I flashed-forward a decade and imagined them strutting around a hospital wards, missing the point as they seemed to miss it now.
Tag Archives: NHS
Please… Write to me.
It calls for better informed patients, a shift of the power-balance, away from ‘papa-says.’ It is an undoing of paternalism towards equality and inclusion.
Winter cannibalism, a theory of economics, healthcare, and D:Ream
Healthcare staff working in the late 90’s and early 00’s will be familiar with the airplane analogy. Sometimes a double-decker bus was used. This supposedly equated either (depending on who was talking and their level of cynicism) to the numbers of patients harmed or killed in US and UK hospitals every day. The UK planesContinue reading “Winter cannibalism, a theory of economics, healthcare, and D:Ream”
Dickens speaks to Marx who is in discussion with Harry Leslie Smith. They reach a compromise.
Yes, the NHS and the Tory.
Sure, the Tory has never liked the NHS, it is too leftie, too socialist, democratic, and yet, it is central to UK political debate; it is locked-in to our psyche.
Why did granny die? They killed Gran. After Priestley. (A redo, 26/11/22)
The last time Elsie was in hospital was 50 years before when her son was born.
Squeeze the capsule and empty the contents on to their sugar puffs. The 21st century balm.
If you open the capsule and sprinkle, everything will be ok.
the empty bed & the red dahlia
blink and you will miss it.
Tangled in safety-nets, a healthcare odyssey.
If you don’t agree, or even if you do, if you are in doubt, call an ambulance. I am sure the crew will be pleased to see you.
Crisis, alert, no beds!
Many are unaware of the pain and sometimes indignity facing the patients (as Old Adam waits on that stretcher, in hospital gown, bottom or testicle peeking-out, he needs the toilet, ‘Just go in your pad,’ he is told.)
I am a Tory! (& the trouble with memes)
You can say, ‘Molly, you are 95, your mum is dead, you have dementia, you live in a care home, sit down.’
Thirty years ago and counting. 90’s reminiscence.
He has a glass that is so half-full that the Kool-Aid is spilling over the rim.
Mild Cognitive Impairment, dementia, and a happy patient.
For the most, I think I know what I am talking about when I talk about dementia.
Cognitive dissonance, the NHS, Virtual Wards, and the rest of the shit that is going down
I even recently read in a patient’s notes the following:
‘Called patient for telephone appointment. There was no answer. Patient has not attended the appointment. See again in six months.’
London’s burning. Damn those firemen.
No one in healthcare works harder than GPs.
Sun, sea and outdated cultural references
(Can you hear the crickets? The Bouzouki?)
Killer whales, the menopause and my colleague A.
There may be women in the Tory party, it is however a sexist juggernaut.
Minimally invasive medicine
They perceive the wonder of human spontaneity, the fragility of hope and fear, the layers of anxiety, of prejudice, hope, joy and deprivation spinning atomic around the patient’s sense of self.
Oxygen masks, paranoid androids and helping others
Not so much, ‘When in doubt, act,’ more, ‘When in doubt, care.’
The cost of loneliness (Roubles, dollars or robots?)
One patient recently attempted to resuscitate her (toy) baby when the batteries ran-out.
The guest that over-stayed its welcome.
The Waltzer that doesn’t stop.
Three days, 15 points and just starting to recover from the British Geriatric Society Autumn Conference
For the most, this was people showing-off their successes, how many older people they had saved from peril (mostly keeping them out of hospital), how many standard deviations from the mean their intervention had generated and so on.
Broken hearts, or why telephone consultations are less than 35% effective (homage to Heathcote)
Although doctors are being battered over the head for not enough F2F appointments, in reality, telephone reviews are much harder than seeing a person in the surgery.
Take away, facial expression, eye contact and body-language and it is far more difficult to know or understand what is going-on.
It’s worse than it’s ever been. Just kidding… Not.
‘When will I receive my Covid booster?’ Asks patient Annie, 98, unable to leave her house for the past three years.
‘We are working-our way round,’ Says the doctor.
Detour into etymology via hell and the NHS.
For all they care we could go to hell, so long as they can keep going.
It’s a bit shit.
#NHS #scapegoating #primarycare @BMA #justtryingtodoourjob
Indulgence – Sunday morning in Waterstone’s Cafe
I read this morning about patients waiting 11 (eleven) hours outside of A&E departments.
Shady Towers, Social Care, Nora and Whitey on the Moon.
The PM announced a rise in NI tax this week. I understand this is to offset some of the damage they have done to the NHS over the past decade. Fantastic. (And yes, Whitey is still on the moon).
To stop or not? (Jerzy Kosinski, Oliver Sacks & other ideas)
If you watch the Robin Williams / Oliver Sacks movie/book Awakenings you will see what dopamine can and cannot do to the brain.
