Asked by media to comment on withdrawal from antidepressants- perennial anxiety about dependence. But have never been asked to comment on withdrawal from meds for ADHD which are addictive and do cause horrible withdrawal symptoms. Puzzled why ?

My thoughts go to the people in LA and the unimaginable horror they are going through. ( so bad that Trump et al are fuelling the flames - sorry for the pun).

Opening the gate and allowing patients better and quicker access to scans will improve outcomes. Can be improved with well designed digital algorithms at front end helping to get patient to right place with right degree of urgency.

Not sure you’re right. Many - PA’s have a first degree including nursing.

Early cancer diagnosis up due to number of factors. Better public awareness, new screening (lung), digital and remote access (algorithms don’t get tired& ask the right questions,and frees up time for GP), better access to diagnostics for GPs.

Who ever invented dancing vegetables - thank you. (And if you don’t know what I’m talking about you’ve not looked after a toddler in recent year)

honoured to go to celebration of Physician Associates becoming regulated by GMC. Proud moment for them. They play a valuable role in #nhs and the attacks on them have been unfair.

Listened to @wesstreeting.bsky.social this evening on a webinar. So impressed with his grip on what needs to be done. So much to do, but already his work has begun to make a major impact. Project hope for the #nhs thank you

I missed so much when the children were growing & noticing now with the babies. Yesterday one took her first step other her first smile. But more. How they learn to feed themselves (messy but determined), early signs of determination (pushing something away), the thrill of exploring and more.

Having a wonderful evening listening to @michaelrosenyes.bsky.social in conversation with @claregerada.bsky.social for @doctorsindistress.bsky.social .

What else have to learnt about grandparenting. OMG. I’m not as strong as I was 30 years ago. I rely on the kindness of strangers to help me on public transport (and so many do, thanks). Undoing those clips on pushchairs and twisting the tops of food pouches - not for 60+ yr old hands.

Sorry. That’s not the point. The NHS is struggling due to lacks resources to meet demand largely due to fall in GNP. As a system it is succeeding as best it can.

I was asked ‘why is general practice failing’. Every day it delivers 1.3m appointments (55% on same or next day, 85% within 2/14’s). We’re most productive part of nhs. We are more, do more, to greater degree of complexity than any other GP in world. Sorry, we’re not failing bad just can’t keep up.

New to grandparenting - unlike parenthood - I don’t try to juggle 100’s of things whilst caring for the little people. It’s them and me. No washing up / rushing to the shops/ cooking/ cleaning/ writing academic papers (yes, I did that whilst on mat have). It’s such joy

What is a ‘blue sky’ post referred to ?

I quite agree. Thanks. I think using this argument is patronising to disabled people. Assumes they have no capacity to make a choice.

Just emailed you

(6) Assisted dying isn’t a failure of palliative care but acknowledgement of its limits. Both are grounded in reducing suffering & respecting pt autonomy. By offering both, healthcare can provide compassionate care that meets needs of pts including those with rare but profound cases of suffering.

(5) Genuine compassion in medicine involves listening to patients' values and preferences, even if those preferences differ from those of a traditional care model. Denying the option of assisted dying may prolong suffering unnecessarily

(4) MND is a compelling example: pts with MND often experience a gradual loss of autonomy, communication, & ability to perform essential functions. assisted dying can be a compassionate choice and right to choose shows, society acknowledges their autonomy & respects their decision.

(3) Assisted dying provides an option for patients who feel their suffering has become unbearable and who perceive that their life no longer aligns with their values or sense of self.

(2) It addresses physical, emotional, spiritual, and social suffering. However, even the best palliative care has limitations. It cannot fully alleviate existential suffering, a sense of loss of dignity, or profound psychological distress in every patient

Ive been a doctor for nearly 45yrs Helping provide patients with as good an end of life as possible has been an integral part of my role. palliative care as essential for providing comfort, managing symptoms, and improving the quality of life for patients with life-limiting illnesses. (1)

My first post on Bluesky. Hoping it’s more friendly than Twitter.