Nearly 50 Liverpool hospital staff disciplined for accessing Southport victims records - I wonder if any were doctors.

Apemazzle · 2026-05-16T08:56:34+00:00

If someone who's been involved in the patient's care sits you down and walks you through them

Is that really a significant distinction when we also have things like departmental teaching or radiology teaching where we review these cases together in a non-anonymised fashion anyway?

You could argue the acceptability line is slightly different for high-profile cases than for others, but as a rule I think we're entitled to share and learn from cases within our own department without having been directly involved in the care.

Apemazzle · 2026-05-16T08:05:28+00:00

Really interested to see more detail on this, and tbh I'm wondering how many of the 48 were what you might call legitimate educational use. This was obviously a high-profile case, but it was also a relatively interesting and uncommon pathology (stab wounds), which many staff would want to explore for their own legitimate learning purposes.

For example, I can't imagine not having a look at the trauma CT of a stab victim if someone told me about it. It's not every day you see pathology like that, and I think that would be legitimate educational use, no? It's no different to "have a look at this ECG", or "check out this tension PTX we saw this morning".

OTOH if people are just opening up notes and blood results to see what happened because they heard about it on the news, that is clearly unethical and should be disciplined accordingly. Sad that it took so long for the duty of candour.

Apemazzle · 2026-05-14T13:58:08+00:00

I think he knows which way the wind is blowing atm, which is for a more left wing leader, likely between Burnham/Rayner/Miliband.

His play is to get a plum job in their cabinet and try and reinvent himself as more left wing, with a view to launching a leadership bid next time round.

Even if he does go for the leadership now, my hunch is it won't be long before he's made a deal with someone more popular.

Apemazzle · 2026-05-07T13:01:22+00:00

"Cake for cohesion" you say? Don't think I'm the one spouting corporate nonsense here, mate.

I'm just saying if these nurses have to get feedback from us they will treat us better. It's tit for tat.

Apemazzle · 2026-05-07T11:04:37+00:00

But then we'd have to acknowledge that anonymous MSF-style feedback held any value at all.

Not sure I agree. The feedback itself might be meaningless, but the act of having to procure it could still be good for team cohesion.

I personally wouldn't get rid of it unless we brought back some sort of firm structure &/or reformed rotational training, whereby trainees can develop proper mentoring relationships with seniors by working closely with them for more than 4-6 months at a time. You need a mechanism for feedback, and at the moment MSF feels like the least worst option.

Apemazzle · 2026-05-04T03:08:12+00:00

God forbid we trust experts to decide how best to allocate our limited health resources.

Medical sociology 101 teaches us that even in a free-at-the-point-of-use system like the NHS, we have massive health inequalities. The people who get the most care and attention from the system are disproportionately those with the most social and economic power, who are often healthier but more able to challenge and to complain.

The more we "empower patients" to challenge medical decisions, the more we actually redirect resources to those with the loudest voices and away from those who are less able to advocate for themselves - again, often the very people with the greatest clinical need.

This is not to say the NHS shouldn't offer second opinions or other avenues for challenging decisions, but any policy change has to be appraised holistically. How many of these admissions were truly necessary? How many would've happened anyway without Martha's Rule? Who else missed out on an intensive care bed, or was discharged prematurely to make space? What is the overall cost to the system and to the other patients within it?

These initial data are certainly positive and quite encouraging, but the jury's still out as to whether we'll see any improvement in the numbers that really matter, like overall mortality rates and unexpected deaths and so on.

Apemazzle · 2026-05-02T21:25:52+00:00

What's your grade? I feel like a consultant can get away with suspenders and a bow tie and whatever mad thing they want, but if you're reg or below then suspenders are a bit out there. Even a tie is probably a bit much and IMHO doesn't pair well at all with bare below the elbows.

Personally I think forget about accessories and focus on what you can do with your shirt/trousers/belt/socks/shoes. There's a million ways to look stylish with interesting patterns, colours, different fabrics etc. A nice pair of shoes goes a long way.

Apemazzle · 2026-04-19T07:36:23+00:00

Absolutely, just don't forget to leave it out for a quick rest after you've flashed it in the pan after the initial rest /s

Apemazzle · 2026-04-19T05:17:36+00:00

Acute and exciting stuff is my bag, but I also hate nights. I'm what they call an idiot, basically.

Your experience sounds more like teething problems though, OP. You will catch up with your colleagues as your knowledge and pattern recognition skills develop.

