Peter Neville
@peteneville65
Followers
7,644
Following
219
Media
33
Statuses
1,357
consultant gastroenterologist @CTMUHB . Interests liver disease, ERCP. Proud to be Irish, but ❤️ Wales. 🥰 opera, chemistry, politics. Views my own. 🇮🇪 🇪🇺
Brecon, Wales
Joined July 2016
Don't wanna be here?
Send us removal request.
Explore trending content on Musk Viewer
Ireland
• 396114 Tweets
Spain
• 291284 Tweets
#MissUniversePhilippines2024
• 219329 Tweets
PondPhuwin WeAre EP8
• 159717 Tweets
Apple Music
• 137344 Tweets
LOST TEASER
• 111617 Tweets
Blonde
• 94470 Tweets
Rishi
• 76157 Tweets
KATY PERRY
• 73334 Tweets
KING KONG MV TEASER
• 69853 Tweets
#RCBvsRR
• 57456 Tweets
#GeneralElection
• 41652 Tweets
Atalanta
• 41276 Tweets
Thriller
• 40733 Tweets
Lauryn Hill
• 37798 Tweets
Maxwell
• 31506 Tweets
Frank Ocean
• 27463 Tweets
ガッキー
• 19567 Tweets
Ahtisa
• 17324 Tweets
Things Can Only Get Better
• 16794 Tweets
TPAB
• 16771 Tweets
Norway
• 13964 Tweets
キスの日
• 13022 Tweets
#JUNON_HBD_26th
• 12699 Tweets
Cassandra
• 11998 Tweets
Taguig
• 11818 Tweets
GOTTA WORK
• 10733 Tweets
MUPH
• 10635 Tweets
Cainta
• 10486 Tweets
Inside the NBA
• 10267 Tweets
Independence Day
• 10157 Tweets
Pinned Tweet
1. Exactly one year ago 1 posted this tweet which went rapidly viral and gained 7m views within 7 days. I think it is time for a review.
Overall morale within the NHS is, if anything, considerably worse...
For those who don't fully understand what is up with the NHS, here is a thread for you that might help.
I'm a consultant physician working as a doctor in the NHS in Yorkshire and Wales for 32 years now. I have experienced the NHS at its best (2008) and its worst (2022).
2K
26K
60K
24
467
1K
For those who don't fully understand what is up with the NHS, here is a thread for you that might help.
I'm a consultant physician working as a doctor in the NHS in Yorkshire and Wales for 32 years now. I have experienced the NHS at its best (2008) and its worst (2022).
2K
26K
60K
All these people tweeting about how expensive the NHS should take a look overseas and see what people get for their money. Whatever happens the taxpayer will pay. I mean - who else is there?
364
1K
11K
I am taking my pension in 3 years. I have worked for the NHS all of my life. I have never known it anywhere near as bad as it is now. And this government are trying to blame it on the nurses. Shame on them.
30
1K
11K
Our elderly use a very large percentage of NHS of resources, unsurprisingly because they are more prone to disease, frailty, and dementia. They need more social care and hospital care as they get older. And they are living longer.
(Immigrants, by the way, use much less care).
95
977
9K
Finally, don't be fooled by the comments about cost. The NHS needs more. If it doesn't get it, YOU will end up paying it somehow. Either through a new state insurance scheme. Or private insurance. Remember the UK spends 9% of GDP on healthcare. The USA spends about 15%.
113
2K
9K
Please understand that the RCN has NEVER supported strike action. These are not militants. They are striking out of desperation. To try and make this morally bankrupt government understand that enough is enough. Because they cannot do this anymore.
21
1K
9K
And they sit on hospital wards waiting. Often bored and frustrated. About 33% of hospital beds are filled with 'fit for discharge' patients. UK hospitals can do nothing about this. We are effectively working on 66% capacity. Which is one of the key reasons why A&E is rammed.
36
1K
8K
We cannot recruit. About 30% of new consultant jobs in UK cannot be filled. There are simply not the people to fill the posts.
The nurses are striking because they have to. Not just because they personally are not paid enough, but because they need the vacant posts filling.
34
1K
8K
Over at least the past 15 years, we have seen a relentless increase in demand, both in primary care and in hospital care. This has been absolutely predictable by social statisticians for decades and is based on the fact that our elderly are surviving much longer.
66
749
8K
This is the responsibility of the local council to sort out. But council funding has been cut and social workers are dealing with huge case loads. So there are big delays. And we can't send the patients safely home until their care package is sorted out. So they wait. And wait.
