Acute care pathways have changed since landmark #VTE #prophylaxis trials were done. What do results from recent observational studies in #SDEC mean for practice and research? #AcuteMedJournalClub recording t.co/0Hxuh9wfyD Don’t forget to have your say #QRcode for 3 questions at the end !

Fantastic to see the updated BSG/BASL decompensated cirrhosis admission bundle in print at FG - practical guidance to improve care in the first 24 hours as well as implementation strategy - congrats Stuart McPherson for driving this! #livertwitter fg.bmj.com/content/earl...

“It's been underinvested in, steadily, for years & years...across governments, across many years — and you have to see it to believe it" Outgoing @NHSEngland chair Richard Meddings talks to Sunday Times Oli Shah www.thetimes.com/uk/healthcar...

In recent decades we’ve lost too many general and acute hospital beds in the UK, without creating sufficient alternative capacity outside hospital. This has resulted in entirely predictable risks and harms, writes @mancunianmedic.bsky.social www.bmj.com/content/388/...

It’s official! Dr Jamie Weaver & I will now be co-leading #TheChristie International Fellowship Programme for Medical Oncology, supported by Jenny Espin. We are happy to have 40+ clinical fellows across various tumour groups, contributing to cancer care & research. Watch the space…more to come!

@cancercaremascc.bsky.social @maryamlustberg.bsky.social @drjonlim.bsky.social link.springer.com/article/10.1...

Patients who wait more than 12 hours in A&E 'twice as likely to die within a month', says ONS www.telegraph.co.uk/news/2025/01...

'As an urgent care doctor I see NHS at its worst - Starmer's plan is deeply flawed' Dr Tim Cooksley, a consultant in acute medicine, says the Prime Minister risks an 'eternal crisis' in the NHS without urgent social care and workforce reform https://buff.ly/4j5qNYj

"The reality for patients and staff is corridors full of patients experiencing degrading care, being treated in the backs of ambulances because there is simply no space in hospital, & the immense physical & emotional harm that inevitably results" Dr Tim Cooksley on the appalling NHS winter crisis.

If only this from the Sunday Times were new - the truth is even worse: that trusts have been advertising for “corridor nurses” for years. A horrendous illustration of how overwhelmed our hospitals are every year, all year. This isn’t “flu” - it’s flu + lack of beds + failure to address social care 🧵

We report 0.9% VTE within 90 days of hospital led acute ambulatory care attendance; similar to traditional medical inpatient care without thromprophylaxis. Further VTE research needed in this rapidly expanding area of medicine#VTE#SDEC @danlasserson.bsky.social www.sciencedirect.com/science/arti...

With patients at risk of harm due to spending days in Emergency Departments and health care professionals left in tears due to winter pressures, the Royal College of Emergency Medicine has asked ‘how has this been allowed to happen again?’ Read our response to new NHSE data 👇 tinyurl.com/2ujbhz7m

"The reality for patients and staff is corridors full of patients experiencing degrading care The fundamental issue is that there is a continued lack of capacity throughout the year - a tough flu season must not be used as a political excuse for the current situation" www.bbc.co.uk/news/article...

“It’s so blindingly - excuse my language - bleedin’ obvious that in an intelligent, affluent, civilised society we get this done.” Sir Andrew Dilnot tearing strips off the government yesterday for deferring addressing the crisis in social care until 2028. (1/3) www.theguardian.com/society/2025...

"The media is full of pictures of patients in corridors; long queues of ambulances outside of emergency departments and stories of horrific patient experiences: this is seen and experienced by frontline staff every day. It is an appalling situation."

This is a really important piece. We have to find a way to significantly reduce hospital handover delays so that next winter is better for patients and better for our staff than this one @londonambulance.nhs.uk

I wrote this just before the general election I was clearly not being negative enough. More "Streeting Duty" than "Sleeping Beauty" www.bmj.com/content/385/...

Another winter of discontent looms for NHS urgent and emergency care www.bmj.com/content/388/...

"The innovative elements of the plan are welcome.. without emergency care recovery, this elective plan will inevitably and predictably fail. The concept of continuing to ringfence elective beds whilst patients are dying, receiving degrading corridor care is immoral" @acutemed2.bsky.social

Critical incidents in hospitals up and down country. All services under immense pressure with no light at end of tunnel. Just when we think it can't get worse: it somehow does. Appalling for patients and scandalous entirely predictable situation.

General Practice doesn’t fit a marketised model of care, so it’s being killed, & the effects are spilling into the 1 remaining bit of the NHS anyone can access. Cooksley is spot on. The patient-blaming angle (including from government’s NHS director) is idiotic. amp.theguardian.com/society/2024...

Current pressures are grim. Not sure this type of message helps. Vast majority of people value their health services and only utilise when in need. That vast minority who do ring 999 for a stubbed toe will continue to do so irrespective. Messaging risks influencing wrong group.

🚨 Snapsot below from staff struggling tonight. You can see in the West Midlands there are over 180 ambulances stuck at hospitals...114 over an hour. Second image shows waits in York A&E...longest for a bed is over 40hrs

Normalised and not yet nadired. The most scary point of all.

