Tony Whitehouse
@Whitehouse_ICU
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369
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1,490
Family, Choral Singing, ICU, Critical Illness, Sepsis, STRESS-L but not necessarily in that order... Intensivist Hon Prof University of Birmingham Views own
UK
Joined February 2020
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I don't get a locker. No travel or accommodation expenses (my contract says I have to live close so that I can attend hospital promptly). No funding for assistance. Expensive parking. Buy my own coffee. Shared canteen with patients and relatives so have to queue for ages. 🤔
Setting up all 650 Members in their offices takes time.
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I have watched in dismay the managed deterioration of the
#NHS
and public services.
The consequences for the UK aren't, in my view, about private healthcare or not, they are about whether there will be any healthcare at all for all but the rich.
Here's why... 🧵 1/n
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As an ICU doctor, I am insulted by this
@BBCNews
story:
THERE IS NO TIME LIMIT ON ICU CARE! To say that we would have "flicked the switch after 30 days" is utter nonsense. Please do not believe that we do this.
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I've been working in the NHS for >30 years - there hasn't been a year where we haven't been asked to make "efficiencies"
Please don't use the excuse that everything will be so much better if there wasn't so much waste. There are no more efficiencies.
3/n
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They make the UK a nicer, less nasty place, a healthier and happier place.
Support public services; support the
#nhs
ENDS
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Now that London isn't being crushed by
#COVID19
, the national press aren't interested.
#nhs
#SavetheNHS
#clapforcarers
Birmingham hospitals 'have more Covid patients than anywhere else in country'
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Yes, a lot of money goes to the NHS but since 2012 the % spend on healthcare as a proportion of GDP has fallen.
This is managed deterioration.
Salaries have fallen by >15% in real terms, waiting times for operations and ambulances have increased.
Life expectancy is falling
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Thank you to
@unibirmingham
and
@unibirm_MDS
for promoting me to Hon Prof.
I've been overwhelmed by messages of congratulations (had to break my "no Twitter before bed"!)
Thanks everyone. Sorry if I can't get round to responding to all.
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So there you have it. I believe that the UK then is on a trajectory that will leave the health of the nation in tatters.
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It is estimated that a doctor dies every three to four weeks in the UK from suicide.
@youokaydoc
I know at least 5 doctors who have taken or attempted to take their own lives - this is real
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I believe that the agenda is to make working conditions intolerable for consultants so they leave. Complaints are increasing as patient frustration is taken out on them. Consultants are retiring early because tax means that they would otherwise pay to come to work.
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The private sector is no more efficient than the public sector even though it thinks it is.
5/n
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It is so boring to hear of our public services; those that protect us, clean our streets, house us, support us when we hit hard times and so much more, are regarded as a drain on the country’s resources.
18/n
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And please don't be condescending and think that outsiders can come in, see through the problems and fix them better than has already been tried. Believe it or not healthcare workers see the fallibilities but don't always get given the tools or resources to fix them.
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Just had a blood test and received blinded dose of
#vaccine
as part of
#COV002
vaccine trial for
#COVID19
. They need more people to volunteer. Good luck to
@OxfordVacGroup
and
@UHBResearch
@uhbtrust
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The pension debacle and relative fall in pay has meant that the NHS has been haemorrhaging staff in recent years.
Please don't use the lazy trope of "greedy consultants" 🥱 - that's just playing into the hands of the underfunders.
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...of market forces simply don’t get the point that a nurse can work in Lidl but a Lidl worker doesn’t have the immediate skills to work on the ward.
The idea that there is a job market that can drive down salaries and make it all “efficient” is wrong.
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It’s now financially more attractive for a nurse to work in Lidl than to take an extra shift where they could be shouted at, spat at or receive complaints despite doing their best in an overstretched ward.
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And this is the problem.
There are neither hospitals NOR staff to deliver the healthcare privately.
