'This is the NHS: a day in the life of the UK's busiest maternity centre' diff viewer (12/13)

This article is from the source 'guardian' and was first published or seen on January 18, 2016 08:24 (UTC). It last changed over 40 days ago and won't be checked again for changes.

You can find the current article at its original source at http://www.theguardian.com/society/live/2016/jan/18/this-is-the-nhs-live-blog

The article has changed 65 times. There is an RSS feed of changes available.

Previous version 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 Next version

Version 12	Version 13
This is the NHS: live from the frontline at St George's hospital in south London	This is the NHS: live from the frontline at St George's hospital in south London
2016-01-18 15:25:08 UTC	2016-01-18 16:00:09 UTC (35 minutes later)
	3.49pm GMT
	15:49
	A wonderful, personal tribute to the staff at St George’s hospital from one of our commenters, Benefic, whose daughter was treated for acute lymphoblastic leukaemia.
	St George's saved my then ten year old daughter's life in October 2014. She was rushed from our local hospital to the Paediatric Intensive Care Unit (PICU) with a huge mass in her chest that was pushing on her windpipe - they reckoned at that point she had less than two days to live without serious medical intervention. She was diagnosed with Acute Lymphoblastic Leukaemia the following morning and started on chemotherapy. She was in PICU for nearly two weeks before she was stable enough to move to the children's cancer ward upstairs. The teams on both PICU and Pinckney Ward were just capable and supportive. They didn't just care for my daughter, but for us as a family, from psychological support to a room at the Ronald Macdonald House (we were a long way from home). My daughter's care was then transferred across to the wonderful children's unit at The Royal Marsden Hospital in Sutton and along with our exceptional local hospital, my daughter continues to make great progress. My daughter's leukaemia was so aggressive and her prognosis was so dreadful that she proceeded to a bone marrow transplant last March.
	She's had, and I don't doubt will continue to have, absolutely first class care in all three hospitals. I've always been grateful to grow up with the NHS, but now I have no words left to express my gratitude to the amazing people that work in the NHS and the society that allows for this system to be in place. I hope that this unique, battle-weary yet exceptional institution continues to to be in place for more generations to come.
	3.23pm GMT
	15:23
	Matthew Parkin, senior intensive care nurse
	Jessica Elgot
	Matthew Parkin has one of the hospital’s toughest jobs. As a senior intensive care nurse on the cardiothoracic ward, he is with patients and families at some of the most distressing moments in their lives, just after major heart attacks or heart surgery.
	Today all 18 beds in the dimly lit ward are full, apart from some that are earmarked for patients currently in surgery.
	It’s in the name: it’s intense. I have met these people at some of the hardest times in their lives. I remember there was one young girl I met when I was on general intensive care, just after she was in a major car accident. There was something about her that really brought home to me how precious life is. You can be having fun with your friends, out having a great time and in a split second your whole life can change for ever, because of one decision, one accident.
	His day shift starts just after 7am when he makes his first rounds to check on patients. “We do 12-hour shifts, seven days a week. I worked on Christmas Day and Boxing Day. Health doesn’t wait for anyone. People think the hospital closes but we are here all the time.”
	Parkin is a fierce believer in the NHS: “We treat everyone here: rich, poor, any race, any sex, and we don’t have to ask them to pay a bill. We are so lucky here in England to have that. Who knows what political changes there will be in the future but for now I really value that, it’s a wonderful thing.”
	Updated
	at 3.35pm GMT
3.15pm GMT	3.15pm GMT
15:15	15:15
Mark Smith	Mark Smith
#thisistheNHS isn’t the only hashtag worth following today. There has been a backlash against Dominic Lawson’s column in the Sunday Times yesterday that appeared to blame the current travails of the NHS on the rising number of female doctors.	#thisistheNHS isn’t the only hashtag worth following today. There has been a backlash against Dominic Lawson’s column in the Sunday Times yesterday that appeared to blame the current travails of the NHS on the rising number of female doctors.
@sarahwollaston What is your reaction to @thetimes blaming the troubles of the NHS on female docs? #likealadydoc pic.twitter.com/XaCoBZ7d91	@sarahwollaston What is your reaction to @thetimes blaming the troubles of the NHS on female docs? #likealadydoc pic.twitter.com/XaCoBZ7d91
Lawson refers to the “the feminisation of medicine” and its impact on the ~~NHS,~~ ~~quoting~~ Brian McKinstry, a former senior research fellow at the University of Edinburgh, who in 2008 warned that “fewer women than men choose to work out of hours, and the increase in women doctors may have partly influenced the recent abandonment of out-of-hours work by general practitioners in the UK”.	Lawson refers to the “the feminisation of medicine” and its impact on the NHS. He quotes Brian McKinstry, a former senior research fellow at the University of Edinburgh, who in 2008 warned that “fewer women than men choose to work out of hours, and the increase in women doctors may have partly influenced the recent abandonment of out-of-hours work by general practitioners in the UK”.
Lawson goes on to argue:	Lawson goes on to argue:
When you consider that it costs roughly £50,000 to bring each medical student up to the status of fully trained professional, it becomes obvious why governments have been reluctant, especially at a time of vast sector deficits, to increase the number of medical degrees to fill staffing shortfalls created by the swelling number of ‘part-time’ female doctors.	When you consider that it costs roughly £50,000 to bring each medical student up to the status of fully trained professional, it becomes obvious why governments have been reluctant, especially at a time of vast sector deficits, to increase the number of medical degrees to fill staffing shortfalls created by the swelling number of ‘part-time’ female doctors.
In response, the hashtag #likealadydoc has sprung up to ridicule Lawson’s assumption that women turn up for a few hours, go to a nail bar over their lunchbreak, and are all home to pick up the kids from the school gate.	In response, the hashtag #likealadydoc has sprung up to ridicule Lawson’s assumption that women turn up for a few hours, go to a nail bar over their lunchbreak, and are all home to pick up the kids from the school gate.
Dominic, does my tinsel look straight in this? No? That'll be the 30mins CPR I just did. #likealadydoc @thetimes pic.twitter.com/lZdkFBbwBy	Dominic, does my tinsel look straight in this? No? That'll be the 30mins CPR I just did. #likealadydoc @thetimes pic.twitter.com/lZdkFBbwBy
I can scrub up 👉🏾 both the DISHES and for an OPERATION #likealadydoc @thetimes pic.twitter.com/CB8FAFnLgY	I can scrub up 👉🏾 both the DISHES and for an OPERATION #likealadydoc @thetimes pic.twitter.com/CB8FAFnLgY
The Channel 4 News anchor Jon Snow even lent his support to the Twitter protest:	The Channel 4 News anchor Jon Snow even lent his support to the Twitter protest:
@doctor_oxford wait till Dominic Lawson finds a woman doctor at his bedside - he may finds he needs her!	@doctor_oxford wait till Dominic Lawson finds a woman doctor at his bedside - he may finds he needs her!
Updated	Updated
~~at ~~3.21pm~~ GMT~~	at 3.25pm GMT
2.35pm GMT	2.35pm GMT
14:35	14:35
The Guardian’s Scotland correspondent, Libby Brooks, has been tweeting in response to fears that our coverage will be England-centric.	The Guardian’s Scotland correspondent, Libby Brooks, has been tweeting in response to fears that our coverage will be England-centric.
For readers asking about #ThisIsTheNHS, there will be plenty of reporting from Scotland by myself and @severincarrell in the coming weeks	For readers asking about #ThisIsTheNHS, there will be plenty of reporting from Scotland by myself and @severincarrell in the coming weeks
Indeed, our Scotland editor, Severin Carrell, has filed a special report from the most remote GP surgery in the UK, in Shetland, which will be launched tomorrow morning as part of our focus on GPs.	Indeed, our Scotland editor, Severin Carrell, has filed a special report from the most remote GP surgery in the UK, in Shetland, which will be launched tomorrow morning as part of our focus on GPs.
Updated	Updated
at 2.51pm GMT	at 2.51pm GMT
2.23pm GMT	2.23pm GMT
14:23	14:23
'I heard I was going into surgery and I was terrified'	'I heard I was going into surgery and I was terrified'
Jessica Elgot	Jessica Elgot
Two days before Christmas, Cassie took her horse out for a short ride. Four hours later she woke up in A&E after being airlifted to St George’s. She had fallen off her horse and broken her neck, damaging her spinal cord.	Two days before Christmas, Cassie took her horse out for a short ride. Four hours later she woke up in A&E after being airlifted to St George’s. She had fallen off her horse and broken her neck, damaging her spinal cord.
It is the start of a long road to recovery for the once-active 26-year-old, who has no feeling in any of her body below her chest and is waiting to go to a spinal rehabilitation centre. “I remember very little about the first few hours,” she said. “I heard I was going into surgery, and I was terrified, though the doctor was very reassuring, I couldn’t really work out what had happened and what was going to happen to me.”	It is the start of a long road to recovery for the once-active 26-year-old, who has no feeling in any of her body below her chest and is waiting to go to a spinal rehabilitation centre. “I remember very little about the first few hours,” she said. “I heard I was going into surgery, and I was terrified, though the doctor was very reassuring, I couldn’t really work out what had happened and what was going to happen to me.”
Since the surgery she has been closely monitored in the neuroscience unit, which can mean long and boring days in bed.	Since the surgery she has been closely monitored in the neuroscience unit, which can mean long and boring days in bed.
