Keir Starmer has described the long-awaited UK-US trade deal as a 'platform for the future'. Here's everything you need to know.

Critical care nurses’ prioritisation of patient care, including delirium prevention and management strategies: A mixed-method study www.australiancriticalcare.com/article/S103...

Nonpharmacological interventions to promote sleep in the adult critical patients unit: A scoping review www.australiancriticalcare.com/article/S103... #OpenAccess

This chart is from @britishelectionstudy.com @jamesdgriffiths.bsky.social, me and Ed Fieldhouse. You can see that 2024 Reform voters mainly came from the Conservatives or UKIP in 2015. This has been a story on the right for *ten years* now, unless something very different happened last week.

Looking for physios or SLTs that work in a UK district general hospital without an ENT department! We are interested in understanding more about how these hospitals manage patients with established laryngectomies and traches. Is this you? Could you help Cesca? Please share! @theacprc.bsky.social

Continuity of care and relationship-based GP is vital… not just for primary care - it will create a scaffold with tangible benefit for hospital care too. A point @ics-updates.bsky.social made in our submission to the Palliative Care Commission too GPs deserve a system that reaps their true value

One of the strangest ironies of the last ten years has been watching Britain immersing itself as deeply as ever in memories of WW2 while proudly turning its back on the project that emerged from it.

#acprc25 Surgical champion session on prehab and enhanced recovery after surgery done 👍. Great presentations and great questions @theacprc.bsky.social

#ACPRC25 #cheynegang - an interactive end to the conference

If you are @theacprc.bsky.social conference today, please see our poster with the UK results from PEAiCE study - 95 ICUs responses. You can see it also at the App -poster no. P89

The importance of boundaries for #HCP. Ask yourself: Would refusing to do this cause patient harm, me to lose my job, is it dangerous, or will it damage my own integrity? If the answer is no, hold your boundary, *even if* it inconveniences others, fires up your FOMO, or is career limiting. #acprc25

Rewrite the 'hard work => success => happiness' narrative. Start with happiness, then productivity, allow the success to follow. Dr. Rachel Morris at #acprc25

Aim for your zone of genius, say no to things in your zone of disinterest. Dr Rachel Morris at #acprc25

Research has found that privatisation of health services reduces quality of care. @franbaum.bsky.social‬ and colleagues look at how the concept of "enshittification" applies to health services and their decline with privatisation www.bmj.com/content/389/...

UK has widest wealth inequality gap in Europe. US still worse.

Dr Rachel Morris opening day 2 of #acprc25 - how to ditch the superhero and become superhuman. Where are you and your team on this curve? Show of hands in the room - majority points 3 or 4. Rachel's podcast is here open.spotify.com/show/3teg92v...

I'm still learning all things Bluesky, but have had a go at making a Starter Pack for #acprc25. The link is here - go.bsky.app/Doq6pHc - if you're at the conference I think you can add yourself?

Where else could you start the day at the seaside, and be learning delightful #respiratory #criticalcare #physio things in an ancient capital city centre by breakfast? It's got to be #acprc25 Edinburgh!

People in North of England and Wales would be the hardest hit by disability benefit cuts. They will suffer three times the economic impact and with twice as many affected residents as London and the south-east. Deprived areas have more people with disabilities. No impact assessment from govt.

Zoe van Willigen and Rachel Devlin presenting the ICUsteps Active prog - 1:1 ax then 6 weeks online, 2 hour sessions: exercise, education and practical support, peer support. Listen to what ICU survivors want us to provide, then design a service to do that! Tick. #acprc25

Gabriella Cork opening a fab looking crit care session at #acprc25 with an overview of @ics-updates.bsky.social #AHP capability framework. From its conception, creation, to implementation. An amazing piece of work - ics.ac.uk/guidance/ahp...

Move away from blame culture in relation to smoking cessation. Unless you've quit smoking yourself you don't know what it's like to stop, and even if you have you haven't done it from your patient's specific circumstances/situation. Ask non- judgemental questions about smoking status. #acprc25

The importance of holistic management of COPD. These may seem obvious, but frequently don't happen. Empower your patients to ask questions of their HCP. Fiona Mosgrove at #acprc25

Havi Carel on breathlessness at #acprc25. We need breath to have a voice, to laugh, to move. To interact with the world. How would you define yourself without these things? Without breath, a person can become invisible - housebound, unheard, isolated.

Fiona Mosgrove on COPD at #acprc25. - Poverty strong predictor of outcome. - Still a residual association with "lifestyle factors" and therefore shame or blame on patients. - Should we reframe COPD as an autoimmune condition?

