A&E Dr, Hon Clin Prof football loving, nhs supporting dad to 4 brill kids.Once voted HSJ wild card top 10 influencers but - since failed to have any influence
As a doctor, the most important skill to have is that of being a “riskatician”.
It’s not a word in any dictionary and so most people realise its importance. It’s about deciding when not to investigate or treat because the risks are greater than the benefits both on an…
Tonight, I’ve come close to tears whilst apologising to patients for the standards of care we are able to provide.
In my 22 years of being an A&E Dr, I’ve never seen things so bad. It’s the same everywhere.
I just hope patients know fault lies with politicians not NHS staff.
I’ve worked in A&E for 22 years & seen nothing like this before.
The NHS is in a critical state. We need urgent action for sake of our staff & patients.
@SteveBarclay
@RishiSunak
we need you to listen to those who know what’s happening.
To get them to listen, pls retweet
Dear British Press,
There is nothing in Prince Harry’s autobiography as scandalous as the implosion of our NHS.
So please report on the things which are actually important
Thanks
Rob (a non spare a&e Dr)
(Please retweet if you would like the press to change their focus)
I'm an A&E consultant and I'm tired after a weekend of nights.
But this am, I've handed over what I described as a "good department". This was said genuinely and with no hint of irony.
We provided great care and have very short waits to see an A&E doctor, but I'd forgotten how…
Just woke after night shifts in A&E.
Never know it like this in 21 years of being a Dr.
Covid doesn’t help.But crisis is essentially caused by political decisions over last 10 years.
We have to stop blaming drs & managers. But start considering moral basis of how we vote.
I have just finished another set of incredibly difficult weekend nights as the A&E consultant incharge.
Some thoughts:
The NHS no longer provides unscheduled care - we provide treatment. Care is with dignity - that's impossible for our patients in corridors.
The model of…
A plea to patients. Please come to A&E if you need us. Still call for help when you have symptoms like chest pain.
We are set up to treat covoid & non covid patients in dedicated areas.
As many may die from delays to get help as from covid.
Please retweet so everyone knows
Just finished a shift In A&E.
It was lovely. Appropriately staffed so we could cope with surges but meaning staff were well rested.
Few patients attended as they were able to access the well resourced community services and so didn't need to come in for non emergencies.…
Corridors are for walking down not looking after patients
@RishiSunak
one of your 5 pledges needs to be the end of corridor care.
Thats what we need if we want to stop 500 people a week dying unnecessarily from failures of emergency care.
#patientfreecorridors
I'm the past I've been criticised for being too political in my job as an a&e consultant.
I disagree - what's happening to our patients is a political choice.
I am in a blessed position of being able to see the reality of what's happening to the NHS.
The GMC says we have a…
We need
@RishiSunak
&
@SteveBarclay
to spend time in any A&E to witness the horrors of corridor care
Then they would understand the reasons for 500 excess deaths a week
And then they might try and solve the problem rather than deny there is one
Pls retweet to encourage them
@joejealxxx
The problem of overcrowding in A&E is not "too many people in a small country". It's the opposite.
The vast majority of people who were in the corridor waiting for beds were elderly British people who have paid their taxes all their life and deserved better.
Bur 75% of the…
Chest pain? Severe abdominal pain? leg weakness?
PLEASE still come to A&E.
We are seeing very ill patients who have delayed coming because of fears of Covid or not wanting to burden us.
NHS is set up to help all - covid & non covid patients.
Please retweet so people know.
I’m a boring bloke obsessed by patient safety, rotas and statistics. No one unvaccinated will listen to me.
So please, can some cool people retweet this.
“Getting a Covid vaccine is so much safer than catching COVID.
And If u go clubbing u will sooner or later catch Covid”
Dear MPs
As an a&e dr, I’m asking for your help
Please do a shift at your local A&E and see the reality of what’s happening to our NHS.
Not a photoshopped PR stunt but a chance to witness reality of our crumbling NHS
Then demand change.
Pls Retweet to help make this happen
Please can media stop describing NHS covid response as front line = heroes, management = bad
As someone who is both, I have same principles & desire to help, scrubs on or scrubs of
Not all heroes have capes. Some have scrubs. Others have pens (and excel)
We are all one team
Dear Jr Drs that I manage.
If u booked leave, & we agreed it - go on holiday and forget about work (& don’t use ur phone driving)
If another dr didn’t turn up for the shift -it’s my problem and not yours!
It’s worrying
@NHS_HealthEdEng
. think this is correct guidance
What’s happening to the NHS, our staff and the patients we serve, is not OK.
In my 21 years of working in A&E, I’ve never seen things so bad.
This is replicated in every UK hospital.
