Judy Carr

#TimeToTalk day on 6 Feb is a chance to come together to talk and listen with colleagues. Use our mental wellbeing in the workplace infographic to kick start your conversations: bit.ly/46BnEIp

Today’s suggestions to fix the NHS 1. People who shelter their money in tax havens can still order an emergency ambulance, but it has to come from the Cayman Islands 2. All members of the cabinet should be treated in the worst performing hospital in the country Add to the suggestions below and come and see the shows…. Devizes, Bath, Bristol, Bridgwater and @edfringe @theSpaceUK Raising funds for @DoctorsDistress Dates and ticket links drphilhammond.com

@SamaWeston1 @cwp_ipc That is brilliant Sam, well done, bit of relaxing now maybe.

📖 Story time; A general dentist reflects upon a case of throat cancer A few years ago, at the practice which I now own, I was making my way down to reception with some papers. The receptionist was talking to a man at the front desk who was not a current patient. She explained that we didn’t have space for new NHS patients. The gentleman explained that he didn’t necessarily want to see someone about his teeth but about the big lump at the back of his throat. He had been to see the GP over the road who had advised him that “it’s probably a cyst, go and see a dentist” as whatever the problem was it was affecting the fit of his denture - red flag 🚩 I had a spare few minutes so invited the gentleman to come to my surgery so that I could “have a quick look” It was not a “quick look” Upon inspection I found that the patient had a firm lump extending down the right hand side of his pharynx from the soft palate. He had no gag reflex to speak of so I was able to palpate quite far down. That was the second red flag 🚩 When discussing the patient’s medical history we talked about his use of alcohol (100+ units per week, possibly more) and his use of tobacco (60 cigarettes per day). Red flag number three 🚩 The patient had also recently lost some weight unintentionally but had, understandably, put it down to the stress of looking after his elderly mother who was terminally ill. Red flag 🚩 4 I had heard enough and put in a call to the local Maxillofacial department and asked for him to be seen urgently. Dentists aren’t able to refer directly into ENT. Within days the patient called to inform us that it was cancer and to thank me for referring him. This gentleman wrote me a letter some months later to express his gratitude that I had “saved his life”. Of course, I had done no such thing, I had merely identified a substantial risk and referred him to the appropriate department. The treatment he received there was what saved him. There are several things to take away from this story (and absolutely no shade to be thrown on my very busy, capable but overstretched GP colleagues) 1) The GP was not able to identify whether this was a lesion of concern (why would they? They have about a one hour lecture on oral cancer or something, the mouth isn’t specifically their area, like it would be for say; a dentist) 2) The GP advised the patient to go and see a dentist (someone who is used to looking at mouths all day), but this patient did not have access to a dentist. Had he not been in the right place at the right time (the front desk of my practice while I happened to be taking paperwork down and have five mins spare to examine him) he might not have been looked at for much, much longer. He was in no pain and would be unlikely to be triaged as “urgent” when ringing any helplines. I have been the identifying/referring clinician several times through my career. I have cared for some of those patients when they have been well enough to come back to primary care. I have even referred some of my patients for skin lesions (on the face & head) which have been malignant. Oral cancer is often painless, unnoticed by the patient. Yes we must teach the public to self screen but where do they go then? GP colleagues are overstretched, NHS dental services are at breaking point. Who will direct these patients into the hospital? A&E would be wholly inappropriate. If you have made it this far, please know that I am not writing this to scare anyone or to virtue signal that I’ve picked up so many of these cases. I work in a deprived area, there is a correlation. There is so much more awareness that needs to be raised around head and neck cancer. The government, healthcare professionals and the public could all stand to know more. A good place to start is here: mouthcancerfoundation.org/mouth-cancer-f… November is a month for Mouth Cancer Awareness and blue is the colour we use to signify that Thank you for reading @TheBDA @MouthCancerMCF @TheBMA

@nationaltrust Calke Abbey

We’re on the hunt for next month’s cover photo! September’s theme is *Glorious Gardens* Reply to this tweet with your best pic, and we’ll choose one of our favourites to be our cover photo for all of September 📷

Apart from the hay fever, the constant sweat, the sunburn, the lack of sleep, the wasps, the bug bites, the baking hot car, the 3am sunrise, the non-stop disco from next door’s garden, the yellow lawn, the heat rash, the absence of air con and the complete lack of energy… I’m actually a big fan of Summer.

We're looking for an Assessor/Inspector – Primary Medical Services You'll need previous experience of working in health, social care, NHS or regulatory environment or related fields. Closes 25 June 23 Find out more: orlo.uk/Iau5v #Job #JobSearch #Recruitment

Fascinated by this years flu wave 🇬🇧 The shark fin 🦈 With respiratory infections, you tend to get a steep rise followed by a gradual decline. This year, the flu left as quickly as it arrived. Can anyone think of another example of this, NOT caused by a lockdown? 🤔

@FlintlockFemme @derbymuseums @JacRiding Solitarie

Quiz! What is it? Answers in comments (clue: object on loan for @derbymuseums forthcoming exhibition "Hogarth's Britons"). @JacRiding you are not allowed to play! 😁

@Samlizmort @WeAreLSCFT Well done Sam, I remember working with you at the old SSSFT, many happy memories of that time.

after 36 years today I retire ( semi ) from the wonderful NHS - brought me passion ,joy , at times frustration but has always taught me the value of this institution of ours. So proud to be a nurse and to continue to contribute thank you @WeAreLSCFT see you soon x

@helen_barnowl @RoyLilley No not mad, no way are you going to get covid from a curtain

I went for a smear last week and there was no privacy curtain due to covid 🤦🏼‍♀️ I emailed the surgery and suggested they should have a privacy curtain. I’ve received a reply to say that the risks outweigh the benefits. Please tell me I’m not crazy.

@ilovenostalgia Still using mine

If you recognise these you are old...

What could we do with £200m? ...at £11 an hour, we could buy 18,181,818 hours of social care. That's eye popping. myemail.constantcontact.com/Your-call.html…

@Carriebugmad @Inclusion_NHS I remember doing a similar thing years ago for flu, although not as far. The staff were lovely at every stop.

@NeilCarrMPFT Time out. A walk along the canal with the dog. Any walk in fact.

It’s #WorldMentalHealthDay with this year's theme being ‘make mental health and wellbeing for all a global priority'. With 1 in 4 adults having mental health issues & suicide being the biggest killer of under 35s - how do we all make our own mental health a priority?