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As I approach the end of another night in A&E, I’m telling ambulance crews that have been here for 2 hours already that I am unable to safely take a handover from them, and that I don’t know when the next space will be available...
... I have patients who have been sat in the corridor for 8 hours waiting to get into an A&E cubicle to be properly assessed... I am operating in a department with only 1 open space to accept a new patient - Resus, Bay 1...
... I am looking at the pre-alert phone hanging on the wall with dread, knowing that the system is so stretched and vulnerable, it might take only 1 really sick patient for me to completely run out of space and resources ...
Read 6 tweets
Ok, I'm not a health expert, or a politician, just a low level, acute care grunt who look after sick people and the elderly.

But here's my idea of why the #NHScrisis is happening, and how to (maybe) solve it.
The government and Hunt are quite right, spending on health is at record levels. Even accounting for inflation, growing needs etc, why are things this bad? With record trolley waits, ambulance queues, mental health crisis, surely something must be wrong?
Where is gone badly wrong is this:

Social care

Social care, which includes everything from care homes, meals on wheels, carers, day centers, are largely funded by the local councils.
Read 13 tweets
Dear Brexiters,
Politicians made it so your completely understandable decision started a fire in our house.
You're in here with us. It's your responsibility to help us put it out.
If you voted Brexit because you were worried about globalisation hurting normal people, well Brexit has brought about "Global Britain".
(Exporting our goods beyond Europe is more expensive, so smaller companies won't cope as well as Multinationals)
If you voted Brexit because the EU is "letting in everyone so they can steal benefits and cause an #NHSCrisis".... it turns out the UK simply wasn't enforcing the EU's restrictions on immigration.
Read 14 tweets
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Like everyone else we’ve been practicing corridor Medicine on a brutal shift today. Moreover,we have two triages: normal triage and resus triage. Our 5-bed has been running with 7-8 patients. Each blue-light ambulance - and there have been MANY...(cont.) #corridorEM #NHSCrisis
...was no longer automatically going straight into resus as they would usually, but handing over in the usual place where we’d decided whether or not they were sick-but-not-as-sick-as-the-ones-already-in-resus. If not, they go into the corridor. If ‘big’ sick, we’d have to...
...decide which one of the pts already in resus was sick-but-not-quite-as-sick-as-the-new-patient, who would then give up their bay and be demoted to the corridor. Tomorrow I think we should just get Estates to take the swing doors off resus, they’re superfluous. This is...
Read 9 tweets
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