Christmas in A&E is a time like any other. Just take off the deely-boppers when giving bad news

If you’re the kind of person who thinks, “It’s Christmas – A&E will be empty,” and comes in to have their verruca treated, you are wrong.

Merry Christmas. It’s that special time of year. For 18 years I’ve worked in A&E, on the ambulances and at an urgent care centre, and been at work plenty of Christmases. It’s a busy time, with the normal injuries and illnesses joined by “seasonal” problems such as drunken behaviour and more wounds caused by partying.

Most of the NHS works over Christmas and this year we’d like a nice, quiet one. So, in an effort to reduce the strain on the service, let me give you a few tips, based on my experience, for avoiding heartache, injury and ill-health over the holiday.

1) If you have children and have bought them toys, I would recommend that you forgo bare feet and wear some sort of boot with thick soles instead. Small toys are not always the best thing to step on in bare feet. I don’t mind pulling a bit of shattered plastic from your foot, but it might be a bit painful for you.

2) If you are 19 and have wolfed down a huge dinner, topped it up with booze and then jumped around on your brand new pogo stick . . . it’s probably indigestion and not a heart attack. If Dad does the same and feels “funny”, it might be.

3) Alcohol: I know people like a drink, but if Uncle John turns into a bit of a daredevil when he’s tipsy, it might be best to keep him away from the strong lager. And the sledge. If Gran gets a bit punchy on the sherry, best keep it out of her reach.

4) When the usual family arguments start just walk away. It will stop you punching a wall in anger or frustration and fracturing your hand. It’s no secret that A&E staff can easily spot when someone has punched a wall. We know you haven’t “fallen”.

5) If you’re the kind of person who thinks, “It’s Christmas – A&E will be empty,” and comes in to have their verruca treated, you are wrong. Here’s a hint: many of the alternatives to A&E are closed at Christmas, so if you find it hard getting a GP appointment normally it’s not going to be any easier over the holiday period.

If you follow these simple rules you should have a nice Christmas. Except, of course, that there’s no escaping bad luck. Maybe the dog trips you up as it chases a wayward Brussels sprout, maybe you come out in a huge rash from an unexpected allergy to tinsel.

What should you expect when you end up in hospital?

First, hope that you haven’t actually developed an allergy to tinsel, because you’ll meet a lot of people wearing uniforms that have been modified with the stuff (please don’t tell the infection control team). Sometimes it’s subtle – a little piece wrapped around the end of a pen – but there are those who go to seasonal extremes and turn out in a necklace of tinsel, tinsel round the glasses, bauble earrings and reindeer antlers on their head.

Christmas bauble deely-boppers should be outlawed, I’m afraid. It’s very distracting to see a nurse giving chest compressions with a pair bouncing around on her head. We should always, always, take them off when breaking bad news to relatives.

For the staff, things are often a little bit more relaxed, mainly because most of the managers and other folk with clipboards just happen to have Christmas off. But beware the manager who comes in for a stealthy unsocial-hours bonus payment. The only time I ever saw the upper management of my old hospital was when they “worked” the millennium and all vanished ten minutes after midnight.

There are a lot of staff who have a love of Christmas (the ones wearing tinsel) and they’ll bring in food and sweets and fizzy drinks and turn the staffroom into a little party zone. It’s a weird party, though, as people rotate in and out in order to keep up staffing levels, and the food lasts for at least two weeks because most of the staff are too busy to do anything but run in and pop a solitary fig roll in their mouth before dashing off again.

Once upon a time, a national supermarket chain would give the local ambulance station a little hamper. This is a tradition that I’d like to see continued.

One of the more surprising reasons for pressures on A&E departments is that of street sleepers. Over the Christmas period, homeless organisations like to gather them all in one place to keep them warm and fed. Although they often provide health services at their shelters, it still increases the burden of work on local hospitals and the ambulance service, which has to transport them between shelter and hospital. On the positive side, it does give the hospitals a chance to catch some rather nasty stuff early on.

In the run-up to Christmas, about three months in advance, staffing rotas will be inspected to find out who gets to see their family and who gets to work (the staffing is the same as at any other time of year). You’ll find previously warm-hearted nurses capable of the most Machiavellian manoeuvring in an effort to get the “big day” off and spend some time with their family.

For those who work, it will be a day much like any other. Doctors will doctor, nurses will nurse and radiographers will take pictures of bones. Ambulance crews will pick up patients while cleaners sweep the floor and HCAs do the mucky work. The NHS is staffed by people who are willing to work on Christmas Day – for them it’s just another day of the year. But even for those working, there will be one consolation: at least we aren’t a patient.

Photo: Getty

This article first appeared in the 19 December 2013 issue of the New Statesman, Christmas Triple Issue

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An unmatched font of knowledge

Edinburgh’s global reputation as a knowledge economy is rooted in the performance and international outlook of its four universities.

As sociologist-turned US Senator Daniel Patrick Moynihan recognised when asked how to create a world-class city, a strong academic offering is pivotal to any forward-looking, ambitious city. “Build a university,” he said, “and wait 200 years.” He recognised the long-term return such an investment can deliver; how a renowned academic institution can help attract the world. However, in today’s increasingly globalised higher education sector, world-class universities no longer rely on the world coming to come to them – their outlook is increasingly international.

