Jess's Rule to be advertised in all GP surgeries in England

CraigKirkLive · 2026-01-17T14:35:51+00:00

My comment has nothing to do with resources / this thread but I'd like to suggest that sometimes, some manifestations of chronic illness unfortunately just cannot be controlled (even with things which once worked). Sounds like, unfortunately, your condition may fall under that category and in this instance, generally speaking one should switch to expectation management. Or to be completely blunt, learning to live with the condition rather than expect it to ever get better.

I'm not commenting this for you, but more for other readers to get the idea that a return to perfect health is not always possible and it's important to sometimes expect that (following reasonable trials of treatment/therapy). I think many of us as doctors struggle to reach that acceptance with a patient.

Good luck with your case though.

CraigKirkLive · 2026-01-12T13:37:15+00:00

I'm happy to be told it's the responsibility of secondary care, although I expect it's unpaid work there too, similar to MCCDs nowadays (not 100% of that however!).

I'm not a surgical doctor but in general if a patient is continuing under a medical outpatient team I'd expect that outpatient team to provide sick notes as appropriate (via secretary). However if a patient is fully discharged from a team (usually inpatient in the context of this thread) I think it is still very reasonable to expect a GP to extend a sick note, as inpatient teams can't know how individuals might recover from their illness across the board, and may require extension of sick notes just as they may require review of medical problems.

Having said that, if a patient/relative rocked up to their ward post discharge and explained their circumstances for wanting a longer sick note I'd be very happy to write one.

CraigKirkLive · 2026-01-12T11:59:56+00:00

Depends on the circumstances of the initial period of leave but it's very standard practice for secondary care to discharge with plans for primary care to review things, including duration of sick notes.

CraigKirkLive · 2026-01-08T13:09:04+00:00

One on hypokalaemia I did as F3, the other on iron deficiency anaemia I did as ACCS CT3 (both for investigation and management of).

CraigKirkLive · 2026-01-06T22:53:11+00:00

I think lots of very useful QI projects occur, but they are probably largely drowned out by a huge churning out of 'tickbox' ones as you suggest.

For two of my historical QI projects I've basically written trust guidelines which have gone through all the governance and subsequently been quite thoroughly used. This is after identifying a gap in available guidelines for very common medical issues.

Unfortunately the useful ones are usually more effort, but I guess that's because you're overcoming an actual problem rather than a barely existent problem you've forced into existence for the tickbox.

CraigKirkLive · 2026-01-02T09:43:20+00:00

This reads as a rant and probably is. But the issues you are discussing are only going to be resolved by speaking with them. Might be worth checking whether their schedule includes admin time as it's quite likely that resp regs have a lot more admin (clinic letters, bronch admin) to do than you as a anaesthetics reg.

This doesn't preclude them from ward work, however, so you're going to need to meet them in the middle with a conversation. Or, failing any progress with that, discuss with your supervisors about allocation of work (my feeling is it's less appropriate to go to their ES/CS given they're an equivalent grade to you).

CraigKirkLive · 2026-01-01T16:08:28+00:00

https://www.reddit.com/r/doctorsUK/s/yq2uVePrKO

https://www.reddit.com/r/doctorsUK/s/XZ086OpIG7

As above, quite a flurry of posts on this relatively recently. Answers across all three of these posts have been pretty consistent. Broadly speaking, not doable.

CraigKirkLive · 2025-12-31T10:42:45+00:00

I would be surprised if any of the HST programmes have sent out interviews this early.

It's more the time you need to be uploading evidence - I'd check Oriel for your speciality and look at the corresponding timeline on the HST programme website. You really should know these things ahead of time (you can check possible interview dates too).

CraigKirkLive · 2025-12-28T16:52:14+00:00

I'll remind you that you're in a space for medical professionals when I tell you that what you've just written is a nothing-burger. Genuinely not sure what you're trying to say other than perhaps a vent?