Consultants want to help, they want to work, they want to deliver healthcare but to do it, you need pharmacists, therapists, nurses, cleaners, secretaries and many more.
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Given that we work with our fabulous trainees every day, I suppose we have to ask: If 72% have failed, are we training them well (in my view, we are), are they good enough (in my view, the majority are) or is there a problem with the exam? I'll leave you to decide
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Serial Secretaries for Health, dead behind the eyes and driven by ideology believe in breaking the NHS and allowing market forces to sort it out.
These “captains of industry” who are blinded by one simple but deeply problematic idea....
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So they are leaving.
The Govt will use the “lazy, money-grabbing consultant” phrase 🥱and roll out the >70 year old “filled the consultant’s teeth with gold” crap (most of us can’t find a dentist in any case since the
#tories
cut those too)
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@ShaunLintern
@ShaunLintern
I expect better.
Below is the new scale - there isn't a 20% rise anywhere.
Because of the rejigging of pay progression there are years where the uplift in pay combines with a step up (e.g. between 13 and 14 years' service). The rest is around 5%.
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Yes, you'll be able to find cases of rich NHS workers but in the vast majority of cases it's about being able to do one’s job with adequate resource
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1) Vaccines do not alter your DNA
2) If you can take the vaccine, you really, really should
3) Vaccines do not contain tissue from aborted foetuses
4) Vaccines do not cause autism
5) Yes, the vaccine has been developed quickly but that doesn’t mean it’s not safe
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This is NOT greed, or a fit of pique, or stamping off in a huff because they don’t get their way.
It’s because there physically isn’t the capacity for modern healthcare in the private sector.
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Many congratulations to
@veenith_tonny
for election to a Macintosh Professorship of the Royal College of Anaesthetists! Well deserved, Tonny!
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...and why do we want to go back to "Normal"?
Normal is trying to squeeze in elective surgery in
#ICU
; normal is having a member of the ICU staff treating patients in ED waiting for an ICU bed to become available.
There needs to be a new Normal
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When a consultant leaves, they will go abroad or work in pharma because there isn’t anywhere else for them to go.
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in the hope that the consultants with time on the hands (and not on the golf course⛳️🙄 ) and the need to work, will work in private hospitals.
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How to transform your ICU to accommodate a surge in Staff and Patients for
#COVID19
. This was how we did it in
@qehbham
The architects were
@UHBCEO
@cesl1975
@tessaoelofse
and so many more!
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So
@MattHancock
wants all Zoom appointments.
It's pretty difficult to examine a patient online.
Tell me, will the NHS accept a misdiagnosis through not examining? Will the GMC hold off sanctioning that doctor?
There's a reason for face2face medicine.
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Have you ever noticed that if there's a waiting list problem, ambulance queue, A&E long wait, it's the fault of the NHS not the policymakers?
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I try not to get political here but to hear our PM saying that wage growth matters more than the health and wellbeing of people is sickening.
Boris Johnson tonight on the BBC "I've given you the most important metric which is, never mind life expectancy, never mind cancer outcomes, look at wage growth."
I beg to differ! Ghastly appalling disregard for our people.
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STRESS-L trial results published today in
@JAMA_current
and also presented at
@ESICM
#LIVES2023
funded by
@NIHRresearch
.
Thank you to all who contributed to the project: our patients, our families, our sites,
@WarwickCTU
, collaborators, DMC and TSC.
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@stephen_t_webb
This seems to have taken a life of its own!!
I do not begrudge the MPs working conditions. I wanted to highlight that good working conditions not only enhance the workplace but also make it more efficient.
The
#NHS
has been cut to the bone and is now deeply inefficient.
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This is an exciting Phase II trial starting at
@qehbham
with CI
@veenith_tonny
. I love the collaboration with
@CRCTU
and look forward to the work with
@OxfordBRC
and
@UCLHresearch
. We've had the green light. I have trained our investigators. We are awaiting our 1st patient
The CATALYST trial, starting recruitment this week at
@uhbtrust
, could lead to major advances in the fight against
#coronavirus
.
