Neil

This is the sad reality of a normal day in the NHS. No strikes, No excuses. Yet we’ve got fully qualified doctors sitting unemployed while patients are left waiting 21 hours in A&E. Years of mismanagement and catastrophic workforce planning failure. What a betrayal to patients

@MerrynSW Its the >60 bus pass that gets me. Rich pensioners off for jollies and others using it to commute. Would be better targeted at those <25 just getting started with careers, learning etc.

Voters. Always ask who pays. Buses aren't cheap. Who pays for everyone to travel at a price below the cost of the provision of the service?

Imagine a 19-year-old scrolling TikTok. She watches a creator list five "signs you have undiagnosed anxiety." She recognizes three in herself. By the end of the week, she's describing herself as anxious to her friends. A month later, she's avoiding situations she used to handle fine. What went wrong? In a new paper by my PhD student Dasha Sandra, titled "Why mental health awareness can harm: Converging explanations for a societal problem", we argue that well-meaning mental health awareness can backfire, and we identify how. Four separate literatures (concept creep, nocebo effects, prevalence inflation, and illness self-labeling) have been circling the same problem from different angles. We show they converge on three mechanisms: 1.Awareness lowers the threshold for what counts as a disorder. 2. It trains people to scan their inner lives for symptoms and reinterpret normal distress as pathology. 3. Once someone adopts an illness identity, they behave in ways that confirm and deepen it. The evidence is wide. Learning that loneliness is harmful makes solitude feel worse. Learning that stress is harmful worsens well-being and performance. Awareness videos about fake conditions like "wind turbine syndrome" produce real headaches. Trigger warnings raise anticipatory anxiety without reducing distress. This does not mean awareness should stop. It means awareness can have unintended consequences, including manufacturing the suffering it tries to prevent. Inoculating people against these mechanisms works, and we already have evidence it does. Link to paper: michael-inzlicht.squarespace.com/s/The-psycholo…

For the next few weeks I’m a hearts fan.

@online_his ...!

@John_Stepek @johndotwills But I agree that it must be a nightmare to run a small pub while the government subsidises your next door rival community space.

@John_Stepek @johndotwills It would be an issue if it was all lovely pubs in small villages closing. I suspect though (with no data to support!) that most of the pubs that are closing are a bit shit and there are lots of alternatives nearby.

Enjoyed this piece on rural pubs from @johndotwills - I hadn't joined the dots on how it's daft to have community "hubs" competing with the community pubs already there (as with many things, suspect this is an ongoing failure, not just the current govt) capx.co/labours-war-on…

@medicalmodelbri Or 111 not sending a person with chest pain to A+E. Considering some of the other stuff they send this would seem like a priority.

@medicalmodelbri The main issue here is the cardiology team downgrading the referral. I'm not sure why they GP is getting the blame.

Another patient dead Another PFD report The coroner was clear. The Info sent to the GP practice by NHS 111 was reviewed by a non medically trained staff member who decided not to escalate to a CLINICIAN- a MEDICAL PROFESSIONAL and did not add this to the medical record 😡

@jonburkeUK @MerrynSW I think they're great for newer housing retrofits and all new builds. Not for older housing. I suspect Merryn is being provocative...

@MerrynSW @neiljshepherd What is niche about heat pumps?

Policy.. meet physics.

@pieandbov I once walked to the airport with my wife and 3 kids + luggage from a B&B in Paisley. After trying about 5 taxi companies and uber nothing was available. They've made it really hard with lots of barriers, busy roads, lack of crossing points etc. Would NOT recommend!

One of the greatest rip offs of our time just got even worse. Aye, hang on and we'll all fucking walk to the airport.

@mgtmccartney Working in ED yesterday. No labels in the printers, drawers unstocked, computers broken, kit missing. Department has 7 bays, currently 8 people waiting for a bed on the ward. Staff too busy trying to look after ward patients that nothing else gets done. So inefficient.

Docman crashed x2. Despite being on phone to IT last week

Australia just recorded zero cervical cancer cases in women under 25 - for the first time since records began in 1982. This is what happens when a country commits to HPV vaccination and screening. We protect our girls and save lives.

The case for a greater focus on medical “expert generalists” in the NHS has been in the health policy news recently. But expert generalists already very much exist in our system. They just need to be supported, says @mancunianmedic bmj.com/content/391/bm…

From the Commercial Inn, Inverurie. Who do we think the chap at the bar supports? 👀🤣 (Video Credit: Commercial Inn)

@DrEilidhMaria Go see a dentist. You’re not well. Entirely reasonable to take the day off for this.

@medicaccountant @goldstone_tony I’ve stopped doing locum GP work on top of my salaried job for this very reason. 60% marginal rate and possibility of AA tax means there’s other stuff I can do with my time.

The last few weeks I’ve been helping @goldstone_tony test his modelling tool for annual allowance & the £100k tax trap. What stands out are the crazy marginal tax rates for some - it’s pays not to work. A productive NHS needs people needs a sensible tax system. We don’t have one

@goldstone_tony Very helpful. Thank you. Has been causing a fair amount of stress…! The whole opaqueness and complexity is frustrating and we don’t trust the figures they give us.

As above the 14/15 is out of scope. The amount is almost certainly an error (unless there was a transfer in from another scheme) but its irrelevant as the 14/15 year isnt assessed. If everything else looks sensible its porobably not worth getting that fixed as it doesnt change anything

ICYMI My latest FOI from HMRC on McCloud this week still shows an *ASTONISHING* number of unprocessed envelopes Most medics get compensation/refund & that has been over £14k. If you don’t process it you get nothing. Nada. Zilch. Don’t ignore yours 👉 bit.ly/MazarsGoldstone