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Bethan J Profile picture
@MsBethanJ
Jan 2, 2023 • 90 tweets • 29 min read • Read on X
Many are not aware of the state of the NHS at the mo.

It's not their fault; there's little in the media.

If you know where to look/have witnessed this, then you'll know. But that's not enough.

So; a 🧵 of tweets showcasing reality.

Please share/RT to those who may not know.
One can't turn a blind eye (as the government is trying their damned hardest to do).

It's not safe.
We need uproar.
We need revolution.

We do not wish for it to be this way but people need to know.

(🧵 will be continuously updated inc articles + voices from HCPs themselves)
1. Up to 500 people a week are dying each week because of delays in urgent and emergency care, says RCEM President Dr Adrian Boyle.

thetimes.co.uk/article/f99945…
2. "Unsafe and undignified" care.

This is absolutely not what we signed up for; the moral injury is HUGE.

theguardian.com/society/2023/j…
3. Considering the above, you may be wondering where our leaders are?

I assure you, we're wondering exactly the same.

4. "I've never known such horrific conditions"

5. Staff retention is a huge NHS issue currently. We're severely short staffed. One reason is pay degradation, & tie that in with the cost of living crisis. This is just one reason for industrial action.

But our pay review bodies are 'independent. Right.
6. #NOTaCovidBacklog

The current state is way bigger than being caused by Covid. Don't let the government fool you into believing that...

7. "The current situation in the NHS is intolerable and unsustainable"

"The government must step up and take immediate action"

Why won't they listen?!

8. Another desperate plea.

9. "Derelection or deliberation"... it's easily both, but "deliberation" is what we really should be worried about.

Where is the opposition?!

10. Public dissatisfaction with the NHS is astronomical at present. Whilst some of that is of course founded, it's still important to try and correct some of those perpetual NHS myths.

11. Again, retention. We can't underestimate the importance of retention.

12. A poignant thread, about how once again the NHS is in an "existential crisis".

It can feel like we are going back in time.

13. We would rather not strike, but what other choice do we have at the moment?!

Because whatever we're in at the moment, it absolutely cannot go on.

14. One of many, many reasons for why we may not be able to recruit nor retain staff.

Stories like this, are not isolated.

15. "Too little, too late". Absolutely.

16. "A leading doctor (Dr Tim Cooksley, president of the Society for Acute Medicine) has said pressure on the NHS is worse now than it was at the peak of the COVID-19 pandemic."

17. "The failure of the NHS is not an accident".

Be under no illusion.

18. Support the strikes. Don't fall for this government narrative.

19. This is different. No other recent winter has been like this. Even in Covid.

standard.co.uk/news/uk/nhs-pr…
20. "A retention and recruitment crisis".

I will not apologise for repeating this. The NHS can't run without its workers.

21. It should be easy to speak out, but unfortunately it isn't. There is real fear of being reported/reprimands and having concerns about "professionalism" thrown at us to name but a few.

The situation is even worse for IMGs/HCPs of colour.

22. "(The NHS) was broken by deliberate choices to break it"

23. "People ARE dying"

24. General Practice has been vilified in the UK. Again, this is deliberate action by the mainstream media and Tory Government.

How can GPs continue with real threats like this?

25. Things have gone way too far for the cracks to be papered over any longer.

Because that's what it feels "targets and pathways" really are at present.

26. There is no jumping to conclusions. This is all really happening.

27. This video, whereas it was once laughable, is now downright offensive.

I have included it in the hope that it will convince anyone on the proverbial fence about whether the government is lying to us.

28. This represents a much wider issue of how detrimental these careers can be to healthcare worker's health now.

Yes, we knew this was going to be hard work, but we absolutely did not sign up for *this*.

29. There are no words needed for this one.

Just read every word of this Emergency Medicine's doctor's account.

30. Another account of the current situation.

31. Why I hope this thread will help: "NHS transparency as opaque as usual".

32. "This weekend I have done things I have never done in my working life"

33. Our Tory Leaders continue to be so far removed from reality.

(Click on QT to see original tweet from Steve Barclay spouting some celebratory crap about the anniversary of the NHS app. Because yes... that's what's important at the moment)

34. Tents. TENTS.

35. Utterly, utterly heartbreaking.

36. Covid is apparently "over" (side note: it's really not), but we're back to a risk of oxygen shortages again.

37. An invitation to our politicians.

38. "Welcome to NHS nursing".

39. But Brex*t was meant to make everything better, right? RIGHT?!

thelondoneconomic.com/news/report-fi…
40. This might look like total small-fry in the grand scheme of things, but never underestimate the impact of constant chipping away of staff morale in the NHS.

We're already running on empty.

41. Despicable how many practices are nearing collapse & handing back contracts.

Considering the huge proportion of total patient/healthcare interactions that take place in GP and primary care, the general public should be extremely worried about this.