44
797
8K
They know that if they do not improve pay and working conditions very soon, morale will collapse and we will face mass resignations and retirements. Because when you can earn more driving an HGV than running a ward, you know your profession is in trouble.
31
770
7K
No self-respecting doctor or nurse enjoys working in this environment. No care worker likes to deliver poor care. Salaries were frozen for 7 years of austerity, and have never caught up since. Doctors and nurses now leave university with large debts to pay off.(Not like me!)
15
760
7K
Those of us left are working in jobs with constant colleague absences. So we must work harder, often covering extra shifts at short notice. Because we have to. There is moral pressure to cover oncall gaps because the service cannot be allowed to collapse. We are all so tired.
18
721
7K
They know that if the government wins this, nursing will collapse anyway.
The junior doctors are militant. A strike vote very soon. This is about money. But it is also about working conditions. Because if conditions don't improve, the NHS will fall. The staff have had enough.
20
723
7K
Over this period NHS funding has, broadly speaking, risen about 1-2% over inflation. If NHS funding increases with inflation yet demand increases, then clearly spend per person will drop. Demand has increased considerably above 2%, which is why the NHS is failing to manage it.
29
667
7K
Secondly, the NHS is not responsible for social or community care. When elderly folk come into hospital they decondition very quickly and require physio and OT to get back on their feet. Often a care package is required, sometimes even a care home place.
35
620
6K
If the pension is no longer an incentive to remain working for the NHS then medical and nursing staff can leave the NHS and do agency work. It pays a much higher rate, and you can work as much or as little as you want. It gives you control back - very attractive for parents.
17
625
6K
So when I do my 'emergency take' ward rounds I am seeing patients in chairs, in corridors, in the back of ambulances. There is little privacy and dignity is impaired. We all do the best we can but it is a poor environment. This has become much worse over the past 5 years.
10
638
6K
So lots of folk are leaving the NHS to do agency or locum work. Once this happens we have a tipping point. There are lots of vacancies in the NHS that have to be filled by agency nurses who cost much more to employ - there are agency fees as well.
21
639
6K
One of the biggest perks of the job was the NHS pension. In 2015 this was rearranged to save money, and ensure people have to work longer. It was not done well and this has led to some facing bizarrely massive tax bills - 5 figure sums are common.
30
613
6K
Genuinely humbled and astonished by how my tweet has gone viral. Normally I get about 10 or 20 views, mostly from colleagues. I'm just trying to explain - I've provided no solutions. But sorting social care would be a good start.
#Dilnot2011
138
245
4K
@cruncherwax
You think they don’t want the NHS? I disagree, they just vote Tory because have always done so. I think these are the people who suffer the most without the NHS. Their insurance costs would be unaffordable.
81
150
2K
@heather_benne
@Lisa21816890
Yes. Jeremy Hunt talked about the 7 day NHS. The thing is, if you want comprehensive routine 7 day cover instead of 5 day cover you need a 40% increase in workforce numbers. Even if the money was there (it isn’t) the people aren’t.
26
170
2K
@KateSaundersLee
Oh yes. Absolutely. I didn’t even go into that. And drug costs, biomedical technologies. The point is that raising NHS funds by standard inflation is meaningless. We have so many excellent, but extremely expensive new treatments to offer that we didn’t have even 10 years ago.
18
98
1K
@WilliamAled
Couldn’t agree more William. But this could be a 100.000 word essay easily. Only so much room to make the points.
10
34
1K
Here is an article that I wrote for the New Statesman. It details a bout of burnout I suffered last year. Before this I had doubts that burnout was an actual thing. I have no doubts now. I’m better now. My sense of responsibility is much tighter now.
21
273
1K
@IanDunt
I have 3 children. The childless are already taxed. They pay for education, child welfare, paediatric services, and child benefit. I also pay plenty of taxes that I don't benefit from. That's fair. But taxing the childless more is not.
10
20
754
@danielgoyal
@NHSMillion
40% in our organisation (their own figures) and I've seen similar figures in other UK organisations. Clearly local variances.
8
25
372
@always_ger
@cruncherwax
I’ve never met a diversity manager and have no idea what they would do. Total non-sequitur.
6
11
355
@JamesMRowlands
Thanks, James. Destroying professions is what governments do. The last thing they want is people standing up and talking with authority against them. They have certainly empowered the airline industry to do it to you. Not just the Tories - Milburn was a massive doctor hater.
