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Everyone moans about the thousands of 'targets' for NHS services.See what happens if you take a few away:https://twitter...
09/06/2022

Everyone moans about the thousands of 'targets' for NHS services.
See what happens if you take a few away:
https://twitter.com/i/status/1527606137675255808
It got far worse!
Apparently the kids cannot do without ...

“It’s not often that I audibly gasp at a graph. Here’s what happened when I revisited a story about NHS waiting times in A&E… 🧵”

For profit vs non-profit healthcare
09/12/2021

For profit vs non-profit healthcare

In short, for perspective.1 UK unit of alcohol = 10ml = 10cc = 0.01 literUK advises max 14 units a week = 0.14 literThat...
19/05/2021

In short, for perspective.
1 UK unit of alcohol = 10ml = 10cc = 0.01 liter
UK advises max 14 units a week = 0.14 liter
That's less than 4 pints of strong beer or cider of about 7% ABV a week.
Or about 6 pints of Chiltern Black at 3.9% ABV a week.

And a glass of wine doesn't have a 'positive' effect on health.
As it's your economic status and/or education level that compensates for the harm from alcohol use.

The effect of alcohol use, of any level, is worse than smoking or BMI (overweight).

Of course, you don't give a s**t, and still you're probably going to argue against it. Why? ;^)

UK study of 25,000 people finds even moderate drinking is linked to lower grey matter density

13/08/2020

contact and tracing data in the UK
Bit late on this, (actually only because I looked on this page to see if I really should send the linke to a Dutch Friend) buut...
Never seen such lunacy in my life
A newspaper reporting that a goverment minister in going to pre-announce that he is going to annoice that local government will get all the data.
That is about a week after he announced that local government already received all the data.
Which obviously they didn't.
He would have gotten away with that if not very importen people like the mayors of Manchester en Leicester, contrary to usual practice believed and supported their helathcare analysts and went beserk on this issue.
And guess what appears, the data is useless becuase it cannot be (easily) linked to standard NHS and local gov systems.
And as soon as you link it it appears useless because it doesn't provied enough details
And as soon as you ask for the detaisl they send you into an Information Gouvernance Jungle.
That jungle takes about 6 months to pass, if you're lucky.
In the meantime guvmint wil invent an explanation why the data you'll get in the end is perfect even though it's useless for you, and that it was all your fault from the beginning, as you should not have expected anything decent from them anyway.

Why The F**k or What The F**k happend there?
Guvmint outsourced a contract for contact and tracing to friends of firends of party sponsors without any serious commissioning process.
Actually guvmint gave away contracts to friends of friends under emergency regulations that were intended to speed up purchase op PPE and other desperately needed items first for NOT at all emergent items, this wasn't one of them at the time.
They do something but not what's needed and present the data in useless formats for the NHS, so a lot of nadycrafting is involved in making sense out of rubbish.
And all the while the continuous attempt to 'keeping up appearances' that they are actually in control.

A underwhelming try at satire?
Wait an see, if your still alive by then.

Coudln't bother the spellcheck, just too angry!

What's  the cost of a life we are prepared to pay?Usually NICE sorts this out in the UK; mostly behind the screens.Two e...
25/04/2020

What's the cost of a life we are prepared to pay?
Usually NICE sorts this out in the UK; mostly behind the screens.
Two examples hit the Dutch press in 2012 when the Dutch version of NICE, zorginstituutnederland.nl (formerly the health insurers united in the CVZ.nl) warned that the costs of Pompe disease and Fabry disease were no longer bearable for insurers.
After protests they said they just wanted to start a discussion. Well, they failed, apparently the Dutch are happy to pay for about 100 persons with Pompe disease about €15m per person per year and for 50-70 persons with Fabry disease about €3.3m per person per year
(source: https://www.volkskrant.nl/nieuws-achtergrond/zijn-sommige-ziekten-te-duur~b7cdcb1c/).
So if it's only a few costs don't matter; we're all human, aren’t we.
Within the EU we normally count with about €50-80k per quality-adjusted life year (QALY) as a measure for 'disease burden'.
(see: https://en.wikipedia.org/wiki/Quality-adjusted_life_year)
Are we prepared to bear this costs when it's not a few, but potentially miljons?
The question has become very alive re 'opening up economies'.
There is actually some research that indicates it's actually not an 'either health, or economy' question, and that lockdowns can be advantageous for the recovery of the economy. (see:https://papers.ssrn.com/sol3/Papers.cfm?abstract_id=3561560)
Or more recently https://www.nber.org/papers/w26882)
In short, you would have to decrease acceptable cost of a QALY a lot before saving lives in a lockdown becomes economically disadvantageous compared to a 'Laissez Faire, Laissez Mourir' (say, opening up too fast).
These decisions can be taken very 'indirectly', as we see in the USofA. You make sure the people out of a job don't have the monies to buy food and they cry out for 'opening up' just to survive.

