Thomas Round 💙

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Thomas Round 💙

Thomas Round 💙

@drtomround

GP @BBB_health AcademicCL @NIHRresearch @KingsMedicine Assoc Editor @BJGPJournal @rcgp ;exTrustee @Barts_Charity https://t.co/BWcZwjjGBy

London Katılım Ekim 2010
4.7K Takip Edilen3.4K Takipçiler
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Parody RCGP
Parody RCGP@Parody_RCGP·
When the NHS is gone (and it will be soon), I will think back to those who felt they deserved first-class treatment while 500 people a week were unnecessarily dying in hospital corridors. Gratitude builds people up. Entitlement wears them down.
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Dr Rachel Clarke
Dr Rachel Clarke@doctor_oxford·
Yesterday you may well have seen the headlines announcing that from April onwards, GPs will be “made” to offer patients same day appointments for 'urgent' health issues. The implication, which I cannot imagine Wes Streeting is unaware of, is that he is on the side of patients, whereas recalcitrant & possibly even workshy GPs are the problem. A subtle undercurrent of GP-bashing, in other words, just as in previous governments. The headlines omit a crucial aspect of the new GP contract, which this letter in the Times brilliantly highlights. GPs will no longer be able to refer patients for specialist care as they do currently. New mandated "advice and refer" systems are being introduced for all specialist referrals from general practice, supposedly to 'streamline' care (as though GPs aren't highly trained physicians who know when a referral is needed). As anyone waiting desperately for an appointment with a neurologist, oncologist, rheumatologist or orthopaedic surgeon will already know to their cost, currently waiting times can be absolutely horrendous – and this looks horribly like yet another barrier to patients receiving the prompt care they need from a specialist. Already, for example, I am aware of patients with a new diagnosis of major, life-changing diseases such as multiple sclerosis, motor neurone disease or lupus having to wait many heartbreaking months to see a specialist for the first time. That is simply not right. It is a national scandal. If Wes Streeting’s aim is to massage the waiting list figures so that it ‘looks’ as though he’s improving care for NHS patients (while actually keeping patients away from doctors via a tortuous saga of ‘pathway navigators’ and other hoops that only create more delays) this would be an excellent way to do to.
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The BMJ
The BMJ@bmj_latest·
#BMJExclusive: Four fifths of England’s integrated care boards would need to at least double their number of general practitioners to meet staffing standards considered safe for patients, a BMJ analysis finds bmj.com/content/392/bm…
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Eric Topol
Eric Topol@EricTopol·
An AI stethoscope for primary care doctors was assessed in a randomized, controlled trial of >1.5 million patients to detect heart failure, valve disease and AF. It didn't help make the diagnoses. Because it wasn't used enough by the doctors. It improved diagnoses when it was used. New @TheLancet, an important lesson for AI med trials thelancet.com/journals/lance…
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Dr Steve Taylor
Dr Steve Taylor@DrSteveTaylor·
People come to us frightened, exhausted, in pain, & half-humiliated by the process, filled in the forms, waited, called back, been cut off, tried again, been told to do it online, discovered the link doesn’t work, then finally - they’re in a room with someone….a human, a GP 😥
Dr Dave Triska@dave_dlt

🗒️The cliff edge and the hot wind. Everyone is angry. Can healthcare survive? 👇👇 open.substack.com/pub/davetriska…

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Zia Yusuf
Zia Yusuf@ZiaYusufUK·
The British government learnt of the data leak in August 2023. 24k Afghans secretly granted asylum, costing British taxpayers up to £7 billion. The government covered it up. Who was in government? Home Secretary: Suella Braverman Immigration Minister: Robert Jenrick
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The BMJ
The BMJ@bmj_latest·
"We can look at the whole system and see that, although staffing costs may initially be higher, in the long run it’s cheaper and better for patients to have experts at the front door." Helen Salisbury reflects on the importance of whole system thinking bmj.com/content/392/bm…
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Royal College of General Practitioners
RTIs drive millions of primary care appointments every year and winter pressure is never far away. Our latest Essential Knowledge Update Hot Topic reviews new BJGP trial evidence on nasal sprays and behavioural interventions for RTIs. Visit our website to find quick, practical learning to support your CPD and everyday patient care. ⤵️ elearning.rcgp.org.uk/mod/page/view.…
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Royal College of General Practitioners
📢 Take a look at this month’s CPD highlights ⬇️ Based on an article in the BJGP, this Hot Topic investigates anaemia, ethnicity and cancer incidence. ➡️ Read the Hot topic: elearning.rcgp.org.uk/mod/page/view.… Join Dr Thomas Round and Dr Helen Jarvis as they discuss metabolic dysfunction-associated steatotic liver disease (MASLD). ➡️ Listen to the podcast: elearning.rcgp.org.uk/course/view.ph… Our latest Hot Topic reviews a 12 month follow up of a randomised open trial of nasal sprays and a behavioural intervention for respiratory tract infections (RTIs) in primary care. ➡️ Read the Hot topic: elearning.rcgp.org.uk/mod/page/view.… Join Dr Toni Hazell and Dr Liliana Risi as they discuss climate health equity, the environmental benefits of social prescribing and the evidence supporting plant-based. ➡️ Listen to the podcast: elearning.rcgp.org.uk/course/info.ph… This Hot topic reviews a BMJ study which investigates trends in the shortfall of English NHS GPs. ➡️ Read the Hot topic: elearning.rcgp.org.uk/mod/page/view.… #RCGPLearning #GetUpToDate #RCGPNetZero #NetZero
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Prof Katherine Sleeman
Prof Katherine Sleeman@kesleeman·
📣📣 New paper! Continuity of GP care is associated with lower total NHS costs for people with dementia in their last year of life. Adds to the evidence that continuity of care is: 👉better for patients 👉better for the system bjgp.org/content/bjgp/e…
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Thomas Round 💙@drtomround·
@DocEmUK @mgtmccartney @drchatterjeeuk @Dr_Ayan Wouldn’t it be great if we got £249 per patient per year for unlimited GP care - would be good to know the ‘core biomarkers’ on offer and evidence for 4mthly testing in overwhelmingly well people? Also no clinical recommendations- so assume usual ‘see your GP’ minor abnormalities
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Doc Em🕷🇪🇺
Doc Em🕷🇪🇺@DocEmUK·
“See your GP”. Obvs. We can reject these at source and make our own assessment of the patient, which is what I do. No role for us in acting on test results requested by someone else for a reason we haven’t assessed the patient for. Test is therefore completely pointless. This crossover with NHS and private really needs tightening up on.
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Margaret McCartney
Margaret McCartney@mgtmccartney·
hey @drchatterjeeuk @Dr_Ayan : please direct me to evidence for benefit from these tests as part of a 4monthly testing programme? what are you planning to do with abnormal results?
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Mike Galsworthy
Mike Galsworthy@mikegalsworthy·
Which begs the very obvious question: Why did you throw away the burger?? 🤦🏻‍♂️
Kemi Badenoch@KemiBadenoch

