Jackie O

Film geek. Serial backpacker. Juvenile doctor

[Jackie O @Jxx]

Cat and Alan right now #CelebrityTraitors

[Jackie O @Jxx]

@beckybarnicoat just finished your wonderful book Cry When Baby Cries and I literally had tears (mostly of laughter, some due to The Feels) from cover to cover. You��re brilliant. Thankyou

[edgarwright @edgarwright]

🎥 Save The Prince Charles Cinema! This iconic London cinema is at risk of closing due to unfair rent demands. Sign the petition to protect its future #SaveThePCC https://t.co/8ic9Iu7Wbk via @38degrees

[NHS Million @NHSMillion]

Immigration is not the reason that you can’t get a hospital appointment, it’s the reason you can get one.

Please repost for all the people who can’t seem to grasp that.

[Headquarters @HQNewsNow]

Must-watch: @MichelleObama makes powerful case for why men should care about reproductive freedom

[Dr Adam Rutherford @AdamRutherford]

This makes me so angry. I’ve known Kev since I was 18, and I’ve never seen him like this. I don’t believe in hell, but these medics and carers were in it, and the bastards who made light of this plague, denied it, called it a flu, and made it worse for everyone, you deserve it.

[Dr Rachel Clarke @doctor_oxford]

My job is caring for people with terminal conditions like cancer. It’s my absolute privilege, best job in the world. But working now in a broken NHS I see dying patients forced to endure terrible - & avoidable - conditions.

Please vote.

Vote.

Please use your voice for change.

[Jackie O @Jxx]

Switzerland..just silently watching the whole song in awe..truly wow #Eurovision2024

[Neena Jha @DrNeenaJha]

“Let PAs take a simple history, examine & then discuss with a GP”

Short 🧵 to explain why this wouldn’t work…

GPs are highly trained diagnosticians. With no immediate investigations to hand, the diagnostic skill we use IS history taking & examination.

1/n

[Jackie O @Jxx]

@sainsburys aware there is a national issue, but can you help with rescheduling shop due this morning? Due 7.30-8.30 but no email or receipt. With thanks

[Bryan Behar @bryanbehar]

Maybe this is an oversimplification, but Ryan Gosling being nominated, but not Margot Robbie and Greta Gerwig, perfectly explains to me why we aren’t in the 8th year of Hillary Clinton’s presidency.

[Farrukh @implausibleblog]

Here's a gif of Rishi Sunak bursting into laughter when a lady asks him to fix the NHS

It would be a shame if people shared this 👀

[Dr Rachel Clarke @doctor_oxford]

In January 2023 Sunak promised he would make 5000 more NHS hospital beds available by winter.

Since then, there has been a *decrease* of 2,675 beds.

The assault on the NHS from this government is deliberate, orchestrated & absolutely relentless.

[Dr Tony Goldstone @goldstone_tony]

1/ NEW & IMPORTANT: OK on the eve of junior/consultant strikes, we need to talk about these charts (NEW data just in!) 👇

We need to look at them to fix waiting lists & its increasingly clear next GE will be won or lost on the NHS

Please read the whole 🧵 & share widely / RT

[Jackie O @Jxx]

@ATRightMovies

[Jackie O @Jxx]

This woman is a genius writer and will be inundated with work offers soon, get in now

[Rob Galloway @DrRobgalloway]

Thoughts on the NHS…..

Einstein said the definition of insanity is doing the same thing over and over again and expecting different results.

But this is what is happening in the NHS right now; hoping things will improve when just giving the same failing medicine.

As an A&E doctor, I am proud of what I do and would not want any other job

But I am getting increasingly demoralised that despite best efforts, it can seem like we are moving deckchairs on the NHS titanic and just applying a sticky plaster to ever expanding gaping wounds of deep routed societal problems.

The relentless pressures are getting worse and we are insane if we think the same solutions will solve the problems we have – even with more money and slightly different politics.

We need to have a different approach if we are to have a functioning NHS in the future

We need to look at the issues and potential solutions

1) A large amount of the problems we see are preventable - problems from poor diet, lack of exercise, smoking, drugs and crucially poverty and people’s lack of opportunity and optimism about the future. Efforts should be made to prevent the problems not react to them

2) We must ask ourselves are we doing too much for people and extending their length of life but not addressing if it gives them a quality of life that they would want. Just because we can do so much for patients, doesn’t mean we should.

3) On the whole, the clinician treating you now, are feeling less happy with taking on risk than those ten years ago – hence why there is often over investigation instead of simple reassurance. The risk of being complained about and being sued is one reason. But how to take risk is not taught explicitly and we are losing significant numbers of highly experienced senior decision makers such as GPs who have learnt these skills through years of practice and are replacing them with much more junior staff who are good at working within their defined skills and protocols but who do not have the training and experience to be good “riskaticians��. This is also true of algorhythm based triage systems where the default position is often 999 ambulance and A&E without consideration of this decisions on other patients whose care is delayed because there are only finite resources.

4) We are providing care in the wrong place. I see so many people who could have been cared for by out of hours senior decision makers who can make a judgment call to treat at home, rather than coming to hospital. Instead, paramedics have to bring these complex elderly patients into hospital where they are then seen by junior staff who often can over investigate and admit which leads to deconditioning and deterioration.

5) Medical services are designed around 9-5 Monday to Friday working. This needs complete overhaul so that the same quality of care is provided 24/7

6) The private sector is not the solution. Where profit becomes before patients there is often a hidden bias to overinvesting and over-treating. The money spent on private sector investment run diagnostic centres may well be used in a better way.

7) Mental health care needs to be prioritised as much as medical care. Both are under resourced but the lack of beds and community care for mental health patients creates enormous pressures on emergency services and crucially leads to unacceptable care for the most vulnerable of patients.

8) Any remodelling of the NHS has to be a phased approach – stabilise the current crisis with investment in community as well as hospital care and then longer term transformation so that we truly become a health service rather than a reaction to illness service,

9) Key to a needed NHS transformation is keeping experienced staff and the only way to do this is empowerment of their decision making, flexible working and appropriate renumeration and recognition. The biggest risk to the NHS is that staff will soon stop caring and just go into self-preservation mode. So worry when people like me stop writing messages like this, rather than when we do!

My biggest worry is that politicians won’t want to face up to these incredibly difficult problems and will try and kid themselves and us that a bit more money and tinkering will solve the issue.

It wont. We need radical new thinking now and the politicians to realise this. Without this, the NHS will wither away to be replaced by privatised medicine and the care which will all deserve, will only be available to the richest in society.

Please feel free to share these thoughts so that politicians of all shades can see the reality and thoughts of someone on the front line rather than just the sanitised version of the NHS they are shown.

Thank you for reading my post weekend literary catharsis

Rob Galloway , a tired but still optimistic (just) A&E Doctor.

📷

[Claire E. Aubin? @ceaubin]

Deeply obsessed with this tiny Irish child’s trolley problem joke

[Sethina Watson @morefluids]

This thread is a great summation of what being a doctor really is. The learning, the art, the decision making. It takes years