Den Langhor
@DLGDen
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Emergency Medicine Consultant. BMA CC. 2 cats, 1 snake, 1 dog and too many bones. LFC fan. Vegan. Told to write all Views expressed are my own. 🌱💙🇪🇺
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Joined July 2015
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Had a plumber out this week to sort a dodgy pipe. His rates were more than double my hourly pay. He was worth it. Why aren’t we? Why are NHS staff so undervalued by this government? Why have we allowed below inflation rises or full on pay freezes for a decade? Enough is enough.
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3 of our amazing junior doctors, all of whom I have encouraged to enter EM specialty training, have informed me in the last few weeks they have secured jobs in Australia. The U.K. needs to sort out its pay, terms and conditions if we want talent to stay.
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Just watched
#Partygate
and well…. It’s a lot. Remembering not even being able to have lunch with my colleagues whilst we were going through it at work. The PPE worries. The FaceTime goodbyes. Just all of it. Whilst they partied.
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I’m a Dr from a working class background who’ll save your life when you have an accident at 2am. I’m a Dr who wouldn’t have gone to uni these days to accrue 100k debt & a salary that’s eroded beyond belief. Right now people like me can’t afford to choose this career.
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Our emergency departments are overwhelmed just now so here are some handy tips on how to avoid needing us:
1. Don’t eat things that aren’t edible
2. Don’t punch walls, each other or anything else
3. If you get toothache see the dentist before it feels like you’re dying
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Hey government, Remember all those doctors you forced into early retirement because of the punitive pensions taxes? What’s that? You want them to come back? To risk their health battling an infection that affects older people the worst? For real?
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Today I roamed my department asking staff to tell me 2 good things they had done today. Everyone struggled despite the fact they’d all done great work. I’m going to do this daily. We need to be celebrating our wins now more than ever.
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A&E literally bursting at the seams tonight. Not a nook or cranny not in use. Hospital full. Told by paramedics other local hospitals are the same. My team have been incredible as always but I genuinely fear for the NHS this winter.
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Getting older is coming to the realisation that being drunk isn’t as good as not being hungover.
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Worked late 3 times this week. Off today. Recovering. Been called. Work in
#NHSCrisis
& they need me so am going.Not sure I can keep this up
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yearly costs of being an EM doctor:
College fees £756
GMC £420
Indemnity £995
This is after thousands spent on exams, courses etc.
car parking on top.
New graduates are leaving university with eye watering debts (I’ve seen several >70k)
Yet our pay is 30% behind inflation.
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Consultants gathering in Liverpool for
#consultantstrike
We say no to further pay cuts! Come back to the table Rishi - we are ready to negotiate. You can stop these strikes!
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Consultants worried about safe staffing during the JD strikes please direct your concerns directly to the government by lobbying them to restore the lost pay of your invaluable colleagues. Don’t punch down at the juniors who have been left with no choice but to take this action.
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‘Well prepared & well equipped’. Mate the NHS wasn’t even prepared for winter & we’ve had all year to plan for that. Getting the Ebola gear out of the cupboard does not constitute well prepared.Hospitals running at full capacity. If extra beds are needed where will we find them?
We are continuing to monitor the Wuhan coronavirus closely and are taking all necessary steps to protect the public
We have completed 31 precautionary tests and there are no confirmed cases in the UK. The NHS remains well prepared and well equipped to deal with all eventualities
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About to start my weekend on call. Ruminating that when I signed up to train in EM as a consultant I expected to be on 30% more pay than I’m on & a safe working environment with no corridor care. 12 years of Tory cuts. Everyone saying we signed up for this - we bloody well didn’t
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In A&E during the first wave we had the luxury of suspended elective care meaning vacant beds & redeployed doctors. Now we have winter pressures and full hospitals. We can manage crowding. We can manage Covid. We can’t manage both.
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In case you missed the memo - our A&E departments are kinda busy just now managing a pandemic on top of the usual stuff like heart attacks & strokes. So if y’all could stop kicking the shit out of each other and attacking people with knives for the time being that would be super.
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Round 2 of handy ways to avoid a trip to your extremely busy local A&E:
1. Keep your fingers away from wild animals and birds
2. Ask someone to hold the stepladder
3. Wear goggles if giving angle grinding a go
4. Get vaccinated
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@DGlaucomflecken
British EM doc here. Yeah you might wait like 8 hours if you’ve stubbed your toe/got the shits/earache etc but if you’re having a heart attack/stroke/been shot and bleeding to death (very rare in the U.K.) we will see you straight away. It won’t cost a Penny. We got you.