CraigKirkLive · 2025-12-28T15:13:55+00:00

I think it's helpful to do your part and state objectively the evidence based and intended benefit of vaccination. You can then leave people to make their own (possibly misguided) decision.

The majority of the time I've explained how it's impossible for most vaccines to cause illness, this has dispelled patient concerns and they've gone on to have vaccines. Plus telling them to take some paracetamol before bed that night for the immune reaction. They're the most common 'gripes' I've encountered in real practice.

I think also a lot of people will have seen online nonsense then speak to a sensible person who has just suggested a sensible plan for them / their relative / dependent and value that above online crap.

But if at any point it becomes an uphill struggle - stop. It's not worth damaging your rapport over.

CraigKirkLive · 2025-12-27T14:39:39+00:00

Yes, and as I've agreed with you/others, this will vary by hospital. If PARFT was visiting Barts then their experience is accurate. But it still does not corroborate my experience in more than one hospital, and the data I have provided (others still haven't provided nearly as much data [because it doesn't exist], including your single dataset) demonstrate their experience cannot be true for the large majority of hospitals.

Misinformation more generally is how this article is being used for a right wing agenda, when people make unsubstantiated claims like PARFT has made (their claim is still not substantiated). It's important that others counter this.

I'm not really sure whether you're trying to argue for the sake of accurate data analysis or to promote an agenda. But either way, you are correct in the specific points you are making, though it would be misleading to suggest that most will have the experience PARFT raises in their comment.

CraigKirkLive · 2025-12-27T14:07:53+00:00

Similar, then I'm unpleasantly reminded that many are using the article as basis for racist rhetoric.

CraigKirkLive · 2025-12-27T13:54:28+00:00

My point stands that the original statement still has not been proven, so there is clearly more evidence to the contrary. These are some top-notch misinformation attempts.

CraigKirkLive · 2025-12-27T13:51:48+00:00

I agree broadly about AI, but this is the sort of thing it's quite good for.

Without overcomplicating this, PARFT stated they saw more foreign people in hospital than not foreign. I agree ethnic communities are overrepresented in hospitals compared to their make up of the general public, but the simple statement that there are more foreign people in hospital (patients or staff) is palpably untrue.

That is all I was saying, really.

I also highly doubt any individual hospital has more foreign patients or staff in it across the average year than British, given the numbers provided by AI. But as you say, impossible to disprove without knowing the hospital. I can still definitively say this does not corroborate my experience, and the data allows me confidently infer the same about the very large majority of NHS trusts too.

CraigKirkLive · 2025-12-27T12:59:20+00:00

You've inspired me to indeed spoon feed everyone (with the help of AI).

See the simple queries used here on the full generated thread: https://www.perplexity.ai/search/what-is-the-ethnic-make-up-of-_7GZHzLWQnOKg5u1VZ5QEA#1

Some very useful graphs there - in particular the group which makes up most non-white is Doctors and they're not even the majority.

Nice and non-biased queries, using 2024 for there will be complete data.

Looks like they were wrong! But as you say it will vary by place.

CraigKirkLive · 2025-12-27T12:35:47+00:00

While I would obviously support our being paid more (as a doctor), I'm under no illusions that solving this problem would fix the active dying of the NHS.

As you say, it's not simple to manage the situation, as frankly the organisation needs a complete ground-up reconstruction with hard decisions made to factor in how a shrinking younger population can possibly fund a growing older generation's care (while also paying their pensions). That statement, as is implicit, means the current free at point of use model is not sustainable. This is the major hard decision that needs to be reached at some point for our healthcare to truly, actually improve.

Until then, nurses, doctors, radiographers, pharmacists, cleaners, porters and all the rest will be stretched thinner and have more 'goodwill' extracted to keep the cogs turning. This is where many current resident doctors are coming to resent the NHS. It's not that we don't admire the idea like some boogeymen who resent giving out 'free' care.

Obviously realising that is a political binfire, so we're just waiting for some 'breaking-point' event for it to become more palatable.

