Chair of UK Council @theBMA Anaesthetic Consultant he/him tomdolphin on the butterfly app

London
Pleased with the DM article that accurately sums up some of the values I live my life by (albeit they used some unkind words to do so), plus they chose a flattering photo. Anyone feeling solidarity with me is very welcome to donate to the Strike Fund too! bmastrikefund.raisely.com/
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For god’s sake, please just tax me properly and spend it on some public services
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Do me a favour: if you know someone who has gone out socialising tonight, text them and tell them that I would willingly take them to intensive care in 8 days' time but there might not be a ventilator left by then, so it's up to them, really. STAY INDOORS. THIS IS NOT A DRILL.
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I've now had 3 people tell me in the last 24 hours that they have broken lockdown, citing Dominic Cummings as justification. His resignation is genuinely required as an urgent and powerful public health intervention; people are flouting the rules bc he did without consequence.
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I think it's probably not right to claim the NHS "coped with the first wave of covid". Yes, we avoided a triage situation of choosing between covid patients for the last ICU bed. But that was bought at the cost of stopping everything else. That's not coping, it's redistributing.
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You don’t get breathless and hypoxic from a false positive covid test result. Our hospital beds are not filled with people who have had a positive covid result and are worried about it. They’re filled with people who are sick, breathless and terrified. They’re not imagining it.
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Just overheard a guy on the train telling someone on the phone, “Yeah Covid’s over now mate, I’m not wearing a f— mask, I’m not a f— sheep” Boris’s message is getting through 👍👍 And when I glanced over, he saw me look, and threatened to “f— punch you”, in front of his kid. 👍
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Hospital after hospital is activating surge plans and redeploying staff or declaring major incidents. We haven't even got to the part where Christmas gathering-related infections show up at the hospital yet. This feels worse than March, perhaps because we all saw it coming.
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I still can’t quite believe we’ve spent £37bn on a Track and Trace system that doesn’t even note down which test kit gets sent to which address
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Just got my payslip today with the income from covering junior doctors during their last strike. I've donated it to the BMA strike fund to support the pay campaign. Pay deductions for striking mean some couldn't afford to strike without this support. bmastrikefund.raisely.com/
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Very disappointing to see NHS England insisting GPs return to face-to-face when it’s been available for people who need it throughout the pandemic. On top of trying to deliver a vital vaccine programme, now GPs are being vilified for no reason, assailed by unreasonable demands.
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A quarter of a BILLION pounds of public money for an unnecessary and brief ceremony, but they can’t find funds for NHS staff to be paid properly, and food bank use is at an unprecedented high. Tell me again how they’re focusing on what the people want
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Well, changing the medical degree so it’s unlikely to be recognised by other countries is one way to stop the exodus of doctors out of the UK, I guess
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That doctor telling Sajid Javid that he doesn't want the vaccine because he already has antibodies from having had covid before overlooks the point that he *survived* that infection. There's no such thing as "natural immunity" to covid, only "surviving the infection".
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Three years tonight since the first of the claps for the NHS We appreciated the claps! If you meant it then, please support doctors, nurses and other NHS staff now, as they campaign to make their pay worth as much it was before years of austerity and inflation stripped it away.
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Why is it that every time someone proposes reform to the NHS, the same people pop up suggesting “a small fee to see the GP”, apparently unaware of or uninterested in the obvious effect this will have of shutting the poorest in society out of primary care, early detection, etc.?
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I'm working a night shift tonight to keep patients safe while junior doctors strike to restore their pay. I will be donating the income from this night shift to the BMA strike fund. Consultants, please consider doing the same, to strengthen the strike! bmastrikefund.raisely.com
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The government thinks they can wait junior doctors out. This is a test of your resolve. I think ministers will find it harder than they expected to outlast a group of people who can go for twelve hours without a drink of water and barely notice. You’ve got this.
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A very gracious apology, thank you @LeeAndersonMP_ Thanks also for the donation; I hope it inspires others to donate to the Strike Fund as well. BMAStrikeFund.raisely.com (Here’s my original tweet that Lee was referring to: nitter.app/thomasdolphin/status/1… )
On the 6th October 2023 I shared a link on X to a Mail Online article entitled ‘Militant union leader at the heart of doctors strikes is a Labour activist who boasted of charging the NHS for a strike cover shift. I accept that my words were misleading as the subject in question Dr Tom Dolphin was not on strike on the date of the shift in question but was simply covering a shift as a consultant for junior doctors who were on strike on 11th August 2023. I would like to offer my sincerest apologies to Dr Dolphin for any distress upset caused. I will also like to add that I understand that Dr Dolphin actually donated his pay for the covered shift which I believe was £1870 to the BMA strike fund and whilst I do not agree with the strikes I want to go on the record to say that I think it is a very unselfish act on the part of Dr Dolphin to put his money into something he strongly believes in. I will make the same contribution to compensate the upset I may have caused Dr Dolphin. Please Repost.