Boasting four world-class universities, Edinburgh not only attracts and retains students from around the world, but also increasingly exports its own distinctively Scottish brand of academic excellence. In fact, 53.9% of the city’s working age population is educated to degree level.

In the most recent QS World University Rankings, the University of Edinburgh was named as the 21st best university in the world, reflecting its reputation for research and teaching. It’s a fact reflected in the latest UK Research Exercise Framework (REF), conducted in 2014, which judged 96% of its academic departments to be producing world-leading research.

Innovation engine

Measured across the UK, annual Gross Value Added (GVA) by University of Edinburgh start-ups contributes more than £164m to the UK economy. In fact, of 262 companies to emerge from the university since the 1960s, 81% remain active today, employing more than 2,700 staff globally. That performance places the University of Edinburgh ahead of institutions such as MIT in terms of the number of start-ups it generates; an innovation hothouse that underlines why one in four graduates remain in Edinburgh and why blue chip brands such as Amazon, IBM and Microsoft all have R&D facilities in the city.

One such spin out making its mark is PureLiFi, founded by Professor Harald Haas to commercialise his groundbreaking research on data transmission using the visible light spectrum. With data transfer speeds 10,000 times faster than radio waves, LiFi not only enables bandwidths of 1 Gigabit/sec but is also far more secure.

Edinburgh’s universities play a pivotal role in the local economy. Through its core operations, knowledge transfer activities and world-class research the University generated £4.9bn in GVA and 44,500 jobs globally, when accounting for international alumni.

With £1.4bn earmarked for estate development over the next 10 years, the University of Edinburgh remains the city’s largest property developer. Its extensive programme of investment includes the soon-to-open Higgs Centre for Innovation. A partnership with the UK Astronomy Technology Centre, the new centre will open next year and will supply business incubation support for potential big data and space technology applications, enabling start-ups to realise the commercial potential of applied research in subjects such as particle physics.

It’s a story of innovation that is mirrored across Edinburgh’s academic landscape. Each university has carved its own areas of academic excellence and research expertise, such as the University of Edinburgh’s renowned School of Informatics, ranked among the world’s elite institutions for Computer Science. 

The future of energy

Research conducted into the economic impact of Heriot-Watt University demonstrated that it generates £278m in annual GVA for the Scottish economy and directly supports more than 6,000 jobs.

Set in 380-acres of picturesque parkland, Heriot-Watt University incorporates the Edinburgh Research Park, the first science park of its kind in the UK and now home to more than 40 companies.

Consistently ranked in the top 25% of UK universities, Heriot-Watt University enjoys an increasingly international reputation underpinned by a strong track record in research. 82% of the institution’s research is considered world-class (REF) – a fact reflected in a record breaking year for the university, attracting £40.6m in research funding in 2015. With an expanding campus in Dubai and last year’s opening of a £35m campus in Malaysia, Heriot-Watt is now among the UK’s top five universities in terms of international presence and numbers of international students.

"In 2015, Heriot-Watt University was ranked 34th overall in the QS ‘Top 50 under 50’ world rankings." 

Its established strengths in industry-related research will be further boosted with the imminent opening of the £20m Lyell Centre. It will become the Scottish headquarters of the British Geological Survey, and research will focus on global issues such as energy supply, environmental impact and climate change. As well as providing laboratory facilities, the new centre will feature a 50,000 litre climate change research aquarium, the UK Natural Environment Research Council Centre for Doctoral Training (CDT) in Oil and Gas, and the Shell Centre for Exploration Geoscience.

International appeal

An increasingly global outlook, supported by a bold international strategy, is helping to drive Edinburgh Napier University’s growth. The university now has more than 4,500 students studying its overseas programmes, through partnerships with institutions in Hong Kong, Singapore, China, Sri Lanka and India.

Edinburgh Napier has been present in Hong Kong for more than 20 years and its impact grows year-on-year. Already the UK’s largest higher education provider in the territory, more than 1,500 students graduated in 2015 alone.

In terms of world-leading research, Edinburgh Napier continues to make its mark, with the REF judging 54% of its research to be either world-class or internationally excellent in 2014. The assessment singled out particular strengths in Earth Systems and Environmental Sciences, where it was rated the top UK modern university for research impact. Taking into account research, knowledge exchange, as well as student and staff spending, Edinburgh Napier University generates in excess of £201.9m GVA and supports 2,897 jobs in the city economy.

On the south-east side of Edinburgh, Queen Margaret University is Scotland’s first university to have an on-campus Business Gateway, highlighting the emphasis placed on business creation and innovation.

QMU moved up 49 places overall in the 2014 REF, taking it to 80th place in The Times’ rankings for research excellence in the UK. The Framework scored 58% of Queen Margaret’s research as either world-leading or internationally excellent, especially in relation to Speech and Language Sciences, where the University is ranked 2nd in the UK.

In terms of its international appeal, one in five of Queen Margaret’s students now comes from outside the EU, and it is also expanding its overseas programme offer, which already sees courses delivered in Greece, India, Nepal, Saudi Arabia and Singapore.

With 820 years of collective academic excellence to export to the world, Edinburgh enjoys a truly privileged position in the evolving story of academic globalisation and the commercialisation of world-class research and innovation. If he were still around today, Senator Moynihan would no doubt agree – a world-class city indeed.

For further information www.investinedinburgh.com