42. Important training and teaching for doctors cancelled. There of course needs to be give and take, but this is a real concern, especially as these pressures are not suddenly going to disappear in a few weeks...

43. It's truly striking how the opposition has been so very quiet about all of this. Where are they?

I hear the phrase "Red Tories" being thrown around. Worryingly, I truly believe there's something in that.

44. A great thread about "community capacity" and why the "patient-blaming campaigns" don't work (i.e. tropes along the line of: 'too many people seeking emergency care').

All of this has gone way beyond what any individual can now do.

45. I think this shows how out of touch our leaders are; blissful ignorance whilst tweeting tosh about the 'couch to 5k' app

See also tweet 33. There it was some other crap about the anniversary of the NHS app. All whilst the NHS is crumbling around us

46. None of us will be surprised to hear that the current state of the NHS is not due to chance; years of Tory austerity is of course largely to blame. Make no mistake.

People saw this coming. (HT to @seanmca3 for this one)

47. I also don't want people to be fooled re: the narrative of HCP locum pay being the cause for the demise of the NHS. It's way more complex

Similarly, the labour trope about training more drs/nurses. This will take years; it's not the solution for now

48. Money will help, but it's not the absolute solution.

I honestly couldn't tell you where this so-called "record investment" has gone...

49. First-hand stories from those on the frontline need to play a huge part in getting the reality out there, to the general public.

Checking out the hashtag #NHSOnLifeSupport is a good place to start.

50. Another first hand account from an Emergency Medicine consultant. They mention a "broken" night team... I don't know anyone in healthcare who ISN'T feeling broken at the moment.

How is that acceptable?

51. These stories will also play a part in getting this information out there to the general public; they are just as harrowing.

This shouldn't be what you need to do after losing a loved one, but how else can one seek justice?

52. This sentiment rings out amongst HCPs at present: "to accept you can't win".

It can be underestimated the toll this can take on us.

53. Back to the fact that our Health Secretary is extremely out of touch at present; I'm glad that more and more people are recognising this and attempting to call it out.

54. Another first-hand account, but this time from a patient. This thread is not an attack on NHS staff (as some have disappointingly responded), but just further demonstrates that many don't realise that the failure of the NHS is all orchestrated.

55. The decisions patients have to make

Recently, my friend was told a time-frame couldn't be given for an ambulance (was clearly having cardiac symptoms). Thankfully took himself to A&E in an Uber. Had a cardiac arrest within 10 mins of arriving.

56. Please don't believe that privatisation of healthcare is the way forward.

With what money will you pay for it?

57. Dental services are also hugely affected.

The work is already hard enough, but some patients feel they have the right to be racist too.

These are no longer isolated incidents. Listen to the voices on the ground; this behaviour is escalating.

58. Another myth that needs to be busted in the media/government's pursuit to vilify General Practice.

"Demand outstrips supply" - the explanation really is as simple as that.

Target your abuse and hatred elsewhere.

59. Not being listened to (even on a local basis), further chips away at morale. This then in turn collectively, has a much bigger impact on HCPs.

60. This thread, and it's included photos/accounts, is first-hand information from the A&E department of the hospital I currently work in.

I am glad this information is now out there.

61. A quote from the thread above. Our hospital's main corridors have had to become make-shift wards (these are corridors not even in the department itself).

62. Ongoing professional development in healthcare is heavy on "reflection" assessments. As this tweet reports, this reflection now mostly focusses on what SHOULD have been done rather than what we actually can do.

This is not sustainable.

63. As seen in an above tweet, important training and teaching has been suspended for qualified staff.

Our students are also hugely impacted by the current NHS situation: "How do I get exposure?"

This is of course worrying for our future workforce.

64. It's worrying when those at the top talk about "strategies" that are ultimately "meaningless".

65. I don't need to explain this one - please just read this thread.

This thread alone should be a public information broadcast.

66. One of our NHS leaders, who was referenced by @PaulNuki in tweet 64, has now described the current situation of excess deaths as "uncomfortable".

Understatement of the century. It insulting, isn't it?

67. Another harrowing account from the frontline.

"There is no dignity"
"I am scared I cannot provide basic care let alone anything beyond that for patients"

#NHSOnLifeSupport

68. And another: "defeated to my very core".

#NHSOnLifeSupport

69. Phrases like this ring out constantly amongst HCPs now: "I'm doing my best but it's just not enough"

Great words from @charlie_psych

70. In the current #NHSCrisis, not only is the health of patients potentially compromised, the health of HCPs are too.

71. Sunak's speech yesterday (4/1/23) was insulting, at best, for numerous reasons. The BMA statement in response to the speech is below.

"baffling lack of urgency in addressing a crisis... he refuses to even admit there is a crisis"

bma.org.uk/bma-media-cent…
72. Also, let's not forget how headlines yesterday also focussed on how the Conservative's aren planning to force young people to study maths up until the age of 18. Because yes, that's what's really important now...