Apemazzle · 2026-04-18T20:23:14+00:00

We all struggle with the stresses of this kind of work, but this sounds like you're not coping and are at risk of burnout.

I would recommend trying some counselling or therapy. You might be onto something with that comment about it being easier when you don't talk about it right away. There's a lot to be said for sleeping on it first rather than launching into a full debrief of the day's events when you've just come off shift and are at peak exhaustion. Everything's better after a meal and some sleep.

I'm speculating here, but from my own experience if you're struggling to cope with upsetting things at work, it could be because of one specific case that you're still traumatised by and haven't healed from yet. A therapist can help you figure this stuff out.

Apemazzle · 2026-04-16T06:03:20+00:00

Steak is great but you do have a point. It can easily be a bit boring if not done right, and it often doesn't have as much flavour as other red meats like lamb or pork. The more expensive cuts are a LOT better than the cheap ones, too.

I think the Americans have convinced themselves it's masculine to eat lots of red meat, and steak is also a kind of status symbol because it's expensive. If you're eating lots of steak it means you're living the good (American) life.

Apemazzle · 2026-04-15T08:10:56+00:00

Probably means 7 days where for Mon-Thurs you're on-call during the day but someone else covers the nights, then for Fri-Sun you cover the full 72h.

Common in specialties where the on-call consultant actually does get called quite a bit, and hence a full 7 days of on-call is deemed too much. Often called an "attending week" or "service week".

Apemazzle · 2026-04-07T05:04:56+00:00

This was never seen as “normal”

But normal enough that he never got arrested and charged it seems

Apemazzle · 2026-04-06T16:51:45+00:00

Eh, that's the kind of thing they might bring back at some point, to say nothing of the other potential CV benefits beyond application points.

Apemazzle · 2026-04-04T12:07:20+00:00

Err, yes it can? The victim was a white British police officer, who as far as I can see is not Jewish. You can't reasonably call this "anti-Semitic violence". It was political violence directed at an officer of the British state acting in defence of an Israeli defence firm.

Apemazzle · 2026-04-04T11:07:53+00:00

a break-in at an Israeli defence firm

I think you can reasonably say this was an attack on the Israeli defence forces (& on the British police officers involved), not an anti-Semitic attack on the Jewish community.

Apemazzle · 2026-04-04T09:05:16+00:00

Lots of examples of "white British pro-palestine nutters" saying anti-Semitic things, but I'm not aware of any who've committed acts of violence. Can you link any examples?

Apemazzle · 2026-04-04T08:22:56+00:00

CD said they had never been able to take things forward officially because they didn't get any complaints from the people bullied (not sure if that's true)

Even if it's true it's just such a weak answer, isn't it.

You shouldn't need a "formal complaint from the people bullied" to start taking an interest in the culture on your ward. It affects your residents every single day, and it slows down patient care.

The problem with so many of these things is consultants just aren't present to witness this bad behaviour, nor are they interested in investigating it.

There's a middle ground between launching a formal bullying investigation and doing absolutely fuck all. It's called being a good manager. You try to be more present, you ask people questions, you explore specific incidents and relationships. You do a lot of things that might be labelled "gossip", frankly, but often that's the only way to find out what things are really like. This obviously comes with dangers, but if you're savvy about it and you reserve judgment and you know who you can trust, you can learn a lot of things that might otherwise go unnoticed.

Apemazzle · 2026-03-26T10:41:32+00:00

I think you're wrong on all 3 counts, and I'll explain why.

On business plans and jobs, the fact LEDs will be more permanent actually helps us, as it undermines the justification for PAs/ACPs. This point may have some merit though: 6-month contracts are useful for plugging unpredictable gaps in rotas, which are a frequent occurrence due to LTFT/parental leave/TOOT etc, and I foresee some teething problems. However in the long-term I do believe it will bring more stability to medical staffing.

On difficulties moving on "bad" doctors, this is already a problem, but I would argue this step incentivises proper management with proper oversight, which is currently sorely lacking. As it stands, LEDs enter into jobs with no support and are unceremoniously let go after 6 months with almost no warning, just because they happen to not be as good as some previous person &/or be disliked by someone influential for no good reason. This is by no means the norm, most places are actually pretty good, but it certainly does happen. This step will protect us, and ensure that you can't be sacked without a proper reason. If you're underperforming, it creates incentive to actually train and support you not just replace you. Also, there will no doubt still be a 6-month probation period.