“The staff know me now. They know I’m not a morning person, they let me sleep in. They adapt to what I need to do. There are times when I have been very low, not about any specific worry, but just generally having a hard day. And they are still there for me to talk to, to reassure me. To make it as easy as it can be, which isn’t easy.”	“The staff know me now. They know I’m not a morning person, they let me sleep in. They adapt to what I need to do. There are times when I have been very low, not about any specific worry, but just generally having a hard day. And they are still there for me to talk to, to reassure me. To make it as easy as it can be, which isn’t easy.”
Cassie has had a stylus attached to her hand to help her write, and a phone that reads out messages from friends on a speaker so she doesn’t have to use the touchscreen. Food is her only complaint. “I don’t like the food. Others seem to disagree, but I don’t like it,” she said. “But my taste buds have changed. I used to live on tea, but now I don’t like the taste at all.”	Cassie has had a stylus attached to her hand to help her write, and a phone that reads out messages from friends on a speaker so she doesn’t have to use the touchscreen. Food is her only complaint. “I don’t like the food. Others seem to disagree, but I don’t like it,” she said. “But my taste buds have changed. I used to live on tea, but now I don’t like the taste at all.”
“I bring in hot dinners for her,” says Cassie’s mother Brewer, who comes in every day from Reading to be by her daughter’s bedside. “It has been absolute hell, there is no word for it. But I have to say, from the moment we got in the air ambulance we have been looked after. And there’s no need for them to look after us. We’re the family, not the patient, but nothing is too much trouble. It is very, very hard for us too.”	“I bring in hot dinners for her,” says Cassie’s mother Brewer, who comes in every day from Reading to be by her daughter’s bedside. “It has been absolute hell, there is no word for it. But I have to say, from the moment we got in the air ambulance we have been looked after. And there’s no need for them to look after us. We’re the family, not the patient, but nothing is too much trouble. It is very, very hard for us too.”
“I can’t do anything for myself,” Cassie said. “It is awkward, of course, when they clean me or change me, but that has to happen, so they don’t make me feel bad about it. It’s done with dignity, that’s all you can ask for.”	“I can’t do anything for myself,” Cassie said. “It is awkward, of course, when they clean me or change me, but that has to happen, so they don’t make me feel bad about it. It’s done with dignity, that’s all you can ask for.”
Updated	Updated
at 2.33pm GMT	at 2.33pm GMT
1.53pm GMT	1.53pm GMT
13:53	13:53
'I should never have made it out of my car alive'	'I should never have made it out of my car alive'
The latest article in our “The NHS saved my life” series features a junior doctor who became a patient after a terrible car crash caused by black ice. You can see the severity of the crash from the picture below.	The latest article in our “The NHS saved my life” series features a junior doctor who became a patient after a terrible car crash caused by black ice. You can see the severity of the crash from the picture below.
My car skidded on black ice, swerved 180 degrees, hit the opposite kerb, went down a ditch and hit a tree. An off-duty paramedic saw what happened and got the emergency services to me really quickly. I’m told there were three fire engines, two ambulances and a helicopter at the scene.	My car skidded on black ice, swerved 180 degrees, hit the opposite kerb, went down a ditch and hit a tree. An off-duty paramedic saw what happened and got the emergency services to me really quickly. I’m told there were three fire engines, two ambulances and a helicopter at the scene.
Related: The day the NHS saved my life: I should never have made it out of my car alive	Related: The day the NHS saved my life: I should never have made it out of my car alive
Updated	Updated
at 2.18pm GMT	at 2.18pm GMT
1.38pm GMT	1.38pm GMT
13:38	13:38
My colleague Matthew Holmes has been compiling some of our readers’ experiences as patients that have been submitted through GuardianWitness.	My colleague Matthew Holmes has been compiling some of our readers’ experiences as patients that have been submitted through GuardianWitness.
Dylan Roberts says he is forever grateful to the NHS doctors who saved him from cancer after he was rushed to hospital on a bank holiday:	Dylan Roberts says he is forever grateful to the NHS doctors who saved him from cancer after he was rushed to hospital on a bank holiday:
I was told eight weeks after my operation that my appendix had been analysed and an aggressive tumour had been discovered, 0.2mm away from the point it had ruptured. Although the tumour was technically removed I was referred to a specialist consultant at the Western General, in Edinburgh.	I was told eight weeks after my operation that my appendix had been analysed and an aggressive tumour had been discovered, 0.2mm away from the point it had ruptured. Although the tumour was technically removed I was referred to a specialist consultant at the Western General, in Edinburgh.
It is such a body blow to be told you have cancer, but I felt at a loss as I had been told that I’d had cancer – but that the tumour was out of me. Good news, I thought! Never been so wrong in all my life …” (click here to continue reading)	It is such a body blow to be told you have cancer, but I felt at a loss as I had been told that I’d had cancer – but that the tumour was out of me. Good news, I thought! Never been so wrong in all my life …” (click here to continue reading)
Reader ‘Waylay’ has praised the care after a ruptured disc in his spine:	Reader ‘Waylay’ has praised the care after a ruptured disc in his spine:
The NHS saved my life, not with a heroic surgical intervention or a transplant or anything dramatic, but with continuing care that was some of the best in the world. My pain was cut in half by various interventions, medicine, and expert physiotherapy, and my mobility is now much better.	The NHS saved my life, not with a heroic surgical intervention or a transplant or anything dramatic, but with continuing care that was some of the best in the world. My pain was cut in half by various interventions, medicine, and expert physiotherapy, and my mobility is now much better.
I will be disabled for the rest of my life, and I suffer from chronic pain, but thanks to the NHS, I function well enough to have a part-time job in research, a limited social life, a wonderful relationship, good friends, and the chance to continue to improve.”	I will be disabled for the rest of my life, and I suffer from chronic pain, but thanks to the NHS, I function well enough to have a part-time job in research, a limited social life, a wonderful relationship, good friends, and the chance to continue to improve.”
Whether you’re patient or a health worker, or if you or someone in your family has been affected by the issues raised in our journalism, we want to hear from you. Share your stories in the comments or via GuardianWitness.	Whether you’re patient or a health worker, or if you or someone in your family has been affected by the issues raised in our journalism, we want to hear from you. Share your stories in the comments or via GuardianWitness.
Updated	Updated
at 1.48pm GMT	at 1.48pm GMT
1.25pm GMT	1.25pm GMT
13:25	13:25
10 truths about the NHS	10 truths about the NHS
Mark Smith	Mark Smith
Did you know that the respected US health thinktank the Commonwealth Fund ranked the UK top of the pile in its most recent study of healthcare in 11 rich countries?	Did you know that the respected US health thinktank the Commonwealth Fund ranked the UK top of the pile in its most recent study of healthcare in 11 rich countries?
The UK came out best in eight of the 11 areas studied, including safety and effectiveness of care and for overall efficient use of resources. It came only 10th out of 11, however, for health outcomes and overall death rates.	The UK came out best in eight of the 11 areas studied, including safety and effectiveness of care and for overall efficient use of resources. It came only 10th out of 11, however, for health outcomes and overall death rates.
For more tabloid-headline-busting facts and figures, read our data-focused piece that’s just launched.	For more tabloid-headline-busting facts and figures, read our data-focused piece that’s just launched.
Related: 10 truths about Britain's health service	Related: 10 truths about Britain's health service
One commenter, Virverax, has raised the omission of relative GDP spending figures as a useful comparison of value for money between countries’ healthcare systems. This hasn’t been forgotten. Remember this is a month-long series, and we will be delving into every aspect of the NHS in depth over the next four weeks. Rest assured, though without giving too much away from a very important upcoming story, we will certainly be dealing with the GDP issue in some detail.	One commenter, Virverax, has raised the omission of relative GDP spending figures as a useful comparison of value for money between countries’ healthcare systems. This hasn’t been forgotten. Remember this is a month-long series, and we will be delving into every aspect of the NHS in depth over the next four weeks. Rest assured, though without giving too much away from a very important upcoming story, we will certainly be dealing with the GDP issue in some detail.
In the meantime, one of the Guardian’s data journalists, George Arnett, has sent this clarification:	In the meantime, one of the Guardian’s data journalists, George Arnett, has sent this clarification:
The latest OECD international comparison showed that the UK spent 8.5% of its GDP on health in 2013. This is marginally below the OECD average of 8.9% and considerably less than France (10.9%), Germany (11%) and the US (16.4%). Countries who spend proportionately less on healthcare than Britain include Hungary (7.4%), Poland (6.4%) and Turkey (5.1%).	The latest OECD international comparison showed that the UK spent 8.5% of its GDP on health in 2013. This is marginally below the OECD average of 8.9% and considerably less than France (10.9%), Germany (11%) and the US (16.4%). Countries who spend proportionately less on healthcare than Britain include Hungary (7.4%), Poland (6.4%) and Turkey (5.1%).
Updated	Updated
at 2.45pm GMT	at 2.45pm GMT
1.11pm GMT	1.11pm GMT
13:11	13:11
My colleague Phillip Inman, the Guardian’s economics correspondent, has some personal experience of St George’s that offers a nuanced assessment. The core treatment was of high quality, but associated care and staffing levels showed the strain. There also seemed to be a problem with gravy.	My colleague Phillip Inman, the Guardian’s economics correspondent, has some personal experience of St George’s that offers a nuanced assessment. The core treatment was of high quality, but associated care and staffing levels showed the strain. There also seemed to be a problem with gravy.
