David Oliver (also on Blue Sky)
@mancunianmedic
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NHS Dr 36 y. Covid wards++ Gov, policy, academic, officer roles. Byline: @BMJ_latest. Columns: health press, papers. @mjauk. Manc-in-South. MCFC. Craic. Schlock
South East, England
Joined June 2014
this is the most sinister thing i have seen on twitter today
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It has not escaped my attention with the Lucy Letby verdict and reporting that the consultants in the department repeatedly raised concerns about her and were warned by managers to stop complaining "or there would be consequences" for *them*!. When will NHS execs learn?.
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it is astounding - and like nothing i have seen in 27 years as a consultant.the number of older people now admitted entirely due to housing, isolation, lack of social support, self neglect, safeguarding and with no acute medical needs of any kind.But hospital only response.
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how on earth did we ever get to the stage when it was removed? .
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"50 year old Karens" keep families, society and workplaces going and hold them together - not least as parents, grandparents, carers, local volunteers/activists and key employees/bosses. Society would be much the poorer without them. So back off.
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Labour have not made a perfect start. And their policies are not perfect. But would anyone *really* want the discredited collection of spivs, charlatans, self-servers, incompetents, ne'eer do wells, and links with dodgy donors we had in government of late back any time soon?.
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"We will shorten, narrow and cheapen training, dump responsibility and cost onto employers and ignore what expert clinicians outside government roles are telling us is required".
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As James Dyson was a very enthusiastic Brexit-pusher.Was in the "VIP Lane" during the pandemic.And moved his company HQ to Singapore.And has bought huge tracts of farming land. I am not sure we can take his self-penned rant in today's Times seriously.
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Not as disappointed as the Labour opposition was when you closed down sure start, slashed local government funding (and hence social care and funding to 3rd sector orgs), held a daft vanity-driven Brexit referendum, let Gove run amok with schools and Duncan-smith with welfare.
I am deeply saddened and disappointed that the new Labour Government has decided to close down National Citizen Service, @NCS. I began pilots for NCS in opposition, to help build bridges across social divides. Young people from different backgrounds, different areas of the.
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The irony is not lost on me of Chris Whitty - a man who is relentlessly honest, candid, transparent shows real integrity &prepared for straight talking, irrespective of any personal abuse or attacks that result. Getting flak precisely for being honest and and open yesterday.
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I have been a consultant working in geriatrics/acute general internal for 26 years now & a junior doctor for 9 years before.And i can never remember seeing so many patients who come in with an acute medical problem only for us soon to discover their housing situation is appalling.
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BBC reporting a national guide dog shortage.But the government have proposed to. Shorten guide dog training from 2 years to 6 months. Provide an apprentice route for fast track dog training. Have guide dog associates to be supervised by actual guide dogs. Introduce guide cats.
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You shall have no Dishy.Sorry, little Rishi.You shall have no Dishy.When the Vote comes in.
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I often look at the multimillionaire Tory front benchers and think "how that rich?" (especially unimpressive ones). Jenrick qualified as a solicitor in 2008. Worked in commercial law till 2014 then became an MP. yet he reportedly owns 3 properties with a net value of £6m. How?.
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Let us never forget that the Tories actually DID make Truss and Johnson Prime Ministers!.
Let us never, ever forget that Starmer and Labour tried to make this man Prime Minister.
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It is almost as if removing the bursary.worsening terms and conditions over many years.offering an inadquate pay settlement .and making working lives miserable.And bullying/lack of support form own line managers.Is not good for recruitment.Who knew?.
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speaking to a consultant colleague today - two children are doctors (FY1/2 level) & both are going to leave medicine cos can't even afford so much as rental on a basic flat and after 5-6 years on a study/content rammed degree course that rejects 85% of applicants and needs A A A*.
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OK .I will say it.I have severe doubts about switching a conventional 5 to 6 year medical degree (not just for people with first degrees in STEM subjects but all) to 4 years, about further shortening postgraduate training and about the crazy gimmick of "doctor apprenticeships".