You get what you pay for. (this is not a happy one)
No, not the climate, not the uncollected bins, the zero hours, no, not the Shitty White Men travelling on purpose-built spaceships that fly over the filth and poverty of a world falling apart, all of it together.
Occupational hazard – emotional blunting.
‘She’s probably holding something in her mouth,’ I said – since the arrival of pup, she has taken to hoarding all sorts of toys and chews in her mouth.
To what extent has Covid damaged medicine?
the back wings
Hey Mr. Blue Sky
What became even funnier was the background I occasionally use of a photo I took in the winter of a cob-web.
daydream believer, this can’t be a second-wave; i haven’t had my summer holiday yet.
And, yes, those bureaucrats, the apparatchiks who felt things were returning to normal will be once again on the back-foot and find themselves redundant, scraping the earth with their over-long arms, their Neanderthal gait giving it all away.
Francis Bacon’s interpretation of our health service as it struggles to catch its breath.
A drooling, dribbling, stuttering, stumbling, drug-addled bully, we express our love through brutality.
Lockdown, solitary confinement and loneliness
Imagine the harm done to those people previously ‘living well’ with dementia who for six weeks have had a dramatic reduction in visitors and day-centre attendances; even the bitter-sweet routine trips to GP surgeries or hospitals have been done away with.
Death in the time of Covid – why I have stopped looking at the official figures
‘Will my mum be recorded within the statistics?’
I haven’t been asked that yet.
Covid – difficult moment when the answers are not straightforward
All we can do in the Time of Covid is to do our best and act in good faith.
Testing in the time of Covid…
We have closed schools which has reduced transmission; we can’t close care homes.
Infection then and now, the Great Influenza and Covid… lessons from the past, reflections on the present.
You wouldn’t send someone into the centre of Fukushima wearing a plastic flimsy? Well, the UK has allowed that to happen.
Corridor Care – the state of the NHS in 2020
Sometimes eight or nine relatives would pack into these airless spaces to spend the last hours and minutes with their mum or dad;
Too negative, too positive, or should I just be quiet? (thoughts on the experiences of people living with dementia in the UK)
Ensure independence, autonomy and the right care and support for people living with dementia (and, yes, older people in general) and the NHS will be fine.
Catch-22, doctors, leaders and the NHS (healthcare, military and other absurdities)
What struck me was the similarity between bad leadership as described in the 256th US Army Air Squadron and… you guessed it, the NHS.
(Admittedly there are no bombing runs in most UK hospitals)
Doctor, my husband will see you now. Home visits, and why we should fight for them.
For today, I hope to keep popping out, spending quality time with patients, understanding what is important to them, their preferences, hopes, fears and aspirations, and supporting them to stay outside acute care.
Why I have been depressed for the past nine years (and how to save the NHS)
..when you see society deteriorating, when there is so much potential for improvement, that is surely depressing; when you see vibrant doctors and nurses forced into early retirement because the work has become too much, that is bad; when you know that people have and will die because of cuts, what could be worse?
You see, The Plan says that more will be invested into community care, yet, the cumbersome nature of the NHS, again, the upside-down system of health and social care has resulted in lots or organisation and reorganisation but little transformational thought, little concept of how we can do things differently.
Medically Fit – 2020
Maybe we should call it ‘hospital check-out’, to get away from the nonsense of fitness, when many of the people described are actually quite sick and are often even dying, it is just that their death need not require a bed on a hospital ward.
Mostly, my approach is to consider that we, that is the community services (those outside the acute hospital) can and do support a far broader range of patients than people realise and, when working well together, can care for a significant proportion of the people who otherwise arrive at the door of A&E.
A nurse’s job?!
I will not go into more detail about this but suffice it to say, this is congruent with my values and probably my purpose.
You see, nowadays, in order to study medicine, you have to be little short of an academic wunderkind.
Doctoring, fast and slow.
In life, there are those who work and act quickly; my mum would say, ‘chick-chak’ which I think is a derivation of Hebrew meaning, ‘promptly, without messing about,’ and, those who tend to dilly-dally.
Manor Field Blog number 10 – blood and other tests
Just to mention – a normal blood test does not mean that there is nothing seriously wrong – this part is the ‘art’ of the clinician.
Manor Field Blog number 6. Doctor, how much should I drink?
Well, most of us – adults that is, have been drinking for many years, and, if you have made it into your 50’s, 60’s or older and are in reasonable health, you are probably close to the sweet spot.
Manor Field Blog #3 – what is de-prescribing?
In the UK we have a fantastic primary prevention service that aims to maintain the health and wellbeing of our population. It is perhaps not as great as Germany or Norway, but it’s pretty good.
politics of today
Like baby ants we scuttle around, working away or in retirement, too busy to look up and out.
Tick box manifesto and dementia.
This tells you how many boxes are ticked – it doesn’t tell you anything else.