4
40
330
@agw1437
Why do you think 'too many GPs are part-time'? Are you suggesting that there should be a law that stops this? I don't think, outside of the military, that you could enforce this. Could it be that GPs go parttime because the pressure of the job full-time is simply too much?
14
13
248
In the garden this morning. We always have hope. And beauty.
10
14
245
@KLGDCF
@drhumki
Here in the UK the number of times you would need it makes it not worth the cost. Far more fun to take a day off and moan. The reason the UK doesn't have much domestic AC is the same reason Orange County Ca doesn't have snow ploughs. Basic economics. Although this may change.
21
1
210
And there was me thinking that withdrawal of labour is a fundamental right, when negotiations fail. Given the massive labour shortages in the NHS, do they really believe that nurses would back down? It’s inflammatory and dangerous to do this.
16
53
188
@doctimcook
This is certainly true. I could have elaborated but there are only so many tweets a person will read...
9
4
182
A terrible indictment of the way the NHS is turning into a meat grinder for your doctors. As a 56 yr consultant, I have (to be quite clear) never known the system to be under such strain. A team with good morale is the only thing that keeps me going now. 3 years and counting...
6
8
168
Great piece of analytical journalism.
Summary: GP practices who see more people face-to-face have longer waiting times, GP practices with shorter waiting times do more phone/online consultations. You can't have both.
9
47
166
11. Personally I'm done. I'm worn out with emergency work, which uses up so much time it compromises my ability to deliver a decent speciality outpatient service.
So I am leaving the NHS. I have taken a job outside the UK where I will be only be doing my speciality. With regret
7
19
153
Re: NHS backup workers, I recall my 1st house job in the Beckett Wing, SJUH. The ward clerk was ferocious/caring, like a mama tiger. A plainspeaking Leeds woman: if notes got lost, we got 'proper brayed'. She was always ready with the tea when the tears came. ❤️.
#unsungheroes
.
6
15
147
Utterly baffled by the online obsession with NHS diversity officers. My employer has 12000 employees. Any big organisation has a responsibility to ensure a safe and happy working environment. I've never met our E&D officer and I'm not even sure we have a designated individual.
19
18
132
@JustineClaire65
I completely fail to understand where this stuff about diversity officers is coming from. It is of zero relevance in my view. Every big organisation has an equality and diversity policy. If that produces better staff recruitment and retention, then they are worth every penny.
8
6
128
@MarkNewlands1
Without doubt. GP numbers have dropped when they need to rise masses. Practices are closing, and GPs are swamped by a demand that is impossible to satisfy. All the GPs I know are worn out and broken.
8
9
125
@mikecranleigh
@jwales37
Apologies. I must emphasise that we struggle on and will no doubt continue to do so. But we need to see change on the horizon. We simply cannot continue like this indefinitely.
5
4
117
6. Astonishingly the government will not talk to the BMA unless they call the strikes off first - a more irresponsible approach is difficult to imagine. They seem keen to continue to play games in the press rather than talk about a settlement. Which is what patients need.
1
12
103
@Fiscalist46
@emilycpb
The NHS hasn't 'got itself' into this state. It has found itself in this state because repeated governments have failed to address the key problems - a looming demographic timebomb of demand that was being talked about in the 80's. 1/
2
4
99
9. This is a massive political failure. This can only be solved by government. No government seems willing to look at social care. But the absence of social care is killing the NHS. It is a key piece of the jigsaw. And yet no politician is talking about it. It beggars belief.
5
15
99
2. Like the frog in heated water, NHS staff have become completely used to working in a highly constrained system. We are all used to seeing five or six patients in bays designed for four. Corridor patients have been reduced but at the expense of worse conditions on the wards.
2
15
98
Why is a hospital grinding to a halt because of bed pressures termed 'business continuity'? Surely it is exactly the opposite of that? Every time somebody uses this term I correct it to business discontinuity. I'm becoming quite unpopular in meetings these days.
9
8
96
8. The second big issue is the ongoing failure of governments to address social care. My point last year still stands - hospital bed states are still hugely compromised by large amounts of patients who need either care packages or placement. They sit and wait. For weeks.
2
13
93
7. Important to state that junior doctors are not a bunch of ideologically driven revolutionaries. Striking is not what doctors want to do. Their militancy is driven by a strong sense of injustice. They just want fair pay. This is the same in Tory England and Labour Wales.
1
7
94
@yuanyi_z
They followed Caesar's doctrine of conquest. Find a minority tribe, support them in overthrowing the leadership then take over. Mostly they didn't have to do the really dirty work they found somebody else to do it for them. They were all classically educated.
