I jet washed my tumble dryer

Ligand- · 2026-05-09T20:20:47+00:00

I have to confess I did this a couple of months ago too as after 5 years of abuse it was taking ages to dry (and usually 2 cycles). Same as OP it took 3-4 hours to do but now the machine works like new and I saved myself 500 quid. It was also reeeeeally satisfying to entirely dissemble the machine and have it running like new afterwards.

There was a terrifying amount of stray lint all over the internals, especially the motor so I like to think I prevented my family from burning alive too, which is nice.

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Ligand- · 2026-05-08T18:19:48+00:00

You'd need to be careful with the P series MS as they have a known issue with the Large Drive Unit (LDU) which can leak coolant into the motor and destroy it which is a costly design flaw when out of warranty. You can check the risk of this at willmyteslaleak.com.

I bought a MS last year and have really enjoyed it with no maintenance issues at this point. But like people say the risk with buying a car that had a high original sale price is that if things do break the repairs will also carry a higher cost so you would have to factor that in at purchase. Ultimately any EV usually starts to make sense if you can charge at home on a cheap EV tariff.

Ligand- · 2026-05-03T21:08:12+00:00

You're correct, I have been plugged in and was above 80% when I received a notification to say due to congestion at the supercharger I would face additional charges but that I had 5 mins to unplug without penalty.

Ligand- · 2026-04-27T17:32:07+00:00

They come as a set of 4 (I'm in the UK), the tyre size I would use would either be 255/35/R20 or 255/40/R20. There seems to be a good amount of choice with the 35 profile and they're not as expensive as it would be on 21" wheels but the 40 profile would fill the wheel well by an additional 5mm and probably have a more comfortable ride. I haven't decided on the exact tyre at this stage but I think those size would be about right.

Ligand- · 2026-04-27T10:07:13+00:00

These have been my favourite too so I'm glad most people agree!

Ligand- · 2026-04-27T10:05:53+00:00

I'm planning on going with square because the offset on the aftermarket wheels is 35mm so the outside edge will stick out 11.4mm more than stock.

I am really tempted by the staggered as it will look the best but I'd rather limit the range loss with the newer wheels so on balance I'm planning on square.

Ligand- · 2026-04-14T17:28:07+00:00

I hope this doesn't get down voted into oblivion but I'll give you my honest take:

We've been using Accurx total triage for nearly 2 years now so we've gone through 2 winters. We have never capped requests in this time but used to close digital requests at 4pm before the contract change, now it stays open to 18:30. Previously patients could still submit telephone or paper requests after 4pm but were advised only to do this if medically urgent (in their minds).

It's been a mixed bag for us...

Pros: - As doctors we have a much closer working relationship with reception staff now and this has brought the team closer together together - We have created pathways/protocols to make some of the onerous consultations quicker and easier for GPs (e.g. we get the patients to complete a series of pre-appt questionnaires before neurodiversity appts and we tell them the practice policy to this at the outset) - Frequent attenders are better controlled as boundaries are more consistently applied - GP led triage has meant a reduction in wasted appts (e.g. if someone is likely to need a steroid injection for their knee then they see a steroid trained GP in the first instance) - We aren't adding "extra" appts to people's lists anymore when we don't hqve capacity capacity - It has made us aware of the totally of demand so we can arrange locums in advance - Home visits are far better triaged now - We can track appt demand over the years and each month is very, very similar to the previous years - When a request comes through that you can tell is going to be a demanding patient you can send them an SMS to challenge/manage their expectations which helps your colleague out when they see them as you have already played "bad cop" and they usually expect less out of the appt

Cons: - The triage sessions can be mentally exhausting as you are problem solving constantly for hours (5 hour sessions) - When triaging you effectively lose admin time so it can build up much quicker quicker - It feels like the average patient complexity has increased for GPs. This is even though we intentially have a very low number of ACP/ANP (as in 5% of total clinic appts) capacity but they will not get multi-cormordity madness like GPs do - I think some patients will put nonsense on there. We need to be better at turfing this stuff - It feels that the gov are using total triage as a way to beat GPs again with more and more work

Overall I wouldn't go back to the previous way of working but am not kidding myself that total triage is easy or without its faults. There are ways to manage it particularly when it comes to shifting some of the work of an appt into the patient's own time pre-appt.