It's an awful experience for pts and staff...in fact some pts will die. It may now not be exceptional, but that just means we have normalised it and that is truly dreadful.

Fantastic talks @mskcancercenter.bsky.social emergency oncology conference this morning. 7 touchdowns at Metlife stadium in great Ravens performance. Fabulous @sixbroadway.bsky.social show tonight. #NewYork

Brilliant day @mskcancercenter.bsky.social emergency oncology conference. Great learning, fantastic opportunities for future work and collaboration. Real pleasure to present at such a fantastic conference.

Many hospitals will undoubtedly fall into critical incidents and patient safety will be compromised the frustration is that this is not unexpected given the longstanding issues with workforce, capacity, community services & a crisis in social care @acutemed2.bsky.social inews.co.uk/news/health/...

RCEM is 'deeply concerned' about the lack of political attention on the pressure facing UEC systems as winter hits. It comes as new NHSE data revealed a ‘tidal wave’ of infections leading to a 70% increase in hospital cases across just seven days. Read more here - tinyurl.com/3pecffkw

Fantastic to be at Memorial Sloan Kettering and to see their cancer urgent care pathways/processes. Many differences but also many identical challenges and issues. @drjonlim.bsky.social

It is a great shame that these "disused care homes" are not being renovated to provide high quality community care that could support and rehabilitate older people currently "stranded" in Acute hospitals. Would be significant step in mitigating winter crisis. www.theguardian.com/uk-news/2024....

just back from a long day in acute medical unit/emergency department and it is Flu/RSV/Covid - Central once again My own home ward is also full of it And no shortage of staff sickness either "Back to the future"

Ambulance handover and shorter A&E waits can only happen in combination with a functioning social care system. "Dr Tim Cooksley, of the Society for Acute Medicine, said it was "concerning" the Health Sec felt the need to spell out the priorities for frontline staff." www.bbc.co.uk/news/article...

"The extra cases of winter viruses...mean many hospitals will fall into critical incidents and patient safety will be compromised – but not as a result of hard-working staff not putting patient safety first but because the hospitals simply cannot cope" @acutemed2.bsky.social @theguardian.com

"The stark reality is not that hospitals and staff on the frontline are manipulating targets, but that they are simply unable to deliver safe care even when trying their utmost to do so given the impossible situations they are in" @acutemed2.bsky.social www.bbc.co.uk/news/article...

Each winter in the past decade has become slightly worse and that trend, which has not been reversed, has resulted in a dire situation that may not yet have reached its nadir. A continuum of often predictable perfect storms has caused a struggling system to reach collapse www.bmj.com/content/384/...

These are desperate times and getting worse. "Review" is stalling nonsense. Solutions are known; but expensive and will take years to deliver recovery. Each year those tough choices are avoided and we have superficial policies and delay (and will ultimately remove) any hope of improvement.

Pressures throughout the system are perfectly and bleakly illustrated in urgent and emergency care where patients experience appalling conditions Extra cases of winter viruses mean many hospitals will fall into critical incidents @acutemed2.bsky.social tells @inews.co.uk inews.co.uk/news/health/...

"It's an ongoing crisis which remains far from being resolved effectively. The extra cases of winter viruses mean many hospitals will fall into critical incidents given the relentless challenges we have faced all year round @acutemed2.bsky.social says. @rcem.bsky.social www.bbc.co.uk/news/article...

If it is only "bumpy" we would all be delighted.

“Sadly many patients who would prefer to die at home end up being admitted acutely at the end of life due to poorly controlled symptoms. This is largely due to insufficient and inadequate community services and this is where initial investment needs to be focused" @doctoroxford.bsky.social

@bmj.com Management of AF in older patients is of great importance but it seems to be the illustration for every BMJ article on Bluesky!

Lower turnover rates for nurses and senior doctors at hospital level are associated with better health outcomes for patients with emergency hospital admissions @bmj.com.bsky.social www.bmj.com/content/387/...

(1st Bluesky post) Our members are seriously worried about being able to keep patients safe this winter. RCEM President: “We speak of percentages and numbers but let’s remember we are talking about people, and a workforce running on fumes trying to do their best..." tinyurl.com/bssSnapSurvey

Outside a large ED at end of October. No queues. Similar scenes in ED and Acute units inside.

At the heart of this appalling new normal is a system where demand continues to exceed capacity. No hospital can ‘play ball’ whilst functioning at 100% capacity. We are hurtling into months of chaos as this winter will be a new terrifying nadir. inews.co.uk/news/health/...

Absolutely this. I also wonder how much of this report had been drafted pre-election? An "oven ready NHS review".

If the plumbing is simply digitalisation, more comm care and prevention then few will argue. Each of those needs investment. Short term support essential whilst those implemented. It has to be said - cold pensioners this winter struggling to pay bills is an appalling start to prevention strategy

None of this is new. Multiple expert reports and basic knowledge of data have illustrated diagnosis which is experienced first hand by patients and staff on a daily basis. There is nothing new in any of the 3 main headline solutions either. All reasonable goals but attempted before. Grim times ahead