My mother-in-law is in an acute ward at St George’s after suffering a deterioration in her heart condition. She was an emergency admission and in many ways has had the best care possible. But it was obvious there was a chronic shortage of nurses, which coincidentally the South London Press highlighted in its front page story last week. They were clearly exhausted from running between patients.	My mother-in-law is in an acute ward at St George’s after suffering a deterioration in her heart condition. She was an emergency admission and in many ways has had the best care possible. But it was obvious there was a chronic shortage of nurses, which coincidentally the South London Press highlighted in its front page story last week. They were clearly exhausted from running between patients.
On the ward, doctors visit her at random times, making it impossible for close family members to communicate and find out first-hand how the treatment is progressing.	On the ward, doctors visit her at random times, making it impossible for close family members to communicate and find out first-hand how the treatment is progressing.
The hospital food was not to my mother-in-law’s liking because it was always smothered in gravy. It took two weeks before the meals provider presented her with food minus gravy. In the meantime we have brought food, but it is clear that her situation has improved since she began eating the hospital food at more regular intervals.	The hospital food was not to my mother-in-law’s liking because it was always smothered in gravy. It took two weeks before the meals provider presented her with food minus gravy. In the meantime we have brought food, but it is clear that her situation has improved since she began eating the hospital food at more regular intervals.
Updated	Updated
at 1.33pm GMT	at 1.33pm GMT
12.53pm GMT	12.53pm GMT
12:53	12:53
Scotland's chief nurse criticised for blog about 'rude, skiving' nurses	Scotland's chief nurse criticised for blog about 'rude, skiving' nurses
Severin Carrell	Severin Carrell
Scotland’s chief nursing officer, Fiona McQueen, has suggested there is still a problem with a small number of rude or dismissive nurses in Scottish hospitals, one of whom she quotes as telling an apparently incontinent patient they risked being called “pishy pants”.	Scotland’s chief nursing officer, Fiona McQueen, has suggested there is still a problem with a small number of rude or dismissive nurses in Scottish hospitals, one of whom she quotes as telling an apparently incontinent patient they risked being called “pishy pants”.
In a blog, McQueen urged her colleagues to show “unconditional positive regard” for patients. An established blogger before taking over as the Scottish government’s official nursing adviser, McQueen noted that some nurses also put their tea breaks above patient care:	In a blog, McQueen urged her colleagues to show “unconditional positive regard” for patients. An established blogger before taking over as the Scottish government’s official nursing adviser, McQueen noted that some nurses also put their tea breaks above patient care:
“I expect registered nurses to speak to all patients and their families with unconditional positive regard, and never again will a registered nurse say to a patient: ‘If you wet the bed we’ll call you pishy pants’.	“I expect registered nurses to speak to all patients and their families with unconditional positive regard, and never again will a registered nurse say to a patient: ‘If you wet the bed we’ll call you pishy pants’.
“At all times I want nurses and midwives to put their patients first. No skipping off for a break when relatives need to speak to you, or worse when patients should be having their meals served.	“At all times I want nurses and midwives to put their patients first. No skipping off for a break when relatives need to speak to you, or worse when patients should be having their meals served.
“But also, nurses in leadership roles need to ensure nurses are working within an environment where there are enough nurses to deliver care safely and effectively.”	“But also, nurses in leadership roles need to ensure nurses are working within an environment where there are enough nurses to deliver care safely and effectively.”
Her remarks have provoked criticism from union officials, the Herald reports. It quotes Gordon McKay, a registered nurse and chair of Unison for NHS Ayrshire and Arran, as saying: “I am both saddened and disappointed by the comments from Scotland’s most senior nurse.	Her remarks have provoked criticism from union officials, the Herald reports. It quotes Gordon McKay, a registered nurse and chair of Unison for NHS Ayrshire and Arran, as saying: “I am both saddened and disappointed by the comments from Scotland’s most senior nurse.
“My experience is that nurses work unpaid, way beyond their contracted hours to provide world class care rather than ‘nipping off for breaks’, as is claimed, and that nurses speak to patients and relatives with the greatest of respect and kindness rather than the way Mrs McQueen suggests.”	“My experience is that nurses work unpaid, way beyond their contracted hours to provide world class care rather than ‘nipping off for breaks’, as is claimed, and that nurses speak to patients and relatives with the greatest of respect and kindness rather than the way Mrs McQueen suggests.”
Updated	Updated
at 1.04pm GMT	at 1.04pm GMT
12.36pm GMT	12.36pm GMT
12:36	12:36
At the clinical research centre: 'The doctor told us that Evie is deaf in one ear'	At the clinical research centre: 'The doctor told us that Evie is deaf in one ear'
Jessica Elgot	Jessica Elgot
In St George’s clinical research centre, three-year-old Evie Taws is here for her first appointment with a genetic counsellor. She and her parents Kelly and Craig Taws, who have travelled from Emsworth in Hampshire to south London to see specialists, have been seeing doctors since Evie was seven months old, because of a range of symptoms which clinicians now believe has a genetic root.	In St George’s clinical research centre, three-year-old Evie Taws is here for her first appointment with a genetic counsellor. She and her parents Kelly and Craig Taws, who have travelled from Emsworth in Hampshire to south London to see specialists, have been seeing doctors since Evie was seven months old, because of a range of symptoms which clinicians now believe has a genetic root.
All three will have blood tests today, to have their genetic makeup analysed. “It’s important for us to get a diagnosis so we can be prepared. We don’t want anymore uncertainties,” Kelly says. “We were at the doctor’s recently and we were told that Evie is deaf in one ear. She could go deaf in the other, but we just don’t know. And it was a surprise to be told that.	All three will have blood tests today, to have their genetic makeup analysed. “It’s important for us to get a diagnosis so we can be prepared. We don’t want anymore uncertainties,” Kelly says. “We were at the doctor’s recently and we were told that Evie is deaf in one ear. She could go deaf in the other, but we just don’t know. And it was a surprise to be told that.
“If we get a genetic diagnosis, we can plan for the future, but we can also help other parents and children who might have the same symptoms, and the NHS would be able to recognise them.	“If we get a genetic diagnosis, we can plan for the future, but we can also help other parents and children who might have the same symptoms, and the NHS would be able to recognise them.
“We were told we should have a conversation with her about deafness, what it means, so we asked her if she knew that she had a poorly ear, and she said ‘Yes, it’s this one’, and pointed to her right ear,” Kelly said. “She knew all along, she just had never thought to say. But we want to help her prepare, not only for her future, but for her future children, if she has any, and what that means for the genes she will pass on.”	“We were told we should have a conversation with her about deafness, what it means, so we asked her if she knew that she had a poorly ear, and she said ‘Yes, it’s this one’, and pointed to her right ear,” Kelly said. “She knew all along, she just had never thought to say. But we want to help her prepare, not only for her future, but for her future children, if she has any, and what that means for the genes she will pass on.”
“Children are so resilient,’ says father Craig. “She just gets on with her life, she adapts.”	“Children are so resilient,’ says father Craig. “She just gets on with her life, she adapts.”
Updated	Updated
at 1.31pm GMT	at 1.31pm GMT
12.26pm GMT	12.26pm GMT
12:26	12:26
The secret 999 call operator's diary: 'I want to end my life, says a man'	The secret 999 call operator's diary: 'I want to end my life, says a man'
Ever wondered what the job of a 999 call operator is really like? Find out with out the latest in our series of anonymous diaries from staff in key NHS roles.	Ever wondered what the job of a 999 call operator is really like? Find out with out the latest in our series of anonymous diaries from staff in key NHS roles.
The anonymity we have granted to the diarists really helps them document their daily routines with stark honesty, and teases out some poignant moments – as well as an ample helping of tragicomedy. The gentleman with a toilet roll holder stuck up his bum, for example.	The anonymity we have granted to the diarists really helps them document their daily routines with stark honesty, and teases out some poignant moments – as well as an ample helping of tragicomedy. The gentleman with a toilet roll holder stuck up his bum, for example.
Related: The secret 999 call operator's diary: I want to end my life, says a man	Related: The secret 999 call operator's diary: I want to end my life, says a man
Updated	Updated
at 1.09pm GMT	at 1.09pm GMT
12.13pm GMT	12.13pm GMT
12:13	12:13
NHS chief calls for new political consensus on how to pay for elderly and social care	NHS chief calls for new political consensus on how to pay for elderly and social care
We’ve just launched the second news story based on our exclusive interview with the NHS chief Simon Stevens, in which he urges to government to rescue social care services from a downward spiral of funding cuts.	We’ve just launched the second news story based on our exclusive interview with the NHS chief Simon Stevens, in which he urges to government to rescue social care services from a downward spiral of funding cuts.
Stevens sets out a target date of 2018, the NHS’s 70th birthday, by which a funding revamp should be in place, and suggests the Tory government’s “triple lock” guarantee for pensioners could be pulled back to help meet the care crisis.	Stevens sets out a target date of 2018, the NHS’s 70th birthday, by which a funding revamp should be in place, and suggests the Tory government’s “triple lock” guarantee for pensioners could be pulled back to help meet the care crisis.
This from Denis Campbell and Paul Johnson:	This from Denis Campbell and Paul Johnson:
Britain urgently needs a new political consensus on paying for elderly and social care, and the funding debate should consider the value of pensions and homes, the boss of the NHS has said.	Britain urgently needs a new political consensus on paying for elderly and social care, and the funding debate should consider the value of pensions and homes, the boss of the NHS has said.