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Is everyone else in A&E just completely, utterly spent at the moment? I started back today after some AL and honestly I feel like I’ve ran a marathon. AL benefits already decimated. It is absolutely brutal at the moment.
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If the NHS is ran for doctors why is consultant pay down >35% and junior doctor pay down >25%? Frontline doctors are literally shouting from the rooftops about appalling conditions, burnout and moral injury. Give over.
EXC
The NHS is too often run for the benefit of doctors, not of patients, Wes Streeting warns in
@theipaper
interview alongside Rachel Reeves.
He promises a decade-long reform programme to empower patients to take control of their own care.
Story:
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If an emergency department is crowded then patient should be moved to wards who should create extra capacity. Keeping sick elderly people on waiting room chairs for hours on end is inhumane. Holding all the risk in one place is dangerous and irresponsible.
Ok, what’s your unpopular opinion in medicine that will get you in this position?
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Anyone else’s A&E gotten mad busy the last few weeks? We are seeing usual mid winter type numbers and then some at times despite the fact it’s spring. Is this a reflection of ED’s being the only fully open door or the impact of chronic health issues accumulating during Covid?
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To all the girls in recent years who got their hair dyed in that style where the roots are long and the ends are light. Thank you. Your contribution to society can not be overstated.
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If you're frightened by 'stay away from A&E' during
#nhscrisis
messages please know if you are critically unwell we will see you v. Quickly.
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As an A&E doctor I’ve lost count of the times the police have helped me in my job keeping staff & patients safe. They’ve done so this last 1.5 years with a great deal of care & professionalism at huge personal risk. I am so grateful to them and believe 0% payrise is a disgrace.
The Police Federation of England & Wales no longer has confidence in the current Home Secretary.
The organisation has made a decision to withdraw its support and engagement from the Police Remuneration Review Body, labelling the current pay mechanism ‘not fit for purpose’.
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Picket growing in Liverpool to the sounds of car horns and cheers. Everyone resolute that we will not back down until a fair deal is offered. Consultant pay is down over a third in the last 15 years.
#ConsultantsStrike
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If you've watched
#hospital
tonight and are concerned about the
#nhscrisis
please write to your MP, the whole country is the same.
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Spirits high despite the freezing winds on the Wirral picket for
#JuniorDoctorsStrike
. Brilliant , dedicated, hard working young doctors who deserve far better than the 25% paycut they’ve been dealt. Keep going guys. Stand firm. We are behind you!
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Consultants & doctors in Merseyside demonstrating once again they will not accept further pay cuts. Chatting to a junior colleague on the picket who tells me he’s off to Aus next year. He’s one of many. To retain staff they must be valued appropriately!
#DoctorsStrike
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Consultants. Your junior colleagues are reaching CCT with over 100k student debt and a starting salary worth 35% less than in 2008. The future of the NHS depends on these colleagues staying in the NHS. Vote yes for them. Vote yes for the future of the NHS.
✅Fix pay
✅Fix pensions
✅Fix the pay review body
Our consultative ballot is now open: eligible BMA consultant members in England will receive a link via email. Have your say by the 27th February.
More info
👇
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So my associate medical director today suggested to cope with staff stress we should get some alpacas. So basically now I want alpacas. I need them. We may need to sacrifice a car park to make this happen. I will take responsibility for organising a rota to feed them.
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Consultants arriving for the second day of
#ConsultantsStrike
in Liverpool. We are united and in this for as long as it takes to bring the politicians back to the table to negotiate a fair deal! Further pay cuts will not be accepted.
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I have some questions about the Statement the NHS is well prepared:
1. How many empty ITU beds are there?
2. How many hospitals actually have enough space for a sudden influx of patients?
3. How many hospitals actually even enough have space to meet the current demands for beds?
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Merseyside consultants out in force despite horrendous weather to once again say we will NOT accept further pay erosion.
@RishiSunak
you can stop these strikes. We are waiting to talk!
#consultantstrike
#ConsultantsStrike
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10k bonus for politicians to safely work from home during the pandemic. Millions on PPE contracts to Tory pals. Nothing for
NHS workers who’ve literally risked their lives to do their jobs.
The Government has confirmed there will be no Coronavirus bonus for health and care staff in England, only adding insult to injury after a recent 1% pay offer.