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It has only taken me 58 years including nearly 35 as a working nHS doctor to realise that if you get hit with a virus you are better off resting up and staying at home or else risk the whole thing dragging on for far longer. Docs are shockers for feeling guilty and poor self care.
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much of worst behaviour i have seen in the NHS is from clinically registered staff on higher pay bands, who have not done patient facing clinical work for years despite often wearing cosplay uniforms - . towards clinical staff on lower bands who still work directly with patients.
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The Bibby Stockholm could be moored on the Thames at Westminster. And used as the London residence for Tory MPs with constituencies too far to commute to. Although i suspect they'd want to check it for fire risk and legionella before moving in.
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something has gone badly wrong with workforce planning where we simultaneously have UK medical graduates from our expanding medical schools unable to secure posts at every grade, yet still relying so heavily on international grads to fill posts (mostly from "red list" countries).
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lots of comments yesterday from people who have little idea what it is like to work day in day out in acute hospitals with no bed capacity, crumbling, outdated buildings, A&E departments far too small for 100s of attendances every day, exit block for people needing community care.
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"Labour will force NHS staff to work weekends". In 35 y as a doctor, I've done c 400 weekends & another 100 Bank Holidays. If i was imagining all the other staff on the wards, I am doubting my sanity. Gaslit!. And wife now thinks I'm a bigamist with a 2nd family. Cheers, Wes.
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the only thing necessary for the triumph of evil is for NHS executives to tell clinical staff to shut up and stop complaining.
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Making digital the main modus operandi for contacting over 75s about covid or flu jabs is bloody stupid. Guaranteed to ensure lower uptake. Digital exclusion. Imagine inverting this and only contacting younger people by landline phone calls.
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"assigned"??. It isn't the fucking sorting hat from harry potter
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@RoshanaMN i have just been reading his tweets. he is a religious fundamentalist who believes in complete subjugation of women to their husbands and that this is what god wants for them. vile. Mind you. That kind of thing ain't confined to christianity.
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One of my medical colleagues today told me a patient has said to her that during Covid restrictions "people became a hunk, a chunk, a monk or a drunk".
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anyone who thinks junior docs are making things up about PAs taking operating theatre/minor procedures/clinic slots because they are embedded and not on on call rotas, and then leaving al the ward jobs to the actual doctors should speak to the docs affected. It is very real.
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and once they are in hospital all urgency vanishes as "place of safety" and acute care is on a stopwatch not a calendar. this is the impact of years of cuts to local government, adult social care, housing, support for carers and the growing atomisation of society.
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within 1 minute of Steve Barclay going on with @SophyRidgeSky #ridge she stops him and says "yes. you've got your headline in now can we answer the question". I can't imagine Laura K/Fiona Bruce doing that to a Tory - even though Victoria Derbyshire certainly would.
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i think it would be good for every NHS manager who has a clinical degree to be made to keep their clinical registration. that way they would still be subject to GMC/NMC codes. and they would have to do enough hands on clinical work to keep registration/revalidation. Win/Win.
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I have been an NHS doctor in acute care since 1989 . My then girlfriend and now wife now thinks that all those times i disappeared for a whole weekend in the hospital i was having an affair. Cheers. Wes
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call me old fashioned.but if i had a teenager who had been abused by a much older man.i might report it to the police .before telling The Sun.(which routinely posted semi-naked pictures of female teens on Page 3 for years). Priorities, innit?.
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As a consultant who looks after a big 28-30 bed ward all year round, year in year out, in addition to my committments on AMU/ take, the most important constant working relationship i have is with the charge nurse/sister . Ours is a bloody marvel!.So were his two predecessors.
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Just a reminder that this man - at the start of his disastrous reign of error as education secretary scrapped the schools building programme within weeks of taking up office (with cummings at his side). Concrete achievements
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I am not sure who is giving him PR advice. But coming out fighting by saying "they were all posh over-educated menopausal birds and by the way, loads of female contestants tell dirty jokes". Is not perhaps the best move.