And that is the thing.
It doesn’t tell you about quality or whether the interaction led to change or care.
When a surgeon is poised over my broken hip I would like that clinical sterility, that void of softness; yet, for that surgeon to function in a team, with people, peers, they need the kindness, caring and empathy of the group, the ability to be told-off for a silly mistake or mis-perception; ego can’t be allowed in.
I veered into Yellow
…you see your destination and intuitively perceive that the way to arrive at that goal is not straightforward, indeed, you might learn that it is only a stepping-stone towards something else.
…all the way from human genome project, face transplants, over-the-counter Viagra, genomics and gene therapy to long-length of stay, delayed discharges and workforce crises.
Doctor, doctor, can’t you see?
All of these add richness to relationship and whilst not essential for me prescribing penicillin are essential to my humanity.
Leaders and Commanders
I am not a military guy. Anyone who knows me likely would agree with this statement – in fact, if you have met me, you would almost certainly wonder why a) I have even said it and b) Why ‘Commanders’ is in my title. Well, I’ll try to explain. It was an unusual Bank HolidayContinue reading “Leaders and Commanders”
Four days, workforce and GP appointments
So, the net investment in more doctors (and nurses and therapists and pharmacists) training is we stand still.
Flow; best left to plumbers.
It perhaps has something to do with my internet settings or preferences, I don’t know; you see, I get a number of emails from different national and international health organisations informing me of conferences and award ceremonies taking place in the realm of Quality Improvement. This is the science of doing things better in healthContinue reading “Flow; best left to plumbers.”
Their eyes were dull, tired, their postured stooped; they emanated nothing more than a faint flicker of a need to keep going, to survive today in order to continue the next.
Statistic – moi…
Now, I have long been one to call screen and not answer numbers from Clitheroe and Cambuslang; accepting that these are usually credit robots.
What would you like to be called?
It means, I am your doctor, I am here to help, I will do whatever I can to support, and, with this the clinical contract – first, I will do no harm, second, this is confidential and, third, well, If I don’t know, I’ll find someone who does.
South Yorkshire Tribe (care sans frontieres)
The pull of this is so strong it overwhelms our logic.
And so, we compete.
Compete for nurses, doctors and so on.
Scare resources don’t go a long way in a finite economy.
Everyone enjoys a crisis (unless you are a patient)
Give a man a McDonalds and he’ll eat it; give him a thousand and he’ll develop metabolic syndrome.
Crossbills, evolution and quality improvement
Would a tiger if given the option have chosen its stripes? Surely;
(When was the last time anyone checked the dirt level of an NHS keyboard)(Oops, should have said that – the snap response there is sometimes keyboard-condom rather than ‘clean the thing’ the former making touch-typing a nightmare)(when you do get to type, rather than write, which is a mixed-methods form of data collection, common in the health service).
I wrote a few months ago about one of the NHS terms that cause me feelings of anxiety – DToC, in other words, the acronym used to describe people who are deemed by the ‘system’ to be ‘delayed transfers of care’ – this being, people, mostly older, often frail, frequently living with dementia who areContinue reading “Super-stranded”
I’d never really considered healthcare as a competitive sport.
Fake news, the NHS and Middle East
…this of course doesn’t mean that you won’t be the sucker to die on the tablet, you are just less likely.
(lots of references!)
Being Jeremy Hunt
In the past when I have written about Mr Hunt I have struggled to use his name, generally preferring the abbreviation ‘JH’ or just that man. As if, by not naming him he is less real, more likely to be the product of a too-vivid nightmare. But, alas, he is real. This leads me toContinue reading “Being Jeremy Hunt”
Some thoughts on being medically fit
The system is not coping now, how will it manage tomorrow?
No, everyone can’t find the meaning of life in work, but so many of us find no meaning at all – the existential treadmill drawing us along.
Beds (or bust)
The government is screwing the NHS through mismanagement at every level and this is left as the elephant in the room. Think of a grey animal. Yes, think of a struggling system.
See you later. I’m going home.
Sure, we know that unnecessary hospitalisation is bad, but what about inappropriate institutionalisation?
Remember, I am not English…
But… Dr Who – he’s international; the guy with the blue police-box, alien time-lord?
Daddy, what did you do?
This was a recruitment poster from WWI – designed to create a feeling of guilt in young men, chivvying them to volunteer, head-off to Flanders, Ypres or somewhere on the Western Front and, likely die. At least they wouldn’t have to face their children… ‘I stayed at home, because I didn’t want to participate inContinue reading “Daddy, what did you do?”
You take a cup, smash it, pollute the river and offer constant interruptions and the result is not tranquillity or effectiveness, it is, a mess.
Freedland and rules
I haven’t had a chance to thank everyone for the incredible send-off I received on Thursday. It was overwhelming and humbling. Such a group of amazing people – thank you and Namaste.