iiinova — where your digital self keeps evolving

Sergeant Wilko @sergeantwilko.bsky.social · 16h

E you prefer the Birmingham Tapestry anyway 🙃

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Sergeant Wilko @sergeantwilko.bsky.social · 17h

But also one of our greatest victories, non? 😉

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Sergeant Wilko @sergeantwilko.bsky.social · 17h

And those numbers-wow! So many more hospital doctors cf. primary care. Really underlines your point.

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Sergeant Wilko @sergeantwilko.bsky.social · 20h

Hard agree. We’re told it is very costly, unnecessary and inconvenient for patients to be in hospital. But we have now arrived at a point where care is hopelessly fragmented and delayed. Outcomes are worse. You cannot run an hospital on 100% bed occupancy. If I could change just one thing….

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Sergeant Wilko @sergeantwilko.bsky.social · 24/09/2026

It’s a great article, thank you. But honestly, I found the ‘hopeful local activist’ section at the end jarring. The only hopeful ending would be hearing that regulatory change is coming and /or these polluters have been made to stop and pay for what they have done.

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Sergeant Wilko @sergeantwilko.bsky.social · 24/09/2026

Is that an option? Why would they not do that if it was is all I’m thinking. Agree re. EA. What is the point of it?

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Sergeant Wilko @sergeantwilko.bsky.social · 22/09/2026

Paywalled, but I’m guessing the article doesn’t lift its gaze from London? The primary schools in my Yorkshire town are all contracting as well. Is it bad? What does a sustainable birthrate look like?

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Sergeant Wilko @sergeantwilko.bsky.social · 21/09/2026

Yep. Letter sums it up nicely. The answer to everything really shouldn’t be ‘another form please’

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Sergeant Wilko @sergeantwilko.bsky.social · 21/09/2026

Agree with this letter. More generally, I think we are way past the point where more paperwork makes better training. Just a distraction from the actual training.

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Sergeant Wilko @sergeantwilko.bsky.social · 20/09/2026

Yea I often wonder this when we reintroduce ‘admission meds’ as patients recover from acute illness. Inpatient management/rationalisation of meds tends to be poor IME. We are generally much happier starting a drug than stopping one.

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Sergeant Wilko @sergeantwilko.bsky.social · 19/09/2026

3 hours is pretty dire. Evacuate to the anaesthetic department!

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Sergeant Wilko @sergeantwilko.bsky.social · 12/08/2026

Certainly not-he’ll strain his eyes!

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Sergeant Wilko @sergeantwilko.bsky.social · 09/08/2026

True and very important. This had been simmering in my subconscious but you’ve put it into words for me.

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Sergeant Wilko @sergeantwilko.bsky.social · 02/08/2026

You read that thread and *this* was your response?!

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Sergeant Wilko @sergeantwilko.bsky.social · 02/08/2026

She does. The Most Reverend Sarah Mullally to be precise. Unbelievably woke, no wonder Tice is in a tizzy.

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Sergeant Wilko @sergeantwilko.bsky.social · 29/07/2026

If only there was a handy guide to money laundering they could have followed to avoid detection 😉

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Sergeant Wilko @sergeantwilko.bsky.social · 28/07/2026

The last paragraph does seem to say that, doesn’t it? Also utterly perplexed as to why we can’t have a GWP* comparison between tiva and sevo.

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Sergeant Wilko @sergeantwilko.bsky.social · 27/07/2026

Needs to be better. So much better. We can’t descend to this.

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Sergeant Wilko @sergeantwilko.bsky.social · 27/07/2026

What’s your sign? (May apply equally to me or my enemies, as circumstances require)

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Sergeant Wilko @sergeantwilko.bsky.social · 27/07/2026

Right, Monday morning gotta go work. We are clearly not going to agree how best to spend our time on this earth via this forum. Suggest we leave it at that no hard feelings. I see from my timeline you have published on PowerPoint in education. Genuine congrats.

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Sergeant Wilko @sergeantwilko.bsky.social · 27/07/2026

Although this debate got silly when you blithely dismissed all these and many more efforts by your colleagues as ‘performative’

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Sergeant Wilko @sergeantwilko.bsky.social · 27/07/2026

Sigh. Why do you think nhse have been funding and providing a toolkit for nitrous manifold decommissioning for the last 2 years? Lobbying of course. Still needs someone to apply for the grants and do the grunt work.

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Sergeant Wilko @sergeantwilko.bsky.social · 26/07/2026

I see the wood! Can we not tackle it at the same time as the trees? It’s already so late.

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Sergeant Wilko @sergeantwilko.bsky.social · 26/07/2026

A little person needs to do these unsexy things. It is tempting to kick back and say ‘well, we’re fucked, nothing I can do’, but top-down and bottom-up are not mutually exclusive. Look, you probably won’t agree, but at the end of the day I at least want to look my kids in the eye and say ‘I tried’

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Sergeant Wilko @sergeantwilko.bsky.social · 26/07/2026

Government is not going to sort out nitrous and entonox in your hospital, or make it easy for you to give simple oral pre meds, or sort trust recycling contracts or stop you using a mountain of gloves, gowns, syringes that you don’t need, or write the SOP to turn off all the AGSS OOH Etc. Etc.

