or regulators then everyone will naturally lurch to being overly risk-averse which will create inefficiencies, unforced errors, and damage morale.

It should be uncontroversial to say that those who were never involved in patient care and yet go on to access patient information should be disciplined, if not sacked.

But those who were previously involved in episodes of care should be given the professional latitude to follow up.

Surely the professional who remembers a patient and cares enough about them to follow up, reflect, and learn is a legitimate and valid reason.

@NHSEngland must come out and clarify this urgently or they risk either undermining professional development or some newfound unintended consequence like institutions getting patients to sign away all rights and protections in new waivers (hello website cookie disclaimers)

[Jonathan @jabberwock951]

News for clinicians: if you access a patient record for reflective practice/education you're required to add a note explaining what you accessed and why.

Did anyone know this? Was it announced? Because it seems intended to catch people out.

https://t.co/oYWYbd7xDq

[Dr Asif Qasim MA PhD FRCP @DrAsifQasim]

This is absurd.

Let’s see how long it takes for NHS trusts to grind to a halt when doctors can’t review the notes for complaints or governance or M&M

This shows @NHS does not understand the purpose of the clinical record or the role of a doctor

[Louella Vaughan @DrLKVaughan]

This piece of 'guidance' attacks the very foundation of Modern Medicine. Which is why I am SO incensed by it.

Let me explain why. A historical 🧵.
1/

[Louella Vaughan @DrLKVaughan]

Just reading over the new rules on IG, as circulated in letter from Jim Mackey.

It is entirely appropriate to reiterate that patient records should be ONLY accessed for work-relate purposes. But the new rules are draconian and restrict the types of reasons doctors often do
1/

[Dr Tony Goldstone @goldstone_tony]

2/5 💰 Big picture on cash flow:

Over the last 7 tax years (19/20–25/26) the NHS Pension Scheme has returned a cumulative

✅ £33.32 BILLION
in surplus cash to HM Treasury.

Contributions consistently outpace current benefit payments currently

[Dr Asif Qasim MA PhD FRCP @DrAsifQasim]

…so the NHS pension returns a £7.4Bn surplus to the treasury but doctors get taxed on the notional non-existent pension pot they don’t get access to which that repayment is part of…

[Graeme Stewart @dgraemestewart]

Got a new lump on my arm , which appears to be a BCC. So, did eConsult with my practice, described lesion, history and even dermatoscopic appearance in detail. The full 10 yards.
Got email back inviting me for f2f.

Who wants to guess what happened next?

[Saul Staniforth @SaulStaniforth]

On Monday it was announced that NHS consultants across England have voted in favour of strike action (the vote was 76% in favour of action)

James Murray confirms he hasn't spoken to the consultants union since that result was announced. He's the man in charge of the NHS, btw