@RishiSunak
u have a duty to solve this crisis. Pls help as we can’t carry on like this.
This needs to be the norm for all staff doing nights in the nhs. It should be so normal that no one would have to tweet this as an example of good practice.
I genuinely dont understand why there aren't mass demonstrations to save our NHS. The health of our families is the most important thing - and we are loosing our safety net
Politicans are talking about single sex wards in the NHS. But a gentle reminder to them, that currently A&E NHS corridors have hundreds of patients of all types mixed together - tightly packed and with no curtains round their beds.
Ending corridor care which is unsafe…
Heathrow had pilots call in sick today, in a&e we also had high sickness rates.
They cancelled flights. We can’t cancel patients
This is what patient safety is so much more complex than aviation safety.
A&E is in a national crisis and this affects everyone. PLEASE read the link
Demand is through the roof and resources are not there to match demand.
We can’t continue like this.
Journalists please cover this crisis to make it politicians’ priority.
We must prioritise vaccines for front line nhs staff.
nhs has not run out of beds.......we have unused nightingale hospitals.
It’s staff we are running out of.
As a doctor I am FORCED to have hepatitis b vaccine if I want to work with patients.
Good. It’s the right decision for my patients health and my health.
Same should go for covid vaccine.
Just over 2 years ago, Martha Mills died in hospital of sepsis. Her tragic death was avoidable and is leading to the introduction of Martha’s law - a right for families to get second opinions.
She died because of a hospital culture – where questioning and challenge were not…
At handover I heard a patient had hyperkalemia.
My sho head hypercalemia
My reg heard hypokalemia
others felt excluded
The patient suffered.
traditionally drs use pointless Latin terms.
Madness
USE HIGH POTASSIUM - 5.7
No ambiguity, no jargon, plain medical English.
Drs didn’t perform miracles today. They followed cpr protocols which can be used by all. That’s why he survived. Not miraculous genius.
Don’t look in awe of drs.
Learn first aid
Dear
@RishiSunak
Before you next say the NHS is just busy or under pressure, please come & do an A&E shift
You’ll see the reality; it’s a crisis with 500 avoidable deaths a week in England
Yours sincerely
@DrRobgalloway
(apparently a just busy & bit under pressured A&E Dr)
Im genuinely worried from a patient safety perspective, if we are going down this route of inexperienced staff having to make complex difficult diagnostic decisions.
I've been a doctor for over 22 years plus 6 years at medical school.
Undifferentiated abdominal pain is…
Starting work with 50k of debt and on just over £14/hour
22% real terms pay cut in 12 years
Having to change jobs every 4 months & hospitals every 1-2 years
Rostered nights on your Wedding despite a years notice
None of this seems designed for our junior drs convenience
Would surgeons accept two patients in an Opertaing theatre?
Would intensive cares have two patients sharing one cubicle space?
Would oncologists accept other patients in the corner of their consultation and room when breaking bad news?
Of course no to all three - but in…
Crowding in A&Es is affecting tens of thousands of staff and patients every day
@RCEM_VP
We have updated our Emergency Department Crowding Guidance to support Emergency Medicine clinicians and their patients during this crisis.
▶️Full details:
If you could redesign medical education, what would you do?
My starters for 10:
All f2 do GP & A&E
All exams able to do open book so examine understanding not rote learning
All healthcare staff train together where skills are generic - eg human factors, communication etc
Thoughts on the NHS…..
Einstein said the definition of insanity is doing the same thing over and over again and expecting different results.
But this is what is happening in the NHS right now; hoping things will improve when just giving the same failing medicine.
As an A&E…
You only have to look at the current state of our health service, to realise that modern medicine, so good at treating acute illness but without as much attention on prevention and long-term illness, is failing our patients.
There is an inextricable rise in demand for medical…
I asked my junior dr to give iv antibiotics.
I didn’t get him to repeate it back
So there was a coms failure
Iv ab were delayed - patient suffered
got home & ordered Chinese takeaway.
They automatically repeated it back.
Drs need to learn from takeaways as much as pilots
We need to solve the overcrowding crisis in A&E. I may have the solution!
It came to me whilst reading my son " A squash and a squeeze" by Julia Donaldson (author of the Gruffalo)
A&E Squash and a Squeeze, adapted by Rob Galloway
A little old A&E, lived all by itself , with…
As someone who currently has to wear both a clinical hat and a managerial hat, please remember it’s not Drs & nurses vs managers.
We are on the same side battaling a dreadful disease with arms tied behind our back because of dreadful leadership from our politicians.
We now have evidence that delays in A&E kills.
For every 82 patients waiting >6 hours for a bed, there is one extra death.
It’s Not just an a&e issue. Not just a hospital issue. Not just NHS issue. It’s a pan governmental issue.
