, 27 tweets, 7 min read Read on Twitter
1/ @Jeremy_Hunt claims his goal is “harm-free” medicine in the #NHS. This is utter twaddle. #thread
2. Firstly it’s naive. Medicine is harmful. Do no harm does not mean do nothing. Drugs = side effects, blood tests=needles, surgery=trauma.
3/ Good medicine always ensures benefits outweighs the risks. But there will always be risks.
4/ This isn’t like flying a plane. Pilots fly planes in perfect working order, we only fly planes that are broken, or sometimes crashing.
5/ Our planes may not want to fly, may decide to land themselves or refuse specific parts or repair. Sometimes we just don't know how to.
6/ As long as the patient is an integral part of the decision making process, as they ethically should always be, medicine will be messy.
7/ Secondly, it’s vacuous. All improvements should be practical, evidence-based and beneficial. Simply crowing “harm free” is none of these.
8/ Thirdly, it’s patronising. Have you ever made a serious medical mistake Mr Hunt? We wake up in the night worrying about it. Do you?
9/ A colleague once ran off the football pitch & went straight back to work to check he hadn’t made a mistake earlier that day. He hadn’t.
10/ Every move we make, every decision has to weigh the “harm”. We try our level best our single day to minimize harm. It's our job.
11/ Naive & patronising aside while you bleat about “harm free” care, you actively ignore the real harm you & your govt have caused the NHS.
12/ What actually causes medical harm? Communication, inadequate information flow, inadequate staffing and policies. ahrq.gov
13/ All of which require time, staff, effective resources and leadership. If we actually want minimal harm we need more of these.
14/ We need more time. Since 2007 hospitals are 33.5% busier but nurses/head fell by 3.5%. Could you do your 8 hour day job in 5 hours?
15/ You might have to skip some breaks. Would you still do so for even LESS money? 14% less? independent.co.uk/news/nhs-staff…
16/ We need more staff. We are 40,000 nurses short, 10,000 GPs short, 6000 midwives short. 1000s of posts lie empty.
17/ A&E, maternity and paediatric departments have had to close with too few staff. We don’t have enough staff. theguardian.com/society/2016/a…
18/ No. of nurses/patient is directly linked to survival outcomes of the patients. No staff = actual harm. nursingtimes.net/news/hospital/…
19/ We don’t have enough resources. We have the largest ever NHS deficit. Lowest beds/head in Europe. theguardian.com/society/2016/m…
20/ We don’t have enough beds to get patients in to hospital, or enough social care to get them home again. news.sky.com/story/britain-…
21/ Treating a patient in a corridor is like trying to do your office job at a bus stop. You’re distracted, underresourced & less effective.
22/ Despite this an “avoidable death” is still vanishingly rare. 97% of all deaths in hospital were “unavoidable”. bmj.com/content/351/bm…
24/ The mortality rate is rising for the 1st time since 60s. In 2015 30,000 may have died due to healthcare cuts. rsm.ac.uk/about-us/media…
25/ You berate us when we struggle in increasingly impossible conditions, another blow to an already demoralised workforce.
26/ All the while the system failings causing the greatest harms are your responsibility, and are roundly ignored.
27/ Your words may talk of "harm free" care but your actions speak far louder. /end
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