A bit of controversy at the moment about medical students redeploying in Healthcare Assistant (HCA) roles. Some unfortunate language which I’m sure is regretted. I’m very involved in the @QMULBartsTheLon@QMUL med student redeployment and would like to point a few things out. 1/8
In the first wave (March), med student studies were suspended. Ours had just finished final exams and *volunteered* to join us to support patient care. They did not expect to get paid. They were incredibly professional and made me very proud to be a @QMUL prof. 2/8
In the second wave (January) our students’ studies have NOT been suspended. We (@QMULBartsTheLon) have *sent* them to help. While many would choose this, not all would. Our final years have major exams looming and must also complete educational log books, attend teaching etc. 3/8
This time round, I’m again inspired by the professionalism of @QMULBartsTheLon students. They are the future of medicine and we have much to look forward to. Student leaders @officialblsa (esp Megan Annetts & Matt Robathan) have worked very hard to help us get things right. 4/8
At @NHSBartsHealth@teamaccu, our students do 36 hours a week of ‘education’. Most time is spent in our communication hub making sure families get regular updates on their loved ones. The remaining time is spent in (unpaid) bedside roles alongside our ICU doctors and nurses. 5/8
These are great learning opportunities but the education must be real. Staff arent all aware of students’ duty to learn while they work. Their usual clinical attachments have been changed. Many are missing teaching they were looking forward to. Some worry about career impact. 6/8
After the 36 hours of education, @QMULBartsTheLon students can choose to work paid 12 hour shifts as Healthcare Assistants with @teamaccu@NHSBartsHealth. They must fit exam revision around this very full week. They are great and we are lucky to have them. 7/8
Like many, I worked as a Healthcare Assistant (Auxiliary Nurse as was) before med school and understand points being made. It’s a vital role and hard work. I guess @icsmsu understand this and regret the choice of words. But the situation is more complex than most realise. 8/8
• • •
Missing some Tweet in this thread? You can try to
force a refresh
Oxygen supply in hospitals is getting a lot of media coverage. Some hospitals are using five times more oxygen than usual triggering low pressure alarms. Media reporting oxygen supplies ‘running out’ and ‘not enough to go round’. The problem is not quite what it sounds… 1/12
We don't usually think about oxygen supply. It isn't something we notice until the oxygen pressure alarms go off. That used to be rare. The unfamiliar and emotive problem can seem frightening for NHS staff and public alike. This from @ChrisCEOHopson 2/12
Oxygen supplies don’t run out like an electricity power cut. Instead the pressure drops like it can with the hot water system in your home. Your shower doesn’t run dry but the water pressure is not what you need. You may need to turn some other taps off to solve this. 3/12
Optimistic news: National data on new coronavirus infections data do now show we have passed the peak. Good news but really this is just the end of the beginning for the NHS response. 1/7
Firstly, the national data hide regional differences. New infections are still increasing in many parts of the UK. NHS hospitals in different areas will need to support each other for some time to come. 2/7
This map illustrates this much more clearly. Many areas of the country still very badly affected by new infections. This affects NHS healthcare in pretty much every part of the UK. 3/7
What reaching the peak means for the NHS: We're increasingly confident we have hit *a* peak and hopefully *the* peak of the second wave of coronavirus infections. Hospital admissions lag behind and will carry on rising for another week or so, but this is still a key moment… 1/10
I have talked before about how and why the healthcare the NHS provides right now is simply not as good as usual. We have protected emergency care but routine care for cancer, cardiac disease and so many other illnesses has been badly affected. Especially surgical treatments. 2/10
The surge in COVID patient admissions has a huge impact on other parts of the NHS. We see this pattern often in the winter flu season but it is far worse right now. The shortage of normal hospital beds and ICU beds makes in-patient work very difficult. 3/10
The number of new coronavirus infections may be levelling off, but patient admissions to NHS hospitals for COVID-19 will increase for another 7-10 days. The question of how we choose which patient gets an ICU bed is now a routine one in media interviews. Doctors are worried. 1/11
The burden of decision making around ICU admission traditionally falls on senior ICU doctors. Most of us are privately very worried about what will happen if we run out of resources. The false suggestion that we rationed ICU beds in the first wave has upset a lot of people. 2/11
To be clear, I am not aware of ANY patient who was not admitted to intensive care during the pandemic when the ICU consultants responsible believed that they should be. But we would be failing in our duty if we do not plan for this situation. 3/11
Recent trial results show some promise for Tocilizumab in the treatment of severe COVID-19. Welcome news at a difficult time and excellent work from @remap_cap & @NIHRresearch. But the results raise some difficult issues for doctors treating patients. 1/9
To recap, Tociluzimab is normally used to treat inflammatory arthritis and other immune disorders. The drug suppresses the systemic (whole-body) inflammation (AKA 'cytokine storm') and may reduce the harm of COVID-19 especially for critically ill patients. 2/9
Scientists from @The_MRC population health sciences unit combined data (meta-analysis) from 2107 patients in six trials including @remap_cap. The results suggest a small reduction in 28-day mortality. But most of the benefit was from REMAP-CAP. The results are not clear cut. 3/9
The vaccine conversation took an unexpected turn this week with the decision to prioritise first doses for people who haven't been vaccinated over second doses for those who have. Staff who all year have worked in COVID zones are now preoccupied with their immunity status. 1/8
This has turned out to be a very emotive issue for NHS staff. The topic has split us along invisible fault lines. In some cases, our position in the vaccination queue (and that of people we care about) seems to define our views on the science. 2/8
I'm not expert in the science but listening to those who are, delaying the second dose seems a legitimate thing to debate. Technical discussion revolves around how long the 2nd dose could be delayed and how much difference this might make make, as opposed to a binary debate. 3/8