Hoeveel is een ernstig zieke patiënt ons waard? Die vraag komt indringend aan de orde in een uitgelekt conceptadvies van het College van Zorgverzek...

16/02/2020

The 'Being there's' ...
A very senior, but totally clueless, NHS manager who singlehanded led her PCT to the border of bankruptcy by giving away millions to neighbouring PCTs. Eventually she gto dropped with a payoff of nearly £600k and within 3 weeks started in a very similar role at a neighbouring PCT.
That's how they treat people 'that need to be taken care of' in the UK. That's not patients of course, but family members and acquaintances of current and former politicians. That’s the ‘curse of NHS London’. The NHS in the London area is still stuffed to the brim with that lot. I pity the good people who have to work underneath who have to cope with these big babies to get some actual good work done for real patients.
Said manager had the interesting habit of arriving at a meeting, late of course as that shows your important, starting with long stories about the meetings she'd just attended and boasting about the people she'd met there, without ever being capable of telling something relevant about what was discussed or decided there, usually followed by telling for which meetings she'd have to leave soon and what people she'd probably meet there, without ever mentioning anything that might be discussed or decided there. Before and after her performance we usually exchanged some practical information among ourselves, the other attendants, and discussed to sort actual problems often deprived of any managerial context, though occasionally we could get a bit more relevant information from some other people who actually had read the minutes and papers of the meetings their manager attended.
And as you would expect by now, she usually introduced herself with the phrase 'Do you know who I am? I'm ... ‘ . As if being related to one of the political founders of the NHS had given her the birth right to strangle the NHS.
Strangely, I loved to work for that PCT. A lot of good people trying to manage the trail of unmanageable mess their boss left behind. And apparently I left some very good work behind, as several years later at a different NHS organisation I found that one of my colleagues there was using some my tools (still MSAccess based) and scripts to enable his work for that organisation. (Hi John!)
And, before you ask: yes they too had a 'needed to be taken care off' senior manager, again with authority to make decisions that could wreck their organisation. Not by accident that was probably the first NHS commissioning organisation, of which NHS London had decided to take away the lead-commissioner role for a big trust located in their patch. That says it all, I'd guess, taking away the toys of the manager to avoid further self-harm for the organisation (and several of its neighbours) instead of throwing out the idiot. Guess otherwise NHS London would have been orderer to 'take care' and parachute him somewhere else in a job where he could do even more harm (otherwise it would look like a demotion, wouldn’t it?)
Don't know why I remembered this this morning; truly didn't meet anyone so devoid of any sense of reality over here in NL, though surely they must exist too, as here too there is an 'invisible employment agency' serving the circuits with people that have to be taken care off.

The official label is sometimes 'political appointments'.
But that doesn’t apply for whole of the UK, as in the rest of the country NHS managers often are very capable. Unfortunately, the idiots in the London area NHS organisations decide what becomes the norm.
Maybe that’s why London still has a high population of one-person GP-practices (a few very good with a dedicated doctor, but most a bit crappy. Maybe that’s why London still has some very bad hospitals (as well as of course some of the best hospitals in the world). And certainly that’s why despite a lot of good people, good GP-practices, and good hospitals, NHS London is still very average, if not below par.

Innovation born out of real needs:Doctors by smartphone in indonesiaIt probably didn't happen over here because doctors ...
03/01/2020

Innovation born out of real needs:
Doctors by smartphone in indonesia
It probably didn't happen over here because doctors over heare feel too much 'elevated' to work in a mere 'call center', and of course there is no real perceived need.
Except maybe for more bureaucracy: so don't get me started on NHSDirect, NHS111, and whatever it's these days

Halodoc merupakan aplikasi kesehatan yang memberikan solusi kesehatan lengkap dan terpercaya untuk memenuhi kebutuhan kesehatan kamu dan keluarga.

24/12/2019

just a quote from an old 2013 newspaper article:
"the benefits of acupuncture are likely nonexistent, or at best are too small and too transient to be of any clinical significance, ... It seems that acupuncture is little or no more than a theatrical placebo."
Think the evidence for this (that is 'nonexistent benefits') only has accrued over the last few years.

Stressed GPs cause more emergency admissions and admissions for chronic conditions!Who would have thought that?Big study...
29/08/2019

Stressed GPs cause more emergency admissions and admissions for chronic conditions!
Who would have thought that?
Big study from Denmark.

Background Physicians’ work conditions and mental well-being may affect healthcare quality and efficacy. Yet the effects on objective measures of healthcare performance remain understudied. This study examined mental well-being, job satisfaction and self-rated workability in general practitioners ...

Shocking bit is not the use of M**A (ex**sy) in combination with psychotherapy for treating alcohol addiction, but the u...
22/08/2019

Shocking bit is not the use of M**A (ex**sy) in combination with psychotherapy for treating alcohol addiction, but the utter senselessness of all other treatments:
“With the very best that medical science can work with, 80% of people are drinking within three years post alcohol detox.”

Researchers say drug is safe and appears more effective than conventional treatments

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