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Like, if I call for an ambulance I’d like one to come. If I lose my home I’d like to know I won’t have to sleep rough. If I drink a glass of tap water, I’d like it to be clean. If I report a crime, I’d like the police to care (and for it to come to court in less than two years).
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Strong backing from the public today for striking nurses - up on the 13th floor we can hear cars honking in support every few seconds, and cheers from the picketing nurses in response 🚙💙 You can show your support by donating to the strike fund here: action.rcn.org.uk/page/11740…
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Incredibly touching to hear the applause (and fireworks!) erupt from the windows and balconies around me on the way home from the hospital. Thank you so much everyone - we really value the support you’re all giving us as we do our best to be there for you. 💙💙💙 #ClapForCarers
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The plan to force trans people to use single-sex facilities on the basis of their pre-transition gender is cruel, unworkable and almost certainly illegal. It also makes little sense within its own bubble: how will women feel safer with big bearded trans-men on their women’s ward?
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Thank you to all who so kindly replied. I’m fine, I just walked away. I’m lucky to live in a society/century where personal violence is relatively rare (and I have male privilege), making this unexpected and grim. Gotta just keep on following the Golden Rule, I guess. Stay safe!
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All the “fat” in the NHS that the Govt thought they could cut back to save money was, in fact, capacity to manage peaks and troughs in demand. Now we have no elasticity at all, and the winter peak has stretched the NHS beyond breaking point and people are dying as a result.
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We nearly got to this point in the UK, just so you know. We stopped using propofol infusions in theatres bc it was all being used up in ICU. We also nearly ran out of muscle relaxants. We racked our brains to think of alternatives. Restraints weren’t on the agenda here, AFAIK.
Some Brazilian hospitals have run out of sedatives, forcing doctors to use restraints while coronavirus patients are intubated "I never thought I would be living through something like this," a doctor says. "The patient is submitted to a form of torture" reuters.com/world/americas/b…
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I'm baffled that people are still unsure whether to cancel work Christmas parties, especially in the NHS. Can the service/company afford to lose an entire team to isolation at once? Do they expect case numbers to get suddenly better in the next week? What are they waiting for?
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The problem we had at work with pigeons coming into the office through the window appears to be escalating.
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Parliament Square is FULL today - people spilling over into the road - thousands of people turned out to defend trans rights: trans people and c1s allies here to show transphobes that they haven’t won, not by a long way 🏳️‍⚧️🏳️‍🌈 #TransRightsAreHumanRights
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Meanwhile again today operations are being cancelled because staff are off sick. Wards are understaffed, leading to greater risk of mistakes, stress for staff, and reduced quality of care. Appointments are being postponed. Covid really isn’t over, even if all the pubs *are* open.
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I went to a medical school event last night. Chatting afterwards, a startling number of final year students have already decided to go abroad, at the earliest opportunity. There’s a slow motion workforce crisis developing but Govt is ignoring it and trying to bluster through.
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We want our pay to be restored to the value it had in 2008. They’ve restored our pay to roughly the value it had last September. Good enough? No, I didn’t think so. “No more talks on pay” - brave words, Mr Sunak. Keep striking. That’s what will bring them back to the table.
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Do you have an upper limit in mind for the number of healthcare staff who have to die before you’ll take responsibility for the lack of PPE, @MattHancock? @patel4witham @BorisJohnson? Is it 50? 100? 250? Is that why you’re not counting our deaths, so you’re not held to account?
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If you’re a consultant or work with consultants, it’s important to pass on this warning: the next 48 hours of media coverage will be relentlessly negative about doctors. They’ll harp on about private work, pensions, inflation and all kinds of nonsense. Forewarned is forewarned.
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Superb turnout from striking junior doctors across the road from Rishi Sunak’s office. I’m sure he can hear the cheers and the honking of passing motorists showing their support for #FullPayRestoration
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We keep being told by certain talking heads that @theBMA’s strikes are not actually about pay, they’re just political. Well done @RMTunion for showing that the Government’s refusal to talk to junior doctors is not actually about pay, it’s just political. bbc.co.uk/news/uk-england-lo…
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Today I want to highlight another unsung group of NHS staff: ICT workers. In just weeks they've set up home working for 100,000s of NHS staff, rolled out virtual outpatient clinics for millions of pts, and connected pts isolated on the wards with their families. Thank you 💙
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I am not interested in hearing from covid deniers about how hospitals are actually half-empty, or that we're making this up. Wishful thinking is a hell of a drug, but I'm afraid this is really happening.