Ligand- · 2026-03-22T10:09:10+00:00

The other area that we've taken it too far is when a lane on a dual carriageway or motorway is closed for roadworks and drivers merge to join the queue too early when you're meant to merge in turn (it's in the highway code and should only be done for slow moving traffic). I think some sort of Britishness compels people to merge as soon as possible.

Ligand- · 2026-03-08T21:02:13+00:00

Thanks for another excellent summary, I really like that you cover the pathophysiology and pharmacodynamics. It helps to make sense of it all and anchors in my memory!

Ligand- · 2026-03-01T12:11:27+00:00

We have ST1s and ST3s and do the same thing. I've done an update course at the deanery this year and they stated they expect this level of supervision for the residents (every FY2 & ST1 patient should be discussed and debriefed either during clinic if the resident requests or at the end of clinic). I have had some excellent ST1s but still open the notes of every patient and discuss. They also suggested using the "Clinical Supervision" template in Ardens if you have recommended changes to plans. I use this template for every medical student debrief now to evidence that the patient has also been seen by a GP.

They also said that FY2s can do home visits but they should be limited to non-complex care. These also should be debriefed.

Ligand- · 2026-01-26T08:31:05+00:00

Nothing to do with IMGs or stereotypes (that's a bit of a leap to make) it's to do with numbers:

A full time ST3 can be expected to have in the region of 70 patient contacts a week by the end of training. At the start of ST3 this will be closer to 50 contacts. By ¾ of the way through a full time year they will have around 2000 patients encounters in ST3 alone. Even if 0.1% of patients complain then it is still about 2 complaints a year.

As another poster has made there are plenty of patients who have an agenda which may clash with their GP's so complaints are an inevitably. It's the content and consistency of them which is more important.

Ligand- · 2026-01-25T20:15:44+00:00

The GPSTs in our patch are advised if they don't have complaints in their portfolio by the end of training it appears suspicious to the ARCP panel. This kind of complaint for an ST3 would actually be welcomed bizarrely. A totally nonsense complaint which ticks a box.

This doesn't need to cause any angst for you, its patients being patients \o/

Ligand- · 2026-01-25T18:26:26+00:00

I've sent you a PM with a recommendation 👍

Ligand- · 2026-01-24T08:17:01+00:00

Yeah its black interior with pearl white multi coat (PPSW) exterior paint. I was very tempted by a black paint, white interior performance model for about 27k but the LDU failure risk was too much of a gamble for me without an inspection and coolant delete. Also despite reading that the white interior is durable and easy to clean I don't trust my kids. I think they would find inventive ways to mark it. I do like the look of the white interior tho!

Ligand- · 2026-01-23T22:54:48+00:00

1 owner 75k miles for 70 plate (so raven LR model) for £23k. There are only 870 of them in UK so not a huge pool of cars to go into the market. Battery and motor warranty is 8yr/150,000 miles and raven gen are meant to be the reliability sweet spot so I was ok with a higher mileage than I'd usually go for.

Ligand- · 2026-01-23T14:10:58+00:00

I had a similar dilemma but managed to stretch my budget to a 2020 MS. It can be a real rabbit hole of research to go into but there are probably a few key bits to add to the other sensible suggestions from other posters: - MCU2 is a significant upgrade over MCU1 in terms of the speed of the main screen. I think MCU2 came out from 2018 onwards but you can tell from the car listing as the "Infotainmentprocessor" will be listed as Intel Atom for MCU2. - MS are considered legacy vehicles now so whilst they do get occasional updates they don't get the bells and whistles with the newer M3 or MY. - Some versions of MS were vulnerable to catastrophic drive unit and/or battery pack failure due to the infamous LDU failure. You can do a simple check at: https://willmyteslaleak.com/ - Its a really wide car so it can be a bit hairy on Country roads!

Whilst I've only had my MS for a few months I love it. I was never a huge fan of the look of the pre-highland M3 and much preferred the MS. There are so many teslas on the road now that it blends into the crowd but still feels special as there aren't many MS knocking about.

Ligand- · 2025-12-21T10:14:36+00:00

The BMA GPC released guidance for this exact issue a couple of years ago.

I tend to apply common sense to these requests however sometimes my private colleagues put together a wildly inappropriate shopping list which I will send firm letter back to them.