Simon Stevens said one of the main questions in tackling the huge challenge of how to pay for and look after an ageing population was “intergenerational fairness”.	Simon Stevens said one of the main questions in tackling the huge challenge of how to pay for and look after an ageing population was “intergenerational fairness”.
He wants the government to rescue social care services from their downward spiral of funding cuts and increasing unmet needs by reaching an agreement on how such care will be paid for by 2018, the NHS’s 70th birthday. NHS England’s chief executive fears the service will be unable to cope if the recent decline in help received by older people, especially in their own homes, continues increasing demand for medical care.	He wants the government to rescue social care services from their downward spiral of funding cuts and increasing unmet needs by reaching an agreement on how such care will be paid for by 2018, the NHS’s 70th birthday. NHS England’s chief executive fears the service will be unable to cope if the recent decline in help received by older people, especially in their own homes, continues increasing demand for medical care.
Without urgent attention being given to the “pressing” issue of social care, there will be a big impact on hospitals, GP surgeries and community health services, he said.	Without urgent attention being given to the “pressing” issue of social care, there will be a big impact on hospitals, GP surgeries and community health services, he said.
Even more older people will become trapped in hospital despite being fit to leave – a key reason hospitals run out of beds – and more operations will be cancelled unless ministers start seeing social care as a top priority, he said.	Even more older people will become trapped in hospital despite being fit to leave – a key reason hospitals run out of beds – and more operations will be cancelled unless ministers start seeing social care as a top priority, he said.
Stevens believes David Cameron’s administration should look at all the options for finding the billions of pounds needed, including revisiting the “triple lock”, which guarantees Britain’s pensioners generous annual increases in their state pension until 2020.	Stevens believes David Cameron’s administration should look at all the options for finding the billions of pounds needed, including revisiting the “triple lock”, which guarantees Britain’s pensioners generous annual increases in their state pension until 2020.
You can read Paul Johnson’s full interview with Stevens here:	You can read Paul Johnson’s full interview with Stevens here:
Related: Simon Stevens: trying to save the NHS from the mother of all messes	Related: Simon Stevens: trying to save the NHS from the mother of all messes
Updated	Updated
at 1.10pm GMT	at 1.10pm GMT
12.03pm GMT	12.03pm GMT
12:03	12:03
Here’s another teaser for you from our NHS quiz. How well do you know the health service?	Here’s another teaser for you from our NHS quiz. How well do you know the health service?
11.31am GMT	11.31am GMT
11:31	11:31
Thanks all for your comments so far – some really good thoughts about the kinds of food hospitals should be offering. Here's a selection of comments:	Thanks all for your comments so far – some really good thoughts about the kinds of food hospitals should be offering. Here's a selection of comments:
ShiteWeasel (great username btw), who works in an NHS trust, said: "It would be nice if trusts were expected to provide healthy options for staff and patients instead of taxing staff who sometimes have no other choice than to buy the already overpriced chocolate bars and fizzy drinks the hospital serves."	ShiteWeasel (great username btw), who works in an NHS trust, said: "It would be nice if trusts were expected to provide healthy options for staff and patients instead of taxing staff who sometimes have no other choice than to buy the already overpriced chocolate bars and fizzy drinks the hospital serves."
Wightpaint says: "You don't have cigarette vending machines in hospitals or health centres, so why machines full of sugary snacks and drinks?"	Wightpaint says: "You don't have cigarette vending machines in hospitals or health centres, so why machines full of sugary snacks and drinks?"
ID412032 says: "I've just spent a few days in hospital where the inpatients menus were full of sugary options. There was no fresh fruit available at breakfast or the evening meal, no plain yoghurts (all were 'fruit, that is sugar-added), there were only two salads allocated to a ward of about 50 people (so always crossed off the menu by the time they got just a little way down the ward) and no special arrangements for the diabetic patient in my bay, who was offered sugary 'sweets' at every meal."	ID412032 says: "I've just spent a few days in hospital where the inpatients menus were full of sugary options. There was no fresh fruit available at breakfast or the evening meal, no plain yoghurts (all were 'fruit, that is sugar-added), there were only two salads allocated to a ward of about 50 people (so always crossed off the menu by the time they got just a little way down the ward) and no special arrangements for the diabetic patient in my bay, who was offered sugary 'sweets' at every meal."
Feel free to share your experiences of healthy/unhealthy hospital foods here in the comments. If you were in charge of hospital catering, what would you serve?	Feel free to share your experiences of healthy/unhealthy hospital foods here in the comments. If you were in charge of hospital catering, what would you serve?
11.29am GMT	11.29am GMT
11:29	11:29
Tim Jones, neurosurgeon	Tim Jones, neurosurgeon
Jessica Elgot	Jessica Elgot
Neuroscience is one of the key specialities at St George’s, but what does it really take to be a brain surgeon? I’ve been speaking to Tim Jones, a consultant neurosurgeon who specialises in brain tumour surgery. Patients are awake throughout the procedure, which usually lasts about three hours but can take up to 10. Jones says he wanted to be a brain surgeon ever since his teens:	Neuroscience is one of the key specialities at St George’s, but what does it really take to be a brain surgeon? I’ve been speaking to Tim Jones, a consultant neurosurgeon who specialises in brain tumour surgery. Patients are awake throughout the procedure, which usually lasts about three hours but can take up to 10. Jones says he wanted to be a brain surgeon ever since his teens:
No brain surgeon would ever pursue this just to be able to say ‘I’m a brain surgeon’. You have to really like a challenge and really like variety because it is one of the most varied pathologies you can do. It is very unpredictable because the brain has very little pattern.	No brain surgeon would ever pursue this just to be able to say ‘I’m a brain surgeon’. You have to really like a challenge and really like variety because it is one of the most varied pathologies you can do. It is very unpredictable because the brain has very little pattern.
The area of the brain that controls certain functions in one person can be completely different to another. You can never say ‘there’s the centimetre that controls speech.’ No two tumours are ever the same, so research is much harder. It’s not like there are pattern predictors like with heart disease or diabetes where you can monitor hundreds of thousands of patients.	The area of the brain that controls certain functions in one person can be completely different to another. You can never say ‘there’s the centimetre that controls speech.’ No two tumours are ever the same, so research is much harder. It’s not like there are pattern predictors like with heart disease or diabetes where you can monitor hundreds of thousands of patients.
One of the things Jones tries to gauge about his patients is which functions of the brain are the most important to them.	One of the things Jones tries to gauge about his patients is which functions of the brain are the most important to them.
For a lawyer, that might be speech or their judgment. For a musician it might be dexterity. For an artist it could be vision. Every patient is different in what they want to know and what concerns them. As a surgeon it is difficult because you know that even if a surgery goes as well as it could be, there can be changes in a person after their brain is operated on. That doesn’t mean it has gone wrong, but it is something you have to prepare for.	For a lawyer, that might be speech or their judgment. For a musician it might be dexterity. For an artist it could be vision. Every patient is different in what they want to know and what concerns them. As a surgeon it is difficult because you know that even if a surgery goes as well as it could be, there can be changes in a person after their brain is operated on. That doesn’t mean it has gone wrong, but it is something you have to prepare for.
Updated	Updated
at 1.14pm GMT	at 1.14pm GMT
11.16am GMT	11.16am GMT
11:16	11:16
Bernard Kelly, senior sexual health adviser	Bernard Kelly, senior sexual health adviser
Jessica Elgot	Jessica Elgot
We’re now in the Courtyard clinic, St George’s sexual health clinic, which sees roughly 120 people a day, from routine contraception appointments and patients with STIs to victims of sexual abuse.	We’re now in the Courtyard clinic, St George’s sexual health clinic, which sees roughly 120 people a day, from routine contraception appointments and patients with STIs to victims of sexual abuse.
Bernard Kelly, the clinical team lead, is interested not just in the modern challenges but also the history of the service. Public sexual health clinics have been around for 100 years and are older than the NHS itself.	Bernard Kelly, the clinical team lead, is interested not just in the modern challenges but also the history of the service. Public sexual health clinics have been around for 100 years and are older than the NHS itself.
They were originally a response to the first world war. Soldiers were coming home and it was important not just to protect them, but the partners they might have back in the UK. It was about staying safe on the frontline and when you got home.	They were originally a response to the first world war. Soldiers were coming home and it was important not just to protect them, but the partners they might have back in the UK. It was about staying safe on the frontline and when you got home.
The most modern challenge doctors and nurses here face is HIV, particularly among young gay men, many of whom are involved in London’s chemsex scene. “Obviously as a central London hospital that is prevalent. We meet a lot of people saying they feel they need to leave the city, even leave the country, because the scene has grown so much. They need to keep themselves away from it,” he says.	The most modern challenge doctors and nurses here face is HIV, particularly among young gay men, many of whom are involved in London’s chemsex scene. “Obviously as a central London hospital that is prevalent. We meet a lot of people saying they feel they need to leave the city, even leave the country, because the scene has grown so much. They need to keep themselves away from it,” he says.
The other modern challenges are all about funding. Sexual health funding now comes from the local authority and is an ever-diminishing pot, not just for the clinic itself, but also for the other services medics want to refer patients to, such as rape survivor support or women’s shelters.	The other modern challenges are all about funding. Sexual health funding now comes from the local authority and is an ever-diminishing pot, not just for the clinic itself, but also for the other services medics want to refer patients to, such as rape survivor support or women’s shelters.