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I'm proud of my consultant colleagues for standing together. Nobody wants to go on strike, but we will if that's what it takes. The NHS is haemorrhaging staff and a business plan that depends on staff accepting their pay declining by a third (and counting) isn't sustainable.
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Thank you to @piersmorgan for retweeting me. It's unfortunately led to a fair number of abusive tweets from people with UK or England flags in their bios - with one hand Piers giveth... 😀 Muting the thread for now, thank you for all your comments and kind feedback.
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As I've said in another tweet, Cummings isn't solely responsible for lockdown adherence weakening. But while he so publicly goes unpunished for breaching the rules, it undermines the sense that *other people are adhering* which is so critical to a collective behaviour holding.
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Sad that @DawnButlerBrent has been forced to close the office for safety. I was there once when someone tried to force their way in wielding a metal club. The polarisation of our country is making it dangerous to speak out, more so for black women. standard.co.uk/news/london/l…
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Starting the year as I mean to go on, injecting people with tiny harmless bits that look like the bad thing, so they are prepared for the real bad thing when it comes at them
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Consultants/SAS Drs: before you leap forward, well-intentioned, to cover juniors’ shifts during the strikes, remember to demand BMA card rates. It adds pressure. You can donate the difference to the strike fund if you want. But taking the shift too cheaply undermines the juniors.
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Another strike cover shift, another donation to @TheBMA Strike Fund. If you’ve had strike cover shifts, please donate the first hour’s income to the Strike Fund: bit.ly/48i54Y1 It supports people to strike, meaning the strike is stronger and the win will come sooner.
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I'm not saying people who display flags are abusive. It's the other way round: the abusive people disproportionately seem to have 🏴󠁧󠁢󠁥󠁮󠁧󠁿🇬🇧 flags, and don't do the flags or their compatriots any great honour by using the flags as a shield for abuse masquerading as patriotism.
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Yet again people who are in favour of continuing some public health measures - masks on buses, venue check-ins, etc - are called "pro lockdown" when I think you'll find we're actually ANTI-lockdown, as in we want to reduce case numbers so we don't have to actually *lock down*. 🙄
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All this faux concern from the government about patient safety is strikingly absent when it comes to legislating for safe staffing levels, or indeed actually paying staff properly so they don't leave the NHS for better paying jobs in other professions or other countries!
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It's fine, I expect the NHS will be understanding and ask me to work 6.5% less this year to reflect my real-terms pay cut, so it'll all even out in the end
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In the meantime there are foodbanks out there who need your help, if you’re lucky enough to be in a position to offer it, eg through @TrussellTrust or @SufraNWLondon
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Thank you to all the senior doctors continuing to keep patients safe for the third night as the junior doctors' strike continues into the morning. This is merely the end of the beginning, and there will be more days of strike action to come unless the government sees sense.
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NHS staff working brand-new, tough rotas, willingly upending their leave and rest arrangements at zero notice to meet the demands of Covid on the NHS, are being told that their pay arrangements for this period will be sorted out "when this is all over". Not good enough, sorry.
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Tonight I'm doing a registrar night shift as strike cover. I will be donating the first hour of the extra strike cover income to the BMA Strike Fund, to support more doctors to take part in the strikes and strengthen the pay campaign. Will you match this? BMAStrikeFund.raisely.com
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Doctors: buy your new house officers lunch in their first month - they have max debt, no income until the end of the month, and some are literally going hungry because they can’t afford to buy food. Don’t ask them as they may be embarrassed; just do it. thetimes.co.uk/article/buy-n…
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Really pleased that finally - after So. Many. Emails. - we’ve been able to turn off the nitrous oxide manifold (wall supply) at my hospital and introduced an alternate supply. This will be a ~~1% cut to the hospital’s carbon footprint just by turning this valve! 🌿
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The NHS needs to value its staff properly if we are to recruit and retain people to do the work needed to bring the huge waiting lists back down. We aren’t worth a third less than we were in 2008. We’ve tried asking nicely and the government won’t even reply to our letters.
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Oh yes, we should discharge all those patients we're needlessly hanging onto when they could just be sent to the many, many available care home and nursing home places that we definitely haven't run down over a decade of systemic neglect THERE IS NO SLACK bbc.co.uk/news/uk-64005274
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How on earth do they expect a hospital to run at the weekend if the coffee shop is shut?
