Keir Harding Profile picture
Apr 19 17 tweets 6 min read Twitter logo Read on Twitter
I don't think that @theRCOT does this for every #RCOTCasson lecture but it's lovely to see a report that perfectly links with my lecture

Or it would be if it wasn't so bleak. I assure you these issues affect every profession. Look at the picket lines if unconvinved...🧵👇
Demand has increased, complexity is higher, staff have to watch needs not being met, people cannot provide the service they want 60% of staff experiencing extreem stress Image
"Being told not to work to gold standard due to capacity issues provides a huge amount of stress" and this is partly due to having to hide it from those we work with. We rarely say "if you'd been here 5 years ago you'd be getting much better treatment". We have to pretend... Image
The pain of going through this is described brilliantly by @DrChloeBeale Image
I'll focus on the first key recommendation... Image
Why? Because if we want to keep an NHS (and despite working privately, I know I do) We need to create an environment people want to work in.

Imagine this being your day in work 👇👇👇 Image
If they don't like it they can leave!

They are. In multitudes.

13%of the NHS mental health workforce left in 21-22
22000 nurses left the NMC register in 2020
2/5 jnr Dr's can't wait to leave

And an extra 5% won't change this Image
So everyone in this system is stressed. Staff are encouraged to develop resilience while trying to put out an inferno with a watering can. People aren't nice to each other in these circumstances (they were not nice to me) Image
So what does this mean for thefuture? Nothing inspiring. 1/4 OTs want to leave too. For every person who leaves, it gets harder for those who stay. Image
We live in a market economy where
the value of labour is determined
by supply and demand
Alas healthcare doesn't really
respond to the market. If you can
afford private healthcare, you may
well not notice the NHS withering.
For ages we've relied on the
vocation and altruism of NHS staff,
but a market economy sees these
virtues as a form of stupidity to be
exploited.
We ask them the put up with the
stressful conditions described
above, and offer them some
banged pans for reward.
And while it's not all about money
conditions won't improve until
retention improves. Retention
won't improve until people want to
stay in work. People wont want to
stay in work until the environment
is less toxic.
Mining the healthcare providers of
less affluent countries who will
tolerate awful awful conditions is
an option, but its neither ethical
nor sustainable.
So let's not just talk about pay
There isn't a figure that let's people
feel OK with this👇👇👇 Image
We need to make the environment better. If the staff aren't there it's the patients who suffer Image
And I will be talking about all of this (and more) at the #RCOTCasson lecture, next week Thurs April 27th. Free to everyone. Do come along. 🙂

rcot.co.uk/2023-elizabeth…

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More from @Keirwales

Mar 19
I don't know enough about this, but seeing that I can't spot people who know saying it, let's have a go.

Are we watching the dismantling of the NHS?

Let's have a look...👇👇👇
Lots of people are leaving the NHS and other public services. 22000 left the NMC register around 2020. 13% of the mental health workforce left the NHS around the same time. Obviously its about pay, but every profession describes conditions that can't be tolerated.
Now much of the media discussion has been about pay for individual professions, as if there was a way to raise the pay of NHS paramedics but not porters. Nurses but not administrators.

This is because the NHS uses agenda for change. Every job (almost) is banded from 1-9
Read 19 tweets
Mar 17
Had one of my
most disappointing theatre experiences ever at @LiverpoolEmpire tonight. I don't know if it was a particularly bad night but wow. The highlights included...
1 A constant sound like a walk through a forest in autumn as it sounded like every single person had brought extra crinkly sweet bags containing sweets wrapped in ultra crispo wrapping paper.
Even when trying to be quiet it sounded like they were searching for the toy in a box of cornflakes.
Read 8 tweets
Jan 27
So some thoughts on the ICD-11 and "personality disorder". Here goes...
First, this describes the changes. Its very accessible. 👇

cpe.psychopen.eu/index.php/cpe/…
Now this adds a bit more detail as to how you get a diagnosis and what difficulties/mild/moderate/severe means

frontiersin.org/articles/10.33….
Read 11 tweets
Jan 25
Right people, this is a list of some of the articles we're talking about in the training today

There's this from @HoppyPelican

journals.rcni.com/mental-health-…
And this from @ProfLAppleby (worth following)

pubmed.ncbi.nlm.nih.gov/3224249/
Read 7 tweets
Jan 25
This is my letter that The Times didn't want...
thetimes.co.uk/.../can-privat…...
Can Private Hospitals Save the NHS?
Perhaps an answer to this question can be found amongst the 2 billion spent each year on private mental health hospitals.
I work with people who recurrently self harm and feel suicidal. The NHS has effectively privatised inpatient care for this group of people with only 55 NHS beds available.
The private sector do a fantastic job of taking these patients out of NHS hospitals but after that the benefits end.
Read 7 tweets
Nov 21, 2022
You can argue that Iran is a totalitarian regime. There are consequences to dissent in Iran.

amnesty.org/en/location/mi…
In a country where "Thousands of people were interrogated, unfairly prosecuted and/or arbitrarily detained solely for peacefully exercising their human rights, and hundreds remained unjustly imprisoned" this happened. 👇 The consequences were worth it.

google.com/amp/s/amp.theg…
The Iranian football team refused to sing the national anthem of a place where "Torture and other ill-treatment, including denying prisoners adequate medical care, remained widespread and systematic" The consequences were deemed worth it.

google.com/amp/s/amp.cnn.…
Read 8 tweets

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