Bryn

We don't really have a lot of choice, we can't safely deliver the service they're asking so how we can we sign the contract? They needed to have a frank conversation about the future of the NHS and design a contract that was fit for purpose, not just deliver a pre-election soundbite and force us over a barrel before they've ever planned or costed it. I don't trust them not to cherry pick the finest and best staffed trusts in the country, give them funds to hire extra doctors and then pilot it, so **** that. We need to go back to the start. There aren't enough doctors to provide a 7 day emergency NHS, the system will collapse with this contract.

Probs Fiesta for good all round performance at a sensible price.

What I would say though, and I don't feel we've done anything wrong here, is that Leicester could do to just be careful how they're doing things. Mud sticks and we don't need to build up a catalogue of bad practice. The Interstellar deal and FFP stuff sounds a bit dodgy, to be honest, and if we accumulate stories like that it might make doing business difficult. Historically other clubs have described us as being good to do business with and it's in our interests to stay that way.

If they didn't do a medical it's their own ****ing fault surely.

Pearce has been very complimentary about us. He's not offending us there at all.

We only finished 3 points behind West Bromwich last season after being whipping boys for most of the season. They've been shit houses for years. If I owned a media outlet I'd keep a very close eye on my pundits. Talksport clearly don't give a shit.

Are they ****, I know the point he's trying to make but haven't they had ****ing Myhill in goal for most of the season? Who's their Mahrez? Would you swap that scrote Berahino for Vardy? Is Sessegnon going to Barca with Riyad?

I'm glad it got done. Can't explain why it was outpatient, perhaps a local policy. Language is always going to be a difficult issue. I worked in a French hospital and found it monstrously difficult (thankfully I was in a fully supervised role so wasn't able to harm anyone!). The majority of the ones that come across are absurdly good, and actually sometimes the ones with the thickest accents are British citizens, so it's tricky. We certainly need to be training more of our own doctors and nurses. This needed to start years ago.

There are measures of truth and of ignorance in this. I think clear communication is pivotally important in healthcare. I know from feedback I receive on my placements that it's my personal strong suit. I'm inferior when it comes to practical skills compared to some of my peers, my clinical knowledge is average and some people are better under pressure but I know I communicate well and I know how much it improves the experience. Sadly, it does go by the wayside. Yesterday I left a poor lady who'd been admitted for observation after a head injury who wasn't seen by us until mid-afternoon and had no information until that time. I know she was medically safe. She needed 24 hours minimum after her injury (she'd come off a horse) and wasn't close to that yet, she was receiving her neurological observations in a timely fashion and her care was proceeding exactly as it should but she didn't know that and was understandably concerned. I got to her at about 3pm and when I left she had the answers she needed and we had a positive conversation and I think she accepted the circumstances and that's the best I can hope for really. She may yet put a complaint it, as is her right and I hope she does. I would have loved to have gotten to her sooner but when I started my shift yesterday there were precisely 36 unseen patients in our department, many of them sick with a sprinkling of inappropriate usages of an ED, and they had to be prioritised. That's how our system works and we are chronically and endemically understaffed and underresourced. It would be a blatant lie to deny that some clinicians don't prioritise the communication aspect of the job in the same way I do and that leads to unsatisfactory patient experiences and that isn't good enough. I think that mentality, of not wanting to communicate, is diminishing rapidly as a result of changes to attitude and training, but sadly it's come as the demands on the NHS have skyrocketed. From my experience of two separate trusts, there is an earnest desire to improve standards and a lot of work goes on behind the scenes but frankly if we don't get more resources soon the whole thing will collapse and we are, alas, only human, and we get pissed off a lot of the time. I suspect the overwhelming reason the car park is empty at the weekend is because NHS staff rarely have their own car park, it is shared with patients, both in and outpatients, and their relatives, and there are fewer of them over the weekend. In addition, we do much less elective work over the weekend. Are you really that bothered that you can't see a chiropodist over the weekend? I agree in an ideal world we'd be able to provide that, but we can't cover anymore with the staff we have. This is precisely what the government is asking us to do and it is unsafe. Please don't conflate elective and emergency care, they are not the same thing and one is far more important than the other. MRI scans are rarely emergent. Have you any idea how much it costs to operate one? Resources are finite. If you need an emergency MRI over the weekend, you will ge tone. That is the beauty of our system. On a shoestring, our emergency care is scarcely excelled worldwide, and there are numerous economic analyses and patient testimonies from other countries to attest to this. Senior decision makers are expensive and as such are in short supply. The consultant will probably cover the entire weekend and can't feasibly be present the whole time. There will be a senior registrar and then his medical team. Without knowing your specific circumstances, I can't comment on which tests you deemed important that weren't done or which decisions you wanted to have made, and I'm certainly not asking you to explain them as that is your business. "It's as if everyone's afraid of being held accountable and therefore the less said to the patient or "the public" the better." This is probably true to an extent, but is an attitude that should shift as blame culture diminishes. For example, doctors used to be discouraged from apologising as it may incur liability, now the principle that saying sorry does not constitute admitting civil liability means the younger generation say sorry a lot more and this hopefully will become more evident. Your private hospital comment is a bit daft I'm afraid, you can't be surprised that a private hospital, lavishly funded and with no burden of emergency care, runs a bit quicker than your local A+E. A lot of people go private for a cancer diagnosis, for an example, and are then promptly bounced back into the NHS because it provides the actual treatment better, generally in a timely and evidence-based fashion, although we do need to improve in that area. It's difficult to try and explain your issues Thracian because they're obviously grounded in specific and personal experiences which I wouldn't expect you to explain. Fundamentally, where you see poor practice you must report it formally because there is, certainly amongst clinicians I know, a genuine desire to learn from our mistakes. I can't comment for senior management and I am aware of instances of alleged cover-ups. The NHS is frankly a miracle in providing the case it does, it's emergency care is world class, still, albeit you might wait a while. You won't find an emergency service in the world that doesn't struggle with demand and waiting times. It's mismanaged from the highest level, understaffed, underresourced and underappreciated. Also, the anti Europe brigade can piss right off, given the extent to which we're filling our gaping nursing rotas with extremely highly qualified Spanish and Portuguese nurses.