We aren’t perfect now, but it is a holistic approach we use. What is at the root of why a patient might be returning with regular infections or as a victim of sexual assault? There is a real risk we could lose that, and in 10 years we will see that hit health services if we don’t address the underlying issues properly. And once we lose that approach, it’s really hard to get it back.	We aren’t perfect now, but it is a holistic approach we use. What is at the root of why a patient might be returning with regular infections or as a victim of sexual assault? There is a real risk we could lose that, and in 10 years we will see that hit health services if we don’t address the underlying issues properly. And once we lose that approach, it’s really hard to get it back.
Updated	Updated
at 1.19pm GMT	at 1.19pm GMT
10.51am GMT	10.51am GMT
10:51	10:51
Matthew Weaver	Matthew Weaver
As mentioned earlier, my colleague Matthew Weaver has been looking into the NHS patient survey and has written this news story about changing attitudes to GP surgeries opening on Sundays.	As mentioned earlier, my colleague Matthew Weaver has been looking into the NHS patient survey and has written this news story about changing attitudes to GP surgeries opening on Sundays.
Record numbers of patients in England are waiting more than a week to see their GPs, prompting the proportion of those backing Sunday opening for doctors’ surgeries to top 40% for the first time.	Record numbers of patients in England are waiting more than a week to see their GPs, prompting the proportion of those backing Sunday opening for doctors’ surgeries to top 40% for the first time.
The NHS’s six-monthly patient survey shows that the majority are satisfied with their GPs and their access to them, but a growing minority report frustration in getting appointments.	The NHS’s six-monthly patient survey shows that the majority are satisfied with their GPs and their access to them, but a growing minority report frustration in getting appointments.
The survey of more than 800,000 patients found that 11% were unable to get an appointment at all, and a record 18.1% had to wait a week or more after appointments were made to see their doctor.	The survey of more than 800,000 patients found that 11% were unable to get an appointment at all, and a record 18.1% had to wait a week or more after appointments were made to see their doctor.
It also found that 25.8% found it difficult to get through to surgeries by phone, compared with 18.4% in June 2012.	It also found that 25.8% found it difficult to get through to surgeries by phone, compared with 18.4% in June 2012.
The survey, which comes a week after the first round of a hospital junior doctors’ strike over weekend working, prompted Labour to claim that the government was struggling to offer patients a five-day-a-week NHS, let alone a seven-day one.	The survey, which comes a week after the first round of a hospital junior doctors’ strike over weekend working, prompted Labour to claim that the government was struggling to offer patients a five-day-a-week NHS, let alone a seven-day one.
It found that 18.7% of patients said their GP surgery was not open at convenient times, an increase of three percentage points since June 2012.	It found that 18.7% of patients said their GP surgery was not open at convenient times, an increase of three percentage points since June 2012.
It also found more support for GP surgeries opening outside normal working hours, with 41.6% backing Sunday opening, a sharp increase since 2012, when the figure was 31.7%.	It also found more support for GP surgeries opening outside normal working hours, with 41.6% backing Sunday opening, a sharp increase since 2012, when the figure was 31.7%.
The shadow health secretary, Heidi Alexander, said the survey suggested millions more patients were struggling to get appointments.	The shadow health secretary, Heidi Alexander, said the survey suggested millions more patients were struggling to get appointments.
She told the Telegraph: “Two elections ago, David Cameron promised to open GP surgeries seven days a week. But these figures show that in the last three years millions more patients have become unhappy with the opening hours of their local practice. Under the Tories patients are finding it harder to access the NHS five days a week, let alone seven.”	She told the Telegraph: “Two elections ago, David Cameron promised to open GP surgeries seven days a week. But these figures show that in the last three years millions more patients have become unhappy with the opening hours of their local practice. Under the Tories patients are finding it harder to access the NHS five days a week, let alone seven.”
Doctors’ leaders said it was the government’s preoccupation with extending opening hours that was stretching the services.	Doctors’ leaders said it was the government’s preoccupation with extending opening hours that was stretching the services.
Dr Maureen Baker, the chair of the Royal College of GPs (RCGP), said: “Access to GP services is very important, but prioritising extended opening hours over everything else can mean that the routine GP service will suffer and our patients could end up worse off.	Dr Maureen Baker, the chair of the Royal College of GPs (RCGP), said: “Access to GP services is very important, but prioritising extended opening hours over everything else can mean that the routine GP service will suffer and our patients could end up worse off.
“Many practices are already offering extended opening hours but for the majority, with current resources, seven-day opening remains an aspiration. Putting pressure on family doctors who are already working themselves to the bone to deliver high-quality patient careis neither safe nor sustainable.	“Many practices are already offering extended opening hours but for the majority, with current resources, seven-day opening remains an aspiration. Putting pressure on family doctors who are already working themselves to the bone to deliver high-quality patient careis neither safe nor sustainable.
“The RCGP is calling for general practice to receive 11% NHS budget and for thousands more GPs over the course of this parliament. Only then will general practice be able to provide more care and services for our patients whenever they need them, close to home, where care is most cost-effective and where our patients want it most.”	“The RCGP is calling for general practice to receive 11% NHS budget and for thousands more GPs over the course of this parliament. Only then will general practice be able to provide more care and services for our patients whenever they need them, close to home, where care is most cost-effective and where our patients want it most.”
Updated	Updated
at 1.23pm GMT	at 1.23pm GMT
10.22am GMT	10.22am GMT
10:22	10:22
Dagan Lonsdale, specialist intensive care registrar	Dagan Lonsdale, specialist intensive care registrar
Jessica Elgot	Jessica Elgot
Dr Dagan Lonsdale, one of the leading lights of the junior doctors campaign, is a registrar at St George’s working in intensive care and clinical pharmacology. He told me the story of the one patient that changed him – and it was one he couldn’t save:	Dr Dagan Lonsdale, one of the leading lights of the junior doctors campaign, is a registrar at St George’s working in intensive care and clinical pharmacology. He told me the story of the one patient that changed him – and it was one he couldn’t save:
He was in his 90s, and had a huge tear in his aorta – a major blood vessel – and we just couldn’t do anything for him. But he was awake, alert and I sat with him, knowing that over the course of the afternoon, he was going to die.	He was in his 90s, and had a huge tear in his aorta – a major blood vessel – and we just couldn’t do anything for him. But he was awake, alert and I sat with him, knowing that over the course of the afternoon, he was going to die.
And he told me the story of his whole life, he had this incredible life story. He understood he was at the end. And yes being there was a service to him, but he did a service to me. He taught me about death, and how it comes to all of that. And death will always be a part of what we do, the hardest part. When you can make someone better, when you work it out, that’s the best feeling.	And he told me the story of his whole life, he had this incredible life story. He understood he was at the end. And yes being there was a service to him, but he did a service to me. He taught me about death, and how it comes to all of that. And death will always be a part of what we do, the hardest part. When you can make someone better, when you work it out, that’s the best feeling.
Updated	Updated
at 11.17am GMT	at 11.17am GMT
10.19am GMT	10.19am GMT
10:19	10:19
Your comments on our sugar tax exclusive	Your comments on our sugar tax exclusive
There has been some interesting discussion of Denis Campbell’s scoop on plans for an NHS-wide sugar tax to help combat obesity – and possibly trailblaze a nationwide scheme. One reader welcomes the initiative, but raises the issue of the NHS’s own catering:	There has been some interesting discussion of Denis Campbell’s scoop on plans for an NHS-wide sugar tax to help combat obesity – and possibly trailblaze a nationwide scheme. One reader welcomes the initiative, but raises the issue of the NHS’s own catering:
Fine, but what about the NHS's own catering for its inpatients? I've just spent a few days in hospital where the inpatients menus were full of sugary options. There was no fresh fruit available at breakfast or the evening meal, no plain yoghurts (all were 'fruit, that is sugar-added), there were only two salads allocated to a ward of about 50 people (so always crossed off the menu by the time they got just a little way down the ward) and no special arrangements for the diabetic patient in my bay, who was offered sugary 'sweets' at every meal. While most people now expect visitors to bring in decent food for inpatients, that's not always possible, especially if they end up in hospital at a distance from family and friends. So maybe the NHS budget should also expand to provide healthy catering for its inpatients, rather than the cheapest and poorest quality options.	Fine, but what about the NHS's own catering for its inpatients? I've just spent a few days in hospital where the inpatients menus were full of sugary options. There was no fresh fruit available at breakfast or the evening meal, no plain yoghurts (all were 'fruit, that is sugar-added), there were only two salads allocated to a ward of about 50 people (so always crossed off the menu by the time they got just a little way down the ward) and no special arrangements for the diabetic patient in my bay, who was offered sugary 'sweets' at every meal. While most people now expect visitors to bring in decent food for inpatients, that's not always possible, especially if they end up in hospital at a distance from family and friends. So maybe the NHS budget should also expand to provide healthy catering for its inpatients, rather than the cheapest and poorest quality options.
While ‘Andrew Lee’ says the argument that a sugar tax will unfairly hit the pockets of poorer people is wrongheaded:	While ‘Andrew Lee’ says the argument that a sugar tax will unfairly hit the pockets of poorer people is wrongheaded:
I think that this is a great measure to curb the prevalence of obesity and type II diabetes which, after antibiotic resistance, are the two biggest challenges our NHS will have to adapt to in order to deliver their usual standard of care. I think that this easily could extend to both primary and secondary schools.	I think that this is a great measure to curb the prevalence of obesity and type II diabetes which, after antibiotic resistance, are the two biggest challenges our NHS will have to adapt to in order to deliver their usual standard of care. I think that this easily could extend to both primary and secondary schools.