It must be tackled.
I am passionate about our NHS and have always wanted to get involved with
@NHSEngland
in a workforce or patients safety role.
But I wrote this article knowing that publishing it would probably stop that happening as they are unlikely to appoint someone who is so openly…
Things that have happened today
1) got COVID vaccine
Things that haven’t and won’t happen
1) grown a second head
2) developed autism
3) been injected with “tracking molecules”
It’s safe, painless, protects you and your loved ones
How come MPs canteen food is so heavily subsidised but NHS canteens aren’t?
Come to think of it why can you buy alcohol there when it’s a place of work?
Things really need to change in our country
It’s hard following the covid rules when they keep changing & there is an utter lack of leadership from the donkeys running country.
But listen to the lions keeping the nhs going in horrendous times.
Things are bad. Really bad. Please please please follow the god damn rules.
@Jeremy_Hunt
get off twitter and sort out the Nhs. Whilst u r playing school ground twitter games, we are trying to look after our patients in over crowded A&E corridors.
Apologies for emotionally driven tweet…..
Just woke up after 1 of most challenging A&E nights
@EDRSCH
@UHSussex
.
Despite difficulties, quality of care provided was unbelievable.
Thank god we still have nhs.
Thank god nhs still has the staff we have.
Long may it continue.
Junior Drs low morale isn’t just about pay.
It’s about unnecessary educational hoops, lack of employment stability & being treated like rota fodder rather than being valued.
Any resolution to strikes which just address pay and not values , will not solve the underlying issues.
The NHS is in crisis.
Upto 300-500 patients a week are dying from avoidable deaths due to failures of our emergency care systems.
Our patients need immediate action.
There are radical solutions which could help.
@RishiSunak
@SteveBarclay
now is the time to show leadership
Dear every single journalist
Please see this thread below
This is what’s happening in every hospital
We need you to highlight it so our politicians are forced to get their head out of the sand and start doing what they are there for; to protect the welfare of our citizens
1)
#TheNHSisBroken
What drs are reduced to during current extreme hospital pressures. From an anon doctor, a 🧵:
This wkend I have done things I have never done in my working life, now expected, it’s breaking me! My standard of care is being dropped to accommodate this fiasco
Utterly disgraceful to exclude junior doctors from the rest of the nhs pay uplift (which isn’t actually a pay rise but just keeps real terms pay cuts less than they would otherwise have been.)
This will not help us keep them in training and in the NHS. Our patients will suffer
Approval for the COVID vaccine is the start of the end. The science shows it works and is safe.
Share that you are going to get the vaccine and help counter damaging misinformation.
#imgettingthevaccine
Rob Galloway
A&E Dr and Dad
Imagine the British army had sent soldiers out with promises that you’d get bullet proof jackets in 21 days time. But then didn’t deliver them.
That’s what’s happening to front line nhs staff
Makes sense to pause 2nd vaccine for patients but not for front line NHS staff.
If the nhs invested in their staff better with flexible Rotas and appreciation of their skills, then it would need to invest less in resilience training put on so staff can cope with awful Rotas and not being valued.
Sorry to be a bit showy-offy. But very proud today. Got a medal and letters after my name as invested by the Prior of the Order of St John on behalf of the Queen as a member of the Order of St.John......and I got to meet Audrey Emerton. Yes the Audrey Emerton
@BuildingAudrey
.
Paying NHS staff a bit more, may not actually cost anything.
Low wages and feeling undervalued force staff out of the NHS.
But they get replaced with very expensive agency staff.
Treat staff well, patients do well and finances improves. It’s not rocket science
@SteveBarclay
If your operation has been postponed, you can’t see your gp or you wait is unacceptably Long in a&e please don’t blame the nurses, doctors, allied health care professionals or managers. We are all trying our best.
Please think about the root cause and question our politicians.
There is a crisis in the NHS.
But to say “it’s a good day if you find no one dead in a waiting room” is a fantasy based on pure click bait fiction.
Hyperbole and exaggeration detract from the reality of the actual harm happening to our patients and staff.
But worse, it…
My last slide and bit of advice for our newly qualifying
@bsms
doctors. Proud to have played a part in their training. Good luck where ever you work. But Come back - we have f3 jobs etc etc
Yesterday I had the best of days; my best friend , soul mate and the best possible mum and step mum, Laura became my wife.
I’m so lucky to be able to call her Laura Galloway. Thank you to all my friends and family who have supported me when things were hard and been there for…
As a front line NHS worker, I’m not sure what worries me more?
How all over the country our patients are suffering because of the current state of the nhs …………or how little the press report it.
Dear public,
Thanks for the claps but please don’t worry about clapping again.
