Martin Vernon

⭐ META-ANALYSIS: Hospital delirium --> devastating long-term outcomes 253 studies, 137,000+ pts: • 5.4x dementia risk • 2.8x institutionalisation • 2.5x mortality • 1.7x readmission ⚠️ Delirium = a serious acute problem AND a risk warning. ➡️ All pts deserve robust delirium assessment

BREAKING: Sky News understands the government will not be giving the landmark assisted dying bill legislation more time in the House of Lords, which means it almost certainly will fall. @SamCoatesSky explains ⬇️ trib.al/SBmlz6r

@CNKAlliance @GeriSoc Glad to see this cut through. While digitally enabled care can be useful in some settings- assessment for assisted dying or end of life care in general is not one of them.

Lord Empey quotes Prof Martin J Vernon, British @GeriSoc Ethics and Law Special Interest Group, on the unsuitability of remote #assistedsuicide assessment: “We have seen a shift in NHS policy in the last year towards greater use of digital means and this is driven by the Covid pandemic. However, we know from experience during Covid that an awful lot happened behind closed doors. Assessing somebody remotely, digitally, without a face-to-face assessment, particularly if they have complex health and social care needs, is nigh-on impossible. So trying to do so remotely and via digital means is infeasible.” committees.parliament.uk/oralevidence/1…

🧵Leadbeater Bill, Lords Committee (Day 8). 1st amendments: require in-person #assistedsuicide advice/declarations/assessments. 📺parliamentlive.tv/Event/Index/5e… 📑Bill bills.parliament.uk/publications/6… 📑Amdts bills.parliament.uk/publications/6… ➕bills.parliament.uk/publications/6… 📑Groups lordswhips.org.uk/todays-lists

@ddhitchens In short this is bad law and needs significant revision before it can go forwards. The NHS is not equipped or funded to deliver an assisted dying service even if this was the right thing to deliver- which as it stands it is not

Lord Stevens, former NHS chief executive, speaks for the first time (I think?) in committee stage. A really significant intervention: —NHS should not be involved since some will receive AS motivated by non-health issues (eg financial problems or feeling like a burden) —The bill redefines the NHS Charter, in a “somewhat camouflaged” way —AS is completely different from withdrawal of treatment —If AS is part of NHS, “risks undermining the trust that people have in their clinicians” —Risks increasing pressure on people to choose AS to “protect the NHS” —Govt have been “less than forthcoming” about the future of palliative care, and have not straightforwardly answered his question from two months ago

Have you visited our Comprehensive Geriatric Assessment (CGA) Hub? A clear, concise, evidence-based set of resources, freely available to all who need them on our website. buff.ly/yZ0Cxzg

🧠🦴 1 in 5 #hipfracture patients have #delirium on arrival. x2 likely to die within a year & 73% less likely to get home. Scottish data - N=18,000 pts. Shows: 4AT works at national scale - NB 91% completion. Takes 2 minutes. Why isn't this standard everywhere?

@lorraineburges2 Absolute pleasure 😊

@runnermandoc Joanne said a big big thank you in caring for her mum.

This is considerably worse than the pandemic and on the front line services are getting decimated. Not good for patients and not good for staff 👇 bbc.com/news/articles/…

In 2019 @NHSEngland committed to invest in better care for older people with frailty by supporting primary care & community services But it’s been eviscerated by successive ‘leadership’. This links directly to the current urgent care crisis👇 nao.org.uk/wp-content/upl…

There is plenty of evidence that comprehensive assessment of older people followed by accurate diagnosis and appropriate treatment improves outcomes. Lowering antibiotic thresholds to treat things they may not have carries its own risks. Geriatricians know this 🙄🤷‍♂️

Professor Sir Chris Whitty urged clinicians to adopt a lower threshold for antibiotic prescribing in this population compared with younger adults #NHS #doctors #antibiotics doctors.net.uk/news/doctors-m…

A hospital that chooses to close its same day emergency care beds & fill them instead with unselected patients is a hospital that doesn’t understand emergency care and is in denial that the same problem won’t be there tomorrow.. leading to more extremis- just sayin.. 😉🤷‍♂️

While parliament debates legalisation of assisted dying we continue to face ever decreasing care alternatives at end of life Despite legal requirement ICBs are failing to commission equitable palliative & end-of-life care to meet their population needs👇 nao.org.uk/reports/the-fi…

@wesstreeting @RoyalFreeNHS I’ve worked for the NHS for 37+ yrs. However the concept no longer works-our population has aged & NHS DNA can’t adapt to ever increasing need- ‘social need’ was mistakenly locked out in1948-but is the principle ‘health’ challenge we now face-we need new policy (not a plan 😏)

Today I received my follow-up cancer scan without being asked to pay a penny. An NHS free at the point of use - revolutionary in 1948 and essential today. Owned by us for all of us. I’ll always defend it. (And thanks @RoyalFreeNHS!)

Excellent call to arms by ⁦@mancunianmedic⁩ - there is specialism in generalism 😏 bmj.com/content/391/bm…

"Pragmatic prescribing to reduce harm for older people with moderate to severe frailty" aims to support prescribing decisions for older people with moderate to severe frailty. View our guidance document here: buff.ly/WofRdSe

@MichaelRosenYes Controversial, openly ageist and downright dangerous. This matters in civilised society because when we start to devalue people according particular characteristics beyond their control, we are already on a very slippery slope towards devaluing everyone.

Is this controversial? Not controversial? Am interested to know.

Have you read our "Pragmatic prescribing to reduce harm for older people with moderate to severe frailty" document? It aims to support prescribing decisions for older people with moderate to severe frailty. buff.ly/WofRdSe

@elonmusk How absolutely dumb 🙄 Pretty much sums up what is wrong with humanity- pointless obsession with immortality..🤷‍♂️

Become multiplanetary or die That is the choice we face x.com/i/grok/share/c…