The argument that a sugar tax would simply exclude poorer people from affording products filled with sugar is completely invalid. It is in those from lower socio-economic backgrounds and with lower incomes where the onset of obesity and type II diabetes is most rapid. It is the poor who are exploited most by manufacturers of unhealthy foods and sugary drinks, who make products packed with sugar easily affordable and widely available so as to chain their customers to a chronic, pathological, perhaps even addictive, sugar consumption. The least our health service can do is oversee the provision of healthier foods while the patients are kept in hospital.	The argument that a sugar tax would simply exclude poorer people from affording products filled with sugar is completely invalid. It is in those from lower socio-economic backgrounds and with lower incomes where the onset of obesity and type II diabetes is most rapid. It is the poor who are exploited most by manufacturers of unhealthy foods and sugary drinks, who make products packed with sugar easily affordable and widely available so as to chain their customers to a chronic, pathological, perhaps even addictive, sugar consumption. The least our health service can do is oversee the provision of healthier foods while the patients are kept in hospital.
10.11am GMT	10.11am GMT
10:11	10:11
Rowena Mason	Rowena Mason
Here’s an early edit of Rowena Mason’s upcoming news story on David Cameron’s earlier interview on the Today programme.	Here’s an early edit of Rowena Mason’s upcoming news story on David Cameron’s earlier interview on the Today programme.
David Cameron has repeated the threat to impose a new contract on junior doctors without their consent, arguing they cannot be allowed to “block progress in our NHS”.	David Cameron has repeated the threat to impose a new contract on junior doctors without their consent, arguing they cannot be allowed to “block progress in our NHS”.
In comments that risk further infuriating junior doctors, the prime minister said the government needed to reserve the right to bring in changes opposed by medics.	In comments that risk further infuriating junior doctors, the prime minister said the government needed to reserve the right to bring in changes opposed by medics.
His position echoes that of Jeremy Hunt, the health secretary, who said the contract could be imposed as a last resort but he would prefer to come to a settlement.	His position echoes that of Jeremy Hunt, the health secretary, who said the contract could be imposed as a last resort but he would prefer to come to a settlement.
Cameron told the BBC’s Today programme: “We can’t rule that out because we can’t simply go into a situation where the junior doctors have a complete veto, block over progress in our NHS.	Cameron told the BBC’s Today programme: “We can’t rule that out because we can’t simply go into a situation where the junior doctors have a complete veto, block over progress in our NHS.
“But we’re talking to them in very good faith, I think we’ve settled 15 of the 16 issues that they raised, there’s an 11% basic pay rise on the table... and for instance we’ve just put on the table the idea no one should be asked to work two Saturdays in a row.	“But we’re talking to them in very good faith, I think we’ve settled 15 of the 16 issues that they raised, there’s an 11% basic pay rise on the table... and for instance we’ve just put on the table the idea no one should be asked to work two Saturdays in a row.
“I don’t want this strike situation to continue. What I want is what I put in our manifesto, which is a more seven-day NHS for which we do need some contract changes.”	“I don’t want this strike situation to continue. What I want is what I put in our manifesto, which is a more seven-day NHS for which we do need some contract changes.”
The government, NHS Employers and British Medical Association, representing junior doctors, are currently all in negotiations in an effort to bring an end to the dispute, which led to a strike earlier this month.	The government, NHS Employers and British Medical Association, representing junior doctors, are currently all in negotiations in an effort to bring an end to the dispute, which led to a strike earlier this month.
They are thought to be hopeful of avoiding a further strike planned for this month and a third that would see emergency care affected but the government is still threatening to bring in the contract without BMA consent if a deal cannot be reached.	They are thought to be hopeful of avoiding a further strike planned for this month and a third that would see emergency care affected but the government is still threatening to bring in the contract without BMA consent if a deal cannot be reached.
9.53am GMT	9.53am GMT
09:53	09:53
Jenni Doman, estates general manager	Jenni Doman, estates general manager
Jessica Elgot	Jessica Elgot
Inside the main entrance of St George’s, through which 10,000 people pass every day, Jenni Doman, the estates manager in charge of running a hospital the size of Westfield shopping centre, is making her morning round.	Inside the main entrance of St George’s, through which 10,000 people pass every day, Jenni Doman, the estates manager in charge of running a hospital the size of Westfield shopping centre, is making her morning round.
“I don’t want to be a manager in an office,” she said. “I need to make sure I’m out on the shop floor as much as possible. I’ve been here 12 years, I thought it would be more like two but I just love the variety of the job: it can be policy work on infection control, to making sure 1,000 people a day get their breakfast.	“I don’t want to be a manager in an office,” she said. “I need to make sure I’m out on the shop floor as much as possible. I’ve been here 12 years, I thought it would be more like two but I just love the variety of the job: it can be policy work on infection control, to making sure 1,000 people a day get their breakfast.
“That means a consultant or a general cleaner have as important a job to me – it’s all about patient care.” This is my local hospital, my partner’s hospital; I’m a patient, a relative, and an employe, and I want everyone to be treated the way I want to be treated.”	“That means a consultant or a general cleaner have as important a job to me – it’s all about patient care.” This is my local hospital, my partner’s hospital; I’m a patient, a relative, and an employe, and I want everyone to be treated the way I want to be treated.”
Updated	Updated
at 11.17am GMT	at 11.17am GMT
9.41am GMT	9.41am GMT
09:41	09:41
It’s worth saying again, this series is not about journalists swooping in to offer their diagnoses of what they think is the best and worst of the NHS; we are committed to assessing the state of health service through the voices of its staff and patients. Whether you’re a health worker or patient, or if you or someone in your family has been affected by the issues raised in our journalism, we want to hear from you.	It’s worth saying again, this series is not about journalists swooping in to offer their diagnoses of what they think is the best and worst of the NHS; we are committed to assessing the state of health service through the voices of its staff and patients. Whether you’re a health worker or patient, or if you or someone in your family has been affected by the issues raised in our journalism, we want to hear from you.
You can comment below the line, tweet us – or if you have a longer story, photographs or video to share then please use GuardianWitness. We will feature your stories in our ongoing coverage.	You can comment below the line, tweet us – or if you have a longer story, photographs or video to share then please use GuardianWitness. We will feature your stories in our ongoing coverage.
Related: This is the NHS: share your experiences	Related: This is the NHS: share your experiences
Updated	Updated
at 10.05am GMT	at 10.05am GMT
9.26am GMT	9.26am GMT
09:26	09:26
Here at Guardian Towers, staff have been treated to a sneak preview of our project in the form of a huge 50ft-ish (I’m terrible at judging distance) floor-to ceiling print along the wall to the canteen. Nothing like a bit of health data to help the kale soup go down.	Here at Guardian Towers, staff have been treated to a sneak preview of our project in the form of a huge 50ft-ish (I’m terrible at judging distance) floor-to ceiling print along the wall to the canteen. Nothing like a bit of health data to help the kale soup go down.
20m wall graphic @guardian office for launch of #ThisIsTheNHS 4-week series of stories https://t.co/QU66pfOYpr pic.twitter.com/SUBEbJ1h83	20m wall graphic @guardian office for launch of #ThisIsTheNHS 4-week series of stories https://t.co/QU66pfOYpr pic.twitter.com/SUBEbJ1h83
Updated	Updated
at 9.41am GMT	at 9.41am GMT
9.15am GMT	9.15am GMT
09:15	09:15
How well do you know the NHS? Take our quiz to find out	How well do you know the NHS? Take our quiz to find out
How many of us have seen a dentist lately? How much does it cost to mend a broken arm? What proportion of NHS England staff receive abuse from the people they care for? Take our quiz to find out how well you know the NHS and how your answers compare with reality – and with other readers’ answers.	How many of us have seen a dentist lately? How much does it cost to mend a broken arm? What proportion of NHS England staff receive abuse from the people they care for? Take our quiz to find out how well you know the NHS and how your answers compare with reality – and with other readers’ answers.
Try the question below as a bit of a teaser …	Try the question below as a bit of a teaser …
Updated	Updated
at 9.41am GMT	at 9.41am GMT
8.51am GMT	8.51am GMT
08:51	08:51
Jessica Elgot	Jessica Elgot
Jessica Elgot has arrived and has sent this bulletin of what she will be up to today:	Jessica Elgot has arrived and has sent this bulletin of what she will be up to today:
I’m at St George’s hospital in Tooting, south London, to get a snapshot of the thousands of different things happening over the course of a working day at one of London’s leading hospitals.	I’m at St George’s hospital in Tooting, south London, to get a snapshot of the thousands of different things happening over the course of a working day at one of London’s leading hospitals.
You might have seen St George’s on Channel 4’s addictive 24 Hours in A&E; but it’s the rest of the hospital I’ll be touring today. It has 8,500 staff, serving an immediate population of around 1.3 million – not counting those who come from further appeal for specialist care, and is one of the country’s principal teaching hospitals.	You might have seen St George’s on Channel 4’s addictive 24 Hours in A&E; but it’s the rest of the hospital I’ll be touring today. It has 8,500 staff, serving an immediate population of around 1.3 million – not counting those who come from further appeal for specialist care, and is one of the country’s principal teaching hospitals.
Over the course of the day, I’ll be with consultant neuroscientists, heart surgeons, touring the sexual health clinic, walking round with estates management, meeting radiographers and junior doctors from countless specialties.	Over the course of the day, I’ll be with consultant neuroscientists, heart surgeons, touring the sexual health clinic, walking round with estates management, meeting radiographers and junior doctors from countless specialties.
