Husband & Father of 2 | Anaesthetist | PhD in Health Services Research | Geriatric Millennial
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Oct 14, 2023 • 12 tweets • 2 min read
In the run up to next week's EGM at the RCoA regarding AAs and training issues I thought I'd write down some thoughts:
1) I've been surprised and relieved that I'm not the only one who thinks the RCoA needs to slow down the move towards AA expansion. Many people have expressed their support to me in private and online.
Sep 30, 2023 • 14 tweets • 3 min read
On training, expertise and minimum standards:
Currently there's a lot of talk about alternative practitioners delivering care in medicine.
Many people claim to have undergone different pathways in their training but are still able to deliver the same level of care to patients.
I think we all accept that there're standards of care we need to adhere to for patient safety and medicine is therefore regulated to ensure that we don't have charlatans delivering substandard care to patients. Otherwise we'd just go back to the bad old days of no regulation.
Oct 28, 2022 • 6 tweets • 1 min read
Do the general public know that because of Brexit we are now finding it difficult to import controlled drugs into the UK for medical use? So we are running out of Remifentanil, an important drug used for anaesthetising patients, and we have to use alternatives techniques.
It feels like we are having to adjust our practice because of resource limitations, completely self-inflicted by the political situation, and patient care suffers. Frustrates me to no end.
Jul 7, 2021 • 13 tweets • 8 min read
Just in time for tomorrow's @Anaes_Trainees conference in Newcastle and online, we have now posted our recent ST3 Recruitment Survey results onto @medrxivpreprint.
The manuscript is available here: medrxiv.org/cgi/content/sh…
The headlines:
Our survey captured responses from over half (n = 536, 50.4%) of the total number of applicants to ST3 posts this year (previously cited as 1,056 applicants).
Jun 20, 2021 • 8 tweets • 2 min read
There were 9 people in the operating theatre last night when I was on call. Only 2 people were not "foreign". One of them was the patient. 7 of the other 8 delivering care were "foreign".
If the NHS wants to wean itself off "foreigners", it needs to pay everyone better, increase training numbers across all roles from medical, nursing to allied healthcare and support staff. The reason why we're needed, is that the demand is high and donestic labour supply is low.
Mar 4, 2021 • 7 tweets • 3 min read
It's fair to say the NHS has been hammered over the last 12 months. The budget announcement yesterday effectively cuts NHS England spending from £148bn in 2020-21 to £139bn in 2021-22. amp.theguardian.com/uk-news/2021/m…
Furthermore, it seems that NHS consultants in their 50s and 60s are likely to take a financial hit via their pensions. There are suggestions that many senior consultants will be reducing their workload as a result.
I'm exhausted. Been helping to transfer intubated patients around the hospital and resuscitate deteriorating patients on the ward in conjunction with colleagues from ICU. But there are still urgent and emergency operations taking place. Its relentless... Our ICUs are overflowing.
Just as I was leaving hospital there were 2 more patients still needing to be intubated and ventilated. Nurses are all running ragged. We are stuffing beds into spaces that can't even be properly called bedspaces anymore. I've never felt desperation like this in the NHS before.
Jan 13, 2021 • 6 tweets • 2 min read
Over 1,500 people died from. COVID-19 today in the UK. That is equivalent to the death toll of the Titanic sinking on the 15th of April 1912.
We are now having one Titanic sinking EVERYDAY in the UK.
During the Swine Flu pandemic in 2009, about 460 people died in the UK. That's the number who died during that entire pandemic.
We are now having 3 Swine Flu pandemic deaths EVERYDAY in the UK.
Jan 9, 2021 • 6 tweets • 1 min read
I'll say it now. If we survive this wave, the NHS will be broken and barely recognisable. The things we are asking the staff to do now in the full to overflowing ICUs will break many of them..
There is dramatic moral distress going on. Surge nurses unused to caring for ICU patients have been asked to step up and are doing things beyond their prior training. Experienced ICU nurses are being forced to cut corners because there's just no other way.
May 27, 2019 • 12 tweets • 3 min read
1. Following discussions elsewhere, I present to you:
*A quick tutorial on conditional probability for medics*
Imagine you receive this one line referral, with no additional information: a patient with a raised Troponin I.
What's the probability the patient actually has an MI?
2. From the literature we know:
