Matt Baker

@DrRobgalloway Had a great year as one of those ED fellows 7 years ago where my wife and I had the same shifts and same AL all year! Amazing department with amazing leadership. Cheers Rob

13 years ago, I came up with a formula. After 13 years of my life being obsessed by this formula, I am steeping back……. This formula works out how many clinical hours people needed to do when working annualised self-preferencing/self-rostering rotas and has become a passion of mine. Not because I care about maths but because it has led to what I genuinely care about; a financially efficient way of improving the quality of life for doctors and other NHS staff whilst improving patient care. Last week I stood back from being involved in medical workforce issues at my trust. Having spent these years helping colleagues to not burn out and get a better work life balance, I am now trying to do the same for myself, whilst allowing time to concentrate on my passion of teaching human factors and patient safety. Crucially though because of the systems created, I am no longer needed to ensure what we have set up continues at my trust. My last job in this role was inducting all the medical and A&E junior doctors at RSCH, Brighton and PRH, Haywards Heath Hospital into how their rotas would work. It sounds a dull talk to give but its so important and one I love doing, because seeing all the doctors genuinely happy with their rotas makes all the effort worthwhile. To provide care today, we need the doctors working where the service needs it. To provide care next year, we need to provide jobs which are sustainable and don’t lead to burn out. To provide care in 2 years’ time we need to do it in a way which is financially viable. Working with healthrota we have managed to do all three and transform the management of the medical workforce at Universities Hospitals NHS Trust @UHSussex . We certainly have not got everything right, but things are so much better than the used to be. We now we have rotas where the doctors have a much better work-life balance as they choose when they are off and its much easier to work part time. We have improved training for the doctors for example by guaranteed clinic weeks. We have better continuity of care, even staffing during the week and 7 days a week ward based care on medical wards, identical staffing 7 days a week in A&E, whilst guaranteeing the doctors all their study leave, self-development time, bank holidays and annual leave they are entitled to without endless fights as is sadly so often the case. We are locum free except for last minute sickness, had 100% fill rates in our jobs and at RSCH/PRH have over 70 FTE fellows doing 25% non-clinical time in research or education. These ideas are simple. Work out how many hours you need to do after all the leave and non-clinical time is taken off and make rotas which work for the individual and the service using those hours to do. This is what annualised self-preferencing/self-rostering rotas are. Simple ideas but ones initially not part of NHS policies and one impossible to implement with what was the dominant NHS rota technology. Originally just thought if as maverick thinking, it is now becoming more common place in the NHS. Lat year it was highlighted as an NHS exemplar, transform.england.nhs.uk/key-tools-and-… Indeed in April 2024 the Chief executive of the NHS sent a letter to all trusts imploring them to “Improve rota management by exploring the opportunities technology offers to move towards greater self-rostering, so doctors have greater control over their lives while meeting the needs of the service.” None of what we have done would have been possible without partnering with @healthrota who have developed the software which allows these ideas to become a reality. But its not just technology which is needed. Its about working with a trust’s HR team who genuinely wants to improve things for the better and have facilitated the idea to become a reality. But behind that is a team of people who share the passion and have the skills to make the ideas a reality. Without the team I have worked with, none of this would be possible. But there is one person who deserves not just a special word of thanks, but whom without none of this could have happened: Amy Brown. @theonlyamybrown Amy thankyou – the work you and your team have done is monumental to so many doctors and so many patients. I hope what we have developed gets spread out further across the NHS and not just with doctors– please email me for further information drrobgalloway@gmail.com

@st07tmc @Louisdebernard Ouch

@Louisdebernard It’s not a can of worms. There is a major trauma hospital that’s takes all the stabbings and shootings not named “GM MT Hospital”. There is a neurosurgical department that manages neurotrauma in a place called the “GM MTH”.

@_hvh_ @AndrewJD I see it’s an option to do an SIA in a year in ICM. I wonder if some DGH are accepting anaesthetics training with an ‘interest’ in icm enough for appointing consultants in both?

