QDeath – the ultimate health app

A robotic voice, powered by exceptional conversational AI, from a smart phone…
heartage“Hello, you’re using Defying Expectation And Timing Health. How can I help you today?
You filled out one of our online questionnaires and would like to talk through your options?
Excellent, very good, this should only take a few moments. Can I just confirm that there have been no deaths before the age of 65 in any first degree relatives or deaths from inheritable conditions in any first or second degree relatives? Excellent, thank you, those tend to skew our data.
OK, before I process your data and feed it into our patented QDeath algorithm I need to read you a disclaimer:
“QDeath is a predictive technology based on the most up to date statistics from the Office for National Statistics, tailored to your individual situation, but the margins for error are greater, the younger you are. Defying Expectation And Timing Health takes no responsibility for erroneous predictions or sudden accidental causes of death. We do not recommend using your predictive data as the basis of securing life insurance or writing a will.”
Are you happy to proceed?
OK, let’s run QDeath for you.
Moments later
OK, that’s interesting. Based on your social class, occupation, previous history of smoking, though I note you gave up at the age of 30, your chance of the big three are pretty much even. So what that means is that you have a pretty much the same chance of dying from a cardiovascular cause, that is a stroke or heart attack, cancer or dementia. Looking at population trends, drug and technology advances, the confidence intervals on the stroke and heart attack data are the widest.
What does that mean? Well it means that, the strokes and heart attacks are hardest to predict. Yes, I know, frustrating isn’t it?
Now I see you completed the supplementary questions on your Priorities In Later Life. Hopefully this won’t be a bitter “PILL” to swallow.
A pause
No, sorry. Yes, no, you’re right. It wasn’t really that funny, but sometimes a little levity can help in discussing these things.
Anyway, back to your hopes and fears. I see that under no circumstances do you want to die from dementia. That is a common request, though to be fair a lack of insight is often a blessing. Would you like to reconsider? No? OK. If we try to lower your dementia risk down and work the calculation backwards then we can see what you need to do from now.
OK, let’s see. How interesting. As there is a negative correlation between dementia and smoking, and smoking is correlated to both cardiovascular disease and cancer we would suggest that you start smoking 20 cigarettes a day straight away.
Can we predict what type of cancer? No, sorry. We haven’t got that type of granularity yet.
What if you have a stroke that doesn’t kill you but just incapacitates you? Well that is a risk, sir. About 23%, as is having a non-fatal heart attack resulting in end-stage heart failure. To increase your chances of a fatal cardiovascular event I would suggest that you stop exercising, drink over the recommended limit of alcohol, put on weight and never have your cholesterol or blood pressure measured. You may also want to consider a prolonged course of drugs associated with a cardiac death, such as diclofenac, domperidone or citalopram, or even high dose methadone. Preferably a combination.
I know it is a different way of thinking. Yes, but actually what healthcare does is not so much disease prevention, but simply death postponement or diversion to dementia. Yes, I know it is odd to think about it that way.
The other issue is that by starting smoking you bring in respiratory causes of death. Now most of these are pneumonia at the end of life, but you may end up with chronic lung disease, disabling breathlessness and frequent chest infections.
Well, only you can decide if that is better than ending your life not knowing who you are, or where you are.
OK. I will put all of this in an email to you, for you to have a think over and discuss with your loved ones. Thank you for using the Defying Expectation And Timing Health app.

My #Twitterdisco #bettercovers

So from (roughly) 9pm on Friday 19th January there was a flurry of internet activity to post and debate whether cover versions could be better than the original – as well as raise money for the Lullaby Trust.

This is my list of #bettercovers that I was going to try to post – I didn’t get round to some of them and other people came up with some of them too…

Any glaring errors? Anything you wildly disagree with?


