Prof Christina PagelA fediverse THREAD on latest NHS situation in England: Ambluance times, A&E, Waiting lists...
1/
Ambulance wait times across the board are the worst they've been for a very long time.
Graph shows category "C2" - not quite life or death, but potentially. Target is 18 minutes wait, but average is now over an hour. Almost 80 minutes in the Midlands and the SW. 2/
Once you get to A&E, waits to be seen are longer than ever. 31% of people now wait longer than 4 hours (target is 5%!).
Unsurprisingly about 5-6% of people leave before being seen - some of those really needed to be seen.
Over 8% of people wait longer than *12 hours* - up from basically 0% pre pandemic.
3/
One of the big issues causing these long waits is that hospitals are full and finding it difficult to discharge people ready to go - often frail older people who have nowhere safe to go with a broken social care system.
About 25% of beds in general wards are occupied by adults otherwise fit to be discharged.
Just since April this year, that's an extra 300,000 days in hospital for patients staying at least a week longer than doctors thought they needed to. 4/
Of course, many people aren't even getting in to hospital for either inpatient or outpatient care.
1.5 million people are waiting for diagnostic tests (30% longer than 6 weeks).
Over 7 million people (1 in 8 of entire population) are waiting for treatment - the highest number ever. 5/
In terms of people waiting longer than 6 weeks for diagnostic tests by type of test, these are all important tests to determine potentially serious issues. The target is 2% across the board. None of the test types are near that target. 6/
This is even affecting cancer services, where waits have been steadily increasing since the start of the pandemic.
25% of patients are now waiting longer than the target of 2 weeks to see a specialist after urgent GP referral. 7/
And finally... what is increasingly a broken health care system is - unsurprisingly - having an effect on the health of our population. Adding to the considerable number of people who report being severely affected by Long Covid (ONS reckons about 340K as of Oct 2022).
The number of working aged people economically inactive because of ill health - already increasing pre-2020 - is going up ever faster.
This is bad news for them, bad news for the NHS and bad news for our economy. 8/
Some of it is 2.5 years of Covid, some of it is lack of investment over years, some of it is staff burn out & cost of living combined with years of stagnant wages. Far too many NHS staff are needing food banks.
What can we do? One thing is to wear a mask in public crowded spaces where possible - reduce NHS burden by not getting sick or making others sick (regardless of which virus!).
Another is write to your MP to ask for NHS action!
And - support nurses! /END
PS thanks to Bob Hawkins for producing the charts for this thread
Nafnlaus 🇮🇸 🇺🇦@chrischirp Thank you for this!
Jane Johnson (books)@chrischirp And yet Cornwall Council advice makes no mention of masks and our local surgery, and hospital public spaces, are mask-free. I queried the councillor responsible for health and was told they were focusing on hand-washing and vaccines 'to keep the messaging simple'. I despair.
Gale@ExC_Gale @chrischirp I mean, what hope is there is even our medical professionals are such minimisers?
@JaneJohnsonBakr @chrischirp Exactly. 😐
Benjamin S-B 
@chrischirp terrifying and infuriating in equal measures. As a parent I'm terrified of my child having some kind of accident that requires hospital care. The fact that this isn't headline news every day days more about the rotten state of our media landscape than anything.
TerryAdirimMD@bensb @chrischirp This is the point that most people miss/ignore - that even a healthy person can unexpectedly need emergency care in a system clogged with Covid cases.😑
Marciano Siniscalchi 🇺🇦@chrischirp I really like your advice to wear a mask to not get sick and not make other people sick --*whatever the virus*. Common courtesy, and smart.
AutisticMumTo3
Riikka Savolainen@chrischirp in addition, any measures increasing the supply of social care (e.g. putting it in the shortage occupation list) would help to free up NHS places.
Jim Parkin
Chris McCabe
C Martin@chrischirp spot on as always
Tim Ward ⭐🇪🇺🔶 #FBPE@chrischirp "Public crowded spaces" ... no ta.
Actually we are meeting some other people today, which we don't do very often. Who are also shielding. In an uncrowded outdoor location (the middle of a forest).
David@chrischirp everyone talks about the cost of the health service, but not about the cost of not having a functioning health service. When people can't get the treatment they need when they need it the economy and society as a whole suffer just as much as the individual concerned. Proper funding for the NHS is the right thing to do, medically, economically, and morally.
Elisabeth RevansThe situation in mental health is also appalling. Our local A&Es are full of extremely mentally unwell patients on s136 of the MHA awaiting beds, looked after by police in the interim as there is no secure environment for them. The ones in a&e not on s136 (and therefore with no police) but in need of admission under the MHA are even worse off. We have had several awful incidents of people leaving A&E before a bed was found and harming themselves severely this week.
Kate 🇪🇺🇬🇧@chrischirp I was told the 2 week period is the timeframe within which an appointment date is agreed, over the phone, for a time beyond that 2 weeks. It is scary. I'm sure 2 week wait used to mean actually seeing a specialist within 2 weeks.
@chrischirp But I thought lockdowns caused all the waiting list problems? 🤨 /s #COVID19
F1fty@chrischirp time from appointment being requested to actual appointment date (May 2023) for my cardiac MRI = 2 years!
artsyhonker@chrischirp I'm not going to boost these posts without CWs.
TheExecutiveEditor@artsyhonker @chrischirp
Trying to understand the CW metrics and conventions on Mastodon.
Would you expect a CW on each toot? I would have assumed that the fact that all detail was "hidden" in subsequent toots and the first toot was a summary would have provided the equivalent protection?