@mattbaker126 @AndrewJD Hi Matt! I think it is getting harder and the ICM workforce will be increasingly single specialty (looking at trainee intake). But I think espec DGH units will find it hard to create job plans for pure intensivists and dual anaes/ICM training works very well for those settings

@_hvh_ @AndrewJD Hans (hey 👋) I did a year of dual and then gave up the ICU. Realistically I didn’t think I could actually be good at 2 increasingly complex specialties (and I didnt want to lose my anaesthetics SIA year. Do you think Dual anaes/ICU should be phased out?

@AndrewJD I think this part is more of a reflection that it’s increasingly difficult to be truly an expert across two specialties. I suspect your regional/airway exposure would have been equally minimal during a year of ICM - a problem with dual training rather than ICM per se in my view

@Davemademedoit @AndrewJD The amount of foundation doctors who get straight into anaesthetics without an f3 year in either ED, ICU or medicine is minuscule, moreover the ones who go through the hassle of dual CCT almost always have significant (enough) medical experience anyway.

@AndrewJD I politely disagree but bit busy to expand but... I think a lot of people go straight into anaesthetics without more than foundation training experience which is no where near enough to cover medicine basics .anaesthetics isn’t medicine. MrCP does not a physician make

@AndrewJD I’d advise you keep reflecting until you realise how bloody great it all was

Long live the Queen, @keelyhodgkinson 👑 #BBCOlympics #Paris2024 #Olympics

@AndrewJD Can’t see you there chief

@jplomas Why the rest of the NW doesn’t follow this is a nonsense

Sent by a colleague in training... is YOUR Trust struggling to cover extras? We often cover shifts in the SAME MINUTE as asking... Pay well Pay on time Treat people well as they rotate through Not rocket science #BeMoreBolton

1999 champions league final full 3 minutes 42 seconds added time

@DrJPGannon @Sajay70 @VirtueOfNothing @BillKilvington @CollegeODP @morefluids @dr_imranahmad @elboghdadly @doctimcook @doctor_oxford @trentconsultant @doctorhelgi @jplomas @Vapourologist @Chakladar_A Bloody lazy anaesthesia at it again

I’d remove the Ladybird Book of Reasons to Cancel a Patient from the Dept of Anaesthesia; Name&shame those who cancel the last pt coz they want to get away on time yet are always late to start; Police the use of break times-always an excuse for not sending? Surgeons back in charge of lists schedule rather than admin staff; Stop the habit of being pulled out of your regular list at short notice to cover elsewhere.

What's the one thing that you would do to improve theatre efficiency in the NHS? @SaferSurgeryU @BillKilvington @CollegeODP @morefluids @dr_imranahmad @elboghdadly @VirtueOfNothing @doctimcook @doctor_oxford @trentconsultant @doctorhelgi @jplomas @Vapourologist @Chakladar_A

@BloodScientist The opinion of people with no hobbies 🤷 youre appointing the person not the credentials

Controversial opinion; Hobbies have no place on a CV. CVs should be factual and straight to the point. What do you think?

@alanshearer BALL HITS HAND = INDIRECT FREEKICK 🤷

Pens given for hand ball pens not given for hand ball. The refs have an impossible job because the law is an absolute shit show. Natural/unnatural. Proximity. Speed. What a mess.

When I was a CMT1 I was in a godawful post where I ended up driving to a lake to drown myself after work one late night after finishing. The Trust's Occupational Health sole suggestion was that I talk to my non existent supervisor "if I was struggling".

Ok. A few bits. Will add a context of intravenous sedation for long bone fracture manipulation as an example. 1. Even when the pre-sedation environment is tense, noisy, loud, etc., speak gently with the patient before you start. Allocate someone to continue to speak smoothly and

@AndrewJD @caffeinemedic Says the bloke sat on a medical ward

@PENGRIFFEY97 @AndrewJD I think Andrew needs to be cancelled for this

@AndrewJD Then I’m sure you are aware there are more pressing issues affecting your profession currently. You could be using your valuable time discussing these instead. (This was someone you don’t know and didn’t enquire as to why they are wearing said attire may I add) FOCUS ANDREW

Mind your Godamn business.

@blidwize_united Good

☠️

@AndrewJD Do you say urinate or wee? Defaecate or poo? Tummy is fine- stop being a turd

@AndrewJD Belly or abdomen because it’s not normally stomach?