BREAKING: Gregg Wallace says accusations against him come from 'middle-class women of a certain age'.
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The embargoed press release for the @NHSEngland Long Term Workforce Plan on Thursday was released 12 hours before the actual 151 page plan (which people had neither seen nor read at that point). The gushing, cheerleading, uncritical praise in numerous quotes was a serious mistake.
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something wrong with our political discourse when . "but you supported Jeremy Corbyn" is weaponised against people. yet "but you supported Johnson/Truss/Patel/Braverman" is not weaponised in the same way. I am not a J.C. fan but he was far less of a danger.
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there is a special place in hell reserved for qualified nurses and doctors who leave clinical practice go into pure executive, national or regulatory roles and then bully/threaten/silence or slave-drive their former colleagues as they focus on "managing upwards". Betrayal.
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#covidinquiryUK . Hugo Keith KC totally humiliating Hancock by quoting from mis meticulously sourced 572 page book detailing events in the Covid response just after Hancock claimed he had no documentation and no recall.
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I am so old, i remember when lots of Australian and Kiwi doctors used to come and work in the NHS.
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In Room 101. Patients with money & snobbery who insist on going private. Get too sick for any private hospital to cope with so they come to us. We rescue them. And even when they are still too sick/complex insisting on going private again. And wanting us to be a concierge.
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never mind re-living the trauma of what it was like working in acute/critical care during peaks of Covid pandemic. currently reliving the trauma of people on twitter claiming none of it actually happened and there was nothing to see.
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Calling Sikora "Britain's top oncologist" when he hasnt worked in the NHS for 27 years is like calling Glen Hoddle "Britain's top footballer".
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anomalies in AfC banding. Ward manager with years of experience, in charge of a ward/a big ward team/budget all year round . Is on a band 7. But so is newly qualified PA without the same experience or responsibility. Newly qualified SALT/Physio/OT with a 3-4 year degree -on a 5.
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@MichelleMone only it turns out that Mark Williams Thomas and his team made the Youtube documentary without making it in any way clear to experts like me who were interviewed in good faith that we would be used to try and lend credibility to your cause or that your company was funding them.
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Sunday Times story on unqualified Banker Richard Meddings - the @NHSEngland chair spending 11 hours in local A&E with his wife & experiencing things first hand but not telling the staff what his job was. Speaks volumes. No NHS clinical staff would recognise him or know his name.
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I know and respect and admire plenty of journalists and count a fair few as friends. But if i see one more right wing journo saying that NHS clinicians are nothing special for working nights and weekends with sick/dying people because they had to work overnight on stories. 🤦♂️.
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35 years since i started as a newly qualified doctor myself. What do they face this year?.Not enough Computers-on-Wheels. Some broken.Very poor battery life. constantly replugging.Very unstable wi-fi connection.Screens requiring constant re-log in.Awful software.
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Just home from 12 hs in acute medical unit and ED. And both there and on the wards. Influenza.RSV.Covid. Surging again . It will be an interesting Winter in acute adult medicine. And staff will be hit too.
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i have seen several people this week alone for whom there is no acute medical need but no other community response was possible even after referral from acute front door.
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I have heard tell:. 1. Hospital trusts will pay nursing/AHP/medical agencies higher rates to fill unfilled shifts than they are prepared to pay their own staff to take them on . 2. Would rather leave shifts unfilled than pay enhanced rates to staff on own payroll. Fair comment?.
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they get paid more (when newly qualified) than experienced district nurses with advanced practice skills, seasoned nurses in charge of whole wards all year round or senior Physios/OTs who lead whole teams of therapists.
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OK I'll say it. The number of stranded patients in hospital waiting for a glacial response from under-resourced social care and community health. Is making the job a miserable groundhog day of apologising to people we can't help for things we can't control. Burnout fuel & grim.