@unibirmingham
@CRCTU
@veenith_tonny
@OxfordBRC
@UCLHresearch
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Antibiotics that aren't treating disease or the risk of disease should not be happening.
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@WelshGasDoc
Dave, with respect, this tweet plays into the "anyone can do what a doctor does" narrative.
A cardiac arrest is literally the time when a life or death decision is made and there is NO other profession willing or trained to make that decision.
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Got a call today from
#NHS
Test and Trace. The post-foreign travel swab from 7 days ago was +ve for daughter.
In the last 7 days, we mixed freely, she went to the
@moseleyfolk
and seen her friends.
It took 7 days for the test result to come back.
How did my £69 reduce
#COVID
?
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Our
#ICU
team were awarded Kind Connected Bold today
Very moving letter from a relative about a patient's care
It's what our team does every day but nice that it has been recognised 😊
Thank you to our patient. Thank you
@UHBCharity
and
@uhbtrust
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To paraphrase de Maistre "Every nation gets the COVID pandemic it deserves".
Lockdown just isn't happening in Birmingham and I'm worried that the ICUs are going to being overwhelmed.
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The patient voice has been lost here. I don't mean the tin-hat "patient researchers" who seek conspiracies on here and FB but the sensible patient groups who advocate for those who are vulnerable.
Why is the
#NHS
being held to ransom by a few vocal staff who just don't get it?
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Looking forward to arranging a F2F meeting with
@uhbtrust
and perhaps
@dameyveb
to discuss how we can bring the largest ICU in the UK up to these standards.
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Our latest position statement on Intensive Care Staffing Standards & the NHS Workforce Crisis ⤵️ .
We stand firm on the need for GPICS staffing standards to be adhered to at all times. Units should not have to struggle with inadequate staffing levels.
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Congratulations to TCB on being awarded his MBE. Well deserved indeed!
Congratulations to Professor Tom Clutton-Brock MBE of
@unibirmingham
&
@uhbtrust
! Tom has been recognised in the Queen's Birthday honours list for services to the NHS during
#COVID19
, where he led an intense ventilator testing drive at
@MDTECcentre
>
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Blown away by the kindness of groups and local companies who are bringing food to our
#ICU
during
#COVID19
. Especially kind when cash flow is tight for them.
#Lockdown
brings out the best in some even if the shops are empty by the time we leave work.
#nomnomnom
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Just spotted our fabulous Speech Therapy Consultant Colleague
@camillacdawson
on the
@BBCNews
website:
Deserved recognition for great work!
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If you could double like, I would have for this from
@iamyourgasman
. Thanks Tamas, well said. There are many attempts at "throwing the kitchen sink" to try to help patients.
#COVID19
needs a systematic response, otherwise we will be back to the age of leeches and blood-letting!
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You can not underestimate the boost that the donation of hot food gave us. The generosity of Restaurants, Fast Food Outlets and other groups when the economy is tight was overwhelming. Thank you.
Thank you so much to anyone who has donated hot food for staff at all of our sites since March. However, we no longer be accepting hot food donations, with a few exceptions. But if organisations would still like to help, please visit our Charity website.
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Did you know that New Onset Atrial Fibrillation (NOAF) in
#ICU
is associated with with worse outcomes for at least 6 months after?
What's more, we don't really know whether to use Amiodarone or Beta Blocker.
We are looking for recruiting sites! Please complete the feasibility form available on our website.
@Whitehouse_ICU
@IngeborgWelters
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#MedTwitter
in the
#UK
Calling all
#ICU
doctors!
The
@NIHRresearch
are asking to compare treatments for New Onset Atrial Fibrillation
#noaf
Are you in equipoise? What are you hoping for your patients?
