Discover and read the best of Twitter Threads about #TeamGP

Most recents (24)

🧵 on repeat infections, negative lateral flow & #PCR tests, and the use of #COVID19 antibody tests. An n=1 experience #OmicronVariant #LongCovid #MedTwitter #TeamGP #psychtwitter #LongCovidKids #COVIDisAirborne #CovidIsNotOver 1/n
I had acute #COViD19 in Nov 2020, PCR +ve. Developed #LongCovid a month after. Had one dose #Pfizer Feb ‘21 which gave me new symptoms. Out of interest I had my anti-spike antibodies done May ‘21- they were above the upper limit the assay could measure 2/n
With the passage of time my antibodies dwindled. I had them rechecked in Dec 2021- both nucleocapsid & spike antibodies were below the protective limit. Therefore I had no protective antibodies. 3/n
Read 18 tweets
🧵 If the use of airborne #PPE & improving air quality in healthcare settings are to be ‘optional’ & ‘a matter of personal choice’, then we should give strong consideration to applying the same rule to the following #MedTwitter #MedEd #TeamGP 1/n
1. Handwashing before, between & after patients (& audits of it)
2. Plastic gloves & aprons
3. ‘Bare below the elbows’
4. Jewellery
5. Hair above the collar
6. Mandatory training
2/n
If you are recoiling in horror because
1. ‘Airborne transmission of COVID is controversial’
2. ‘The above are established evidence-based practices’
3. ‘COVID is mild, we can’t avoid it, we have to learn to live with it, we’re all vaccinated now anyway’,
then;
3/n
Read 7 tweets
Pleased to share ⁦@FarazFallahi⁩’s #MECFS video this time with English captions featuring some of my favourite German & Austrian names #LongCovid #MyalgicEncephalomyelitis #pwME #MedTwitter #MedEd #TeamGP #psychtwitter. A sobering watch.
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a severe neuroimmunological disease that mainly occurs after infections (including COVID-19).

Please watch, like and share the video - help us to finally get attention!
Unfortunately, there are no therapies, hardly any research funds and no significant care structure. Due to COVID19 the number of sick people is increasing drastically.

Those affected demand:
Read 6 tweets
What I have learned since being unwell myself has destroyed any faith I had in my profession’s leaders. I used to think that deep down most senior clinicians acted because they had the best interests of the patient, their colleagues & society at heart. That illusion is gone. 1/n
Be it the treatment of those with #MECFS #LongCovid #Fibromyalgia #POTS #MCAS #EDS #HSD #PansPandas #Lyme #FQtoxicity #vaccineinjuries & other so-called invisible illnesses; 2/n
the refusal of senior medics to stand up & protect colleagues, the public & schoolchildren from airborne spread of #SARSCoV2 as they are too afraid to displease those in the ivory towers of infection control, @UKHSA & @NHSE management & @UKgovcomms; 3/n
Read 7 tweets
I’ve been wondering whether to post this for a while, because I knew that it would increase the trolling in the short term. But I’ve decided to do it.

Since I’ve started @EveryDoctorUK, the organisation and myself have been subjected to smear campaigns and bullying from many…
…high profile individuals, including some within the medical profession. A tiny number of influential people have successfully sabotaged newspaper articles containing important petitions, sabotaged collaborations by meeting with potential collaborators and smearing our name…
…by spreading misinformation about us. By setting up fake social media accounts to spread rumours and obtain information. By setting up abusive parody accounts (look up ‘EveryDogtor’ on Facebook for example). By accusing me of severe mental health problems publicly, on our …
Read 11 tweets
When I was 7 yrs old, my cousin Sameera died from #leukaemia

She was 15 & initially we thought she had the ‘flu

There were no curative treatments in the 80’s & she sadly died

I was heartbroken

In our faith, people gather at the family home to pay their respects

1/5
After school, I would go & visit my aunt & cousins

The front door was always open

People would come & join in prayers

And I remember our childhood #GP , Dr Minwalla, coming after surgery

He wasn’t #Muslim but was very much our family dr & came every evening

2/5
He would come in, take off his shoes & just sit in the corner with a cup of tea

I remember his burgundy socks & sometimes he would smile at me as I said a prayer on little colourful beads