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I'm deeply worried about Jan. It'll be hard to sustain much elective work (it would be hard in a normal winter, let alone this year). The problem is staffing. Everyone's exhausted and demoralised. And yet the staff plough on because that's what they do: cope. Or so we hope.
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I'm still a little puzzled by the idea that PA School is much more intense than medical school so they can cover much the same material in <1/2 the time. I seem to recall medical school being pretty intense, at least 9-5 for 5 days a week, with (IIRC) no summer break in years 3-5
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The chant of “B-M-A! B-M-A! B-M-A!” fills the air at @TheBMA rally in Manchester. A large crowd in Manchester, thousands upon thousands of doctors united and out on strike across the country, and an NHS that desperately needs the government to come to the table and negotiate.
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If the government thinks that they can deal with NHS staff going on strike to protest against shocking working conditions and 30% real terms pay cuts by making strikes illegal and insisting they can't offer more than a 2% pay rise (ie -7%) this year then I think they may be wrong
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If we should learn one thing from 2016, it’s that on the difficult topic of strike action, you *really* don’t want to be interviewed by the news unless you’re trained for it. The media are looking for junior doctors, and they’ll be all friendly and nice… until you’re on air.
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Dismayed that Wes Streeting has extended the ban on puberty blockers for trans kids (yet somehow they're fine for non-trans kids taking them for other reasons). The Cass Review continues to have a long tail of damaging and unjustified effects on trans healthcare here and abroad.
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Well, @theBMA has been warning that this was happening for years, but we keep being told "oh, people are lining up to get into medical school! You're worried about nothing!" There's no point getting people through medical school if we then drive them out of the NHS afterwards.
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Out with the rest of @TheBMA Council joining the junior doctors on strike outside UCH in London - passing motorists honking all the time, and passers-by bringing coffee and snacks! The public support is great and patients stop to offer support on their way in. Thank you! 💙
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Not a huge surprise: @TheBMA Consultants Conference has voted overwhelmingly to call on the BMA to ballot consultant members in England on industrial action. @BMA_Consultants meeting tomorrow to consider how to take things forward most effectively
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Solidarity to the junior doctors striking today and this week. You deserve full pay restoration. The campaign has moved the offer from "Get stuffed" to over 10% rise but it's still not pay restoration, so keep going until you get that!
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Standing room only here at @TheBMA to hear @Vish_Sharm and @RMTunion’s Mick Lynch speak about consultant pay and how we can and will win this fight. Mick making a great case for improved pay and conditions across society. Solidarity!
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Sunak: "Whenever Labour run something they run it into the ground" Does this look like a country that is thriving under your government, Rishi? Does this look like a country with adequate healthcare? A well-functioning justice system? Happy schools? Fast and cheap transport?
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Do we think this is filled with liquefied Jaffa cake orange jelly, or a dozen or so enormous six-foot-diameter Jaffa cakes?
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When you start seeing articles and tweets about public sector pensions being "gold plated" again, remember that this comes from the IEA, Taxpayers' Alliance etc. - they want the public sector to shrivel and die. Attacks on pensions are attacks on pay and we will not stand idle.
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Good luck to the nurses picketing outside in sun-zero temperatures this morning! Your fight is key to the survival of the NHS - without fair pay, staff are leaving; without staff, there is no NHS.
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Great to see ⁦@SadiqKhan⁩ at the head of the Pride March - it makes such a difference to have leaders like him sticking up for minorities. Thank you Sadiq. X
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There is no campaign to remove Churchill’s statue. There is, however, a drive to take us past the 31 June deadline after which we cannot extend Brexit deal negotiations due to end in Dec 2020. It’s impossible to negotiate a deal by then —> No Deal follows. Focus on that.
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Pride and dismay. Pride that consultants have come together, like the junior doctors did, to defend and rebuild our terms and conditions. Dismay that the government has forced us to the point of striking by their refusal to negotiate or even to recognise the problem properly.
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“Save our democracy - stop the coup” - the crowds are still blocking Parliament Square. The police helicopter hovers overhead. This is not over. #stopthecoup #parliamentsquare
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If he wants us to stay ahead of omicron by NHS staff providing this booster (20m+ doses in three weeks), does he not think it might help to take some measures to slow transmission down? Use whatever overly complicated metaphor you want, we’ve got to slow transmission somehow.
