iiinova — where your digital self keeps evolving

Becky Taylor @drbeckyt.bsky.social · 25/01/2026

I think performance rather than accountability occurs in the NHS particularly when there is a lack of cultural safety. Fear of professional consequences can lead to the performance of a report being seen as an action complete and personal risk abated, avoiding the difficult questions

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Becky Taylor @drbeckyt.bsky.social · 25/01/2026

I think Eliot's description of the dysfunction of democratic institutions can apply to the NHS too. Even worse when those within an organisation see the performance as the aim, rather than seeking the outcome of meaningful patient safety actions, in whatever guise that may take.

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Eliot Higgins @eliothiggins.bsky.social · 25/01/2026

The events of the last 24 hours show why it's important to build functional verification structures in public and counterpublic spaces to resist the authoritarian erosion of our democratic systems, as described in this thread.

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Becky Taylor @drbeckyt.bsky.social · 21/01/2026

I agree that front loading senior decision making has benefits throughout the system. In our Trust at least, that requires significant expansion of those senior staff numbers. Consultant's can't be at the front decision making when their bandwidth is taken up fire fighting patient safety/crowding

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Becky Taylor @drbeckyt.bsky.social · 19/01/2026

The US truly is a foreign world Recognition of ordinary dying is a core emergency medicine skill that allows patients and their family dignity and to prioritise what is important for them No family *wants* their relative to die, but it is our job to counsel and support them, not offer false hope

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Becky Taylor @drbeckyt.bsky.social · 30/12/2025

Quiet as in "not newsworthy", but far from quiet in our Emergency Depts. Not newsworthy as it is just the predictable pressures on acute care of a four day festive w/e with an ageing & multi morbid population who try to hold out over Xmas & whose limited community safety nets are still in twixtmas

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Patient Safety Learning @patientsafetylearning.org · 18/12/2025

In a new blog on corridor care, Claire Cox argues that to have a significant impact, guidance needs to move beyond what 'should' happen. ▶️ www.pslhub.org/learn/improv... #patientsafety

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Neil Pettinger @kurtstat.bsky.social · 09/07/2025

It was good to see @samfr.bsky.social say today that "the main reason for lengthy A&E waiting times is the lack of hospital beds for people who need admitting, which gums up the whole system as they have to keep being treated by emergency staff." samf.substack.com/p/optimism-o... #rstats #ggplot2

Two scatterplots side by side. The chart on the left shows the relationship - or - rather - the lack thereof - between the number of A&E attendances per day and each day's four-hour compliance. The chart on the right shows the (quite strong) relationship between the level of crowding in the A&E each day and each day's four-hour compliance.

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Becky Taylor @drbeckyt.bsky.social · 04/07/2025

And I also worry about the misapplication of AI in EM - computer says diagnosis is/isn't xyz. AI/LLM could have useful roles in EM, but as a decision aid in diagnosing AI is open to the same input/output traps as current decision aids

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Becky Taylor @drbeckyt.bsky.social · 04/07/2025

As departments are under increasing pressures to stream undifferentiated patients from triage, I worry that patients may lose out on seeing a specialist generalist, and are put too early into rigid boxes of medical/surgical, or PE rule-out path/low risk abdo pain etc.

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Becky Taylor @drbeckyt.bsky.social · 04/07/2025

I've found PE on CTPA when low Well's/negative D-dimer, ICH in people not meeting NICE HI criteria, and significant cardiac disease in the under 30s. All of these required thinking beyond the decision aid

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Becky Taylor @drbeckyt.bsky.social · 04/07/2025

Musing today that decision aids in EM can lead the unwary (more junior colleagues especially) into quite rigid and narrow assessments/thought processes, when people are a lot more varied and complex and nuanced. And then how as seniors can we mitigate this and educate in the busy modern ED 🤔

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Rob Ford @robfordmancs.bsky.social · 11/05/2025

Until and unless we have a political class willing and able to state these basic truths about social care, reform its provision so it doesn’t carry on destroying local govt, and actually raise the taxes needed to fund it properly, we are, not to put to fine a point on it, f***ed on this issue.