  1. Somewhere Over the Rainbow – Eva Cassidy https://youtu.be/2rd8VktT8xY (original by Eva Cassidy) #Twitterdisco #Bettercovers
  2. Torn – Natalie Imbruglia https://youtu.be/VV1XWJN3nJo (original by Ednaswap) #Twitterdisco #Bettercovers
  3. Hallelujah – Jeff Buckley https://www.youtube.com/watch?v=WIF4_Sm-rgQ (original by Leonard Cohen) #Twitterdisco #Bettercovers
  4. All Along the Watchtower – Jimi Hendrix https://youtu.be/TLV4_xaYynY (original by Bob Dylan) #Twitterdisco #Bettercovers
  5. One – Johnny Cash https://youtu.be/CGrR-7_OBpA (original by U2) #Twitterdisco #Bettercovers
  6. Rent – Carter the Unstoppable Sex Machine https://youtu.be/1omqMqpyj4Y (original by Pet Shop Boys) #Twitterdisco #Bettercovers
  7. Man of Constant Sorry – Blackberry Smoke https://youtu.be/SFhFiLmzIpk?t=1m20s (original from O Brother Where Art Thou Soundtrack) #Twitterdisco #Bettercovers
  8. The Drugs Don’t Work – Ben Harper https://youtu.be/k3YjRaUb4WI (original by the Verve) #Twitterdisco #Bettercovers
  9. Rocket Man – Iron Horse https://youtu.be/forqmom3YuY (original by Elton John) #Twitterdisco #Bettercovers
  10. Dream On – Boyce Avenue https://youtu.be/wvCq6-zWw7M (original by Aerosmith) #Twitterdisco #Bettercovers
  11. Give in to me – Three Days Grace https://youtu.be/02VRCVh05NU (original by Michael Jackson) #Twitterdisco #Bettercovers
  12. In The Air Tonight – Nonpoint https://youtu.be/OoGg9bIyDPY (original by Phil Collins) #Twitterdisco #Bettercovers
  13. Easy Like Sunday Morning – Faith No More https://youtu.be/vPzDTfIb0DU (original by the Commodores) #Twitterdisco #Bettercovers
  14. Lake of Fire – Nirvana https://youtu.be/zgvUaOuEdwA (original by the Meat Puppets) #Twitterdisco #Bettercovers
  15. Careless Whisper – Seether https://youtu.be/g0_dyc4IrLg (original by George Michael) #Twitterdisco #Bettercovers
  16. Smooth Criminal – Alien Ant Farm https://youtu.be/CDl9ZMfj6aE (original by Michael Jackson) #Twitterdisco #Bettercovers
  17. I’m too Sexy – Leo Moracchioli https://youtu.be/7L0Wri7r7CE (original by Right Said Fred) #Twitterdisco #Bettercovers
  18. With a Little Help from my Friends – Joe Cocker https://youtu.be/POaaw_x7gvQ (original by the Beatles) #Twitterdisco #Bettercovers
  19. The Man Who Sold the World – Nirvana https://youtu.be/fregObNcHC8 (original by David Bowie) #Twitterdisco #Bettercovers
  20. Hurt – Johnny Cash https://youtu.be/vt1Pwfnh5pc (original by Nine Inch Nails) #Twitterdisco #Bettercovers
  21. Nothing Compares 2U – Sinead O’Connor https://youtu.be/0-EF60neguk (original by the Family) #Twitterdisco #Bettercovers
  22. Respect – Aretha Franklin https://youtu.be/6FOUqQt3Kg0 (original by Otis Redding) #Twitterdisco #Bettercovers
  23. Twist and Shout – The Beatles https://youtu.be/YgVWot_xrxE (original by the Top Notes) #Twitterdisco #Bettercovers
  24. I Will Always Love You – Whitney Houston https://youtu.be/3JWTaaS7LdU (original by Dolly Parton) #Twitterdisco #Bettercovers
  25. Learn to Fly – Rockin’1000 https://youtu.be/JozAmXo2bDE (original by Foo Fighters) #Twitterdisco #Bettercovers
  26. Don’t Look Back in Anger – Chris Martin https://youtu.be/RYF4Gsrxur4 (original by Oasis) #Twitterdisco #Bettercovers
  27. Hound dog – Elvis Presley https://youtu.be/lzQ8GDBA8Is (original by Big Mama Thornton) #Twitterdisco #Bettercovers
  28. Free Fallin – John Mayer https://youtu.be/20Ov0cDPZy8 (original by Tom Petty) #Twitterdisco #Bettercovers
  29. Jolene – White Stripes https://youtu.be/yXlULkwhgrc (original by Dolly Parton) #Twitterdisco #Bettercovers
  30. Kiss From a Rose – Jack Black https://youtu.be/xj5VI9KEpbM?t=1m25s (original by Seal) #Twitterdisco #Bettercovers
  31. Killing me Softly – Fugees https://youtu.be/oKOtzIo-uYw (original by Roberta Flack) #Twitterdisco #Bettercovers
  32. I Fought the Law – The Clash https://youtu.be/AL8chWFuM-s (original by The Crickets) #Twitterdisco #Bettercovers
  33. Womanizer – All American Rejects https://youtu.be/vXsdvsZHQf8 (original Britney Spears) #Twitterdisco #Bettercovers
  34. Hit Me Baby One More Time – Travis https://youtu.be/sqJ1bgY2Ww8?t=38s (original Britney Spears) #Twitterdisco #Bettercovers
  35. Without You – Harry Nilsson https://youtu.be/8dnUv3DUP4E (original by Badfinger, then subsequently wrecked by Mariah Carey) #Twitterdisco #Bettercovers
  36. Knocking on Heaven’s Door – Guns n Roses https://youtu.be/dmNlUnsWZOQ (original by Bob Dylan) #Twitterdisco #Bettercovers
  37. November Rain – Steve n Seagulls https://youtu.be/fvrogxMHmlg (original by Guns n Roses)
  38. Alone – Heart https://youtu.be/1Cw1ng75KP0 (original by i-Ten) #Twitterdisco #Bettercovers
  39. Only Love Can Break Your Heart – St Etienne https://youtu.be/vZAajrxvDs4 (original by Neil Young) #Twitterdisco #Bettercovers
  40. Tainted Love – Soft Cell https://youtu.be/XZVpR3Pk-r8 (original by Gloria Jones) #Twitterdisco #Bettercovers
  41. Every Time You Go Away – Paul Young https://youtu.be/nfk6sCzRTbM  (original by Hall and Oates) #Twitterdisco #Bettercovers
  42. The Loco-motion – Kylie Minogue https://youtu.be/POWsFzSFLCE (original by Little Eva) #Twitterdisco #Bettercovers
  43. Where Did You Sleep Last Night – Nirvana https://www.youtube.com/watch?v=-pBrDjSFT_E (original by Lead Belly) #Twitterdisco #Bettercovers
  44. Mad World – Gary Jules https://youtu.be/AhT_wusAyoc (original by Tears for Fears) #Twitterdisco #Bettercovers

