The Mrs works in critical care environment. Four docs on a nine doc rota.

So many rotas got gaps. Whether Saturday is a normal day or not there are no staff to work it.

Currently work 60+ hours a week. Without working Saturdays…

Carvetii very good – home delivers from Cumbria. Supplies the coffee/tea shop in dolgellau

Last couple of times have bought from dealer have just phoned and said ‘I want to come and buy this car today – can you call me back with best prove for a sale today’ – have got price reduced before even setting in door. The got bit more off and stuff thrown in once there.

May not always work but puts onus on them to get you in the door….

Thanks Graham S.

Surgical death rates are far higher from emergency surgery than elective. And emergency surgery carries on.

It’s been said before and I’ll say it again – all juniors who are full time work 48 hours a week. The only way to have more staff on sat/sun is to reduce numbers Monday to Friday. And we already rely on locums as not enough staff.

Data suggests strikes improve outcomes as more care delivered by seniors….

Plates need screws through both cortices I.e. both sides of bone. Through the other side, not nearly through.

Removing plate leaves a stress riser which is there for months or years – holes may always be weak – rugby players often won’t have plates for this reason.

There is still massive debate about what should and shouldnt get plated and will be for some time.

Medical treatment is always best guess – little of it is based on 100% fact. A key part of it is trust in the doc treating you – I would ask to be seen elsehwere or by someone else if not happy. Sounds like all been unideal for you, hope things improve.

Minor detail and who cares but are 18 bikes not in Derbyshire?

Robdob – we have a seven day emergency service.

Nowhere in the world had a seven day elective one.

Only way to have more staff on weekend is have less in week. So likely weekday complication rates will go up and weekend down a bit. There are many, many ways things could be better without more staff at weekends.

Complex issue.

Pay aside, a seven day service is now where near.

Many units rely on locums already to cover Monday to Friday and some rotas have 50% empty slots.

There aren’t enough docs to cover five days fully, never mind 7.

Thus the ‘7 day nhs’ is arguablaly a smoke screen for across the board paycuts.

It has all been evidenced in Salford, who themselves even say they don’t have a 7 day service!

No info yet on why talks broke down sadly. Interesting that JH reckons 15 of 16 issues resolved yet BMA say multiple unresolved issues

As above – duva in Majorca good option as can ride flat or mountains. Road to cap formentor been resurfaced too which is a beautiful ride.

Tri4thealps good in France too but may prob but early for Alps unless staying lowish. If weather ok lots of other options in morzine too but may be crap weather in May.

Tacx turbo muin – reduced at wiggle at mo too

What position are the splints? If they hold the wrist pushed back as many do will make it worse.

We bend the metal in our splits to make it straight so wrist held neutral – makes a big difference.

James (orthopod)

Pay for most of training and conferences out of pocket. No time back even if weekend or evenings – not unusual to have 11 days at conferences.

So seems not that bad a deal youve got!

Have had one with Yorks BS for last 2 years – they offer a huge range at very good rates.

Very useful as you say to save but withdraw savings in future and can either pay mortgage off early or annually reduce mortgage payment to pay off over term.

If a higher rate tax payer means you effectively earn a fair wack on savings (offset) – less benefit to lower rate taxpayer but still better than savings rates. YBS offset rates often close to non offset rates from other banks/build socs.

Brooess spot on. Some interesting data on healthcare – suggests that economic burden of healthcare is rapidly unaffordable for the whole world within 25 years.

It’s not just an NHS problem…

Sheffield. National park within 20 minute cycle of town and two big hospitals.

Also lots of good climbing, walking etc.

And a lot cheaper to live than Bristol!

Diesel service intervals shorter a d usually more expensive to buy – offsets fuel costs. Tax likely to go up at somepoint too due to emissions

As above engine prone to expensive disasters – ford one that is. Mine managed new dpf, newturbo and various other bits before gave in with it

As per other posts – the NHS runs seven days already for emergency care.

No health system in the world runs a seven day elective service.

Elective surgery frequently gets cancelled Monday to Friday in winter due to lack of beds. Running operating lists on a weekend will just mean more cancellations as there will still be no beds.