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Becky Taylor @drbeckyt.bsky.social · 11/05/2025

Make it make sense...🤦 *Screams* in Emergency Medicine

Screen shot of BBC News article. Text reads: Care worker recruitment from abroad to end, Cooper says. Up to 50'000 fewer lower-skilled workers will come to the UK under new measures aimed at tackling net migration, the home secretary says.

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Becky Taylor @drbeckyt.bsky.social · 23/04/2025

I'm particularly enjoying the tulips and daffodils this year. They seem especially abundant and vivid. I can't decide if that is because the weather conditions have been just right for a particularly good crop this year, or I'm noticing them more as I missed the season last year

Close up of a red tulip flower in a garden bed, with a daffodil out of focus in the background

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Rick Body @richardbody.bsky.social · 21/04/2025

One of my favourite quotes from Pope Francis, who said he would be a “Pope of the poor”. He spoke out against injustice, emphasizing the need for compassion, calling for peace & strongly supporting the Palestinian people under attack. Rest in peace.

A photo of Pope Francis with the quote: “We must meet one another doing good. ‘But I don’t believe, Father, I am an atheist!’ But do good: We will meet one another there.”

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Becky Taylor @drbeckyt.bsky.social · 21/04/2025

And, I think residents are much more likely to pick up the phone for advice if they know the consultant hasn't been on shift since 8am +/- got a clinic/another 24hr on call the next day. I certainly became more willing to "disturb the boss" when the EM on call changed from 24hr to 1700 start.

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Becky Taylor @drbeckyt.bsky.social · 21/04/2025

I can't recall who proposed, as way of analogy, the use of formal consent quantifying the risks of hospital admission in older people. But I really wish I had figures at the tip of my tongue to help challenge the notion that admission is "safer" when relatives are refusing to allow discharge

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Becky Taylor @drbeckyt.bsky.social · 19/04/2025

I enjoyed this episode. You don't know the talent you are missing unless you allow it in. And sometimes (often) that needs people to actively invite those not previously considered. Diversity. Equity. Inclusion. Good things.

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Becky Taylor @drbeckyt.bsky.social · 19/04/2025

Whilst I'm very glad journalists continue to expose more details of this particular war crime, I remain flabbergasted that Israel is able to continue to flagrantly ignore international law daily without consequence

news.sky.com

Two hours of terror: Sky News investigation reveals how Israel's deadly attack on aid workers unfolded

New evidence unearthed by Sky News contradicts Israel's official account of the killing of 15 aid workers.

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The Mary Rose Museum @maryrosemuseum.bsky.social · 15/04/2025

On the anniversary of the sinking of the Titanic, we thought we'd answer a question that's often asked, "If they raised the Mary Rose, why not raise the Titanic?" Allow our scaled diagram to explain...

A light blue diagram depicting the sea, with the water's surface at the top, and just below it is an outline of the Mary Rose, with the depth (12m, 40ft or 6.7 fathoms). There is a line showing the seabed, which takes a rapid dive into the vertical...

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The Museum of English Rural Life (MERL) @themerl.bsky.social · 03/04/2025

"they hate our beef because our beef is beautiful and theirs is weak" our beef:

An extremely stocky and muscular ox, painted by George Garrard in 1813.

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Becky Taylor @drbeckyt.bsky.social · 14/03/2025

I love learning new things! I did not know this. Another complication to add to the list of why *measles is a bad thing*

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Eliot Higgins @eliothiggins.bsky.social · 12/03/2025

🧵 I want to follow up this earlier thread by examining why the USA finds itself in the state it does at the moment; the process of disordered discourse capturing state institutions and how it inevitably results in a slide towards authoritarianism, a process we're seeing unfold before our very eyes.