Countdown to #Twitterdisco January 2018

I have stumbled across a positive corner of Twitter where a group of health professionals and their followers have a virtual #Twitterdisco along a predefined theme by posting links to music videos (and videos of themselves). I’ve managed to accidentally get myself invited on as a “Guest DJ” which is ironic as I have bought next to no new music for the last 15 years and I’m not known for being the most positive social media user…

So for those curious enough to know, this is my dusty old website which I rarely use these days. Probably because I have been busy as a GP, dad, father, husband etc… But also because I have been doing some management work (CCG project and a superpartnership; yawn – now finished) and for the last few years I have been luck enough to get things I have written put on other people’s websites (see here)

When I am not faffing about on Twitter, seeing patients, helping run a GP practice, and trying to not to get too much in the way of the raising of three children I amuse myself by going climbing (reminiscing days when I was lighter and stronger), playing guitar, painting and watching films. I have occasionally been known to record songs too. The latest song was a collaboration with all the staff at the surgery where I am a partner as a surprise leaving present for a retiring partner.

So on Friday 19th January I will be “on the decks” with a special theme: #bettercovers – cover versions of songs that are better than the originals. I’ll need lots of people to join, have fun and help raise some money for the Lullaby Trust. One of things that this charity does is help families affected by Sudden Infant Death Syndrome (and the lesser-known Sudden Unexplained Death in Children) – a charity that friends of ours found a real support when their 18 month old died overnight.

Part of Who I am

A powerful message about our own personal stories


This blog was first published on the NHS Vale Royal CCG website in September 2015.