5
6
81
4. Strikes are already planned for 2024 in Wales and England. The junior doctors rightly argue that £15 per hour is not an acceptable pay rate for the enormously hard and demanding work they put in. The Welsh vote was 98% which speaks for itself.
2
9
83
15. Remember that NHS workers are just people like you. Working hard and trying to do their best under difficult circumstances. Try not to use the NHS for trivial stuff, but don't hesitate to use it for serious issues. It will always be there for you in an emergency. With time.
1
4
81
@CourtneyEllaP
My sec (this is absolutely true - how could I possibly invent it) managed to write "this patient was admitted with a tree elf rib relation" in a discharge summary. Say it quickly.
4
1
79
14. But patients are going to have it tough for a lot longer. My advice: be polite but assertive when dealing with the NHS. Remember the person you are speaking to is not responsible for the service. Consider going private - at least for an opinion, if you can afford it.
1
4
80
Mistype above. I meant to write "there is no benefit in getting an income tax reduction...."
Evil X strikes again....
5
4
76
10. It is absolutely clear that the politicians have left the room (and I mean both Westminster and devolved governments). They choose to ignore it. We are in the 'too difficult' box. And an election is coming. So everything will go into purdah soon and nothing will happen.
1
3
75
Massively impressive article from
#doctoroxford
Brutal but entirely fair and well evidenced too.
0
30
71
@CarolineVBuchan
Yes. They would have really helped. But the progressive geriatricians are of the view that patients are best having rehab in their own home. The team should go to them. This is much cheaper than building and running hospitals.
2
4
73
The notion that there are hordes of these people roaming the wards like Soviet commissars is completely wrong, and verging on the deranged.
I'd be fascinated to understand where this nonsense originates.
6
4
70
5. We are dependent on locum posts. Which cost more and are less consistent. Juniors come and go, chasing short term contracts that give them more control in their lives. The stability of our ward team is now so reduced. We don't know who will be on the ward each week.
1
7
70
So we understand that the maximum number of illegal immigrants Rwanda will take is 500. The UK has paid them £240m so far. That would be £500,000 per migrant. Even if you are prepared to ignore morals this is spectacular financial incompetence.
3
27
69
16. And think hard before you use your vote at the next election. Examine policy. There is more benefit in getting an income tax reduction if you have to spend on inflation or private healthcare insurance.
Wishing you all best. Stay healthy if you can. Look after yourselves.
3
7
67
12. But it is no fun working in a system that is failing its patients. And having to take responsibility for this failure again and again. I must emphasise that I have no gripe with my previous employers. They are doing their best in a constrained system.
1
6
67
13. I have no doubt that things will improve. But this is going to take from 5-10 years to turn around. And that is me being optimistic. But doctors will find their way through this. They are masses of choices.
This article says it all very well.
2
10
65
Here is an interview i did on Times Radio this morning. 0510-0525 in the show
14
17
63
Hear this from a hospital manager. They work to hard to ensure stuff works. Just the clinical staff, they are trying their best in all really difficult environment. I'm tired of people denigrating them when they don't know what an important job they actually do.
Ok. Settle in…I’m finally writing an actual thread as I’m bored of this argument now.
Before I start - absolutely support people being paid more, and also completely aware there are some useless people in non-clinical posts, just as there are in clinical posts too!
42
80
459
9
14
62
@CorriganPaul
This model might work if the government paid for their training. As the nursing bursary was abolished and nurses have to pay for their training, it would seem terribly unfair to do this. In reality, of course, it's impossible to make somebody do a job that is making them ill.
2
4
61
@mrjamesob
I particularly enjoyed the phrase 'morally bankrupt officialdom'. To whom could he be referring I wonder?
0
2
60
@yuanyi_z
Classical warfare actually. What the Romans and the Spanish conquistadors did before the British. Build up an alliance. Don't engage until you are sure you have the power to win. Warfare is just a branch of politics. Pretty much what Sun Tse said in his special little book.
2
6
58
@CourtneyEllaP
The other one was 'the patient with discharged with an in-dwelling cafetière.' With grave accent correctly placed.
3
3
58
@TikkaTemple
Almost certainly. I didn't mention Brexit but I'm quite certain it will have made the situation worse. Difficult to quantify though from a subjective position.
8
0
59
3. In 2023 the frustration felt by NHS staff erupted into a series of strikes. Thus far, the nurses strike seems to have been settled. There has not been a mandate for further nursing strikes. For doctors though it's a completely different matter...