Updated	Updated
at 9.05am GMT	at 9.05am GMT
8.45am GMT	8.45am GMT
08:45	08:45
Cameron refuses to rule out imposing new contract on junior doctors before next strike	Cameron refuses to rule out imposing new contract on junior doctors before next strike
Obviously the biggest NHS news story of the last few months has been the government’s attempts to get junior doctors to agree a new contract, ostensibly to pave the way for a seven-day health service. (To help you understand why junior doctors are not happy with this new contract, this video explainer will fill you in.)	Obviously the biggest NHS news story of the last few months has been the government’s attempts to get junior doctors to agree a new contract, ostensibly to pave the way for a seven-day health service. (To help you understand why junior doctors are not happy with this new contract, this video explainer will fill you in.)
The prime minister was just interviewed on BBC Radio 4’s Today programme, and has repeated the health secretary’s previous threat to impose the controversial new contract on junior doctors anyway, despite two more rounds of industrial action planned.	The prime minister was just interviewed on BBC Radio 4’s Today programme, and has repeated the health secretary’s previous threat to impose the controversial new contract on junior doctors anyway, despite two more rounds of industrial action planned.
Andrew Sparrow, over on the Politics live blog, was listening in and transcribed the full exchange here:	Andrew Sparrow, over on the Politics live blog, was listening in and transcribed the full exchange here:
Q: Do you think junior doctors and the BMA are using this as a political opportunity to attack a Tory government?	Q: Do you think junior doctors and the BMA are using this as a political opportunity to attack a Tory government?
Cameron says the BMA can answer for themselves.	Cameron says the BMA can answer for themselves.
But they were telling doctors they would lose 30% of their pay. That was not right. They had a pay calculator on their website, but they had to take it down because it was not accurate, he says.	But they were telling doctors they would lose 30% of their pay. That was not right. They had a pay calculator on their website, but they had to take it down because it was not accurate, he says.
He says you are 20% more likely to die from a stroke if you go into a hospital at a weekend.	He says you are 20% more likely to die from a stroke if you go into a hospital at a weekend.
Q: Doctors have complained that that statistic is misleading.	Q: Doctors have complained that that statistic is misleading.
Cameron says people in the medical profession know there is a problem with NHS treatment at weekends.	Cameron says people in the medical profession know there is a problem with NHS treatment at weekends.
Q: Will you just impose this contract on junior doctors?	Q: Will you just impose this contract on junior doctors?
Cameron says he cannot rule that out.	Cameron says he cannot rule that out.
But he hopes to get an agreement. He is going into this in good faith. The government has just put on the table a proposal that no junior doctor should have to work two Saturdays in a row.	But he hopes to get an agreement. He is going into this in good faith. The government has just put on the table a proposal that no junior doctor should have to work two Saturdays in a row.
Q: Could the contract be imposed before the strike in February?	Q: Could the contract be imposed before the strike in February?
Cameron says he hopes it will not come to that.	Cameron says he hopes it will not come to that.
Updated	Updated
at 9.06am GMT	at 9.06am GMT
8.32am GMT	8.32am GMT
08:32	08:32
Today's health news roundup	Today's health news roundup
Obviously our #thisistheNHS project does not exist in a bubble – in fact, last week’s strike by junior doctors caused us to postpone the start by a week. So it would be remiss of me not to point you in the direction of the health stories making the news in other papers today (as well as our own fine scoop on NHS plans to introduce a sugar tax).	Obviously our #thisistheNHS project does not exist in a bubble – in fact, last week’s strike by junior doctors caused us to postpone the start by a week. So it would be remiss of me not to point you in the direction of the health stories making the news in other papers today (as well as our own fine scoop on NHS plans to introduce a sugar tax).
The Telegraph is currently splashing its website on findings from the GP patient survey 2016 that shows more than 10 million patients a year are struggling to get a GP appointment. The paper says:	The Telegraph is currently splashing its website on findings from the GP patient survey 2016 that shows more than 10 million patients a year are struggling to get a GP appointment. The paper says:
NHS statistics show that the proportion of people who are unhappy with the opening times of their local practice has risen by one fifth in three years, amid pleas from patients for seven-day opening. Family doctors last night said they are overwhelmed by growing demand, and increasingly unable to provide safe levels of service.	NHS statistics show that the proportion of people who are unhappy with the opening times of their local practice has risen by one fifth in three years, amid pleas from patients for seven-day opening. Family doctors last night said they are overwhelmed by growing demand, and increasingly unable to provide safe levels of service.
The story goes on to say that patients’ groups blame the “increasing reliance on female GPs, often working limited hours” for the “part-time service”. This is bound to provoke some debate. Joyce Robin, from Patient Concern, said these female GPs often work only “a couple of mornings or afternoons a week”.	The story goes on to say that patients’ groups blame the “increasing reliance on female GPs, often working limited hours” for the “part-time service”. This is bound to provoke some debate. Joyce Robin, from Patient Concern, said these female GPs often work only “a couple of mornings or afternoons a week”.
We have a reporter looking at the figures on which this Telegraph story is based, as we think there may have been some slightly unfair extrapolation. I will post the story here later this morning once we have it.	We have a reporter looking at the figures on which this Telegraph story is based, as we think there may have been some slightly unfair extrapolation. I will post the story here later this morning once we have it.
The BBC is reporting on the remarkable results of a cancer treatment used on multiple sclerosis patients in Sheffield that appears to have “rebooted” the patients’ immune systems. The full story will be in tomorrow night’s Panorama programme.	The BBC is reporting on the remarkable results of a cancer treatment used on multiple sclerosis patients in Sheffield that appears to have “rebooted” the patients’ immune systems. The full story will be in tomorrow night’s Panorama programme.
The treatment – known as an autologous haematopoietic stem cell transplant (HSCT) – aims to destroy the faulty immune system using chemotherapy. It is then rebuilt with stem cells harvested from the patient’s own blood. These cells are at such an early stage they’ve not developed the flaws that trigger MS. Prof John Snowden, consultant haematologist at Royal Hallamshire hospital, said: “The immune system is being reset or rebooted back to a time point before it caused MS.” About 20 MS patients have been treated in Sheffield in the past three years. Prof Snowden added: “It’s clear we have made a big impact on patients’ lives, which is gratifying.”	The treatment – known as an autologous haematopoietic stem cell transplant (HSCT) – aims to destroy the faulty immune system using chemotherapy. It is then rebuilt with stem cells harvested from the patient’s own blood. These cells are at such an early stage they’ve not developed the flaws that trigger MS. Prof John Snowden, consultant haematologist at Royal Hallamshire hospital, said: “The immune system is being reset or rebooted back to a time point before it caused MS.” About 20 MS patients have been treated in Sheffield in the past three years. Prof Snowden added: “It’s clear we have made a big impact on patients’ lives, which is gratifying.”
Meanwhile, the Mail is claiming to have solved the mystery of why some people catch colds more often than others. It’s nothing to do with how many times you let toddlers sneeze on you, or lick the handrails on the tube, apparently. No, it’s more to do with genetics and whether or not you’re stressed.	Meanwhile, the Mail is claiming to have solved the mystery of why some people catch colds more often than others. It’s nothing to do with how many times you let toddlers sneeze on you, or lick the handrails on the tube, apparently. No, it’s more to do with genetics and whether or not you’re stressed.
Updated	Updated
at 9.00am GMT	at 9.00am GMT
7.41am GMT	7.41am GMT
07:41	07:41
Your morning briefing	Your morning briefing
Mark Smith	Mark Smith
Welcome to the first day of what is probably the most ambitious project the Guardian has ever undertaken. Over the next month, we will use the breadth of our journalistic expertise to get closer to the NHS than any news organisation has ever attempted. We want to hear the authentic voices of those on the frontline to understand the endless cycle of pressure – whether it be in an accident and emergency unit, an ambulance call centre, a GP surgery, a maternity unit, or a mental health unit. We want to hear the stories of hope, of achievement, of human kindness and patient care.	Welcome to the first day of what is probably the most ambitious project the Guardian has ever undertaken. Over the next month, we will use the breadth of our journalistic expertise to get closer to the NHS than any news organisation has ever attempted. We want to hear the authentic voices of those on the frontline to understand the endless cycle of pressure – whether it be in an accident and emergency unit, an ambulance call centre, a GP surgery, a maternity unit, or a mental health unit. We want to hear the stories of hope, of achievement, of human kindness and patient care.
Related: NHS chief to introduce sugar tax in hospitals to tackle UK obesity crisis	Related: NHS chief to introduce sugar tax in hospitals to tackle UK obesity crisis
Fundamentally, we want to answer the question: do we have the NHS we need? We aim to do this though diaries, fly-on-the-wall reporting, interviews, films and data analysis. Whether you work in or are fascinated by the NHS, have a strong personal or family experience, or simply have a passing interest, please join in.	Fundamentally, we want to answer the question: do we have the NHS we need? We aim to do this though diaries, fly-on-the-wall reporting, interviews, films and data analysis. Whether you work in or are fascinated by the NHS, have a strong personal or family experience, or simply have a passing interest, please join in.
Our daily email will give you a fresh summary of the best of the previous day’s coverage, outline the plan for the day ahead and explain why we’ve chosen to report on that specific issue. It will also round up the most incisive comment on our coverage so far from our journalists, readers, and health industry experts. Sign up below to make sure you don’t miss out.	Our daily email will give you a fresh summary of the best of the previous day’s coverage, outline the plan for the day ahead and explain why we’ve chosen to report on that specific issue. It will also round up the most incisive comment on our coverage so far from our journalists, readers, and health industry experts. Sign up below to make sure you don’t miss out.
