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Dr Dan Goyal

@danielgoyal

29 Oct

The NHS needs MORE CAPACITY!

NOW!

At the start of the pandemic The UK Government reduced NHS bed capacity. The further into Winter we get the more catastrophic this failure/decision becomes.

There is still time...

1/5

Make Some Noise!
RT pls

#YourNHSNeedsYou
#COVID19

2/5
The math is quite easy:

Going into the Winter we normally have 15% bed capacity available. We currently have 5%.

6% of beds taken up by COVID-19 patients
+
4% of beds cut at the start of the pandemic (was 8%)

That is the 10% loss. Or a 70% reduction in bed availability.

3/5
Almost every other country in the world increased basic care capacity..

It was one of the first things the World Health Organisation advised.

More people to treat = more capacity to treat them.

Read 6 tweets

Dr Dan Goyal

@danielgoyal

27 Oct

To those that use the NHS,

You will have no doubt heard about the pressures on the NHS just now. It is true, we are worried. We have begun this Winter under considerable strain - more than usual. And, I won't lie, we expect things to get worse.
1/15
#NHS

We have little capacity - both emotional or beds. We are short staffed, and on top of all this we have a pandemic to deal with.
I understand you too may be running out of capacity... to face even more calamity after a calamitous 20 months. You too must be worried.
2/15

Firstly, can I say, we are still here. We get up in the morning (or night) and come to work. We donn our PPE, roll up our sleeves and face the avalanche of patients, requests, relatives, battle-hardened colleagues, and a pathogen that we have lost many colleagues to.
3/15

Read 19 tweets

Dr Dan Goyal

@danielgoyal

26 Oct

The government's £6bn NHS investment for waiting lists is...

...too little,
...too late,
and raises further concerns about the priorities of this government.

theguardian.com/society/2021/o…

Firstly, don't be fooled. Investment into waiting lists are unavoidable. The restricted access during the pandemic mean a catch-up initiative was always going to be needed.

The first question: would more decisive leadership have led to less restriction to care and less backlog?

The second: how much have the years of underinvestment in the NHS worsened the problem?

The waiting lists have been growing massively under this government prior to COVID.

[source BBC - chart is over 10 years]

Read 16 tweets

Dr Dan Goyal

@danielgoyal

24 Oct

Summary thread (for me too).

Clinical care for COVID-19 in the UK: shortcomings and lessons to be learned.

+

My view on what next...

Here, I summarise the threads I have written over the last couple of months.

It will tell part of the story of the UK's national response from a clinical perspective.

I have attached the previous threads only for those who wish more detail.

There are several critical failures in the clinical pandemic response, including:
1. The Herd Immunity Strategy
2. Reducing basic healthcare capacity
3. Bypassing primary care triage for non-clinical Covid triage
4. No Covid follow-up service

Read 23 tweets

Dr Dan Goyal

@danielgoyal

22 Oct

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

Dr Dan Goyal

@danielgoyal

21 Oct

Dear Prime Minister,

I will be brief.

Ideology has no place in a national crisis. You must do the first part of your job: protect the people. The second, promoting growth can only be done after you have been successful in the first - living being a pre-requisite for success.

I fear I am not getting through to you. Another way then. When the dust settles, and the true endemic level of SARS-CoV-2 is known, there will be a tally. There will be a count - with all the data, across all the domains that the many observers have collected.

The count will not be in your favour. In fact, when historians put pen to paper, the Johnson-era - on your current trajectory - will be remembered as a cautionary tale, a bookmark in history to teach those that come after you a simple fact: decisions are rarely binary.

Read 9 tweets

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