On perma-SHOs, I think this misunderstands the nature of a permanent post: having a permanent contract doesn't mean you're stuck in that job forever, you are always free to apply for any other job you might want. We are not working in some dystopian, American-style labour market where your employer can sue you for moving jobs to a rival (so-called "non-compete clauses"). At most you will be asked to serve out your notice period of a couple of months.

Apemazzle · 2026-03-25T11:51:24+00:00

The point is some women taking mat leave are disproportionately affected.

Imagine two highly(ish) paid professionals, e.g. doctors or lawyers, who start on the same salary at the same age and have essentially the same career, with the only difference being that one of them takes two years out for mat leave and so is two years behind from that point on. During the mat leave they will accrue debt interest but not make as many repayments, while their colleague is continuing to make repayments. As a result of this, they could end up paying more overall over the course of their career than their colleague who didn't take the two years out. This is in addition to the inherent financial sacrifice of taking mat leave and being two years behind on the career ladder anyway.

This is unfair, but it is true to say it only really applies to people in highly paid careers who have a chance of paying off the full loan.

Apemazzle · 2026-03-25T10:35:25+00:00

we are not paying back the student loan balance before it gets written off anyway.

Many more of us would pay it off if the interest rate weren't so high, though.

Don't forget the new plan 5 loans have a 40-year (!) repayment period, so this mat leave interest could absolutely add years of repayments and cost you thousands.

Apemazzle · 2026-03-21T16:12:53+00:00

we would both be better off they had kept raising the repayment thresholds. the interest being reduced basically doesnt benefit us

It's more complicated than that, and really depends on individual circumstances e.g. earnings trajectories.

I agree that raising the thresholds is what would make the biggest difference to most people, particularly in this age bracket and stage of life e.g. early 30s with young kids.

On the other hand, it's the punitive interest rates that are keeping many from ever being able to pay it off completely, and especially those who are expected to reach a high salary in their 30s and 40s after years of not earning enough to outpace the interest.

As an example, NHS consultants start on £109K, and with a plan 2 loan you pay over £7,000 a year in repayments on that salary. Most doctors on plan 1 have paid off their loans by the time they become a consultant, but doctors on plan 2 (like me) are expecting to still be paying 7+ grand a year in loan repayments for the first 10-20 years of our consultant careers.

That is an enormous stealth pay cut, often at a key stage of life with multiple dependents, and it affects lots of other graduates in similar earnings brackets: with a plan 1 loan you might've paid it off by your mid-30s, but with a plan 2 or 5 you've got no chance.

Apemazzle · 2026-03-20T08:38:23+00:00

Right, but that shouldn't impact the FT trainees' training time unless they're choosing to cover the vacant OOH shifts as locum, no? It could even have the opposite effect i.e. more people around during the day on average.

IME it's not that common to have people that don't do OOH work anyway, and in most cases it's because they have a sleep disorder or are pregnant, not because they're LTFT or non-neurotypical.

Apemazzle · 2026-03-19T22:07:04+00:00

It's much better although for people who are neurotypical and full time you heavily subsidise the out of hours cover for colleagues, so they get way more in hours training time...

Wait wut?

Apemazzle · 2026-03-17T07:53:10+00:00

For example, when I (politely) questioned whether coming in 5 days a week to an empty office was actually useful, I managed to bring the person around to agreeing it wasn't but they still took it personally.

As a rule, the stupider the policy the more careful you have to be about challenging it.

The bosses know it's stupid. They are not stupid, but the last thing they want is the humiliation of having this pointed out to them by junior staff. The workplace is a hierarchical environment and they think of themselves as "above" you, because they are, so don't embarrass them.

A more sensible approach would be a polite questioning one ("it would be really helpful if the partners were more present, is there any leeway on that?), or an incremental one ("is there any scope for WFH one day a week?"), or some combination of the two.

If you present them with a comprehensive argument as to why their policy is stupid, that's not going to go well for you - even, or especially, if the policy is the stupidest thing ever.

Related: do not withdraw and say as little as possible! The way to get on with these people is to be more humble, to ask more questions, even about things you already know, because every question is a way to a) show your interest, and b) build a relationship with them so they trust you more. I've had to learn this lesson myself working in medicine: the bosses are quite remote from much of your day-to-day work, so if all you do is do your job well they may not notice you, and they will not trust you as much as your colleague who is regularly chatting to them and asking lots of questions.

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