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Dr Dan Goyal Profile picture
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18 Nov, 9 tweets, 3 min read
We can now say with confidence that the government's NHS strategy is leading to more people dying (all-cause).

This report by the Royal College of Emergency Medicine is a shocking and sickening indictment of the Johnson leadership.

#JohnsonMustGo
#YourNHSNeedsYou
1/9
Under this government, the number of available hospital beds (and therefore frontline staff) has declined dramatically...
2/9
And look what happened during the pandemic...
[Bed capacity fell dramatically]
3/9
I don't think I will ever cease to be shocked that Johnson/Hancock could REDUCE the number of available hospital beds DURING a pandemic...
4/9
 rcem.ac.uk/new-report-rev…
And after 20 months, and while pursuing a mass infections strategy, they STILL have not increased bed capacity back to pre-pandmeic levels...

...let alone the additional 10% needed for our new, additional Covid cohort...

And Waiting Lists capacity?

This is beyond incompetent!
With nowhere to put patients is it any surprise the length of wait in ED is so high...
6/9
And with just this additional waiting in ED, the RCEM calculate at least 6,000 additional deaths last year!

There are over 1200 more deaths each week in the UK...it's supposed to be going the other way!!!
7/9
At some point this calamitous government that seems to destroy everything it touches, while simultaneously funnelling public funds to incompetent 'commercial partners' has to step aside.
And what are the @Conservatives doing? If they continue to defund the NHS and fail to...
...protect the public during their gravest hour of need, they will be lucky to get re-elected in the next 20 years.

They cannot:
Pursue mass infection +
Weaken the NHS +
Give away Public money

It is all way, way too much. And no amount of spin will save them.
#MakeSomeNoise
END

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More from @danielgoyal

Dr Dan Goyal Profile picture
18 Nov
What the UK can learn from South Korea’s Covid response | Devi Sridhar

Brilliant article by @devisridhar. A must read for all involved/interested in the pandemic response.

Below, I expand the point on clinical lessons from S.Korea.

1/9
theguardian.com/commentisfree/…
The first part of any pandemic response is to identify those who have the infection. It sounds obvious, I know. And I can't believe it actually has to be said. But such are the times we are in!

There are two reasons:
1. Isolate.
2. Treat.

@theAliceRoberts
Isolation prevents the spread of infection and thus death and disability.
Treatment directly prevents death and disability - the actual threat posed by the virus. It is this 'threat' we are concerned with. Fail to identify and treat cases, more people die and the threat grows.
Read 10 tweets
Dr Dan Goyal Profile picture
14 Nov
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
Dr Dan Goyal Profile picture
14 Nov
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
Dr Dan Goyal Profile picture
13 Nov
Covid-19 at home.

➡️ Some signs of severe Covid-19 to look out for while at home.

As requested by some Tweeples...here is a non-technical summary of this BMJ paper.

1/5
The paper is publicly accessible here: bmjopenrespres.bmj.com/content/8/1/e0…
Firstly, you should use the same judgement as you did before the pandemic. Who would you normally contact if you are concerned about specific symptoms?
You may think you are saving healthcare resources, but waiting until you are worse neither helps you or the health service.
Secondly, if you test positive for COVID-19 and are either over 65 yrs old or have a condition that makes you clinically vulnerable you should contact your primary care provider (GP practice) to let them know you have Covid and request 'remote home monitoring'.
Read 7 tweets
Dr Dan Goyal Profile picture
12 Nov
The NHS needs REFORMED.
Indeed, the NHS needs serious overhaul.
It is no longer providing world-class universal care [IMO].
It seems to not even be providing ‘value-for-money’ anymore.
But it is our money and our health, so we must have a say…
🧵1/n
RT pls. Image
The NHS once provided the most cost-effective healthcare of all developed nations. Indeed despite consistently spending the LOWEST percentage of GDP (national income) of similar nations (graph), up until the last couple of decades it still provided world-class outcomes. Image
In the 70s the UK had one of the lowest infant-mortality rates in the world. But by 2010 it looked like this (source BBC):

news.bbc.co.uk/1/hi/health/86… Image
Read 23 tweets
Dr Dan Goyal Profile picture
11 Nov
I fear we have not learned how to respond to a pandemic. Both clinical and public health responses in many nations have been chaotic, inconsistent and had disappointing results. So what would a decent response look like? Pls add your own…
#Covid19
1. Early “circuit-breaker”.
Debate remains as to the justification for lockdowns. The argument being that lockdowns cause more damage to non-Covid problems than the lives saved from the virus. I think that depends on a few things:
a) Healthcare capacity
A new pathogen will lead to extra strain on health services. Unless the health systems in place had capacity prior to the pandemic, then the additional burden will impact all diseases. The UK is a good example of this. All cause mortality = +1400 per week.
Read 12 tweets

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