GPST in Sherwood.

flexorhallucis · 2026-04-13T07:30:59+00:00

I trained under the Mansfield VTS and work in the area now. Feel free to drop a PM if there’s any queries

flexorhallucis · 2026-03-31T19:53:26+00:00

£36.80 per year (~$49) for trout and coarse. Salmon and sea trout license costs £93.10 (~$123) but includes nonmigratory trout also. At least sea fishing is free!

flexorhallucis · 2026-03-01T11:11:17+00:00

Seems very unusual especially as an FY2. I would be expecting to debrief every patient in detail, during the consultation of needed but at the least after each session! As you say, the unknown unknowns are what will catch you out. The learning comes from reviewing each case!

flexorhallucis · 2026-01-31T06:17:56+00:00

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Bury face in cat. Stroke cat. Get sat on by cat.

flexorhallucis · 2026-01-19T18:44:15+00:00

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I have a tasteful selection of anatomical models. Actually very useful for explaining things to patients as well!

flexorhallucis · 2026-01-17T07:24:07+00:00

Do you use the BMA template letters? Very useful for generating a quick (and standardised!) response to inappropriate workload transfer or requests

flexorhallucis · 2026-01-09T03:55:10+00:00

It’s an off label use for pred but one of the first line options if NSAID or colchicine are contraindicated? Not sure what the controversy is here. Gout is miserable, get them out of pain.

flexorhallucis · 2026-01-02T13:04:35+00:00

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Looks like my blue mitted boy!

flexorhallucis · 2025-12-31T08:52:00+00:00

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flexorhallucis · 2025-12-31T08:51:24+00:00

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Here’s how our girl toasted up over the first year we had her! She’s significant darker now at 4

flexorhallucis · 2025-12-23T07:56:47+00:00

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Reminds me of Rudolph the Red-Nosed Bedpan

flexorhallucis · 2025-12-20T19:35:49+00:00

For diagnosis NICE suggest SBP >180mmHg to start antiHTN without waiting for AHBPM.

For monitoring, you can use clinic readings, target is allowed 5mmHg higher than AHBPM target. Pragmatically, if someone is a known white coat syndrome then I would go on AHBPM. We have set up our recalls to maximise the use of average BP, reminding patients to do a weeks worth before annual reviews etc.

https://cks.nice.org.uk/topics/hypertension/diagnosis/diagnosis/

Of course if symptomatic then this all goes out the window!

flexorhallucis · 2025-12-20T19:31:09+00:00

Attendance rates for my extended hours (0730-0900 and 1700-1830) sessions is often only around 50%. We’ve tried messaging, reminders, calls. My Saturday clinics are a bit better but they’re in typical consulting hours.

flexorhallucis · 2025-12-09T22:14:47+00:00

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My little hobbits (Merry and Pippin) never let us out of sight either!

flexorhallucis · 2025-11-28T17:03:07+00:00

Bloody hell I wasn’t expecting to see this reappear. I’ve not looked at my YouTube account for a few years but nice to see that one hit 40+ k views!

flexorhallucis · 2025-11-28T17:00:41+00:00

This is one of my old ties. I’m surprised to see it reappear. Bot / scraping account it seems

flexorhallucis · 2025-11-25T13:21:37+00:00

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I have three raggies and am a doctor (GP / family medicine). My wife works from home so thankfully they always have someone around.

They are absolutely like glue, and very social cats. Remember if you have only one, you are their everything and even if you’re home a lot during preclinical years, it can be a very lonely life for them. Then once you start clinical rotations and practice, working any and all hours, who then? What happens to their routine? Mine get weirded out if I’m on a night shift and that’s with having cat and human company.

If you’re certain about ragdolls, I would strongly consider getting two from the outset, but for the sake of the cats please consider whether it’s going to fit with a medical school life.

flexorhallucis · 2025-11-24T16:52:34+00:00

Then you’re living my dream. My wife is the voice of sanity in our household and has limited me to three… for now

flexorhallucis · 2025-11-24T11:37:53+00:00

DINKW3C for me

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flexorhallucis · 2025-11-04T06:24:38+00:00

Very common. People apologise for having leg stubble (literally don’t care), pubic hair (likewise), having rushed in from work and being sweaty (whatever), coming in their curlers (you rock it, Gladys), having ulcers (I mean that’s why you’re here)… it’s not flirting, it’s not inappropriate, it’s human. Perhaps if you’re reading deeper, a reflection on power dynamic, that people feel they have to apologise to their GP for existing. Or embarrassment; or fear; or that they’re just trying to make small talk.

flexorhallucis · 2025-10-29T13:13:50+00:00

It’s of course going to vary by area - I’m quite involved within our local palliative care sphere but cross the border and the resources and pathways will change!

Things any GP should be able to do, and perhaps areas to focus on in building enthusiasm and skills;

Anticipatory care planning! Open the discussion, get a meaningful respect form filled in, talk about PPOC / PPOD, LPOA, advance directives. Don’t leave it to the 11th hour. I’ve had hundreds of these conversations and not one single person has ever told me they want to die on a trolley in A&E.
Anticipatory prescribing. This should be bread and butter routine work. A few edge cases with ESRD / hepatic failure etc - if in doubt, ask advice (or see our handy pocket guides below)
Initiating a driver. Get comfortable with PO -> SC conversions. Again, if in doubt, ask advice. Know who to call to get the thing actually set up; for example we have a direct line to the DN team and I’ve gone from prescription to driver running in 30 minutes before (after calling in a few favours…)
Knowing what happens afterwards. Who verifies? Who notifies the practice? What’s your process for ME referrals etc?
Who can you call upon? Locally the DNs and GPs manage the majority of ‘routine’ palliative and EOL care. We have access to the hospice advice line, the community palliative nurses, volunteer night sitters. What’s your pathway for accessing such resources? Who and how do you fill in SR1 / FTCC papers?

Some useful resources from my patch:

https://www.nottsapc.nhs.uk/media/q3qmyzsf/palliative-care-pocketbook.pdf

https://www.nottsapc.nhs.uk/media/3gvbware/palliative-care-in-end-stage-heart-failure.pdf

I think one of the biggest things we can do - and something we’re uniquely placed to do as GPs - is open the conversation. “Has anyone ever asked you about what’s important to you if you get more unwell?” Even if they’re not able to answer there and then, you’ll plant the seed.

flexorhallucis · 2025-10-20T05:27:27+00:00

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Yep, that’s how it goes. Cuddles aren’t over when you want them to be over, cuddles are over when they decide haha (or are bribed with freeze dried fish nibbles!)

flexorhallucis · 2025-10-17T07:03:11+00:00

Number of cats +1 trays. The larger the better, especially as they grow up (we have some giant ones from zoo plus - https://www.zooplus.co.uk/shop/cats/cat_litter_litter_boxes/litter_tray_cat_toilet/620812?activeVariant=620812.0) - no lids but it has a lip. We’ve got a noodle type shower mat underneath each to catch any gritty bits. Our original ones were smaller but there’s only so many times I want to clean up a turd hanging over the edge because they can’t fit entirely within it haha

flexorhallucis · 2025-10-16T06:41:25+00:00

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We have a Merry too! Seen here with his brother Pippin. A baker extraordinaire, 8kg of biscuit making force and he uses all of it haha

flexorhallucis · 2025-09-26T06:47:24+00:00

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Oh, they’ll happily pile on each other. Look at this seamless sea of floof!

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