He’d stay for a bit & then head home

At the time, I thought this was rather special

3/5
Read 5 tweets
Despite the #gpcrisis we've gone from: Struggling with unmanageable 'demand', exhaustion & low morale.
⬇️
A thriving & hopeful team with excellent patient feedback.
How? Dozens of factors.
This thread describes 1 subtle essential ingredient
#TeamGP
1
link.medium.com/JpbZd1BQHnb
Primary care is over worked and overwhelmed. The GP crisis is exasperating for staff and patients. GP numbers continue to tumble. Part of the solution is before our very eyes: the receptionist. But perhaps not as we know them.
2
How much of a GPs frantic day is spent solving problems that could have been better solved by someone else? Either by a GP who knows them better, another service or an additional PCN role? GPs also waste time untangling messy tasks like old referrals, prescriptions/ sick notes
3
Read 18 tweets
GP nationalisation 🧵 - It’s not really about that. SoS is talking about GPs giving up their contracts & being employed by hospital trusts incl foundation trusts. Foundation trusts are independent publicly owned organisations, bit like academy schools. 1/5
So why do this? Integrated care systems are being formed (44 in England). Modelled after ACOs in 🇺🇸. Although it’s supposed to be a partnership, it’s likely the local trust or another large organisation would be prominent. So, having GPs employed by them is better for system. 2/5
There’re GPs employed by Trusts in Wolverhampton. In Yeovil (Somerset) via a subsidiary. We have large corporations/partnerships running GP practices. So this isn’t really nationalisation of GPs, it’s just moving to a salaried model under a large employer NHS or private. 3/5
Read 5 tweets
14 mths Long Covid RHR 110 bpm ^ to 147 bpm *just* on standing. Still experiencing hypnagogic auditory hallucinations. There is an ongoing pathological process; it’s not rehabilitation patients need. #TreatLongCovid #pwLC #pwME #MedTwitter #MedEd #TeamGP
For anyone who thinks I’m exaggerating. Postural Orthostatic Tachycardia Syndrome (POTS) everybody:
Medics, if you haven’t heard of POTS pls educate yourselves. Many patients with Long Covid have a high resting HR (for the majority this is due to dysautomnia; a faulty autonomic nervous system, *not* anxiety). Some will also have POTs (i.e. ^ tachycardia on standing), as shown
Read 18 tweets
Great question; thanks for asking. The main reason people with medically unexplained physical symptoms (MUPS) are resistant to psychological therapy is because, they have been victims of relentless medical gaslighting./1 🧵
In absence of obvious biomarker & return of normal test results, patients with MUPS are often incorrectly ascribed a psychological diagnosis. Psychologisation of MUPS has become commonplace, and it is not acceptable. It is important to consider:/2
(A) The absence of obvious biomarker does not mean one does not exist. Simply, it has not yet been identified./3
Read 14 tweets
How complicit has NHS Leadership been in Johnson’s pandemic calamities? And have lessons been learned?
There is a long list of failures:
▪️Ageist policies
▪️Blanket Do Not Resuscitate orders
▪️Inadequate PPE
▪️Ethnic disparities on the frontline

#TeamNHS
#TeamGP
▪️No Triage
▪️No clinical follow-up
▪️The ‘Stay Home’ messaging
▪️Ineffectual Contact and Trace
▪️Circumventing primary care
▪️Rationing of access to healthcare via ‘111’.
▪️Oxygen rationing
▪️Shrinking the NHS during a pandemic
And these failures, while still remediable, continue to place HCWs in unsafe and traumatic working conditions, and are still leading to unsafe care provision for the British public.
Read 10 tweets
Raising concerns about patient safety

Where problems with care seem national, those of us actually delivering care can feel quite helpless to change it. Take the government’s pandemic policy...

🧵
1/7
gmc-uk.org/ethical-guidan…
We on the frontline are also victims, collateral damage, of ill-conceived healthcare policies.
But the GMC guidelines, while adding yet another responsibility on our shoulders, also provides the encouragement and compulsion to speak out.
“If you have reason to believe that patients are, or may be, at risk of death or serious harm for any reason, you should report your concern.. Do not delay doing so because you yourself are not in a position to put the matter right”
Read 8 tweets
Thank you Dan, once again you’ve explained with absolute clarity one of the most significant failings of @10DowningStreet ‘s catastrophic #COVID19UK management.
@danielgoyal

1/22 - Sorry🙏🏻💙
I qualified as a GP in 1996, but no longer work in “normal” General Practice & have not done so since Oct 20.

