Matthew Roycroft

Consultant Physician (Geriatric/Internal Medicine), Rotherham. Med Ed.

[Matthew Roycroft @MattRoycroft]

@kurtstat It's defined as bed position at midnight in national data - Not the most helpful when we know that isn't the time that matters, 4am would be much better.

[Matthew Roycroft @MattRoycroft]

@kurtstat The trouble is the numbers don't tell you necessarily how that part of the system is working - long stays on AMU could be people waiting to be seen or people waiting to move to wards that are full for really.

[Matthew Roycroft @MattRoycroft]

@kurtstat Does this work in a system where the arrival rate isn't stable (increasing over time but with seasonal variation on top)?

[Matthew Roycroft @MattRoycroft]

@kurtstat Even breaking down a simple admission isn't simple: Attendance time, Triage time in ED, Clinician time to first seeing, clinician time to decision, time to admission bed, admitting time first review, admitting team consultant review, decision on MOFD/MRFD, time meds sent etc.

[Matthew Roycroft @MattRoycroft]

@kurtstat The bit you probably want to get at is "where is the bottleneck" and "so what" - e.g. lack of discharges due to lack of social care leads to long E.D. stays (as no beds to move people to). 3/x

[Matthew Roycroft @MattRoycroft]

@kurtstat @P_H_S_Official Thanks - nicely put together!

[Matthew Roycroft @MattRoycroft]

@kurtstat @neilcgray Do you have a link to the original source for this?

[Matthew Roycroft @MattRoycroft]

@mancunianmedic @G_D_Phillips1 Do you think HEE leads had any real control over this? They understand the problem but are just as helpless in fixing it. It's almost entirely driven by money which is controlled by secretary of state/treasury. In the end HEE/colleges have influence on these people and that's it.

[Sara Page @drsarapage]

📢Geriatric SpRs

🙏 Please can you take a moment to complete this brief survey on end of life, bereavement and grief?

https://t.co/YhQn3JWeis

I would be VERY grateful if you could share with geriatric SpR colleagues!

[Matthew Roycroft @MattRoycroft]

Know anyone looking for FY3+ posts in medicine? @MedicineTRFT are advertising rotational posts starting in August with great study leave access and an ability to take doctors through the 'alternative certificate' route into Higher Training. See https://t.co/pvS0UwZLLo or msg me.

[Matthew Roycroft @MattRoycroft]

@OrthopodReg This is a dangerous interpretation of this study. You simply can't generalise in the way this says. Things where (IMO) people most want it (child abuse, sexual assault etc) aren't covered. It highlights need to study specific warnings and not generic "trauma".

[Matthew Roycroft @MattRoycroft]

@parthaskar @PPushbike @rcgp @BMA_GP @DrSelvarajah @Richard_GP @drgandalf52 @WeGPNs @drpatrickholmes @doctor_katie @trishgreenhalgh @MFAminGP @NHSEngland @NHSDiabetesProg @gmcuk Of course we know it and I doubt any doctor doing this doesn't. You can't apply our secondary care priviledge to primary care setting. There are so many questions here that we don't have answers to - your can't judge other people off limited info.

[Matthew Roycroft @MattRoycroft]

@parthaskar @PPushbike @rcgp @BMA_GP @DrSelvarajah @Richard_GP @drgandalf52 @WeGPNs @drpatrickholmes @doctor_katie @trishgreenhalgh @MFAminGP @NHSEngland @NHSDiabetesProg @gmcuk say "you MUST only prescribe drugs when you have adequate knowledge of your patient's health" (https://t.co/qYXwq6JW8E) - a patient not engaging in review at all may mean you don't have that knowledge. Might explain some of this?

[Matthew Roycroft @MattRoycroft]

@kwallacet @danfurmedge @Shruthi_Konda @RCPhysicians @Raghuram_1 @RodricJenkin You can't put on a good course for that money. We deliver (a very good) one in house every few years and without significant consultant pay it still runs over that.

[Matthew Roycroft @MattRoycroft]

@AlisonMudge @EatWalkEngage @AngelaByrnesAPD @Age_and_Ageing @CindyStorer73

[Matthew Roycroft @MattRoycroft]

@parthaskar @RoshanaMN @OrthopodReg @DrSelvarajah @Rezaidi @ShivaniM_KC @WhistlingDixie4 @AmarPut @trishgreenhalgh @morefluids @eveosh IMT introduction kept trainees starting/finishing per year exactly the same. A shortening in programme length means fewer ST4-7s compared to previous ST3-7s but same at each grade. Actual increase at ST3 (20%ish) although trainees are generalist not specialist at that stage now.

[Matthew Roycroft @MattRoycroft]

@DrTomNewman1 @DrRobPM @ollieburtonmed This topic is really interesting - we also have a significant pool who want (at IMY3) full autonomy when on call and to lead it themselves. There's such huge variation between people and what/where is best for them. Impossible to match perfectly.

[Matthew Roycroft @MattRoycroft]

@OrthopodReg @RoshanaMN @ollieburtonmed @trishgreenhalgh @parthaskar @AquaAsif @MedCrisis @BMA_JuniorDocs HRA decision tool (https://t.co/JGUjSEN5ki) generally doesn't think research involving staff requires ethics approval. I find it slightly strange but a journal going against it is effectively inventing their own ethical rules.