Leaving the EU but joining a customs union is like throwing away the burger and eating the napkin, said the Conservative peer Lord Hannan. He’s right. Recent weeks have seen a bizarre push by some Labour and Lib Dem politicians – including in major newspaper interviews – to rejoin the EU’s customs union. Most of these MPs were not present during the political chaos of 2017–2019 that followed the Brexit referendum, during which many in Westminster fought to overturn the vote. And those Labour MPs who were there, and who now want to rejoin the customs union, clearly learned nothing. The only people advocating for such a policy – and here I include the trade union bosses who have also proposed it – do not understand what a customs union actually is. As a former Trade Secretary, I know that trade is about hard choices. You defend British interests. You say no to deals that are easy to sign but bad for the country. Yet Labour, despite all the dramatic changes to the global trade system this year, have still not grasped one simple lesson. Trade policy is power: lose control of it, and you lose the ability to govern yourself. This is why the renewed chatter about dragging Britain back into the EU’s customs union should worry us all. It is not a sign of pragmatism – it is a symptom of Labour’s weakness. It’s now painfully obvious to everyone that Keir Starmer entered government without a plan. The list of humiliating U-turns is so long that, I hear, Labour MPs now think twice before supporting a policy announcement in case the PM scraps it a week later. From winter fuel payments to freezing income tax thresholds and the Family Farm Tax, Labour haven’t just broken their pre-election promises, they’ve inflicted untold damage to the British economy while doing so. And now the government is weak and has no plan or new ideas, it has re-opened old Brexit wounds in the vain hope that doing so will make it more popular. It won’t. Going back into the customs union would make us all poorer and damage British business and British farming. Four major benefits of Brexit would be lost: we would no longer be able to set our own tariffs, negotiate our own trade deals, maintain the deals we’ve signed as an independent nation, or reject deals struck by others, even when they harmed our interests. Worse, the bloc would demand even more concessions from us to rejoin – and this hapless Labour government would no doubt surrender. Keir Starmer’s previous attempts at ‘negotiating’ with the EU have been one humiliation after another. The PM gave up our fishing rights to get into an EU ‘defence fund’ that we still don’t have access to, and then paid almost £600million to rejoin an Erasmus scheme we’d decided was too expensive at £100million and was mostly being used by EU students studying here, not young Brits going abroad. Starmer’s trade agreement with President Trump, though considerably worse than the deal the @Conservatives had ready to go with America, is nevertheless clearly better than anything the EU has managed to agree with the world’s most important economy. Why would we give up the trade deals we’ve negotiated, all structured to work for British businesses, to join a customs union designed to benefit firms in EU countries, with vastly different priorities? Britain is in a slump. Talk of a customs union is a distraction. I’m not here to make excuses for previous Conservative governments: we got things wrong, or we’d still be in government. However, we did leave Labour the fastest-growing economy in the G7, record levels of employment and inflation on target at 2 per cent.

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Farrukh
Farrukh@implausibleblog·
Excellent from Sophy Ridge and Wilfred Frost interviewing Professor Christina Pagel ✅ Flu cases are up and earlier, but is it really as bad as the headlines suggestion? No ✅ Maybe if we want to lower flu cases every year we could offer flu vaccines to more people and wear masks when you'll ill to protect others Simple 👏 - It's not rocket science Which confirms that Wes Streeting and Labour are just as incompetent as the Conservatives with basic public health policy
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louis appleby
louis appleby@ProfLAppleby·
Good example of how under- & over-diagnosis can exist simultaneously. We may be over-diagnosing well-functioning adults & missing young offenders for whom treatment of “ADHD” will change the course of their lives. theguardian.com/society/2025/d…
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Eric Topol
Eric Topol@EricTopol·
Important new, large (N>28,000 women) randomized clinical trial of breast cancer screening: age-based vs risk-based by polygenic risk score, genomics "opportunity to modernize screening" jamanetwork.com/journals/jama/… @JAMA_current
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GoggleDocs
GoggleDocs@GoggleDocs·
Retatrutide TRIUMPH-4: 29% weight loss at 12mg. Impressive. ⚠️But here’s what needs discussing: 20.9% experienced dysesthesia (abnormal skin sensations) at that dose vs 0.7% placebo. Before everyone panics: - Generally mild - Rarely led to discontinuation - Overall dropout rates similar across all arms This is novel for incretins. GLP-1s and dual agonists don’t typically cause sensory symptoms—they stick to GI effects. Triple agonism (GLP-1/GIP/glucagon) may affect neural pathways differently. What we don’t know: - Mechanism (why would metabolic receptors affect skin sensation?) - Long-term persistence - Whether slower titration helps The risk-benefit still looks favourable. Most people tolerated it and stayed on treatment. But 1 in 5 experiencing unexplained neurological symptoms at therapeutic doses deserves transparency, not dismissal. For context: This efficacy (29% weight loss) exceeds anything currently available. That’s practice-changing if the safety profile holds. 🎯Bottom line: Unprecedented efficacy with a manageable but unexplained sensory side effect. We need larger, longer trials to understand this fully.
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Alan Stout
Alan Stout@AlanStout19·
This figure is very telling. It is about 0.2% of the number of patients seen in GP in the same time period. A struggling GP service and a tiny increase in this fraction can collapse the whole system Never underestimate the volume and value in GP
NHS England@NHSEngland

There were over 200,000 A&E attendances last winter for conditions that could have been dealt with elsewhere – including 96,998 sore throats. This is why the NHS is making it easier to get help through services like pharmacies or NHS 111. england.nhs.uk/2025/12/aes-un…

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