A scene familiar to doctors and nurses. An urgent call in the middle of the night followed by a rapid fumbling with clothes and shoes as you shake the too little sleep out of your head. The run through the quiet and empty corridors of the hospital before bursting onto the ward, your destination immediately made obvious by the busyness and urgency around one patient. As you approach you see resuscitation already underway, someone doing chest compressions and someone else ventilating.
Many of you reading this will relate to the scene. Two things make this memory different for me. Firstly, the patient is not an elderly person potentially coming to the end of a life well-lived,but is only 17 months old. Secondly, the patient is my son.
Over 11 years ago, this scene brought to…

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A letter to Theresa May via my MP

Please feel free to copy and paste this in an email to your own MP, sign a petition, do anything. You can find your MP by using this link

Dear Prime Minister,

I was dismayed at your inability to directy condemn the US president’s vindication of the use of torture and also your frankly lacklustre and tardy repsonse to his latest exectuive order about immigration controls into his country. Whilst I cannot know what goes on behind closed doors between you I believe you have a duty to outwardly show your own country that you serve, that you do not condone such actions at all, and not just when they affect British citizens (it is already, by the way).

I would politely ask you to cancel the State visit of President Trump until such moment as his Executive Order over immigration is revoked. If you are not able to do this immediately then I expect nothing more than a full and frank explanation as to why not. Please feel free to write to me directly, or make a public announcement.

I look forward to hearing from you

Yours Faithfully


The GP 5 Year Forward View, the importance of inequality and the Deep End

Great blog by Greg Fell about inequality and how it affects general practice

Sheffield DPH

So we are all doing responses to the GP 5 Year Forward view
Who knows whether there’s any REAL investment fund. Meanwhile the world keeps revolving.

General Practice, you know the bit that everyone says is the jewel in the NHS crown, gets ever more fragile.

The point re General Practice in the most disadvantaged parts of our communities, you know the bit of the narrative everyone manages to forget, isn’t going away anytime soon.

The amazing Deep End group keep shining a light on it.

Here are some thoughts as we finalise where we are re the GP5yFV.

Regular readers will recognise rehashed material (sorry, but got to say the same thing again and again)


The slice of the NHS £ going to primary care and in particular General Practice

GP funding seems like it’s going down not up

General practice funding has fallen to 8% of…

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What many doctors think is happening

London, United Kingdom - April 27, 2016: The Second Day of the Strike By Junior Doctors. The junior doctors resolve is strong on the second day of the all out strike over working conditions.A slimy man is at a very large desk. He is speaking into a phone.

“Don’t worry Richard, sorry, yes, Sir Richard. Don’t worry Sir Richard. Look we have talked about how we were going to have to break it a little bit before…sorry…yes, I know, well look it is  just a little bit. No, no, no it’s not a basket case like the East Coast mainline.”

There is a buzzing sound from a red telephone on his desk, “Look, hang on a minute, I have an important call on the other line.”

He mutes the mobile phone, puts it down on the desk and lifts the old-fashioned red telephone to his ear, “Hello, Rupert,” he listens for a minute or two, “Well that is very kind of you to offer. This week, let’s do nurses, followed by consultants the week after, with a dash of immigrants. If the comments sections seem a bit tame then why not go after the hospital executives and managers, you know publish a few salaries, significant events, patients complaints – you know the sort of thing?”

He listens for a few moments, “Yes quite, I completely agree, ungrateful sods. Speak to you soon,” he replaces the handset and picks up the mobile phone again.

“Sorry Richard, Sir Richard, where were we?” he checks his fingernails and holds the phone away from his ear to protect his eardrum from the shouting, “Look, Rich… SIr Richard, I promise you I will not completely break it. It just needs to be a little bit broken, you know, for us to be able to seal the deal, splash the cash, bring home the bacon… No, no I haven’t been smoking.”

He sits forward in his chair, “Listen, when have we ever let you down? Tell me, eh? Leave this to me and I’ll make sure it will all work out fine for us. Even if they suspect, there won’t be anything they can do about it. Everyone will be panicking about bloody Brexit for a start… Yes, I know… Can’t believe we have been so lucky to have such a massive distraction from our plan land straight into our laps. They always vote with their wallets as you know.”

A woman walks into the office. He cups his hand over the mobile phone and mouths, “Who are you?!”

“Your new specialist advisor, sir.”

“But I’ve already got three, what does her up the road think she’s playing at? No Sir Richard, not you!”

He glances angrily at the woman, “Look, I have got to go. Need to figure out how to make sure Number 11 keep their coffers shut. Speak to you soon.”

He turns to face the woman as the mobile phone is silenced, “And what, pray tell, are you going to advise me about?”