Mathilda

ScotGEM Student 🩺 Interests in GP, Inclusion Health and Harm Reduction.

[Mathilda @mathildaellis30]

@A_MacLullich Just being devils advocate - of course better awareness of appropriate delirium Tx is important. Just also aware that staffing levels are a barrier for implementation…

[Mathilda @mathildaellis30]

@A_MacLullich Agree its important, but difficult in practice for nurses working with limited resources - agitated pts often require 1:1 support, hard to balance caring for all acutely unwell pts with current ratios. I think we need systemic changes to support reduced antipsychotic/sedative use

[Dr Rachel Clarke @doctor_oxford]

In a time such conflict & uncertainty, we need to hold on to every bit of good news - & this is truly magnificent story. Thanks to the wonders of medical vaccination, women who receive an HPV vaccine in early adolescence now have virtually zero risk of dying from cervical cancer before the age of 30. A safe, simple jab has almost eradicated one of the cruellest cancers women ever experience.

Cervical cancer is the fourth most common cancer in women (about 3300 new cases are diagnosed in England every year) & human papillomaviruses (HPV) cause 99% of cases. We already knew that the HPV vaccine prevented about 90% of cervical cancers, but this new study used official cancer mortality & vaccination data to assess the vaccine’s impact on survival. That impact is so great that the authors estimate the likelihood of girls who are vaccinated at age 12 or 13 dying from cervical cancer before the age of 30 is almost zero.

But there’s a sting in the tail.

Vaccine hesitancy means take up of the vaccine is falling. Only 75% of girls who could receive the vaccine are doing so, no doubt in part because of the tsunami of anti-vaxx disinformation & scaremongering out there online. Some of these girls are destined, one day, to develop an avoidable cervical cancer that will claim their life, and that is a tragedy.

Please know the safety data for the HPV vaccine is robust and clear - it’s incredibly safe and it could save a teenager's life. The NHS has excellent info on vaccines - please read up on vaccines from reliable sources. Or talk to a doctor - we want to help & are only too happy to discuss your concerns. Thank you.

[Cricket Scotland @CricketScotland]

OUR FIRST-EVER WOMEN'S #T20WORLDCUP WIN 🤩

[Dr Rachel Clarke @doctor_oxford]

Sir William Osler, 1849-1919, renowned as the father of modern medicine, famously instructed medical students to: "Listen to your patient, he is telling you the diagnosis." It's a simple dictum, but the foundation of the way Osler revolutionised healthcare by insisting that doctors step away from their desks and focus on their patients.

Everyone longs for functioning, joined-up NHS IT, @jamesmurray_ldn (though not via Palantir) - but to suggest, as you have in this post, that history-taking is a tedious irrelevance is to completely misunderstand the nature of medicine. That first conversation between doctor and patient is a close, shrewd, vital therapeutic encounter. As we listen, we observe, appraise, distil. Invariably, the diagnosis can be made. But history-taking, like the rest of medicine, is the marriage of science with humanity. It treats patients as people, not as objects with disease. Through your time, care and attentiveness in history-taking, you communicate something vital to a patient - that they matter and that you care.

Please never forget that healthcare is not a production line of objects, it's an enterprise built on relationships, with humanity at its core. Medical history-taking is its bedrock.

[Alasdair MacLullich @A_MacLullich]

I'm sure that in the next few years we will look back with horror at the weird neglect of delirium as a serious condition in global healthcare practice.

#delirium #geriatrics #hospitalmedicine

[Neena Jha @DrNeenaJha]

WTAF???!!

As his final act, Wes Streeting just signed off ALL OUR PATIENT RECORDS to Palantir WITHOUT our knowledge or consent & then resigned

“Your medical notes, prescriptions & DNA will be used however a politician decides; you’ll have no say & no choice”

TO PALANTIR!!! 🚩

[Jeremy Corbyn @jeremycorbyn]

How the world works in a nutshell: giant corporations profit from an illegal war whilst the governments who wage them tell the rest of us to tighten our belts.