Deflection, deflection, deflection.

73. Quick maffs.

74. Sunak also mentioned in his speech that the door was open for dialogue.

This is pure gaslighting, no?

Striking is a last resort; we didn't go into this longing to strike, but when this is what we're dealing with, there really are no other options.

75. It was also really saddening to see this all come out yesterday evening, about "strike law". Legislation may be announced today.

This is really not the way to fix things.

Rights? What rights?!

thetimes.co.uk/article/rishi-…
76. A very good point about Sunak's other attempt at deflection, this time about cutting waiting lists.

77. Further deflection.

The fact that "small boats" made it onto the Prime Minister's list of top pledges, tells us everything we need to know about this Government's priorities.

Image
78. 🐿️

79. Again with the political spin. Another reminder that this is not solely down to recent Covid and flu cases; the fact the Tories are still claiming so, is offensive.

It's down to neglect; utter neglect.

#NOTaCovidBacklog

80. "Soul-crushing"

#NHSOnLifeSupport

81. The distress that patients are experiencing cannot be underestimated.

"She (the patient) was crying and telling us she wanted to die. She was praying and asking to be taken"

"The staff were trying their best... They are victims of this as well"

82. Some GPs have found themselves having to drive patients to hospitals to receive emergency care. This is not normal.

But sure, carry on vilifying General Practice.

gponline.com/sunak-urged-re…
83. Aaaaaaand despite all of this, they're still on recess.

dauk.org/news/2023/01/0…
84. We're all still waiting for those massive staffing trees!

85. Make no mistake; this could be any of us.

86. I have no words for this.

87. Some more numbers for you. Unfortunately, it really can be as 'simple' as this.

88. It's all we want to do.

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More from @MsBethanJ

Bethan J Profile picture
Nov 16, 2023
Today, a senior colleague (in a pastoral/supervisory role) subtly took me to one side and in the most normal & natural way possible, gently commented to me about my appearance/how I was presenting myself lately.

It wasn’t made out to be a big deal and it was complimentary, 1/11
but most importantly, it was a comment of genuine concern as they enquired how I was doing.

Not just a pleasantry, but how I was REALLY doing.

They had somehow recognised that how I was trying to conduct myself/my appearance was maybe being used as a type of “armour” or 2/11
to detract people away from finding out what was really going on underneath it all.

And they were of course, absolutely, well and truly, spot on.

I don’t know how they knew. But they did. And I’m so, so glad.

Over the last few months I’ve found myself wearing more make-up 3/11
Read 11 tweets
Bethan J Profile picture
Jan 4, 2023
There’s been some trolling since my thread yest; people who think they’ve had their “gotcha” moment, telling me it’s already all over the media .

That argument doesn’t wash. Especially when you still have rhetoric like this

You really think you’re always getting the bigger pic? A screenshot of an article online. The article is from Tuesd
The government will get stuff out in the media to try and divert attention; like this for example.

It’s incredibly out of touch!
So I’ll continue to collate articles/tweets about the #NHSCrisis.

Yes, some of those articles may come from the media - I’m glad those items are out there, but there needs to be more.

To think otherwise, has such a gaslight-y vibe.
Read 5 tweets
Bethan J Profile picture
Nov 11, 2022
Degenerative cervical myelopathy (DCM) should definitely be on your differentials list with this presentation!

It’s a (often) subtly progressive neurological degenerative condition that I feel can be easily missed…

Hence: tweetorial! Thread 🧵 1/
I heard of a case diagnosed as bilateral carpal tunnel, awaiting ortho clinic appt.

Ended up under geris due to new falls/suddenly not managing at home (v. independent prior).

MRI C-spine confirmed diagnosis & patient transferred for specialist Ax/surgery. So… 2/
DCM = cord compression in the neck; commonest form of spinal cord dysfunction in adults

Recent prevalence estimates ~1.6/100,000; actual prevalence likely MUCH higher as many patients go undiagnosed.

Due to its mobility, the C-spine is prone to degenerative changes 3/
Read 29 tweets
Bethan J Profile picture
Apr 14, 2022
As the pandemic and then 1st lockdown started I should’ve been starting my PhD - I was so excited.

But of course, that was then not to be. NHSE requested us to return to clinical practice for obvious reasons and so I did. Gladly.

I couldn’t sit by and watch this…
I was redeployed to paediatric neurosurgery; the last clinical post I had just left as a registrar.

We were a small team, and if any of us got covid, it had the potential to wipe the entirety of the team out - a team responsible for providing a tertiary service to a large part
of the North West of England and North Wales.

I started working shifts 24 hours on/24 hours off. Some of those 24 hour shifts were ok. Many were not.

We of course weren’t caring for adult Covid patients like many of our colleagues in the region were, but the traumas,
Read 19 tweets

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