2
4
59
@Joancostbiz
@bea_johanssen
Hi. Can't say that I'm an authority in this but medicine remains a very popular career. Medical training costs considerably more than the 9k per year universities receive so copious government subsidy is required for every place. More places needed but again, down to money.
2
0
59
Oncall for endoscopy this weekend. Two patients to scope on Christmas morning. Thanks as always to our wonderful endoscopy nurses, and the support staff in CEPOD theatre and ITU for making it happen. Nadolig Llawen.
#CwmTafMorgannwgHB
#GIbleed
#RCNStrike
support the nurses
#NHS
2
2
51
Just heard about a nationwide blood vial shortage. Official request to consider how to request fewer blood tests? Obvious answer: cancel my clinics and stop seeing patients. How to practice hepatology without blood tests is a mystery to me. $6m question: is this Brexit or COVID?
12
25
50
@d_w_k
@danielgoyal
@NHSMillion
A hotel charges less than a care home because they don't provide care. Your proposal is viable as a quick fix. Not really viable long term.
More progressive trusts (eg Sheffield) are using "discharge to assess" models where all the assessments are done in the patient's home.
3
2
49
Anybody out there prepared to support the proposal that the Met actually isn't a stinking cesspool of misogyny, racism, and nepotism? If so, please provide primary data evidence. Because it does appear that way.
8
7
46
BBC is looking more and more like Правда. GL is a sports presenter not a political reporter. He has the right to say what he wants. Would the government be so quick to cancel him if was complimenting them. No, I thought not. Welcome to Orwell's Britain. We have finally arrived.
"I don't think he has anything to apologise for"
John Barnes supports Gary Lineker and says the language used by politicians is similar to Nazis in the 1930s
Read more here:
📺 Sky 501, Virgin 602, Freeview 233 and YouTube
141
527
3K
4
11
47
I think somebody has lost their s*it with the messages about cleaning up.
5
8
44
@PetronellaWyatt
Wow. What a thing to say. You outmale the men. She looks smart and professional. Isn't that enough?
3
2
45
And so, after over 9 years, I am leaving Prince Charles Hospital. That strange combo of tristesse and excitement when you move to pastures new. Iechyd dda to all of my friends.
21
0
45
The truth is that every manager and director does half an hour of E&D training every couple of years and bears responsibility for ensuring a safe and supportive working culture. It improves employee recruitment and retention. The NHS is a highly diverse organisation already.
2
3
39
@DrBenLovell
I've been working in the NHS for over 30 years and have never, ever, known it as bad as this. It is utterly relentless and terribly daunting. I'm seriously considering early retirement have never known morale as bad.
6
5
40
@DrEilidhMaria
Hi Eilidh. You guys have this grumpy old consultants full support. I'd go further. If the government continue to refuse to engage you should all agree to submit notice of resignation. The penny would drop before D day I guarantee it.
3
5
41
Remember that 'junior doctor' means anybody who is working in a post-graduate training scheme. They could easily be aged in their 40s and 50s. They are not medical students.
TLDR
'junior doctor means'
FY1
FY2
CT1
CT2
CT3
ST4
ST5
ST6
ST7
ST8
GPST1
GPST2
GPST3
It means anybody below consultant. It does not mean medical students. Do not be misled by the news.
And no, fy1's are not on £40,000.
31
951
4K
2
10
39
Yet another patient story (from a highly respected journalist) confirming the situation re the NHS
0
14
38
First daffodils - and before Dewi Sant. Happy spring to all.
0
0
37
Most doctors are activists and will take control of their lives. So, rather than striking, they will quietly up sticks and go somewhere that appreciates them more. The government is extremely complacent on this issue. Senior doctors are leaving the UK now. They won't come back.
1
5
31
In our little hospital in S Wales we have lost 2 consultants to Dubai in the past 6 months in our department alone. So important the papers are picking up on this story.
1
8
33
@ivor_park_fin
Couldn't disagree with what you say. But it is an unignorable reality. There is no easy fix. It would help if politicians spoke to people like adults. Healthcare isn't a priority for the young and fit. When they fall ill, they realise it is everything. We all get ill. Eventually
5
4
33
Im not a public health specialist but here is a great paper from the world-leading IHI in Harvard comparing healthcare systems between France, Canada, the UK and Germany. Very interesting to compare.
1
16
32
@WelshGasDoc
The truth is, if we can facilitate a discharge, we will. This happens already. If the relatives are willing to support pending care package delivery, then we will happily discharge them. The ones that are stuck are the ones with no carers. Sending them home would be negligent.
2
1
31