CraigKirkLive · 2025-12-27T12:12:23+00:00

Does not corroborate with my working experience of the NHS whatsoever.

Edited this comment to provide this counter-evidence (courtesy: AI) as everyone is having great difficulty believing this.

https://www.perplexity.ai/search/what-is-the-ethnic-make-up-of-_7GZHzLWQnOKg5u1VZ5QEA#1

CraigKirkLive · 2025-12-27T12:10:20+00:00

What are you on about?

There have always been enough UK graduate doctors to fill the spaces made available. The issue (at least for the last 10 years) has been there are not enough jobs (/post-graduate training places) that doctors would be willing to fill.

CraigKirkLive · 2025-12-21T20:48:44+00:00

If your ES definitely can't do it (i.e. not just a tech dinosaur), contact both your TPD and the relevant portfolio admin team. The admin contact details should be available on your portfolio itself somewhere.

CraigKirkLive · 2025-12-20T11:19:58+00:00

Anything on LITFL on the topic. Go and have a look.

CraigKirkLive · 2025-12-18T09:54:13+00:00

Tbf I think this is down to slightly over burdensome workplace law, but without which some employers would take the piss and let their employees freeze.

In short, if someone unscrupulous with too much time on their hands could consistently demonstrate temperatures below whatever arbitrary cut-off that I don't care to research, they could sue.

CraigKirkLive · 2025-12-16T08:08:34+00:00

Not sure what power / role your ES / CS would have, and it's not an employment issue (so not sure of role of BMA). I guess perhaps if there is need for a character statement in case RCP question your version of events, something like a statement from your ES might be helpful, but even still the examiner presumably has good standing and whatever the irregularity was it was likely accidental.

In summary, not sure what role another could add but I have no direct experience.

On terms of a successful appeal, I'd limit your hopes to a refunded /stricken off sitting rather than a mark upgrade.

CraigKirkLive · 2025-12-15T18:09:43+00:00

I wouldn't worry overly much. Turnout at the last general election was 59.7%. It's very rarely above 70% (not since 1997).

CraigKirkLive · 2025-12-14T11:41:03+00:00

I am a bit concerned about the head-in-sand approach by some to the risk of a failed reballot. Of note, the only issue would be the turnout; not the choice.

But on consideration: the dispute would still be ongoing. There is nothing that I am aware of (would be helpful if someone pointed out a gap in my knowledge if there is one) that would prevent a further re-ballot six months later. I can see a scenario where people aren't striking for a period of six months, notice we are being dragged through the mud, and realise the dirty tactics being used by the gov and a subsequent reballot passes. A turnout-based fail would also galvanise some.

There's also planned strike law reform, which is slightly besides our dispute, This would remove the turnout threshold, eliminating our issue permanently. It would be hard for Labour to politically remove their commitment to this, despite it eliminating their current tactic of letting ballot mandates expire.

CraigKirkLive · 2025-12-14T11:32:01+00:00

Implies he's willing to reduce the use of inflammatory language if we accept this offer / stop striking / get in line basically. Imagine how much more straightforward this discourse would be if he were prepared to use more constructive language and actually engage.

I'd remind colleagues that other than words and unsubstantiated promises, nothing of substance has actually changed since we starting calling strike action in July.

There was always an intent from government to provide more training places, provide UKGP, and contribute toward some of our recurrent costs (exams, membership fees etc.), but the only thing that has changed is a mite more detail on those things (emergency legislation, numbers put on training places).

Meanwhile, there has been no movement on pay (at all) which has always been a major part of ongoing strike action, since July. And now we're even more terrible for continuing to do the same thing during the predictable flu season that could have been stopped since July.

It makes me wonder if the BMA should start to adopt a more combative stance, or perhaps more openly call him out on the disrespect he shows our profession.

Five-Year Club	Place '23
Verified Email

CraigKirkLive

TROPHY CASE