[BladeoftheSun @BladeoftheS]

Today Wes Streeting overruled NICE so he personally buys medication for the entire NHS

He did this so he can give an extra £6.4bn a year to the USA for nothing

Paying Doctors an extra £0.6bn a year is too expensive

But 10x as much for Donald Trump is done without question

[Neena Jha @DrNeenaJha]

**When something does wrong - patients are rushed back to the NHS** 🚩

Private hospitals cherry pick
the easiest cases & have no emergency care

Private companies made £1.6 billion profit from the NHS over two years!

The NHS MUST be protected- our lives literally depend on it

[Dr Rachel Clarke @doctor_oxford]

This may seem arcane, but it’s a deeply concerning & spectacularly cynical move from this government to sideline NICE - the National Institute for Health and Care Excellence - whose role is vitally important in protecting NHS patients from the lobbying clout of the Pharma industry lobby.

Until now - and since 1999 - NICE has made independent, evidence-based decisions about which medicines constitute value for money for the NHS to buy. Largely free from political manipulation, it’s renewed internationally as a model of how to protect patients against excessive drug company prices. It enables the NHS to strike hard bargains with Big Pharma.

But @wesstreeting has just used a statutory instrument in parliament (that no-one has voted on) to award himself power to dictate what the NHS pays for drugs, overriding NICE’s vital role in insulating the NHS from pharmaceutical price gouging.

Why would he do something so self-evidently bad for patients? Because, it seems, this is a price the government is willing to pay to do a deal with Trump on US-UK drug pricing.

What an outrageous power grab for a man who claims to care about patients. Already hospitals up and down the country are cutting staff and closing services under pressure to make cost savings. But every pound spent on, essentially, increasing profits for US Pharma is money that *doesn’t* get spent on nurses, doctors and treatments we know are good value for money.

As the editor of the BMJ, @KamranAbbasi, wrote this week, this: "will end up harming vulnerable people to boost the profits of already obscenely profitable drug companies."

Starmer has shamelessly caved in to the White House. Even the former Tory Health Secretary, Andrew Lansley, now a Lord, has joined forces with Labour and Lib Dem MPs opposing Streeting’s power grab.

Truly an appalling move from a government that claims they’re rebuilding the NHS while, in this case, blatantly undermining our abilities to provide cost-effective care.

[Neena Jha @DrNeenaJha]

🚨 Almost HALF of all NHS Trusts are using non-doctors to fill doctor rotas due to “shortage of doctors”

FYI - 40,000 doctors applied for only 10,000 available training posts last year

Doctors are unemployed
Doctor substitution is real
And it’s DELIBERATE

[Artur Nadolny @ArturNadol7566]

NHS FIRED THE DOCTOR ASKING WHY BABIES WERE DYING

Martyn Pitman @MartynPitman spent over 20 years as a consultant obstetrician. He was good at his job. Colleagues respected him. An actress whose life he saved showed up to protest outside his tribunal.

Then his hospital merged. Standards dropped. He started raising concerns about maternity safety at Hampshire Hospitals NHS Foundation Trust @HHFTnhs. Repeatedly. Formally.

The trust's response was not to investigate the concerns. It was to investigate him.

His communication style was described as critical and upsetting. Two years suspended. Then sacked.

Grounds: breakdown of relationships.

Here is the part they presumably hoped you would not notice. The trust hired lawyers Bevan Brittan four months before Pitman even filed an Employment Tribunal claim. Someone was planning ahead. The total bill for legal fees and external reviews to fire one senior obstetrician came to nearly £650,000. Public money. A trust already in financial special measures with a £27.7 million deficit.

Pitman asked for an independent inquiry into his treatment. He was met with silence. When one was eventually set up, the terms were quietly changed to protect the Chief Medical Officer from scrutiny.

The independent investigator appointed to review his case turned out to be a former lawyer from Capsticks.

Capsticks specialise in, and this is their actual branding, difficult doctors.

He lost the tribunal. The judge accepted virtually all of his whistleblowing claims as legitimate. Then decided he had suffered no detriment for making them.

The CQC subsequently confirmed what Pitman had been saying all along. Maternity services at Hampshire Hospitals were unsafe. Babies were at risk.

