The Twyford Code

I was a little cautious about this one as Janice Hallett’s first book, The Appeal, though a refreshingly original concept, didn’t quite hit the mark for me. If I’m honest, it dragged a bit and I was suspicious that this one might fall into the same bracket. However, the code element to this one (I love a good code or puzzle-type story) enticed me in for another go. 

I’m glad I returned for more because this book was much better. An adjustment to the original concept – from emails and texts from multiple different characters, to a more concise and flowing voice note transcription from one character – has made all the difference. It is more clever and well thought out. There are twists and turns and overall, a thoroughly enjoyable novel. Good for a Sunday afternoon. Would recommend. 

Madly, Deeply

I was looking forward to this as the concept seemed new to me and intriguing. The subject was similarly appealing – Rickman has always interested me.

As I began the book, I immediately became concerned that it was not going to be a good one. Diary entries in shorthand with name drops all over the place, some doubtless impressive but the majority obscure (at least to me) and often events discussed without any context. To my mind, that’s on the guy who edited it. More notes on the films or projects he was working on at the time would have been helpful.

However, as I read on, I got used to the structure and felt myself sinking into Rickman’s life. It begins in the mid 90s and so I found myself thinking about what I was doing in the moments he describes and how totally separate my life was from his. Once you get into it, it really becomes quite immersive and rather emotional considering some of the names he writes about are no longer with us.

The end became one of foreboding anticipation and sure enough it left me feeling quite emotional. Biographical accounts spanning a life-time can certainly cause one to look inwardly (Any Human Heart) and throughout the course of these diaries, I experienced a similar sort of reflection.

Woodland pursuits

I was browsing on Amazon a while back, as one does. For those who’ve done it, you’ll know just how dangerous that can be. Sure enough, my cursor fell on a trail camera (or camera trap). – the kind they use on nature programmes to film wildlife covertly. 

I snapped it up. Living in a flat at the time, it was a little tricky to find good places to put it. I caught a door mouse and a Robin in the undergrowth just outside the building but little else. 

Having just moved house however, I am now lucky enough to live a mere 20 seconds away from a large area of woodland. Quite apart from it being a huge therapeutic escape (and a terrific new playground for my Corgi, Bowie) it is also begging for the trail camera’s attention. 

So, I thought I would give it a whirl. One Friday afternoon, I trekked into the middle of the woodland and found a tree that faced what looked like a bit of an animal highway through the bushes and rigged up the camera with all fingers crossed. In the interim, I actually couldn’t stop thinking about it. Tragic though some people may find it, I couldn’t wait for the next morning to come so I could go out again and collect it. I’ll admit, I wasn’t really holding out too much. I would have been happy that it lasted the night without running out of batteries. 

So it was with almost elation that I flicked through several captures of not one but four different types of animal.

This was the first video I saw. After that came a deer, then a badger and then, out of the darkness, a house cat! In the back of my mind, I’m thinking I probably won’t beat that so I had better just leave it there but the rest of me can barely contain myself to get back out there. I am not saying I am going to turn into some balaclava-wearing nutcase who hangs around in the woods after dark, but I can definitely see my next addiction coming along. To that end I’ve even set up an instagram account… (wilfredsnighttimecreatures)… to chart my discoveries. Who knows what I’ll find out there. 

The truth is, in a busy and sometimes bleak world, something like this is an incredibly therapeutic pastime. Even just being in the woods with nothing but the birdsong is a pleasure that seems to dissolve away the noise and pressure from the outside world. They say the natural world is a great healer and that is something I can certainly appreciate. The secret goings on of the forest add an extra excitement to that. Give me a follow on instagram to keep posted.   



Health in the UK – an updated reflection

I was speaking to an elderly patient last week, well into their 90s, who was frail, unwell and needed some attention. Throughout the conversation, they could not stop apologising for, in their words ‘wasting my time’ as they knew how busy we all were. The conversation left me quite emotional if I’m honest, not least because that very same day I lost count of the number of appointment requests we received from, for example, people who had woken up with a bit of a raspy throat, or who had been congested and coughing from a cold or chest infection for the last week. The contrast in perspective of what the role of the health service should be could not have been sharper.