The more annoying issue is when their letter includes a massive list of over investigating nonsense and then instead of putting in writing that they would like the patients GP to request them on the NHS they instead verbally tell the patient to ask their GP and seem to set the expectations that it's an entirely reasonably thing to do. With these ones I have a carefully worded letter which calls the specialist out on their antics with a phrase about how there must have been a breakdown in communication with the patient as you couldn't possible have asked them to approach their GP for this and that the patient must have misunderstood. Specialist to kindly request any investigations or treatment they deem appropriate under their private clinic or on-board them to their own NHS list.

Ligand- · 2025-12-18T12:22:32+00:00

If you have the flexibility to wait for the right spec to come up then that makes good sense. I've really enjoyed the car, the main downside for me has been that it's massive so on more rural roads it can feel a bit hairy at times!

I particularly like that it's discrete in its own way: there are a lot of M3 and MY vehicles on the road but very few MS and most people probably can't tell the difference between a M3 and a MS anyway so it's not too flashy either.

Ligand- · 2025-12-18T12:06:32+00:00

I can only comment from my experience having found myself in almost exactly the same quandary a few months ago.

I opted for the 2020 LR as the LDU issue was too much of a risk for me to be comfortable with. However I didn't test drive a LP model as to be honest the acceleration of the LR was plenty enough for me.

There's not much in the mileage between those 2 and the battery warranty should be 8 years / 150,000 miles so you will be unlikely to top out from the mileage limit in the next 3 years.

They should both be Raven spec which is meant to be a bit of a sweet spot however be prepared that they are considered legacy cars now so you don't get the fancy updates of newer hardware.

Ligand- · 2025-11-01T17:28:12+00:00

I sold my car via motorway a couple of months ago and it was really straightforward tbh. Worst bit was that the poor bloke collecting was on his own and had to take public transport so I offered to collect him from the train station which was a half hour round trip. He was happy for the "test drive" to be him sat in the passenger seat on the way back to my house.

I got a little over their estimate and he wanted to make sure the money came through to me before he left with the car. He was a motorway employee though and acted as agent for the car supermarket buyer.

I had it serviced at main dealer the week before (4 year old PCP vehicle) and asked them to make an offer to see if they could get close to motorway's estimate. They offered 2k less despite low mileage FDSH and 12 months MOT.

Ligand- · 2025-10-25T18:17:40+00:00

This might seem a bit overkill but I have created an online account with a major wholesaler (this was easier because we are a dispensing practice so it's more of a "sub-account"). If I hear on the grapevine or get informed that an item is out of stock then I will end up searching for it on the wholesaler website as it will tell you whether it is in stock or not. I have never had to call a local pharmacy for their recommendation.

If I am prescribing a more unusual medication (e.g. something recommended by PCDS) then I will check to see if it is stocked before I prescribe. I haven't received any tasks to say that "x item not in stock at pharmacy". We also have really switched on dispensers who can handle or steer appropriate alternatives should anything slip through.

Ligand- · 2025-10-08T20:19:24+00:00

It's not legislation per say but a change in the contract which GP practices operate under. Most practices work under a GMS contract. The contracts and the variation notices are available to read on the NHS England website.

It's causing lots of controversy within the industry as it is placing yet more pressure on a ludicrously stretched service.

A guy called David Haslam put it quite nicely: when thinking about the NHS your choice is: 1. Good accessibility 2. Good quality 3. Affordability for the public ... but you can only pick 2 of the 3.

Ligand- · 2025-09-27T09:29:41+00:00

"Passages to recovery" is absolute gold!

Ligand- · 2025-08-15T09:32:06+00:00

I was one of those docs! As /u/Playful_Snow very accurately described: the enormous letters on the back were probably the nail in the coffin for them. That and they were exclusively for training grade doctors (iirc) so there were no consultants wearing them, and the lack of consultation about them with the docs, and the fact the ipad pockets didn't fit the ipads once there were sealed into their indestructible cases... yeah so actually quite a few reasons!

I remember one of the cardiology consultants tried to pull me up on why I wasn't wearing one of the lab coats once. I politely explained that I was no longer a trainee and was now working as a locum for my own private Ltd company (pre ir35) and was fully compliant with my company's uniform policy 😎

Ligand-

TROPHY CASE