Trying to understand the CW metrics and conventions on Mastodon.
Would you expect a CW on each toot? I would have assumed that the fact that all detail was "hidden" in subsequent toots and the first toot was a summary would have provided the equivalent protection?
@TheExecutiveEditor
I didn't use a CW because i put no data in the top tweet (public) and then all the following content as an unlisted thread - so people ONLY see that content if they click on the thread to view it.
(At least that's what I understood it does, and what was recommended to me as best practice)
TriciaB@chrischirp @TheExecutiveEditor Yes, seems good to me and seems to follow my newbie understanding of OK, too.
@chrischirp @TheExecutiveEditor I'm with Christina on this one. The only thing I would have suggested is to add a few hash tags to improve discoverability
@bensb I keep forgetting about hashtags!
I would go back and "delete and redraft" the top tweet with a hashtag but i think that would break the whole thread so I won't. Next time!
@chrischirp 👍 FWIW, I also learnt that you can't edit the top toot of a thread without breaking it when I forgot to add more hashtags 🤦♂️ Could do a public reply with the tags in, but that's not very elegant
Chris GallagherWould editing the first (or any other) toot of a thread break the whole thread? Would be useful to have that confirmed.
@chrischirp
Yes, that was my understanding too. You see the top toot, then click expand to see the rest if you want to. Which seems very similar to what happens when you click the CW button in a single toot.
Yes, that was my understanding too. You see the top toot, then click expand to see the rest if you want to. Which seems very similar to what happens when you click the CW button in a single toot.
@chrischirp @TheExecutiveEditor No, that is not how it works.
Unlisted toots don't appear in the public timeline, but they *do* appear in the timeline of everyone who is following you. So I got every toot in that thread in my timeline with no CW on any of them.
@chrischirp And so did every other person who follows you. And every toot that was boosted appeared in someone *else's* timeline, again with no CW. @TheExecutiveEditor
@chrischirp Having everything after the first toot in a thread is indeed good practice, for keeping your local instance timeline and the federated timeline less cluttered and more chilled. But a toot being unlisted has no impact on its visibility for people who follow you., who will see all of them. @TheExecutiveEditor
@artsyhonker @TheExecutiveEditor oh really? i didn't know that. I had a conversatin with someone about thread best practice and this is what they suggested!
So - should i do BOTH unlisting AND CWs?
@chrischirp @TheExecutiveEditor Yes, if you want people who follow you to have a choice about what they read.
@artsyhonker i thought that's what my method did, but I hadn't considered that other people can boost subsequent tweets and I thought it wouldn't show up for my followers either.
I *am* trying to be respectful and have been using CWs
@chrischirp Yes, I saw you using CWs before, and was pleased and impressed, which was part of why I got so annoyed this time.
Thank you for being responsive about it, however you decide to handle future threads.
@chrischirp @TheExecutiveEditor CW stuff is always worked out in context, in community, and it gets messy sometimes.
For example, it's *not* appropriate for me to ask black or brown people to CW their experiences of racism, or disabled people to CW their experiences of ableism. But it's also not appropriate for me to boost those toots without CWs, because I also have black/brown/disabled followers who sometimes really need a break from that stuff.
@artsyhonker is thre a way to boost someone's post and *add* a CW? I've been wondering about that.
@chrischirp Not easily. I usually reply to the post and put a CW on the reply, with content something like "replying with CW"
@chrischirp The other thing you could do is paste a link to the toot into a new toot iwth a CW. Like I'm doing here, only we already had CWs on the conversation.
Prof Christina Pagel (@[email protected])
Content warning: CW conventions, racism mention
@chrischirp Anyway -- it is late, and I am tired.
Thank you for all your work with COVID data and news, I do very much value your contribution. And thank you also for engaging on the CW stuff, it is tricky to get the hang of at first and I was pretty grumpy.
@artsyhonker it's fine. I get that it must be annoying have all these people come over here trampling around like idiots. sleep well!
Jeri Dansky@TheExecutiveEditor I'm all in favor of CWs when appropriate, and I think you did fine! Nice example of Mastodon threading. And I'm glad you're here.
@jeridansky
@chrischirp
I think that CW's should be context relevant.
I.e. if I follow an account that mostly provides information on a certain subject then or in a certain way that is probably because I want to see that information. However if it were to post something out of the ordinary for it then I would expect a CW.
A lot of accounts seem to function that way from what I have seen.
@chrischirp for context, this is what the creator of Mastodon says:-
https://mastodon.social/@Gargron/109323118267580967 and previous toot
@TheExecutiveEditor @chrischirp No, because I was following @chrischirp I saw every single one of the toots in my timeline. Much better to CW every toot than not. If people don't like expanding them individually there is a setting to auto-expand.
@TheExecutiveEditor @chrischirp I've unfollowed for now. I want to stay on top of such news, but I also want to be able to use social media without getting stressed about the state of the world; if other people aren't going to use the existing tools that give me that kind of granular control over *when* I read, then I am going to cut back *what* I read instead.
@TheExecutiveEditor @chrischirp And I'm certainly not going to boost un-CWd threads about NHS crisis into the timelines of people who follow me.
@TheExecutiveEditor @chrischirp So yes: the appropriate thing to do, in my opinion, would be to CW every toot in the thread.
That's easy to do, because when you reply to the first toot it keeps the CW for the next one.
Oh that's helpful to know. I'm also finding a lot of variation in what is considered CW worthy which doesn't help those of us still getting used to the conventions.
Thanks for taking the time to explain things though, now I Ned to see how to "unlist" a toot and why one would bother since it doesn't seem to do what was thought.