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Never underestinate the strong bond between consultants and nurses they have worked alongside for years and years together through plenty of shared stress, trauma, laughs , ups downs, shared history and memories. Strong solidarity and loyalty.
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i hear radiographers are only providing a skeleton service today.
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RSV winning the race against Influenza, Covid and Norovirus today at the hospital. RSV everywhere.
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I see Sarah Vine in the Mail-on-Sunday trying to blame the riots and Huw Edwards on Keir Starmer - who has been in power for 4 weeks.
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clearly, a serial child killing nurse is a very rare thing. But clinical staff who raise concerns/blow the whistle being slapped down/silenced/warned/disciplined/constructively dismissed. And trusts being more concerned about news management/bad news suppression is all too common.
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Just what the Tories and their mates wanted all along.
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"because all the surge beds from last year are still open and because we wasted loads of money forcing expansion of very poorly evidenced "virtual wards" and because there remains no solution to social care and we are too timid to say this to the politicians".
NHS England director warns 'we can't surge beds and capacity' this winter
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It is precisely 1 year since i resigned from RCP President-elect & never started. I was pretty ill before & after and then having got better, spent the next 9 months boring the arse of myself, my wife and everyone else i know beating myself up over it. 12 months is enough. End of.
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the being duped and manipulated is understandable. but the slapping down and silencing and warning senior doctors who still practiced clinically (unlike Ms Rees) when they raised concerns is not understandable. 2 separate things.
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acute care ends up being the default for any kind of crisis.
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remember Grenfell, scandals in children's homes owned by private equity, polluting water companies, dodgy PPE contracts or P&O treatment of workers. When you hear likes of Tufton Street, Rupert Lowe or RIchard Tice arguing for "a pared down state, deregulation, slashing red tape".
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@AdamBienkov When he said "we want a prime minister who has a personality, who is known, who can represent britain on the world stage". He didn't specify who that might be.But i had a strong sense he meant either "Boris Johnson" or "Nigel Farage".
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Anger as NHS Car Parking Scandal Worsens.With patients shelling out £146m to private companies. (Not to mention staff being "fined" for parking at their own workplace while doing shifts).
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A young Scottish guy with floppy hair and a white T shirt who has been on same carriage as me ever since Manchester 0927 has been an absolute arse the whole way down the country .And he is continuing his form by having his phone & own voice on speaker at max vol for us all.
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No useful purpose served by weaponising grim conditions for junior doctors in 70s/80s/90s to attack current generation who also face a whole set of challenges - some old, some new. "Think you have/had it hard?" race to the bottom intergenerational culture wars help nobody.
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i had a tiny little male insight into travails of clothing sizes for women this morning. Annie went shopping for tops yesterday. She is a petite size 8/10. Got two shirts. One is a 14 and the other is an 8. She just tried them on to show me. The 14 is actually smaller!. WTAF?.
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I am starting to feel a bit old for this looking after a big inpatient ward and the acute medical take year round schtick. Almost 60. Fat. Unfit. Sleeping like crap. I am fine once i am at work but recovery time longer and dragging the old bones into work gets harder.
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There is no point blaming jobbing shop floor NHS nurses, doctors, HCAs, AHPs for overcrowding, delays, short staffing . But guess what? It is us who get all the aggravation and not senior managers or NHSE/DHSC folk a healthy distance from the clinical shop floor.
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Next?. Classroom teaching assistants running PGCE programmes and in-service training for qualified teachers?. PCSOs teaching at the police staff training college?. Paralegals teaching the bar exam?.
I really don’t know what to say. Is it appropriate to have a PA teaching medical students or F1/F2 doctors? .
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letter in the paper today pointing out that if you go on NHSE websites and look for information on cervical/ovarian cancer it avoids saying "women" or "females" yet if you look for prostate cancer it quite openly says "men".
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So far I have done 34 years in the NHS and 6 years getting degrees to join. Put together with my father who did 37 yrs & 5 Yr degree (we overlapped for first decade of my career). And my grandparents who grew up poor remembered when it wasn't there. Grateful to be on board.