Thanks in advance
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I too believe that the language of the UK government is similar to that of 1930s Germany
This is the narrative - don't let them spin any other way
Nation shall speak peace unto Nation
WE are the Nation
RT if you agree
#GaryGate
#GarylinekerSpeaksForMe
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After a
#COVID19
delay, the protocol paper for
@StressLTrial
is published in
@BMJ_Open
.
Thank you to all involved.
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***Calling all UK Intensivists and Microbiologists who work in ICU***
We are trying to understand differences in empiric antibiotics for patients with(out) Penicillin Allergy
Please distribute widely!
We are grateful for your time
@UKCCRGroup
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Very moved by
@MichaelRosenYes
on
@BBCRadio4
@BBCFrontRow
.
Mr Rosen is so eloquent in describing how much ICU Nurses care.
Thank you for uncovering some of the mysteries of
#ICU
.
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Absolutely
@aelsharkawy75
.
As cases regress in the community everyone forgets that the
#ICU
pressure remains high. If a patient is going to survive
#COVID19
they stay in ICU for about 3 weeks.
This isn't over for us yet by a long way.
@ganeshran
Still a huge number of patients in
#ITU
beds. This is what is placing a huge strain on
#NHS
and limiting services. Need to see significant falls before easing restrictions IMHO.
@CholestasisDoc
@Whitehouse_ICU
@drdhruvparekh
@cesl1975
@JVLazarus
@jfergus75
@GregDore2
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COVID is not over. Please RT to remind everyone
With COVID cases on the rise, we believe it’s time for decisive action. 2 years on from the beginning of the pandemic, it’s still vital we protect the NHS from becoming overwhelmed.
Read our latest statement on the pressures on ICU here 👉
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#COVID19
will eventually end.
@StressLTrial
will see you again when things settle. Thanks for all of the supportive messages.
Be careful everyone and keep well.
#WashYourHands
#NHSstaff
#NHSThankYou
#stressl
#icuresearch
In response to
#COVID19
the decision has been made today to temporarily halt screening and recruitment to the
@StressLTrial
trial until further notice. Thank you to all of our sites for all your hard work to date. Stay well and best wishes to all
#stressl
#icuresearch
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Ooh! Look!
“Metabolic liver disease is growing in this country, and these patients are going to be presenting to your ICU right now, and we need to understand how to manage them better”.
Join our Liver & Nutrition study day with
@Whitehouse_ICU
to do just that.
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Looking forward to performing in this. Great orchestra, great soloists and, though I say it myself, quite a good choir 😉
Come and see the CBSO Chorus sing Handel's Messiah for the first time!
✨ Handel's Messiah
📅 Wednesday 8 June, 7pm
🎟️
🤩 Featuring John Butt,
@MaryCBevan
, Reginald Mobley (
@doctorfate77
),
@JamesTenorGilch
, Christopher Purves and the
@CBSOChorus
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I'm pleased to say that there will be some news on
@StressLTrial
soon
Delayed announcement here - live announcement on
Watch those spaces!
#icu
#septicshock
#betablocker
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Too right,
@drjen_w
! The sight of senior surgical consultants supporting our Critical Care nurses in an open and friendly way is very touching.
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I know that the BBC was only reporting what Patient 91 said but it saddens me that people believe that we would stop providing organ support after a fixed time. It may be true in countries with private insurance but NOT in the UK
As an ICU doctor, I am insulted by this
@BBCNews
story:
THERE IS NO TIME LIMIT ON ICU CARE! To say that we would have "flicked the switch after 30 days" is utter nonsense. Please do not believe that we do this.
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Congratulations to
#UoB
Medical Student Elise Davis on her poster presentation
#esicm2022
today.
Photo posted with permission
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Amazing!
I got to sing in a World Premiere!
'In This Brief Moment' by
@brettdeanmusic
Brilliantly conducted by
@nicholascollon
Soloists
@Jenni_France
@patrickEterry
speechlessly great!
