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 !

Decompensated cirrhosis: an update of the BSG/BASL admission care bundle Acute decompensated cirrhosis (DC) and acute-on-chronic liver failure are common reasons for hospital admission that have a high in-hospital mortality rate (10%–20%). Patients require a detailed asses...

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...

I chaired the NHS and hardly believed it: sewage flows into sinks The outgoing chairman of NHS England is full of praise for its staff but says the service is ‘sclerotic’ and relies too heavily on politicians

“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...

Hospital corridor with gurneys

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!

Low-risk febrile neutropenia: does combined chemotherapy/immune checkpoint inhibitor necessitate a change in approach? - Supportive Care in Cancer Purpose Management of patients with low-risk febrile neutropenia in an outpatient setting guided by the MASCC score is proven to be safe and effective. Most patients on ambulatory low-risk febrile neu...

@cancercaremascc.bsky.social @maryamlustberg.bsky.social
@drjonlim.bsky.social

link.springer.com/article/10.1...

Burnout, shame, heartbreak: nurses are being crushed by our broken NHS | Sonia Sodha A shocking Royal College of Nursing report reveals the toll chronic underfunding has taken on staff, and rings alarm bells for the future

www.theguardian.com/commentisfre...

Patients who wait more than 12 hours in A&E ‘twice as likely to die within a month’ Britain’s most senior emergency doctor says figures ‘too compelling to ignore’ and calls for ‘urgent political action’ to tackle crisis

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...

Labour in Wales
SNP in Scotland

These appalling events are happening in all 4 home nations.

It is worsening each year.

No political party prepared to accept route causes and undertake the huge take of actually addressing them.

Until then this will continue

'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

'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

Winter pressure causing strain as bad as pandemic, NHS bosses say - BBC News More than 5,400 patients a day are in hospital with flu, as delays in A&E and for ambulances mount.

"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 🧵

Same-day emergency care: a retrospective observational study of the incidence and predictors of venous thromboembolism following hospital-based acute ambulatory medical care Same-day emergency care (SDEC) is an expanding area of hospital acute medical care. It aims to minimize delays and manage medical emergency patients w…

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

Alarm as skyrocketing flu cases add to NHS strains More than 5,400 patients in hospital with flu as delays in A&E and for ambulances mount.

"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...

‘Get this done’: Andrew Dilnot attacks three-year plan for English social care Architect of previous attempts at reform says government could announce what it wants to do by end of 2025

“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

David Oliver: Will a Labour government rescue adult social care? Social care is in crisis. It’s failing the people who need it, and their families. This failure has a secondary effect on NHS services. If Labour becomes the next party of government, it will assume r...

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 With a sense of inevitability and clear predictability, urgent and emergency care in the UK is rapidly heading into another winter of discontent. We are seeing signs that we will experience another wi...

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.

Dr Tim Cooksley, the immediate past president of the Society for Acute Medicine, said patients were losing confidence in their ability to access primary or community care. "They will access any care they can in desperate times and have often sought alternatives before presenting." Prof Julian Redhead, NHS England's clinical director for urgent and emergency care, said A&Es were experiencing "record levels of demand", and urged the public to "play their part" by only turning to them for serious injuries or life-threatening emergencies.

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.

Ingat sa byahe

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.