Alan Grayson

Dear people of Britain I appreciate that you're probably a bit bored now. Please be careful. It's a tad busy in EDs where I work and although japesome frolics may be fun, we don't want to have to stitch you up, remove foreign objects, or treat your burns. Be safe. Love ED

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Did not have “Olympic Ski Jumper Penis Injections” on my bingo card when searching for coverage of the Curling #WinterOlympics26 bbc.co.uk/sport/articles…

Today I saw a patient whose notes read " He could climb the stairs in railway station to catch his train on the platform 3, with a suitcase easily 9 months back. Now he gets breathless with a small backpack" His cardiologist had written such beautiful, detailed functional assessment. Simple variables like BP, pulse rate etc have their place - but are often reductionist. That's where a clear description of fitness /frailty comes in. The cardio could have written NYHA class and called it a day. But he made it so vivid that anyone can understand. And in a beautiful handwriting. Reminded me of my cardiology Prof JBC. Doctor goals : write such beautiful case history that another doctor is so impressed that he shares it online 😍

@BrimfulOfAshia @HTFC_Matt_ Breitenreiter mark 2. The problem is not the manager. It's the culture of the club. Markham needs to just calm down - if it's not meeja bollox which is likely - and work with Grant. There are still, what, 26 games and 78 points? Can't win it by Xmas. Can sure lose it

@HTFC_Matt_ We’re being linked with highly rated German manager Alex Ende of Preussen Munster,admittedly his stats don’t look great but he’s got a pretty poor team mid table in Bundesliga.2

Chris Markham I was not familiar with your game

@EdRollsOff @htafc After 3 x 3-1 wins and away against Luton - who were in the Prem yesterday - a struggle was likely

@dralangrayson @htafc Far from it unfortunately

LTFC 2-1 #htafc Luton have the lead. Yates. [⏰71’]

@EdRollsOff @htafc We are not the finished article yet mate

@htafc That was an absolute disgrace

@fourhourtarget Well done on getting through and making your shop better than it was when you took on the responsibility Enjoy being purely clinical and educational......until the itch to meddle needs a scratch again

Thirteen years today since starting as a consultant. Just shy of ten years in leadership (CL/CD) role. Stepping back as it’s been quite a year on many levels. Still keeping my 8 DCC as always, but give the leadership to someone with fresh ideas and drive. It’s been a journey.

@ThatTownFan And as others have said, who would come? Sacking a manger every season isn't the sign of a well-run club. If people want to whinge, we should look at ourselves. The Stadium atmosphere has been appalling. We don't sing. We barely clap.

@ThatTownFan So, help me out here. Apart from making the subs too late - and let's not forget he's managed a dozen top senior games, being successful in 8 of them - what did Grant do wrong? Dodgy free kick leading to a penalty Dodgy advantage leading to second goal

All these people saying grant out, who do we get in then?? #htafc #htfc

Found a printout on the ward from ChatGPT indicating a colleague had asked it a long, complex medical question about a specific patient. Words cannot express what a bad idea this is.

@jabberwock951 Probably worth a chat with the MD/Caldicott Guardian. Agree. Is bad in many ways. Just needs to stop first of all.