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Doctors TARDIS @doctorstardis.bsky.social · 10/03/2025

We can upload 3 minute videos now. YOU KNOW THE RULE

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Eliot Higgins @eliothiggins.bsky.social · 11/03/2025

HE'S LITERALLY READING A SALES PITCH

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Kate Prior @doctorwibble.bsky.social · 08/03/2025

Happy International Women’s Day. I’m fortunate to have brilliant women in my life as friends and colleagues along with male allies prepared to stand up and be counted. Keep on keeping on. #IWD2025 #wingwomen

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Medlife Crisis (Rohin) @medcrisis.bsky.social · 04/03/2025

Important point. I am extremely pro-defibrillators and CPR. When you have a primary CARDIAC problem causing cardiac arrest, with a rhythm that can be shocked, quick defib gives an excellent outcome, even in older or more clinically frail patients 1/2

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Adam Kucharski @adamjkucharski.bsky.social · 23/02/2025

Once upon a time, some villagers came across a large, ornate wooden box in the local woods. On the side of the box was a message: “Whatever money you put in this box will, in future, grow to become 2.5 times larger.” 1/

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Becky Taylor @drbeckyt.bsky.social · 18/02/2025

Watched many movies where the "bad people" are signposted as bad by wearing black/growling/uniforms like SS etc. What role does media play in peoples inability to recognise real badness when in reality it comes dressed in pompoms/fireworks/multicoloured glory presented by "nice" smiling people 🤔

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Becky Taylor @drbeckyt.bsky.social · 13/02/2025

It is also much more clinically satisfying, and arguably less risky, for one clinician/team to complete a care episode than to hand over part way through (when discharge is predicted) for the sake of a time target.

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Becky Taylor @drbeckyt.bsky.social · 13/02/2025

Maybe one answer is that, yes the 4hr standard is a reasonable aim for many patients, but a 6hr standard would fit a whole bunch more folk who await diagnostics/definitive management before discharge.

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Becky Taylor @drbeckyt.bsky.social · 13/02/2025

Can't access the paper, but I can say that, yep, it's more complex than just getting the assay/guidelines. Sampling logistics & patient flow are key. There are implications for 4hr standard in where indeterminate risk patients are held awaiting 3rd sample. SDEC not 24/7, but don't need admission 🤔

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Rob Fleming @robjimfleming.bsky.social · 10/02/2025

1/ I thought I would post some highlights from the talk I'm giving for a local Trust here. I used to do a lot of this on the hellsite, and it seemed to be well received. My talk to night is entitled "Becoming a Specialist - how to have an alternative career", subtitled "introducing the #SASsix".

Title slide, as described in the contents of the post.

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Atul Gawande @agawande.bsky.social · 03/02/2025

This is not just a "pause." It is an unlawful destruction now. Foreign aid is a cornerstone of national security with diplomacy and defense. USAID's work reaches 100s of millions worldwide and America will be harmed. Here are some of the lives at stake.

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Becky Taylor @drbeckyt.bsky.social · 01/02/2025

neurosymptoms.org is a fantastic resource for patients and clinicians - I've found their leaflets explain the processing/signalling errors of FNDs in clear language. They help to explain how different "reprogramming" therapies and treatments work too - akin to mirror therapy for phantom limb pain

neurosymptoms.org

Functional Neurological Disorder (FND) – A Patient's Guide to FND

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Dan Snow @thehistoryguy.bsky.social · 31/01/2025

An astonishing exploration of the reality of ‘DEI’ in this excellent @drkevinfong.bsky.social podcast about 1970s NASA. The testimony from older male astronauts on how female excellence changed their minds is memorable. podcasts.apple.com/gb/podcast/1...

podcasts.apple.com

New Frontiers

Podcast Episode · 16 Sunsets · S1 E4 · 56m

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Becky Taylor @drbeckyt.bsky.social · 31/01/2025

This article is about US practice, but there are some parallels to the UK. Many patients don't actually need the specialist palliative care provided by palliative care services, but most need someone with the expertise and crucially the time to discuss realistic goals and advanced care planning

pulmccm.org

Why don't oncologists refer to palliative care?

