Paul Wright

@parthaskar @NHSEngland My great great grandfathers job was to rearrange the deckchairs on the Titanic (he was a steward). I often say my current role is maintaining the family trade ;-)

Ladies & Gentlemen. Children of all ages... Once upon a time? There were 28 Strategic Health Authorities (2002) Then they became 10- with 152 Primary Care Trusts (2010) Then SHAs got abolished and we had @NHSEngland with 212 Clinical Commissioning Groups (2013) Then CCGs went and we had 42 Integrated Care Systems (2022) And now we have NHSE being abolished with ICS being reorganised to.. Yup...28. (2025) Rearranging deck chairs at it's finest- to even make the Titanic proud. With increasing costs- and rarely any good outcomes Leadership is a thing. Or not. #FridayFact #NHS

@ankitkant I’d also point out that NICE OA guidance says: 1.6.2 Use clinical assessment when deciding to refer someone for joint replacement, instead of systems that numerically score severity of disease. So why is completion of the score mandatory for referral?

Hey Google, show me a referral form that has been designed to take maximal time for a GP to complete and ensure that every step punishes the patient and the GP by introducing hurdles. Sure.... (this is a test patient). I can't imagine a hospital colleague accepting this as an acceptable process. I know about bma.org.uk/media/rhjfkmu2…

@anish_k_patel @DrEmmaNash Personally I’d prefer Consultant in Family Medicine - but don’t feel that strongly. I love being called a GP (and don’t really want to change)- but the ‘go and see your GP “brand”’ is so entrenched in the UK that we need GP to become a place not a person.

@DrEmmaNash Treated differently by who? P.S. I'm open to being convinced about the consultant part, but I've still not seen a very good argument for it. I am not a fan of the primary care bit, as dental, opticians, and pharmacies are all part of primary care.

“Just a GP” – a phrase once wielded to belittle, now one I use with pride in my bio. The debate about the GP title continues. Does it still work? Is it holding us back? 🧵

@ankitkant @Ankit__AI Happy to try to help if I can (not a trainee though)

Are you a GP trainee? Are you able to help me improve Ankit AI? I am looking for official publicly available information that I can train Ankit AI on? It needs to be national, accredited, and ideally high quality. Please post relevant links below and I will see what I can do.

@GoCarpediumDoc Try to get a seat on the right side going in if you can.

@GoCarpediumDoc You’ll get a cool view of the volcano from the plane 😁… here’s last summer:

@DrEmmatheGP @NHSE_WTE More than ok… can I enter?

@DrSelvarajah I had a request to confirm fitness to ride a horse last week…

@DrEmmatheGP @NHSE_WTE @NHSEastEngland And a happy HoS!

@GoCarpediumDoc Quite correct that it’s an observation of British cultural norms… but to make it worse - merging early turns out to be worse for safety and efficiency rac.co.uk/drive/advice/d…

@myuniformshrank @WhichUK discovermagazine.com/planet-earth/1…

@WhichUK Let’s be clear, unless it came from a mammal, it isn’t milk

If you put milk in your coffee, what type do you go for? Whether you're cutting out or cutting down on dairy, find out which plant-milk alternative, from oat milk to soya to pea, is best for you 👉 which.co.uk/reviews/food-a… #WorldVeganDay

@JudeDockray @Doc_IonaCollins I’m going to address your Christmas card with that now!

@Doc_IonaCollins I feel your pain… Just to make it worse, the sender was my own GP!

Exciting opportunity to join us at UEA as a GP academic clinical fellow! Details on Oriel (search for East of England vacancies if link doesn’t take you to it directly). Closing date 16th October 2023 so not long!! Please share and RT. oriel.nhs.uk/Web/PermaLink/…

Said it before on here: GPs amaze me What’s coming through the door? A woman w painful periods? 89yo man w depression? A 2-week old baby w/a runny nose? Teenager w/neck lump? Could it be cancer? No blood results/imaging They have to be an expert in everything, an expert in risk

The Primary Care Clinicians PhD programme is now open for applications. 🗓️Closing Date: 12noon, 20 December 2023. For full details visit: bit.ly/SPCR-PHDPCC @NIHRSPCR @wellcometrust @sapcacuk

@JudeDockray I just knew you were going to post this. Just suprised you didn’t tag @myuniformshrank

Patients have better outcomes with female surgeons, studies find | Doctors | The Guardian theguardian.com/society/2023/a…

@jennyjwilson3 Is that you volunteering to have a few more…? Asking for a friend…

But we also understand not available according to demand on supermarket shelves. Every GP reg I take means I personally can see slightly fewer patients myself, particularly early in their placement

@DrEmmatheGP @NHSE_WTE I assumed you had them in the same order. As a scouser my loyalty is fairly clear!

@DrEmmatheGP @NHSE_WTE I’m strongly on Pete’s side with that…

@sheiybani @NEndoscopy @Parody_RCGP @UKGastroDr Just remember to dip the wee (or make sure someone has) 1% of IDA are renal tract malignancies and it’s really embarrassing when we’ve all scoped them - sometimes repeatedly - but not done a urine dip.

@NEndoscopy @Parody_RCGP @UKGastroDr I'm only an SpR but my practice has been to investigate IDA with OGD and/or colon or CT. I investigate small bowel if young and/or really significant IDA. Often we don't find a cause and monitoring with 3 monthly bloods plus iron replacement and re-refer if persistent

Pt has anaemia and abnormal FIT. Referred under 2WW. Seen by Surgeons. CT virtual colonoscopy normal. Discharged. Shouldn't they carry on looking for the cause of the blood loss? Or is this for General Practice to keep tabs on these patients and then follow them up?