What does a good clinical conversation look like? I don't know what it *feels* like to live with your condition, or your life; can you tell me? What is worrying you now? As a clinician, you may be expert in a condition, but not in each person's experience. Have epistemic humility. #acprc25

Picking apart pathological versus normal (healthy?) breathlessness. Havi Carel at #acprc25 I think the loss of control is the key here, and everything else spirals from there.

Describing breathlessness- no clear cultural distinction between healthy and pathological in language- "I was so out breath" to describe healthy response to exertion the same as severe pathological breathlessness. Havi Carel at #acprc25

Prof Havi Carel on phenomenology of breathlessness from both a professional and lived experience pov. I like the idea of health as the 'silence of the organs'. When our bodies 'work' we don't pay them attention, it is often only with pathology that our focus turns inward. #acprc25

Harriet Shannon opening #acprc25 conference. Excited for 2 days of learning and socialising. The agenda looks amazing! 🥳 @theacprc.bsky.social

Skytorial: pH management in DKA! I've been following debates about this for a *long* time (eg wrote this blog in 2016, which stands up pretty darn well: emcrit.org/pulmcrit/bic...) after years of arguing, lemme break down my take on this 😁

Am on LBC shortly talking about how Musk's reported plans to donate $100m to Nigel Farage shows how broken our electoral system is -- and how we can fix it This has been the most popular Democracy for Sale post so far. Can read all the stories here: democracyforsale.substack.com/p/musks-100m...

Matt Hancock told the #CovidInquiry that he wanted individual doctors to make triage decisions for admission to intensive care. CEAPI looked at this in 2005/6. They predicted a postcode lottery of discrimination and subjective judgements about moral worth (1/5)

IV glibenclamide (glyburide) did not improve functional outcomes or survival in patients with large MCA strokes in the CHARM trial, failing to replicate initial excitement from the GAMES RP trial. pubmed.ncbi.nlm.nih.gov/39577921/

From today, women effectively work for free until the rest of the year due to the gender pay gap. It’s two days earlier than last year because the gap has grown for the first time since 2013. We must end the undervaluation of women’s work for good.

“Patients who have the same GP for 15 years have 20% lower mortality than those who have been with a GP for <1 year” Makes you think! Continuity of care is important Fabulous opening plenary from Dr. Gavin Francis at MED+ @rcphysicians.bsky.social conference, discussing his book “Free for All”

The stroke iceberg: covert stroke 5x higher than symptomatic strokes that present clinically and 16x higher if previous stroke @gerisoc.bsky.social #BGSConf

Looking forward to the discussion about these next week at #bgsconf - some practical, operational application of the recommendations #gerisky #medsky www.bgs.org.uk/ProactiveCar...

Shocking statistic that if we can lift people out of poverty, we could prevent dementia in 1 in 6 cases in East London #BGSConf

Interesting paper about how poverty affects your cognitive function Due to increased cognitive load with the stress? Is it food differences. Need to do more research in this #BGSConf

My desert island MDT member for my patients living with #ParkinsonsDisease? An OT #OccupationalTherapy Clare Johnson teaches #BGSConf the value of occupational therapeutic techniques: *Mental rehearsal *Reward-based goals for anxiety *Social anxiety mx *Fatigue and power naps @gerisoc.bsky.social

Call to arms from @zudin.bsky.social to protect our multi-professional team to look after our patients for rehab and ongoing care #BGSConf

Patients want a follow up clinic following ITU Holistic, humanised and includes the family and access to the multi-professional team Huge links with the work of @gerisoc.bsky.social and the right to rehab campaign #BGSConf

Lessons from England’s National Health Service. Tldr: the UK NHS is in principle a great model but is now precarious, undermined by austerity and redisorganisation. Primary care is critical to the whole thing but is facing huge risks. www.nejm.org/doi/full/10....

And then when the bigger kids play area needed repairs, it took several months to get agreement to use unspent S106 funds from the sale of Heaton Library in 2008 to make it happen, because, in their view, it was Urban Green's problem to fix / fund it! Use a photo of something you did!

Word of the Day, should you need it, is ‘latibulate’, a 17th-century verb meaning to find a corner somewhere and hide in it.

If you are showing an interest in the upcoming assisted dying bill - you must also read this #NCEPOD report into End of Life Care published this week…. ncepod.org.uk/2024eolc/Ful...

My time at #lives2024 comes to an end JAMA have published a ton of the new research presented this afternoon on their website- all free to access jamanetwork.com