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Merseyside consultants out on strike to tell the government to come back to the table and negotiate with us. We do not accept another real terms paycut.
@RishiSunak
you have the power to stop these strikes. We are waiting to talk.
#ConsultantStrike
#ConsultantsStrike
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Anyone else playing a game of ‘Is this definitely my hayfever?’
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ED Xmas!
On the 12th day of Christmas the Tories gave to me:
12 twelve hour breaches
11 on the corridor
10 ambulances outside
9 patients in resus
8 needing side rooms
7 bed meetings
6 hour waits
5 flu A’s
4 hour targets 😆
3 nurses short
2 doctors down
And a career in A&E
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I have a question.......
Given that our hospitals are operating at full capacity and emergency department corridors are lined with trolley queues, where will the extra patients go if
#Coronavirus
takes hold in the UK?
Do you have questions about
#coronavirus
? We're regularly updating our websites with the latest information.
Information about the illness and symptoms:
▶️
Information about the situation in the UK and our response:
▶️
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Well the return to schools have produced a swathe of snotty and wheezy kids. Our ED has been very busy. Clearly though the UK needs a bedside Covid swab test. Trying to determine the potential Covids from the usual respiratory virus culprits is a real challenge.
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The government needs to start paying doctors what they’re worth. They can’t afford not to. 15 years of pay erosion is driving doctors abroad.
Consultants don’t forget to post your ballots. We need to restore our salaries to encourage our junior colleagues to stay in the NHS.
A snapshot of UK doctor numbers in a single department, in a single hospital, in Australia.
As of today our ED has :
26 UK trained Resident Medical Officers
23 UK trained Registrars
10 UK trained Consultants
Pay your staff what they're worth
@SteveBarclay
or lose them
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Other countries are reporting their health care worker infection rates. Why isn’t the UK? It would be useful to see the comparison rates to assess whether our PPE guidance is indeed sufficient or not.
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Junior doctors worried about what your consultants will think if you take strike action over your pay - our consultative ballot shows we are with you. We stand together. We are one profession. To retain our future workforce in the NHS - pay, pensions and the DDRB must be fixed.
🚨🚨🚨 BREAKING!
Following a consultative ballot of
@BMA_Consultants
the government is now on notice to outline serious proposals to fix pay, pensions and the pay review body by April 3rd.
If they fail to do so an industrial action ballot of Consultants will begin on 17th April.
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#DogsAtPickets
at the Merseyside
#consultantstrike
. In a true family affair we have babies and children with us too. Support from the public has been massive. The horns are deafening.
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So here’s the silver lining for healthcare workers. As everyone else faces lockdown and social isolation, for us, even though the circumstances suck, we are going to get to see our friends every day and seriously my ED friends are the BEST!
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Lots of people have pointed out not all civil servants got a raise. Sorry if the tweet seemed misleading in that respect. I should have written ‘some’. Also people please don’t bash hmrc. They do a bloody hard job! This isn’t a race to the bottom.
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Consultants out on strike again to tell
@RishiSunak
we do not accept another real terms paycut. And we have ice cream!!
#ConsultantStrike
#ConsultantsStrike
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Delighted to see the motion that corridor care should be classed as a never event passed at
@TheBMA
#ConsultantsConf
thanks to everyone who voted to support their ED colleagues and demand better for our patients.
#crowdingkills
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Jesus, Mary, Joseph and the wee donkey. If I have have another shift again like that it’ll be too soon. 😳 Huge thanks to the legends from medicine who rocked up to help us tonight and all the ED staff who stayed late and kept on swimming. You’re my heroes.
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Is pre traumatic stress disorder a thing? Because I feel like it’s a thing. There’s never been a more important time to look after each other than right now. Check on your colleagues. And maybe bring cake.
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What’s alarming here is the response to this tweet. Colleagues across the UK and from varied disciplines saying the same. The weather is still good. There’s no flu yet. We are right to be concerned.
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A late Christmas present has just made my day. I now have a Chris Whitty t shirt! I shall wear it whilst drinking my brew from my Chris Whitty mug. 😀
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Spirits high despite torrential weather on the Wirral picket. Consultants and doctors standing together to say we need a mechanism to restore our eroded pay to retain our vital workforce.
@RishiSunak
we are waiting to talk.
#DoctorsStrike
#consultantStrike
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Consultants have said no to another real terms paycut and sent a clear message to the government that the pay erosion over the last 15 years must be addressed and corrected. We are not worth over a third less than our predecessors.