I now spend 90% of my time as a “GP in A+E” & work in our 2 local UTCs.

I’ve also been part of the local #COVID “hot” services - in our #HotSite & doing home visits.
2/
From talking to my GP friends & colleagues, I believe my experience is not at all uncommon & has played a HUGE PART in the current #GPCrisis - both for the health & wellbeing of our patients but also for the recruitment/retainment AND wellbeing of GPs themselves.
#TeamGP
3/
Read 23 tweets
The truth about the GP crisis...from a non-GP doctor.

I share this with you for 3 reasons:

1. To highlight the source (and fault) of the current GP crisis.

2. Because the primary care crisis is at a critical point and can be salvaged.

3. Public support matters.
We go back to March 2020, when all the health service staff were preparing for the arrival of this new, unknown pathogen. We were all nervous.

Those who expected to be right in the thick of it were:

Primary care - GPs, DN's, receptionists, etc
A&E (+ paramedics)
Medicine
ICU
For those who don't know, the typical pathway begins with the GP or Practice Nurse..

they assess, then either test and send home with advice, or send to A&E for further assessment...

if deemed 'unwell', they are admitted to medics.

That is what we were preparing for.
Read 20 tweets
#RCGPAC A wonderful day celebrating the success in the Midlands, presenting trophies to those unable to attend.
#InspireAwards21
Congratulations to our Fab First5 GP of the the Year 2021:
Dr Zarmina Rayaz,
GP Partner at City Road Medical Centre in Birmingham
#InspireAwards21
RCGP First5 of the Year 2021:
Dr Zarmina Rayaz
Here is Dr Rayaz receiving her #InspireAwards21 RCGP First5 of the Year award from our Vice Chair, who originally met her as one of Dr Rayaz’s TPDs during VTS training
👏🏼👏🏼👏🏼
Read 10 tweets
Clinical Response to COVID-19

How are other countries providing care to COVID-19 patients?

Here we compare UK versus Singapore.

[Evidence at end of thread]

1/n
SINGAPORE

TRIAGE:

Any cold/flu symptoms are triaged as ?#COVID19

ALL suspected or confirmed Covid cases are clinically triaged at public health clinics (run by primary care).

All cases have vitals taken, are swabbed and are clinically assessed.
FOLLOW-UP:

ALL cases are followed-up 3-5 days later, with an open-return policy

If confirmed positive (clinically or PCR) or develops signs of LRTI..

..patients transferred by dedicated ambulance to secondary care assessment.

Mean time to admission - 2.6 days (over 1yr)
Read 16 tweets
The British public feel abandoned by their GP (and the NHS generally).

They feel GPs were hiding from the pandemic and afraid of getting #COVID19

The truth is so much more concerning…

@RCGP
@trishgreenhalgh @MartinRCGP @martinmckee @DrSimonHodes @drphilhammond
1. This government, under PM #Johnson And against the will of #TeamGP, bypassed GPs during this pandemic.
As shown in the above thread, There was a very clear objection by many GPs and GP leadership to being side-lined by the government’s pandemic strategy ….back in April 2020!!!

THIS IS OUTRAGEOUS!!!

And the public are completely unaware of this.
Read 8 tweets
Oh my word!

This was a thread from April 2020! @DrSimonHodes #TeamGP

This lack of triaging of patients was noticed and raised from the start…

Why have GPs been cut out the loop with covid testing and triage?

Rant follows 1/n
How can you have a pandemic response with NO Triage…seriously!!! @WHO

And if you get into the thread above you will see the comments are an echo of today “bizarre” “ideology led”

And a complete lack of frontline clinical representation on the government’s expert panel.
And it is the same with the parliamentarians reporting on the pandemic response…no clinical experts at all, or literacy, as far as I can tell…
Read 7 tweets
Lessons I have Learned so far

#COVID19

Experience:

+ Clinical Lead for level 1 and 2 (HDU) COVID Unit

+ Clinician for CAC (Covid Assessment centre)

+ Regional Lead for Remote COVID monitoring and follow-up service.