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Sergeant Wilko @sergeantwilko.bsky.social · 26/07/2026

You get that’s more than a million tonnes of co2, though? Probably much more. My own trust (outsourced to consultants) wasn’t even including nitrous or entonox in their carbon footprint as ‘it wasn’t clear how much was administered to patients’ ffs.

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Sergeant Wilko @sergeantwilko.bsky.social · 26/07/2026

Do the things you can easily do. Lobby for the structural change you cannot. There are a LOT of ways to render your anaesthetics less carbon intensive.

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Sergeant Wilko @sergeantwilko.bsky.social · 26/07/2026

Well yes-taking this to its logical conclusion, it’s far more sustainable to close all icus and splash the cash on child and adolescent health. One difference which I think you both overlook, is that anaesthetic technique is in our gift to change right now. Tomorrow.

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Sergeant Wilko @sergeantwilko.bsky.social · 26/07/2026

I’m especially frustrated that miliband was moved from his brief when he was making such progress. AB said he would not indulge in such factionalism. Didn’t take long. I despair.

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Sergeant Wilko @sergeantwilko.bsky.social · 26/07/2026

How about people remaining loyal to an elected PM/government and just getting on with their jobs instead of wasting energy on internecine warfare? This cabinet reshuffle will inevitably lead to more delays in actual competent boring old governance.

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Sergeant Wilko @sergeantwilko.bsky.social · 25/07/2026

I get that. They think we will reach ‘steady state des’ and only make things a bit hotter. But why des? Why map every GA ever using just desflurane? What most people (ok some people…) want to know is sevo vs tiva, or maybe sevo vs des 🤷‍♀️

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Sergeant Wilko @sergeantwilko.bsky.social · 25/07/2026

Like, why are these people so obsessed with des?!

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Sergeant Wilko @sergeantwilko.bsky.social · 25/07/2026

Sevo vs tiva is what I actually want to know. Sevo comparison would be much more helpful.

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Sergeant Wilko @sergeantwilko.bsky.social · 25/07/2026

They didn’t show that. Just claimed it as a fact. Also, why no comparison to sevoflurane? Weird. 13k tonnes co2e pa if every operation everywhere uses des? That is some very bold extrapolation. Found the whole article dense and very, very odd.

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Sergeant Wilko @sergeantwilko.bsky.social · 25/07/2026

France wildfires: is it safe to drill right now?

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Sergeant Wilko @sergeantwilko.bsky.social · 25/07/2026

RAIN!!!! Thank f*ck. Hope it’s raining in the cairngorms as well 😬

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Sergeant Wilko @sergeantwilko.bsky.social · 22/07/2026

Reverse Midas Day, eh? Courage, brother-you will rise again!

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Sergeant Wilko @sergeantwilko.bsky.social · 22/07/2026

Pretty sure Cumberland council voted NOT to ban them only this week 😕

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Sergeant Wilko @sergeantwilko.bsky.social · 18/07/2026

This is devastating if true. I have been worried about ABs climate policies (lack of). Red line for me, do not think I can vote for a politician who thinks the markets matter more than physics.

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Reposted by Sergeant Wilko

Royal College of Anaesthetists @rcoanews.bsky.social · 17/07/2026

We are pleased to announce that Bradford Teaching Hospitals has been reaccredited under our prestigious ACSA scheme. This demonstrates the hospital’s commitment to patient safety and excellence of care 🙌 Read the full article 👉 ow.ly/S2qq50ZoQkC #Ansky #Medsky

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Sergeant Wilko @sergeantwilko.bsky.social · 17/07/2026

I frequently follow up my patients. Really don’t know how else I would know if I made the right call, or whether I was wrong or maybe missed something. Keep learning or retire!

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Sergeant Wilko @sergeantwilko.bsky.social · 17/07/2026

I agree. He has the diplomatic contacts and much good will. I’m sure it’s been suggested, we’ll have to see.

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Reposted by Sergeant Wilko

Akru @akru.bsky.social · 14/07/2026

Our Father, who art in heaven, hallowed be thy name. Thy capital growth come, thy riches be won, on Earth, that it become Hell. Lead us not into rewilding, but generate asset growth, for we desire money, power and glory, forever and ever, Amen.

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Sergeant Wilko @sergeantwilko.bsky.social · 14/07/2026

Motion to add the walls of children’s wards and operating theatres to the list?

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Sergeant Wilko @sergeantwilko.bsky.social · 12/07/2026

Agree the doctors are there and willing! Feel for my younger colleagues trying to get a training post in anaesthesia atm.

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Sergeant Wilko @sergeantwilko.bsky.social · 12/07/2026

Not to mention drive ++ (possibly biggest of all, especially for the children)

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