It would also need a huge increase in staff – we have one junior mon-fi which some weeks is a locum – we don’t have enough staff and they all work maximum hours. More on at weekend = we would need even more locums. The sound bite is great, the reality is seven day services are nowhere near happening.

Sorry if gave hat impression, thought fair question.

Chewy producing as many as ever. Many juniors, even with the existing contract just find the hours/rota patterns/increasing assessment and training requirements not worth it and are choosing to locum for a few months/years or go overseas.

Some specialties – eg A/E frequently fail to fill their training posts every year.

Morale is low, stress levels are perhaps highest ever – contract changes have come at the worst possible time in many ways.

And seven day services needs way, way more than a few more doctors. Will need massive numbers of all staff groups.

I would still maintain being a doctor is the best job in the world, but if staff feel undervalued enough then they will walk.

The reduction in locun pay will cause huge problems – the suggested values are likely to be far less than people value their free time at…

Just one other point that is being missed – some rotas have 50% vacancies – even in big city hospitals.

More doctors at weekends will just mean less in the week. IF we assumed death were rates were different they will probably rise in the week due to far less staff.

And no it’s not numbers being suppressed- government dictate medical school places

Pinnacle dolomite and cannondale synapse both worth a look.

The dolomite at 1000 for hydraulic discs and 105 is good value.

Leave home about 6.30. Home between 8 and 10pm. Bonus!

Always the best thread of the year!

Risk of fracture through screw holes if removed as they take a very long time to fill, if ever.

Thus usually left in.

Got a Mazda 3 for that budget and so far so good. Cheap motoring if uncool.

Petrol so economy fuel wise less but no diesel issues. Had focus tdci before and not sure I’d go diesel again

Done.not sure on questions. Different options have different comprises and you have to pick which you are happiest with.

Eg brompton folds smallest, dahon better ride and stiffer having ridden both

If anyone decides they don’t want their XL…..

ninfan – government said they would impose on all. Not just new starters.

just5minutes – correct but the allowance is only if working 48 hours, and weekends/nights/evenings but yes fair comment

Nice link. Didn’t know that. U.S. Style healthcare would be a disaster.

Equally current NHS format either needs more money or less services as it is not sustainable.

Guess the question is is any politician prepared to stand up and have that difficult conversation….

To avoid misunderstanding I would agree nurse practitioners are excellent,

They earn equal and in some cases more than the ‘junior’ docs who may often have to give advice in some roles – just trying to make the point that juniors (I.e. All non consultant docs) are fantastic value for money when you compare pay for mon-fri for other groups.

That said there is no doubt that cutting pay of all other NHS staff will be the next target.

Correct. Nurse practitioner posts often better paid too than many more ‘senior’ junior docs of you look at pay for mon to fri hours

GPs are not juniors. Shortest route to being a GP is five years post med school. Some specialties nearer fifteen years post medschool hence you can be a junior doctor for a lot time depending on career route.

Junior just means not consultant or GP.

Wanmakylung – full time is 48 hours but that’s an average over six month rota. Currently it’s up to 91 hours a week officially but often 100 for week of nights, days off elsewhere then bring average down,

Many jobs are over 48 hours on average but the only way to reduce that is more time off in daytime hours which no one wants as impacts on training.

One of key issues is nights/weekends etc need minimal levels of cover and cannot be cut.

We probably need to change the way we deliver some stuff – lots of stuff that is done by a doctor does not need a doctor to do it of that makes sense,

Poah ‘overtime’ means normal work really. Standard full time posts are 48 hours a week – which in reality usually means 50-60. Depending on specialty weekends are 1 in 3 to 1 in 5 where you usually do three thirteen hour days or nights fri to sun with normal week either side.

100 hour weeks of nights although not common still happen as ‘standard hours’ so it is in effect overtime but not optional.

Doctors get paid fairly well but being expected to work those kind of hours, and if JH gets his way more weekend/late night working and a pay cut of up to 30% is a bit of a joke.

Got a tacx one wit cable adjusted resistance looking to sell if interested.

Based between Sheffield and Leeds.