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why the fuck is michael mosley on as the expert talking head on the NHS.he barely used his medical degree to practice medicine.got rich outside it by flogging health lifestyle stuff.likewise Lord Bethell who was an unelected junior health minister with no relevant background.
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I am a Labour supporter and glad they won. And i realise the need in political comms to repeat messages ad nauseam. But if i see one more Labour spokesperson say . "3 big shifts. Hospital to Community. Analogue to Digital. Sickness to Prevention" . I will smash the TV/Radio.
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Interesting. I can't really wrangle a news story out of this, and i clearly won't get any on record quotes so i will just post it on line. I FOI'd @NHSEngland to ask them about the decision made a few months back to end access to @NHSPracHealth which has helped so many doctors.
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If PAs are medical practitioners practising medicine how come a dr cannot be employed as one?. An Advanced Nurse Practitioner or Paramedic Practitioner can still decide to work as a jobbing nurse or paramedic on a different band. And i cannot get a job as a physio or nurse.
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DIY mare . I manage somehow to put a new seat on the small downstairs loo. But in pulling myself off the floor in a confined space, i pull the sink off the wall (it appeared to have been glued on by the plumber). This is why I don't do DIY.
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58 today.Where did all that time go?.I do seem to have indestructible perma-hair mind you despite being twice as fat as i was in the 1980s
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Mrs O re Oasis. "If i want to spend all day watching grumpy dark haired men from south manchester, i don't need TV news to do it". Harsh.
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maybe NHS England can announce a standard national colour scheme for Fridges so each profession and grade can know which is their fridge.
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when i was getting the coffees in for my team today at the end of our ward round, none of them had heard of the film "Groundhog Day" . Mind you, a few weeks ago, none had heard of Rex Harrison or My Fair Lady. My cultural reference points clearly receding in rear view mirror.
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"I will GMC you". is the new. "I will DATIX you". Both piss poor behaviours.
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I got a "CC Everybody" email this morning from Amanda Pritchard reminding me to put shoes and a shirt on before coming into work and to avoid drinking neat scotch from a bottle on my ward rounds or chatting up CQC inspectors and asking them out mid-inspection
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And Yet Old Etonian Boris who read Classics at Oxford and wrote Torygraph/Specator Columns and came from a posh background was not?. Starmer is from an ordinary background, went to a day school, did his first degree at Leeds.
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#battlefornumber10. It is a strange world where there are people who think is is a *bad* think that Keir Starmer worked for years as a human rights barrister and as director of public prosecutions before entering politics. It beats being a career politician or a hedge fund bro.
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On acute take it seems that Covid (of the respiratory/hypoxic/admission-requiring kind) is making a modest come back.
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this would certainly "energise" me. sprinting for my life right out of the door, out into the street and breathlessly coming to rest several streets away, once i could be sure i was safe. just like enforced group dancing at medical conferences
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6 degrees of separation.I have a medical student on ward called Unwin .He sounds like a fellow Mancunian.I ask him where he is from "Trafford".I ask him if he has anything to do with Unwin's Greengrocers in Chorlton-cum-Hardy (very familiar to me from childhood)."My family". .
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Covid.RSV.Influenza A. The triple threat.With Norovirus coming up on the rails. An awful lot of it about in acute care again, sadly.
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George Osborne is a malign Mr Benn figure. He becomes Chancellor with no background in economics.Editor of Evening Standard with no background in journalism.Banker with no background in banking.Chair of trustees of British Museum with no background in museums/history/archaelogy.
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Just trying to get home after 12 h of strike cover in A&E /AMU. All roads round house closed cos deep flood. Back in hospital early tomorrow. Option is either get hotel or park car a mile away . Get into trainers and trackies and walk home. Dont want wife facing flood alone.
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is there any skilled, learned, safety critical profession where shortening training, reducing training requirements, or replacing wherever possible fully qualified graduate professionals with less qualified or trained ones will improve the quality or safety of services?.
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