Consultants in England have voted a resounding YES to taking industrial action this July.
✅Turnout: 71.08%
✅Yes votes: 20,741 – 86.08%
Together we can
#FixConsultantPay
now and for the future. Read more:
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As an emergency medicine consultant who has worked through the COVID pandemic I was asked to be a case study for
@theBMA
’s
#fairnessforthefronlinecampaign
. If you think consultants should be fairly rewarded please add your name to the campaign’
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Are there any emergency departments not completely up shit creek with unmanageable crowding, exit block and staffing issues? Is anywhere managing well at the moment? Is there anywhere where the job is still enjoyable? Anywhere?
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Yes to
#FixConsultantPay
Yes to
#RestorePensions
Yes to encourage our junior doctors to remain in the NHS
Yes because we are not worth a third less than 15 years ago
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Honestly if feels like the entire NHS has essentially upended itself into the ED just now. It is completely untenable. 😩
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Amazing turnout in Manchester for
#DoctorsStrike
@RishiSunak
we are waiting to negotiate. You can stop these strikes. Time to end 15 years of real terms pay cuts and pay us what we’re worth!
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Please do not attend Emergency Departments to request a Covid test unless you are seriously unwell and require hospital care. We are only able to test those needing hospitalisation. If you have mild symptoms please stay home and arrange testing via 119. Do not put others at risk.
RCEM urges patients to seek coronavirus testing via 119
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Consultants
@TheBMA
is only as strong as it’s members. Right now you have the opportunity to say that 15 years of real terms pay cuts are unfair & you aren’t willing to see your pay & pension devalued further. Vote yes in our ballot on 15th May. This fight belongs to all of you!
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Anyone else looking at their corridors wondering how the hell they are going to cope when proper winter hits?
#NHSCrisis
is here. It’s not going away. It’s getting worse.
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We are hearing from more and more trusts that BMA rates have been agreed for consultants covering the JD strikes. If you are at a trust not offering these rates ask why you are less valuable than other colleagues nationally - the answer is you aren’t.
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After reading a lot of commentary on
#ThisIsGoingToHurt
I watched it. Whilst I accept the trauma for women patients in such stories is real, the story for me was Shruti. I’ve known doctors like her. Dr burnout and the risk of suicide is too high and we need to talk about it more.
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Working a late today in A&E. What I really hope for over Christmas is that we don’t see patients having to attend due to injuries from violence. Please drink responsibly and be nice to each other.
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I know we are all supposed to be resilient and just able to get on with it but I’m seriously hitting a point of ‘I need to get out of this.’ Anyone looking to hire someone to maybe just sit play with kittens all day?
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Of course foundation doctors need ALS. Does this person have any awareness that ALS isn’t just cardiac arrests (arguably the easiest bit) but is about identifying and treating critically unwell patients? Foundation docs are often the first person to attend an unwell patient.
@CCWearmouth
Not every doctor needs ALS
Teach and reinforce good BLS for all, then target the ALS for those in roles that need it.
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Sad at the state of our nhs. Just come out of a very difficult shift juggling patients into non existent spaces in the A&E. Every hospital in the region the same all requesting diverts to each other but none able. We can’t carry on like this.
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Restoring doctors pay would encourage retention of doctors on permanent contracts and be far cheaper than paying locums to cover the ever increasing numbers of vacancies.
Consultants don’t forget to post your ballots back!
🚨 NHS workforce plan delayed again as new analysis reveals some A&E departments are spending 80% of their wage bills on costly locum doctors to fill staffing gaps:
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Lots of talk just now about busy GP waiting rooms being an unsafe option and rightly so. However where’s the talk on the state of our emergency departments? We are inundated with a huge surge in attendances.
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So this weekend the Granghor family welcomed a new member. Twitter meet Arthur. He is the goodest boy!
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It’s that time of year when all any emergency medicine doctor wants is not to have to treat patients because of violence. So drink sensibly people and don’t be dicks to each other.
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Just worked a night shift to cover registrar rota gaps. Wasn’t looking forward to it. Honestly one of the best shifts I’ve worked in a very long time! I actually really enjoyed it. It’s amazing how nice the job is when you aren’t worrying about beds.
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Watching cardiac arrest for the first time as it’s gone onto bbc iPlayer. My god they’re burnt out. And being underpaid. The show is so old it’s a square on my tv instead of a rectangle but same shit different day!