The big picture	The big picture
The National Health Service is arguably the most complex organisation in western Europe. It employs 1.6 million people, making it one of the five largest workforces in the world, alongside the US Department of Defense, McDonald’s, Walmart and the Chinese army.	The National Health Service is arguably the most complex organisation in western Europe. It employs 1.6 million people, making it one of the five largest workforces in the world, alongside the US Department of Defense, McDonald’s, Walmart and the Chinese army.
When it was launched in 1948 it had a budget of £437m (about £9bn at today’s value); it now stands at £136.7bn. The statistical story is staggering: last year there were almost 10m operations, 22m visits to A&E, 16m hospital admissions, 82m outpatient visits and almost 2 million people getting help from specialist mental health services. And, of course, it is never out of the headlines.	When it was launched in 1948 it had a budget of £437m (about £9bn at today’s value); it now stands at £136.7bn. The statistical story is staggering: last year there were almost 10m operations, 22m visits to A&E, 16m hospital admissions, 82m outpatient visits and almost 2 million people getting help from specialist mental health services. And, of course, it is never out of the headlines.
We asked many readers what they wanted from this project. Some of the most engaging responses concerned balance – covering the good as much as the bad: “I’d like to see both sides of the story, as all we hear about is the failings or pay issues,” said one reader. “What about those patents who have been cared for amazingly, staff who are brilliant at their job and enjoy it?”	We asked many readers what they wanted from this project. Some of the most engaging responses concerned balance – covering the good as much as the bad: “I’d like to see both sides of the story, as all we hear about is the failings or pay issues,” said one reader. “What about those patents who have been cared for amazingly, staff who are brilliant at their job and enjoy it?”
So that is what we intend to do, with regular features such as The day the NHS saved my life and My toughest decision. Though our coverage will reflect our readers’ top concerns – the cost of the NHS and mental health – we won’t forget the patients and their experiences.	So that is what we intend to do, with regular features such as The day the NHS saved my life and My toughest decision. Though our coverage will reflect our readers’ top concerns – the cost of the NHS and mental health – we won’t forget the patients and their experiences.
Today’s focus	Today’s focus
The first day of our project serves as an introduction to the health service and its key resource: its staff.	The first day of our project serves as an introduction to the health service and its key resource: its staff.
Jon Henley has spoken to 16 people who work in the NHS in roles from paediatric intensive care consultant to matron to linen assistant. The result is a beautifully photographed series of first-person accounts that make a fitting introduction to our series:	Jon Henley has spoken to 16 people who work in the NHS in roles from paediatric intensive care consultant to matron to linen assistant. The result is a beautifully photographed series of first-person accounts that make a fitting introduction to our series:
Britain’s National Health Service is a sprawling, many-layered and infinitely complex thing; an institution famed around the world yet reviled here, at times, as much as it is revered; an organisation so large that the numbers beggar belief.	Britain’s National Health Service is a sprawling, many-layered and infinitely complex thing; an institution famed around the world yet reviled here, at times, as much as it is revered; an organisation so large that the numbers beggar belief.
Want to know the history of the NHS? Duncan Campbell, the Guardian’s health policy editor, has produced this 800-word guide to the health service since its founding by Labour’s Aneurin Bevan in 1948 – complete with some cuttings from the Guardian archives.	Want to know the history of the NHS? Duncan Campbell, the Guardian’s health policy editor, has produced this 800-word guide to the health service since its founding by Labour’s Aneurin Bevan in 1948 – complete with some cuttings from the Guardian archives.
Related: For a clear view of the NHS, look past the politics and promises of a cure \| Polly Toynbee	Related: For a clear view of the NHS, look past the politics and promises of a cure \| Polly Toynbee
Polly Toynbee puts the Guardian’s project in a political context, likening the health service’s current financial strain to “a ligature tightening around its neck”.	Polly Toynbee puts the Guardian’s project in a political context, likening the health service’s current financial strain to “a ligature tightening around its neck”.
Reporting on the NHS since I wrote a book about it in 1977, I have watched each health secretary seize a scalpel and begin to operate, all declaring that they are the first to open up this “monolith, unreformed since 1948”. Yet these perpetual political cures are applied before diagnosis or evaluation of the medicine.	Reporting on the NHS since I wrote a book about it in 1977, I have watched each health secretary seize a scalpel and begin to operate, all declaring that they are the first to open up this “monolith, unreformed since 1948”. Yet these perpetual political cures are applied before diagnosis or evaluation of the medicine.
You can also read the first instalments of our two daily series:The day the NHS saved my life, and ‘Secret diary’. The first seeks to highlight the personal stories of people who owe their lives to the health service, while the latter will each day grant an insight – (genital) warts and all – into the real working days and weeks of an NHS professional, from paramedics to sexual health doctors.	You can also read the first instalments of our two daily series:The day the NHS saved my life, and ‘Secret diary’. The first seeks to highlight the personal stories of people who owe their lives to the health service, while the latter will each day grant an insight – (genital) warts and all – into the real working days and weeks of an NHS professional, from paramedics to sexual health doctors.
This morning we’re also breaking the news that NHS chief Simon Stevens has revealed plans to impose a sugar tax in hospital cafes and vending machines, and local health centres, by 2020. In a wide-ranging interview with Denis Campbell and Paul Johnson to kick off the Guardian’s #thisistheNHS month, Stevens also urged ministers to take radical action against obesity, including forcing food firms to strip sugar out of their products, as part of an unprecedented assault on bad diet.	This morning we’re also breaking the news that NHS chief Simon Stevens has revealed plans to impose a sugar tax in hospital cafes and vending machines, and local health centres, by 2020. In a wide-ranging interview with Denis Campbell and Paul Johnson to kick off the Guardian’s #thisistheNHS month, Stevens also urged ministers to take radical action against obesity, including forcing food firms to strip sugar out of their products, as part of an unprecedented assault on bad diet.
Related: The NHS data dashboard: babies born, salaries paid, the winter crisis	Related: The NHS data dashboard: babies born, salaries paid, the winter crisis
There’s no better way to appreciate the scale of the NHS than in numbers. Our singular data team have put together this “data dashboard”, highlighting the key figures such as number of babies born and level of salaries paid. The team will be tracking live figures over the next month in order to chart exactly how acute this year’s winter crisis actually is.	There’s no better way to appreciate the scale of the NHS than in numbers. Our singular data team have put together this “data dashboard”, highlighting the key figures such as number of babies born and level of salaries paid. The team will be tracking live figures over the next month in order to chart exactly how acute this year’s winter crisis actually is.
Where we are today	Where we are today
Each day this week, our intrepid reporter Jessica Elgot will be liveblogging from a different NHS service. Today, she is at St George’s hospital in Tooting – one of the country’s principal teaching hospitals, which serves a population of 1.3 million across south-west London.	Each day this week, our intrepid reporter Jessica Elgot will be liveblogging from a different NHS service. Today, she is at St George’s hospital in Tooting – one of the country’s principal teaching hospitals, which serves a population of 1.3 million across south-west London.
Today’s diary	Today’s diary
As part of our attempt to cover the NHS in appropriate depth as well as breadth, Jessica will be speaking to various experts, specialists and key personnel at St George’s, including Marios Papadopoulos, professor of neurosurgery, who will be able to explain some pioneering work on spinal cord injury that is taking place at the teaching hospital. Also being covered will be genetics, clinical trials, and the GUM clinic.	As part of our attempt to cover the NHS in appropriate depth as well as breadth, Jessica will be speaking to various experts, specialists and key personnel at St George’s, including Marios Papadopoulos, professor of neurosurgery, who will be able to explain some pioneering work on spinal cord injury that is taking place at the teaching hospital. Also being covered will be genetics, clinical trials, and the GUM clinic.
In the afternoon Jessica will interview Christopher Smallwood, the chairman of the trust that oversees St George’s, who will be able to talk through the singular challenges that face the NHS’s business leaders.	In the afternoon Jessica will interview Christopher Smallwood, the chairman of the trust that oversees St George’s, who will be able to talk through the singular challenges that face the NHS’s business leaders.
Also on today’s agenda, Simon Stevens, the NHS England chief executive, is giving evidence to the House of Commons public accounts committee at 4pm. He is due to talk about the financial sustainability of hospitals. We’ll bring you coverage of this, as well as round up the latest health news from the other papers.	Also on today’s agenda, Simon Stevens, the NHS England chief executive, is giving evidence to the House of Commons public accounts committee at 4pm. He is due to talk about the financial sustainability of hospitals. We’ll bring you coverage of this, as well as round up the latest health news from the other papers.
Thanks for joining us on day one of our NHS coverage. You can tweet Jessica and me – @jessicaelgot and @marksmith174 – and please join in the conversation with the hashtag #thisistheNHS and below the line. We’ll be monitoring your comments and will feature the best in the blog.	Thanks for joining us on day one of our NHS coverage. You can tweet Jessica and me – @jessicaelgot and @marksmith174 – and please join in the conversation with the hashtag #thisistheNHS and below the line. We’ll be monitoring your comments and will feature the best in the blog.
We also hope you sign up to the daily email and stick with us for what will be a fascinating and thought-provoking month.	We also hope you sign up to the daily email and stick with us for what will be a fascinating and thought-provoking month.
Updated	Updated
at 8.35am GMT	at 8.35am GMT