The inability of leaders to delegate is one of the most significant blockers in workforce productivity & in making change happen. So I appreciated this new article by @RoFernn that offers a refreshing perspective & practical actions. Teams often don’t see the pressure that their leaders carry. Leaders fear that if something goes wrong, it will ultimately fall back on them. That’s why delegation feels risky: when we delegate, we can no longer control every action or thought. We can only have influence. The shift from control to influence triggers more fear. Most leaders don’t struggle with delegation because they don’t know they should delegate. They struggle with the daily symptoms of not delegating. The core problem is often a lack of clarity, trust & good processes. But because leaders are constantly firefighting, they rarely get the chance to step back & see it. Effective delegation focuses leaders on controlling what they can control: providing examples of what good looks like; leading by example - creating shadowing & learning opportunities; continuously improving clarity; designing systems with built-in visibility so fewer status meetings are needed & setting clear principles & fair rules. What actions can we take to enable both oversight (direction/control) & autonomy (delegation)? 1) Define the outcome & success criteria: don’t tell people how to do something - make the “what” crystal clear 2) Create visibility without micromanagement: build check-ins, dashboards & visual cues 3) Systematise autonomy: Build templates, process checks & decision prompts so teams can act effectively without leader presence 4) Multiply effort with repeatable systems: delegation through systems (templates, shared steps, clear rules) supports sustainable delegation 5) Use the “Five levels of delegation” to build autonomy: The author suggest using the @MichaelHyatt model to work out where current levels of delegation are & how people can move up stages as capability & systems improve Article: @rociofernn/the-brutal-truth-about-delegation-why-70-of-leaders-get-it-wrong-830d67f8e96a" target="_blank" rel="nofollow noopener">medium.com/@rociofernn/th… The Michael Hyatt "levels of delegation" model: fullfocus.co/the-five-level… Graphic via @hosseini_samira

@clifford0584 Thanks mate We've got a particularly irritating strain of covid that seems to give you a hoarse voice, myalgia, a bit of GI upset, and a cough that turns productive. I think our winter, acknowledging your winter, will be tough Some places on corridor in August 😢

@dralangrayson Lots of influenza A and B, bit a local pertussis outbreak, RSV. Not sure if any weird and wonderful strains

You can definitely tell the summer is over by the number of emails flying around and the number of urgent Teams meetings being scheduled

@htafc Class again that lad. Looks so comfortable on the ball. So much time to play the right pass Our kids looked better than Newcastle's kids

Dan Vost spoke to HTTV after tonight's win under the lights ⤵️ #htafc

@clifford0584 Oh mate How have the viruses been? Just for modeling our winter?

@dralangrayson Hope winter ends soon this side of the world - it’s been horrible

Every single man jack of the squad, those that didn’t play, through injury or rotation, Lee Grant and the coaching side, the medical staff, and @KevinNagleMLS Not the surprise of the round - HT to the chickens, Wendies, and Cambridge - but that's big for #htafc

@DrLKVaughan @clifford0584 NCA covers 4 EDs, a big chunk of GM, and sees an awful lot of patients. There are a lot of challenges in GM, particularly around deprivation and pathway 1-3 discharges Not really a surprise that a big trust has a higher legal burden.

@clifford0584 Interesting. Also several years since the Prime of David Dalton.

The rising costs of negligence in English EDs. Interesting distribution of trusts with biggest payouts. While UHB has been struggling for some time, surprise to find Northern Alliance (Salford) in the mix. Need data correlation with waiting times etc to get to drivers.

@sib313 @ArunBaksi @wesstreeting @Keir_Starmer @alanmilburn1958 @HSJnews Sorry for the delay There's lots of creep Cleaning Porters Restaurants Security Car parking Facility management I'd agree with your second point to a degree. However an NHS OS was offered over a decade ago.

@dralangrayson @ArunBaksi @wesstreeting @Keir_Starmer @alanmilburn1958 @HSJnews Context matters. First there hasn't been much creep. second, since the NHS, for example, neither makes its own drugs nor writes its own software, the private sector will always have a role.

And, our government is desperate to copy the American health system. @wesstreeting @Keir_Starmer

@sib313 @ArunBaksi @wesstreeting @Keir_Starmer This by @alanmilburn1958 in @HSJnews today isn’t wholly reassuring about the steady creep of public money going to private providers Steve app.hsj.co.uk/2025/08/07/nhs…

@ArunBaksi @wesstreeting @Keir_Starmer What? Where is there any evidence the government wants to copy the US health system? Even Policy exchange and the IEA (right wing think tanks) argue the US system is the worst and should not be copied.