@TheCBSO
- just fantastic
@CBSOChorus
and
@hallechoir
Wow!
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If you've been part of the Research Response to
#COVID19
, this article from the
@ObserverUK
won't say anything new.
If you missed it, the UK's research response has been world leading. Not world leading in the politician sense, truly world leading.
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I definitely had something in my eye during the Hallelujah Chorus...
👏Congratulations to the
@CBSOChorus
for their first Messiah last night at Symphony Hall with
@MaryCBevan
, Reginald Mobley (
@doctorfate77
),
@JamesTenorGilch
and Christopher Purves! Special thanks to John Butt for conducting at short notice.
@simonhalsey
@JulianWilkins
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As the restart from
#COVID
continues please remember septic shock has a higher mortality rate than many other diseases even cancer.
Continued research is urgently needed to discover treatments and improve survival for our
#ICU
patients.
STRESS-L reaches 114 patients recruited. Thank you to our sites, patients and families for your ongoing support of this vitally important trial. STRESS-L is aiming to recruit 340 patients and looking for sites. Help us today to improve patient care & save lives
#septicshock
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Really interesting and balanced editorial from JAMA about
@StressLTrial
(Although Para 4; sentence 2 "Whitehead" should read Whitehouse 😭)
From the editorial by Steven M. Hollenberg on The STRESS-L RCT
“β-Blockade may have beneficial effects in some areas, such as inflammation and metabolism, but potentially deleterious effects in others.”
Published w/
#LIVES2023
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Congratulations
@AndersPerner
We with
@NIHRresearch
will start the
#ABBRUPT
study into New Onset Atrial Fibrillation
#noaf
in
#icu
- a prospect study of just amiodarone vs beta blocker with the Outcome of 90-day mortality
@IngeborgWelters
@DarkNatter
@dfmcauley
AFIB cohort study from 44 ICUs in 12 countries published
AFIB occurred in 16% of acutely admitted ICU pts
Associated with worse outcomes
Diagnostic and therapeutic strategies varied considerably calling for clinical trials
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Just been to the pantomime at
@brumhippodrome
@JDonOfficial
is a great sport; he and the rest of the crew camp it up magnificently.
There's a circus and giant puppets. Motorbikes! Real motorbikes on stage.
Great evening!
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OK
#UKMedTwitter
, we are applying to
@NIHRResearch
to study short-course antibiotics for Hospitalised CAP. Would you be interested in your site taking part? Details later but we think it's an innovative design. RT pse
Please fill in our survey at:
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Pleased to be able to answer questions about the forthcoming ABBRUPT trial.
Opens in April
We are comparing
#BetaBlockers
with Amiodarone for New Onset Atrial Fibrillation I'm the critically I'll.
Thursday evening Louise Thwaites
@TomHellyer
@KeithCouper
@agordonICU
@bronwenconnolly
@Whitehouse_ICU
and More
#UKCCRF24
#bepartofresearch
@iceman_ex
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If there's one thing I've learned over the years is that if you're the only one in the room who thinks you are right, it doesn't matter whether you are.
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@DocEd
We have a version in our hospital. Please feel free to come and see it in action.
Every hospital I've worked in has their own version of the ICU chart and so you have to get used to the new layout every time you move jobs.
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Thank you
@joshweilerstein
@simonhalsey
@TheCBSO
and
@CBSOChorus
for a momentous evening.
Imaginative programming from
@stephenm68
and the team demonstrating the full dynamic and emotional range of the CBSO.
It might have taken the best part of 100 years to have its UK Premiere, but some things are worth the wait. Thanks to everyone who joined us for Dett’s The Ordering of Moses tonight & of course our fabulous soloists, conductor
@joshweilerstein
& the
@CBSOChorus
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Once you've taken up an position so vocally, it's difficult to do an about-turn.