And will their own society's strong recommendation ever change their minds?

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Kevin Fong @drkevinfong.bsky.social · 27/01/2025

Ep 4 #16Sunsets New Frontiers. Worth a listen on this day more than most. #NASA has always pushed back boundaries in space & here on Earth. In 1978 it selected the Thirty Five New Guys, at the time the most diverse astronaut class in its history. podcasts.apple.com/gb/podcast/1...

podcasts.apple.com

New Frontiers

Podcast Episode · 16 Sunsets · S1 E4 · 56m

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Auschwitz Memorial @auschwitzmemorial.bsky.social · 27/01/2025

Auschwitz was at the end of a long process. It did not start from gas chambers. This hatred was gradually developed by humans. From ideas, words, stereotypes & prejudice through legal exclusion, dehumanization & escalating violence... to systematic and industrial murder. Auschwitz took time.

A bird's-eye view of a former Auschwitz II-Birkenau camp showing a wide dirt pathway flanked by parallel rows of barbed-wire fences. Groups of visitors walk along the path, surrounded by the remnants of brick structures and barracks, now reduced to foundations. Green grass contrasts with the somber history of the site, as the path leads toward a guard tower in the distance.

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Becky Taylor @drbeckyt.bsky.social · 23/01/2025

How do you balance legitimate public interest with the fundamental right to healthcare confidentiality? We all want answers, but we may not get all we want. I do know that adolescent mental health is both fiendishly complicated & vastly underfunded

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Becky Taylor @drbeckyt.bsky.social · 21/01/2025

It is often easier to be despondent from the sidelines, to tut and shake one's head & take comfort in criticism shared amongst friends. Bishop Budde delivered her sermon with quiet conviction and dignity. Moral courage like this gives hope - it shows us that it is ok to politely but firmly say no.

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Clare Eliza @clare-eliza.bsky.social · 12/01/2025

‘Acceptance of failure’ - so what’s the alternative? Not ‘fix social care’ - I mean today? What is the alternative *today*?

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Becky Taylor @drbeckyt.bsky.social · 11/01/2025

Top of High Pike -wind blown. Lots of folk out, most happy to a post-hole their way on foot, but occasional ski and snowboard descent tracks seen

Snowy summit scene. Trig point cairn on the left with ice rime, ridge of Blencathera in far distance, ice covered stone seat on right of scene. Sun backlighting the clouds adding some yellow to otherwise blue and white scene

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Becky Taylor @drbeckyt.bsky.social · 11/01/2025

Time for a ski before the thaw. Bit of a walk in as daren't risk the unploughed/untreated roads

Snowy scene. Snow covered fields in the foreground with slowly rising fell behind Wooden finger post on right pointing towards the fells saying "Caldbeck Common 2 Miles". .

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Becky Taylor @drbeckyt.bsky.social · 08/01/2025

Coverage of ongoing crisis is good. But please @rcem.bsky.social can we stop the BBC from referring to Emergency "Wards". If my department was a "ward", the patients stuck there for >24hr would have access to more than a solitary toilet between them, meal services, washing facilities etc etc

bbc.co.uk

'Patients are collapsing in the waiting room': A&E nurses speak out

Nurses working on the front line of emergency care have spoken to the BBC about pressure they are facing.

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Becky Taylor @drbeckyt.bsky.social · 08/01/2025

Storms & shifts colluded to prevent me getting out for a ride (commutes excepting) in over a month. Snow & ice aplenty still on the small roads of North Cumbria. Suboptimal ride conditions, but darn good for the soul.

Black drop handlebar bike stood up unsupported in snow. Sky behind is pastels of yellow and blue

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