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I don’t know whose idea it was to put the grand national, a home football match and the sunshine all on the same day but from a Merseyside A&E late shift perspective this was not appreciated.
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So a patient comes to our A&E. I might be the only doctor to see them but without the receptionists, porters, cleaners, support workers, IT techs, maintenance workers, lab staff, security team, cooks, procurement staff etc there wouldn’t be a functioning A&E to see them in!
🏥Almost half of all NHS staff are managers, administrators or unqualified assistants, it has emerged
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@OslersChild
Because the correspondence states duties can persist for prolonged periods. A&Es are at major incident levels just now. I feel my ‘duty’ is better spent helping to treat record numbers of patients in our overwhelmed A&E.
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Our hard working junior doctors on the Wirral out for
#JuniorDoctorsStrike
to a cacophony of beeping horns. Their pay has fallen by 26% and today they take a stand against their eroded conditions. Consultants and SAS doctors are keeping patients safe. Stand firm guys!
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Mixed emotions as its terribly sad to have come to this but a definite yes to
#FixConsultantPay
. We absolutely have to do this to retain our doctors and ensure our junior workforce choose to work for our NHS. We owe it to them, to ourselves and to the patients that need us.
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Serious question: why on earth do we have junior doctor changeover during the school holidays? Trying to staff a department to cover the induction period is a nightmare.
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@melaniedesmith
@DocRods
Don’t get me wrong - they absolutely deserve it and do a massively important, difficult job but when medics have faced the worst pay erosion in the U.K. and nursing pay is horribly low for the highly skilled work they do, we deserve a fair uplift too.
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@robertpurbrick
All those elderly people living alone that don’t have family and neighbours checking on them now. How are they? It’s making me anxious thinking about how many patients we normally get ‘found in bed/on the floor very unwell’....... seriously anxious about this.
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@alwynkotzee
@vix_405
It is not the walking well struggling to see a GP causing crowding in emergency departments. It is unwell patients waiting for beds in a full hospital that can’t safely discharge well patients due to a lack of social care. GPS are also overwhelmed with demand.
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It’s the micro aggressions on incident forms that are the most irritating. You’ll run an intense resus case, save a life, juggle multiple other patients simultaneously & the ward will do a datix because you forgot to do a VIP form for the cannula the paramedics put in. 🤷♀️
So today I’d like to discuss emergency medicine bashing. I’ve seen and experienced a bit recently and it’s not pleasant.
Emergency Medicine is sort of uniquely placed to be scrutinised by nature of the game.
Everyone in ED has to interact with the rest of the system opening
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Most EDs have no access to MRI OOH. Has the time not come to blue light these patients straight to a neuro centre like suspected MIs go to a PCI centre? Rather than a crowded ED that probably doesn’t have an empty trolley and a does have an 8 hour wait to be seen?
@DrLindaDykes
@dr_irfan_malik
Guidelines have just been updated again
An MRI must be performed within 4h of suspected CES -
Don’t sit on these
Send straight to the local A&E - this is a secondary care problem and it is up to them to ensure appropriate management once there
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You know those days when you turn up for work and you realise even its a horrendous shift it’ll be a good day because the people you’re on with are just so awesome? I have that day today.
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Consultants in our recent consultative ballot you told us
@TheBMA
that you are willing to take action over pay, pensions & the DDRB. Pressure from you all has seen some positive (not perfect) pensions changes. Now to keep up the momentum in the battle against your pay erosion!
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As governance lead for my dept I hold teaching sessions for the juniors on errors. My message for them when discussing incidents is always to investigate ‘What went wrong in the system to allow a competent, caring person to make this mistake?’
#BawaGarba
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And thank you to all of the IROs and BMA staff who made today possible! You guys have been simply amazing and we are a very fortunate union to have you all.
Thank you to all
@BMA_JuniorDocs
and
@BMA_Consultants
members who came to the
#BMAPayRally
outside the Conservative Party Conference in Manchester today
You certainly showed the government your strength of feeling
#DoctorsStrike
#FixConsultantPay
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Please remember it’s not the staffs fault if the waits are long. Don’t yell at us. We are seeing record numbers of patients. Try to be patient and understand if you’re kept waiting it’s because someone else is sicker than you and needs us first.
Exclusive: Patients face 15-hour wait in hospital A&E as summer crisis grips NHS.
@KatherineRCEM
warns NHS faces worse situation than any previous winter:
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