But that's OK
#itsoktochangeyourmind
#getavaccine
#vaccine
#booster
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Congratulations
@drdhruvparekh
🎉Congratulations to
@drdhruvparekh
on being selected for
@acmedsci
FLIER programme! 👏 Dhruv is 1 of 19 participants joining
#FLIER3
to develop future leadership skills for collaborating across academia, industry, the NHS & government 🙌
🔗Press article:
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There are so many times when patients have benefitted from an ODP; handing the right airway equipment at the right time, sorting blood and blood products; getting the right drugs at the right time and so much more. Under-celebrated.
#ODPday
#odpday2022
Today is National ODP Day!
Operating Department Practitioners (ODP) provide skilled care for patients at all stages of their operation – from when they arrive in the theatre department, to discharge from the recovery room.
Thanks to all our ODPs and theatre teams.
#ODPDay
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Sandra gets it. Do you?
Although the scrubbing brush is a bit too Lady Macbeth for my liking
#COVID19
#WashYourHands
Sandra the orangutang started washing her hands because she saw all the zookeepers doing it repeatedly during the COVID-19 crisis.
Wash your hands.
Be more like Sandra.🌎❤️🧼🌎
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Thank you to all our sites
@StressLTrial
@WarwickCTU
.
We are keen to finish our recruitment and understand Beta Blockade in Septic Shock
#sepsis
#septicshock
#WorldSepsisDay
1⃣0⃣ sites have now restarted recruitment to
@StressLTrial
Welcome back St George's!
@stgEDresearch
@StGeorgesTrust
#ICUclinicaltrials
#WhyWeDoResearch
#septicshock
@WarwickCTU
@EPPiC_Warwick
@CRN_WMid
@Whitehouse_ICU
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Oh my!
It looks like if you have a job where you can't work from home or can't isolate adequately, you are at a higher risk of death.
Yes, there will be other risk factors too - poverty, over-crowding, nutrition etc - doesn't make it any better though, does it?
When looking at broad groups of occupations, the highest rates of death in men were in:
▪️ elementary occupations, with 66.3 deaths per 100,000 males
▪️ caring, leisure and other service occupations, with 64.1 deaths per 100,000 males
➡️
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Looking forward to joining
@ICS_updates
virtually for the
#soa21
@Whitehouse_ICU
@perkins_gd
@hugh_montgomery
@dfmcauley
will debate rise of platform studies. Is this really the future of all ICM research ?
#soa21
6-8th December
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@drandrewmackay
Na! The 5 words that induce rage are "I'm not having a vaccine"
#doctorsforvaccine
#GetVaccinated
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If someone isn't very good at arranging things, shouldn't we now say "Couldn't organise a p*** up at No 10"?
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It's been a busy few days at
#soa23
so this is a bit late!
Thanks to
@TasPirani
@ICUbreeno
@bangash_mansoor
& Bryan O'Farrell for a lively & fascinating session on
#ACLF
Hope we can begin to discuss moral and ethics around the transplant soon
Thanks
@ICS_updates
- great meeting!
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@stephen_t_webb
Queuing for 20min (or missing lunch altogether) is the norm. Cross-site working is impossible when parking is a 20min walk away. The loss of secretarial assistance makes no financial sense when the time taken for typing our own letters or organising diaries is cost
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Fabulous 2min read from
@hugh_montgomery
. Also highlighting a fabulous charity
@ICS_updates
that has helped support and inform staff, patients and relatives through
#COVID19
Guilt, flashbacks, anxiety: intensive care work is brutal, but you can help
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Very happy to announce that
@AdaptSepsis
is now open at
@uhbtrust
Queen Elizabeth Site (having already been open at our sister Heartlands site).
Screening from today!
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#MedTwitter
No-one should be looking at their mobile phone during handover unless there is a family emergency or you're looking something up relevant to patient care.
Am I wrong?
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Deeply, deeply touched by this. Our patients are so brave and still remain so thoughtful. Thank you ☺️.
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