+ researcher orcid.org/0000-0003-0418…
1. Respect experience.

The two best preparations I undertook were to read, properly, the WHO guidelines (deep dive where necessary)
+
Spoke with the clinical lead in Singapore.

We are juniors in pandemic management and treating SARS. They are not.
IMO: when there is a new pathogen, the experts are those on the frontline treating the disease. At least until enough data is collected to analyse empirically…
Read 12 tweets
This slide shared by @scotgovhealth in a webinar for #teamGP on #LongCovid today.
#MedTwitter #MedEd we need to get these terms away from LC:

Tiredness
Deconditioning
Anxiety
Functional

These may come in after associated conditions are excluded. 1/
Fatigue👏🏻doesn't👏🏻equal👏🏻"tiredness"

Anxiety👏🏻doesn't👏🏻cause👏🏻#longcovid

PEM👏🏻needs👏🏻to👏🏻be👏🏻excluded👏🏻before👏🏻we👏🏻mention👏🏻deconditioning

And don't get me started on functional!!!! 2/
There is increasing evidence of microendothelial damage leading to #longcovid

O2 sats dropping, microemboli, dysautonomia are not functional disorders
medicalxpress.com/news/2021-10-e…

3/
Read 7 tweets
There is a strong case for Mr Pritchard to publish all income he receives. How that income is spent, what percentage of private work is undertaken and the hours he works? The government needs to call for more transparency & champion taxpayers' interests @Keir_Starmer. /1
I am also tiring of the lambasting of all GPs by Tory’s & their supporting newspapers. I tend to let this stuff wash over me but as @parthaskar has noted this feels sustained & is accusing my staff of being lazy, part time & not seeing patients. It’s time for facts and balance
/2
First fact: primary care sees 95% of patients on 9% of the NHS budget. That’s ~ £19 billion of the £212billion allocated for spending this year by Dept Health and socialcare. You may want to compare this with NHS track and trace back which had double the budget ~£37 billion.
/3
Read 14 tweets
Very moving thread @HZiauddeen, thank you 🙏🏻 for taking the time write it.
One of the reasons many of us are feeling so despairing of current govt “policy” is exactly as you highlight - we are just expected to “get on with it”, as if our feelings of moral injury don’t count.
1/4
Unnecessary human suffering, avoidable harm, preventable death & chronic disease….just because we may have seen it before doesn’t mean we’ll be able cope when it becomes our “new daily normal”.
There will be a tipping point.
Some have already reached it, others are close!
2/
We don’t appear to be more than a passing consideration in @10DowningStreet discussions on preventing the #NHS “being overwhelmed” & we’re still expected to wear an inadequate level of #PPE for the daily Russian roulette wheel of working w/ known or suspected #COVID patients,
3/
Read 4 tweets
Good afternoon @RishiSunak & @BorisJohnson

Claims that “we can’t control the spread of the virus.The virus is doing what’s doing….”, that we must learn to “live w/ #COVID” & exert “personal responsibility” are incorrect, disingenuous & dangerous!
@BBCNewsnight @simakotecha
1/13
What you actually mean is that YOU (& your government) have deliberately CHOSEN to prioritise the ECONOMY over the HEALTH & WELLBEING of the British ppl…..but are dishonestly & patronisingly pretending there is no other option?

@10DowningStreet @sajidjavid @Conservatives

2/
W/ easy access to scientists & public health experts, anyone used to researching, looking for & assessing evidence, can find plentiful, accessible information on how to reduce #coronavirus transmission!

For highly educated ppl like yourselves, it would be an absolute doddle!
3/
Read 14 tweets
I can’t remember how many ‘extras’ (when we run out of appointments - patients who feel their matter is urgent are put on an ‘extras’ list) I saw yesterday. It all blurs into 1 with eStuff etc. But one patient said they called 104 times to get through …I hate this for them…
But genuinely: what more can we do? We already squeeze in concerns about other matters, address issues for family members, do SO much digitally. We already start earlier, finish later and forgo practice meetings so that time can be spent sorting out extras.
I genuinely love my job, and we are trying our flat-out best (whilst running on fumes) and I really feel for those who struggle to access us or other services. I was struck yesterday that about a quarter of what I was helping with was still with us in primary care because of…
Read 6 tweets

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