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From @YouGov tonight - widespread belief from across the political spectrum that the Cummings row will make it harder to get future lockdown messaging across to the public. (n=2368 people)
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Looks like they’re throwing out this old heater, which is a shame as it has one of the most stylistically-appealing hand-written notices of belonging I’ve ever seen on an NHS asset
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I’m not imagining it, right: they’re proposing to means test the winter fuel payments? So the people who will be affected adversely will get it, and the people who can afford to do without it won’t? Have I missed something?
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Another day, another colleague off to another country to work. Same on Thursday. Same on Wednesday. The government has not valued the staff of the NHS; their warm words and clapping have not been matched with actual resources to match the scale of the problem
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I was initially less than excited about being called down to speak to the radiologist at 3am but midway through the conversation I looked past him and spotted my special cup I was given 2 years ago, there in completely the wrong department! Rescued and returned to Anaesthesia. 🥰
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So @getadrip have opened in Westfield in White City, selling intravenous therapies of things that most people can take very easily by mouth. I confirmed that those numbers are pounds. £75 for a bag of saline with K! Dubious, costly medicalisation of basic nutrition/hydration.
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Most people do survive and get antibodies, of course, but a significant percentage don't, which is kind of the reason the world reacted as it did from early 2020 onwards... and it's becoming clearer that Long Covid is going to be a big source of ongoing ill health for millions.
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The difficult thing about the breakdown of society as we've grown used to it is that it's usually not an abrupt collapse. The Decline and Fall of the Romans took a few hundred years from the end of the Republic to Romulus Augustus.
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It’s hard to believe this level of derangement in the medical jobs market is an accident. The government has been deliberately reshaping the NHS workforce, especially in GP, and this is a feature, not a bug. Patients need to #AskForADoctor before the workforce is too far gone.
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"Downing St insists there will be no pay talks with @theBMA unless junior doctors abandon their starting position of a 35% rise and call off the strikes." Those sound like preconditions to me, ones which ignore the underlying basis of the pay restoration demand. Short answer.
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If you clapped for the NHS in 2020, please support the nurses' strike now (and the doctors' strike that's next). NHS staff have had pay cuts of more than a fifth - some nearly a third - due to below-inflation pay awards in the last decade. Solidarity >>> clapping Thank you! 💙
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I don't know who in @Helen_Whately's team thought it would be better for her to do this TV debate by video link but compare how it looks to have her on a screen, while @wesstreeting is in the studio with the healthcare workers. Distant and inaccessible vs present and listening.
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New cases may be falling but ICUs are still full (and still nowhere near the 1:1 nurse:pt ratio that an ICU bed normally offers). The purpose of lockdown is to prevent the NHS collapsing completely (it has already broken down to some extent), and that pressure hasn’t eased yet.
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In case anyone LGB or T hadn't noticed, the LGB Alliance exists primarily to make life harder for trans people. They don't speak for the majority of LGB people, and given their spreading of transphobia they shouldn't benefit from registration as a charity with the @ChtyCommission
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You should see @RMTunion as an inspiration, not an irritation. They stand together collectively to resist pay erosion and the relentless chipping away at working conditions most people will recognise from our own employers. The strike IS inconvenient: it demonstrates their value.
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Unless I’ve missed something significant in the design, it ought to be possible to barcode every test kit and note which was sent to which address, so the missing Brazilian variant patient should be traceable to one address at least, surely? What am I missing?
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N501Y is a more infectious strain, so we're told, which suggests we should at least review the evidence about PPE for areas like wards, in case change is needed. Most hospitalised covid pts will remain on the medical wards where PPE requirements are not as stringent as on ICU.
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If your answer to the charges made in the Panorama programme is “but the people interviewed are Labour activists!” then you’re deflecting and haven’t rebutted anything. It’s not surprising that trade unionists are involved, and there’s plenty of evidence beyond their testimony.
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Has anyone considered discharging patients? Thanks team!
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PAs are not equivalent to doctors. Trusts replacing one with the other are putting patients at risk #AskForADoctor
It's been shown that doctors were unsafely replaced on medical rotas by PAs on 109 occasions, across 11 trusts over 3 months. This appalling patient safety scandal must end. Read our letter to @NHSEngland. And our response to @Channel4News revelations: bma.org.uk/bma-media-centre/…
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We shifted resources - staff, space, kit - from most other parts of the service to meet the anticipated demand from covid. We'd seen Italy's health service horribly overwhelmed by their first wave, so it was an appropriate response. But it wasn't new capacity that we'd created.
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Other medical royal colleges should take note: this is how to respond to widespread deep concern from the profession you represent
RCGP governing UK Council has today voted to oppose a role for Physician Associates working in general practice.   You can read more here. rcgp.org.uk/news/physician-a…
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