Just stick to the rules, be understanding if you need our help and get a vaccination when offered.
I can’t face the thought of seeing
@BorisJohnson
clapping when so much was preventable.
Thanks
Dear anyone who has heard me moan about my job in A&E and thought......oh shut up you always moan.
But what’s happening in a&e is serious.
Please read what the Royal College of emergency medicine say about situation.
You will be as worried as me.
I genuinely can not understand what reality our current government live in
We have a crisis in our hospitals - we have patients waiting days in A&E for beds because we do not have enough carers in the community.
They have no thoughts about the vulnerable in society
This…
Today in Parliament we have laid an order to ban overseas care workers from bringing dependants.
This is just one part of our plan to deliver the biggest-ever cut in migration 👇
On the NHS 75th anniversary it’s time to reflect on its past, present and future
Everyone has their own stories about our NHS. For me, it’s saving the life of my baby and wife to be and helping my dad when he was dying.
I’ve spent 22 years working as an A&E doctor and I’m proud…
I work with NHS nurses & paramedics who are heroic but they aren’t heroes.
Heroes don’t need money to pay for food/heating/housing.
It’s time we paid them a wage which recognises their skills
#idontworkwithheroes
I am passionate about evidenced based medicine.
I also organise medical and a&e rotas.
For my sanity, I just need to know that there is evidence that isolating doubly vaccinated, pcr negative, asymptomatic, track & traces nhs staff does more good than harm.
Is there any?
Ever wondered why A&E staff up and down the uk are stressed?
Most other services/jobs can curtail demand or stop services if inadequate staffing
A&E can do neither.
Staffing models must based on busy days with expected sickness preplanned, not average days with no sickness.
For our patients' sake, NHS lies from
@RishiSunak
have to stop
He said that the flow of patients through emergency care is faster than it has ever been
That’s just not true
For our patient’s sake, he needs to accept there is crisis & manage it. Lying wont help our patients.
Care about our NHS?
This graph is scary.
2021 is by far the worst year for A&E performance.
A&E is canary in mine for the whole NHS.
Isn’t just a statistic. It’s your loved one who has a higher chance of dying or suffering.
Need urgent recognition & political action.
“It’s now a war & not what we have known before. Our NHS shall defend our nation, however hard it be. We shall fight on the wards, we shall fight in the laboratories, we shall fight in the community and in A&E, we shall fight in ITU. The NHS will never surrender to COVID-19”
Self rostering rotas
@HealthRota
for no other reason except this email I just got.
Hi rob
please can I work sat 17th August late.
My husbands family are coming and I need an excuse to not be at home.
Thanks for this - rota is a lifesaver .
Thanks
Dr xxxx. A&E Consultabt
Dear
@NHSEngland
Can I check that you know how much harder if is to ask front lines nhs staff to continue to work additional shifts often in areas redeployed when you are not offering them the protection they need?
Front line staff need evidence based Pfizer vaccine regime.
The NHS is nothing but it’s staff.
We had to Lockdown as nhs is running out of capacity.
Lack of physical beds cured with nightingales but it’s staff that are needed; weren’t adequate numbers pre covid. Now even worse.
10 years lack of investment in nhs staff is to blame.
My mum just called in a panic. She is due her second shit of vaccine but is worried about getting a lung clot.
To everyone like my mum with same worries........it’s COVID that gives you PEs. vaccines stop COVID.
So Take the vaccine and lower your chance of a PE.
Imagine if public sector pay had been tracked to MPs pay for the last 15 years.
There would not be strikes or a workforce crisis affecting our schools and NHS.
We need a public sector pay lock tracked to MPs pay.
Thoughts from those of us involved in running hospitals please.
Is it me or was the Planning for the acute covid surge easy compared to planning for treating covid patients over a longer term basis whilst planning for usual business?
#mangerssavelivestoo
If it’s your first day as a Dr and absolutely bricking it then that’s a good thing. If your not - then as I Consultant I would be worried by you. Never worry about not knowing stuff or asking question. Always worry that you could become unconsciously incompetent.
To celebrate the nhs birthday, I don’t really want a clap this Thursday or 1 millionth bit of a medal.
What I do want, is to see the nurses and junior drs I work with, paid a wage which allows them to buy a house near to where they work so they don’t leave.
For those who are walking around wearing masks because of the fear of Coronavirus but not getting their kids mmr vaccines, I am offering free on line courses on assement of risk and health decision making........Because you need it.
Dear
@TheBMA
&
@SteveBarclay
Let’s be honest - patient care is at risk
short term because of industrial action
long term because of the recruitment & retention crisis affecting doctors.
Please please agree to meaningful talks to solve the crisis & stop the strikes.