Absolutely. It'll be hard if he doesn't want to engage though.

Is there any one person he responds well to, or any setting that makes him feel more positive?

This is spectacularly accurate. Speaking both as a doctor and as someone who has experienced persistent depressed mood I think this is wonderful and will perhaps start to say exactly this to my patient. I believe depression is actually a term applied to a wide range of disorders. You've got the psychiatric at one end; the sort of catastrophic chemical low mood that comes with a psychiatric disorder such as bipolar or schizoaffective disorder. At the other end and far more common is a very behavioural thing, in my opinion. For a wide variety of reasons people get into spirals of reacting negatively to an experience (sometimes hugely justifiably) and develop poor coping strategies, which lead them to miss opportunities for positivity in their life which lowers their self esteem, leading to further avoidance tactics and a continual decline. I see a lot of depression in ED and it can be terribly sad at either end of that scale. There are a huge number of people who simply no longer have the capability to positively react to life and have developed this role of a "depressed person" and have serious problems with chronic pain, fatigue and illness. I don't mean that disparagingly, the circumstances of that decline are extremely varied. I do believe our quick fix, instant gratification society does lend itself to this form of poor coping with the harshness in life in a lot of cases but that's a very simplistic view. Recurrent deliberate self harm is often attributed to a need for control and I think that's often true but sadly I think there are a lot of people who are stuck in a cycle of fear, poor decisions and regret and desperately want to be "fixed". Fundamentally, this form of depression is extremely hard to treat. @@Ozwin, the most important thing you can do for your brother is try to support him to understand what it is he's reacting like this to. I agree that doctors can be really terrible at treating this; partly because I don't think it's an illness as such, more a pattern of behaviour. That's why it responds so much better to interpersonal therapy. What's your relationship with him like? Is it possible for him to open up to you?

I'd happily feed anyone that abuses a vulnerable living creature of any kind their own freshly pruned genitalia.

If you'd said pun descending I'd have lol'd.

Exactly this, I interpret this as "we played a good team and we nearly bested them" which isn't untrue.

That's not what he's saying. Can people just stop going looking for this shit? Get a grip of yourselves and just enjoy the football.

Unsurprisingly, given how fvcking wooly it is. The Government could tell me the sea is wet and I'd double check.

Why are you being simple?

That's the worst yet.

I actually enjoyed that article and think it's pretty accurate. You really think other teams aren't broken down statically like this? What do you think all those statisticians we employ do? This is the modern game and I suspect we have every other team analysed like this.It highlights weakness we have quite nicely, other teams should target Schmeichel more and finding a way to shackle our midfielders is effective. What we have to demonstrate to play with the big boys is that we can grind out results even when we're targeted like that. So far, so good.

It's an anti-anginal. She's either doping or had a serious heart condition and shouldn't not be playing professional tennis.

Can we please have some threads which aren't politicised??

Can we start banning those who don't provide names?

So much pop-up.

Can't understand why anyone would give a **** what other fans think.