The doctor who told them first lost his career. The managers who ignored him kept theirs.

If you raise a safety concern in the NHS and the trust does not want to hear it, it will not be addressed. It will be repackaged as a conduct problem and handed to a law firm with a specialism in getting rid of you.

Sources: @ITVMeridian | Westminster Confidential @davidhencke | Alexander's Excavations @minhalexander | Employment Tribunal Judgment 1404274/2021 | Patient Safety Learning @PSLearning | Protect @WhistleblowersUK |

[Neena Jha @DrNeenaJha]

Labour gov has mandated that ALL GP referrals (not cancer 2WW) must go via a “triage process” with an aim to REJECT 1 in 4 🚩

There is NO guarantee the person triaging is even a doctor

All to give the ILLUSION of reduced waiting lists… in reality it’s detrimental for patients

[Anish Moonka @anishmoonka]

A parasite that has been eating people for 3,500 years is about to be wiped off the planet. It infected 3.5 million people in 1986. Last year, it infected 10. And I have not seen it make a single front page.

It is called Guinea worm. You drink contaminated water from a pond in a poor village. A year later, a worm up to three feet long starts coming out of your leg through a burning blister. There is no pill that stops it and no surgery that works. You wrap the worm around a stick and pull it out slowly, over days or weeks, inch by inch. If you rush, the worm breaks inside you and causes a fresh infection.

Guinea worm is ancient. Preserved worms have been pulled out of Egyptian mummies from around 1000 BCE. The Ebers Papyrus, an Egyptian medical scroll from 1550 BCE, describes pulling the worm out with a stick. For three and a half thousand years, that was the best humans could do.

Then in 1986, public health workers decided to kill the parasite off. They had no vaccine and no drug. What they had was cheap cloth water filters and a small army of volunteers willing to walk from village to village for decades.

The plan was simple. Give everyone who drinks from a pond a cloth filter to strain out the tiny water fleas that spread the parasite. Then send volunteers walking house to house, year after year, teaching people how to use the filters and keeping anyone with an emerging worm out of the water.

It worked. From 3.5 million cases a year to 10. Four were in Chad, four in Ethiopia, two in South Sudan. The other four countries where the worm used to be common, Angola, Cameroon, the Central African Republic, and Mali, had zero human cases for the second year in a row. The World Health Organization has already certified 200 countries as Guinea worm free. Six are left.

The last hurdle is dogs. Cameroon had 445 infected animals last year and Chad had 147, so a lot of the remaining work is on animals, not humans. Strays get leashed, and crews treat ponds to kill any remaining worms. The campaign keeps watching until the number hits zero.

When Guinea worm hits zero, it becomes the second human disease ever erased from the planet. The first was smallpox. It will also be the first parasite humans have ever wiped out, and the first disease ever ended without a single dose of medicine. Volunteers walked village to village with cloth filters for 40 years. Now a plague from the age of the pharaohs is about to be gone.

[lemn sissay OBE FRSL @lemnsissay]

I watch this over and over and over again. Go Leonie.

[Neena Jha @DrNeenaJha]

Your reminder that @Keir_Starmer, a former HUMAN RIGHTS LAWYER, has said NOTHING about Israel approving a race-based death penalty.

Absolutely nothing.

[Dr Steve Taylor @DrSteveTaylor]

I’m fuming

Dr Amir Khan on ‘No Appointment Necessary’ nails the problem with the new Advice and Guidance

It’s effectively moving the hospital waiting list to the community so it’s not counted against Govt targets

We see you @NHSEngland @wesstreeting

https://t.co/KLryiZJvs2

[The Secret Barrister 🦋 @BarristerSecret]

Read this thread. Every word.

And then read it again, because you will not believe it can be true.

But it is. Every word.

@DavidLammy and @sarahsackman want to remove the right to jury trial in cases involving *death*.

Homicide cases.

[Zack Polanski @ZackPolanski]

Palantir has no place in our NHS.

The Labour government must get this Mandelson and Trump backed company out now.

Listen to what health workers are saying.
https://t.co/eDq6zbKhtL