The average number of times an adult saw their GP in 2015 was seven times a year. Twenty years prior to that it was Three times a year. Much of the increase is related to an increase in chronic disease with which GPs must contend. But it also seems that the threshold with which patients seek help from their doctors, even in the face of headlines about how overwhelmed the NHS is, has lowered. The average adult will get two or three colds a year (the number is higher for children at eight or even more) and at no time is that something a GP needs to see. Yet GP surgeries are inundated with people suffering from sinus infections, colds and chest infections, the vast majority of which are caused by viruses and which will get better eventually on their own. Crucially there is nothing a GP can do to treat these infections. Antibiotics do not work against viruses. The natural course of these infections tends to be an initial sore throat and/or fever followed by congestion, coughing and fatigue. Often people will say the cough has gone to their chest. It seems to be a common misconception that this is the time to go and see a GP whereas it simply means the virus is either a bronchitis, effecting an area a bit lower down in the respiratory tract or even that the congestion is beginning to loosen and the virus us on the road to recovery. Granted the viruses are bad at the moment. Having endured a bit of down time during the social distancing prompted by covid, our bodies are a little less resilient to them and so they are more severe and last a bit longer. Three weeks is not uncommon. That still makes no difference ultimately in how we manage them.

Flu is also causing problems for much the same reason. Flu is also a virus and the vast majority of cases require rest, fluids and will get better on their own. Severe flu can be more serious and so if you are breathless at rest, really drowsy or unable to get enough fluid on board to stay hydrated, then contact your GP. Otherwise, no it’s not nice, no you probably won’t get out of bed for a few days, yes you’ll have a high fever, yes you’ll feel achy and tired but you don’t need to automatically contact your GP and you certainly don’t need antibiotics.

If you are at all worried, your first step should be to look at the NHS website. If you are not sure having looked at that, your next port of call is the pharmacy. Only after that should you consider contacting the GP surgery.

Part of the demand issue at the moment has been the Strep A outbreak which has understandably caused some concern, particularly for parents of school age children. Of course if you are concerned that this may be effecting your child, of course contact your GP but please do apply some common sense. There are lots of viruses that cause similar symptoms but if they develop the characteristic rash and red tongue should you call the GP.

GPs are commonly faced with demands for antibiotics from patients and surveys have shown that a majority have felt pressured into prescribing them even when they know they will do no good.  Clearly it is inappropriate for patients to come in with such demands, but we as clinicians must take some of the blame. The truth is, in a busy hectic day (and they really are non-stop), sometimes the easy thing for a GP to do is to give someone an antibiotic. All that does is increase the number of people that come in for antibiotics the following year whilst adding to the already huge problem of antibiotic resistance – a calamity hiding in plain sight.

There are many things that need addressing in the NHS at the moment. Nurse to patient ratios on hospital wards have been unsafe for a long time. In the UK there are 2.8 doctors to every 1,000 patients compared with 3.7 per 1,000 in comparable EU nations. The population is ageing and the increase in prevalence of chronic issues such as diabetes, obesity, alcohol and substance abuse, heart disease and mental health mean that as people age, they do so with a high level of morbidity. In other words, people are less healthy. This necessitates a lot more GP and nursing time as they care for ever more complex patients as they spill over from hospitals and secondary care. One study showed that around 40% of all GP appointments are accounted for by just 10% of patients. This has doubled in the last 20 years.

Most of these people really do require that care but there is a proportion of patients that access health services entirely inappropriately and put extra strain on the system as a result.

As healthcare professionals we want to help people. But when it isn’t possible and moreover, when it starts to impact upon other people who are far more in need or our help – the person who is unwell with cancer, the person who’s been having symptoms preluding a heart attack, the person who is suicidal, the elderly in need of support and care – that is when it becomes more than a little frustrating from our side of things. When people start taking liberties with a health system that is on its knees, the system falls apart. Those who shout loudest are not always the ones who need help.

With that I wanted to end with a couple of suggestions. I won’t get involved in the political aspects. But there are two things that I think would make a huge difference to the pressures the service faces.  

At the moment, much of the focus is on more funding, more staff, more hospitals and greater infrastructure. While that is all important, it is only necessary because demand has gone up. If the demand was impossible to reduce any further then absolutely, focus everything on increasing supply. But of course demand is no way near that lower threshold.  

In the short term, reducing unnecessary utilization of the health service is something that could have a fairly immediate effect. Looking forwards, it is a case of empowering people to keep themselves healthier so that, even though the population is older, it is healthier and so requires less intensive input. It may seem simple and maybe even a little vague, but I have heard no better suggestion in the face of the ageing population.

As such, the following suggestions are the two key things I think we need to fight for in the face of the NHS crisis which deepens every year.

1 – Health and medicine as part of the school curriculum – while people need to know when it is not appropriate to access health care, it is at least as important for people to know when they should. There are lots of people out there who ignore health issues and do not get help when they need it. Education around health will also have invaluable longer-term benefits for a healthier and happier population.

2 – More aggressive action on the availability of food containing high levels of sugar and salt. Diabetes and heart disease along with obesity are chronic issues which are only getting worse. Shops lined with junk food are a feature only of the last few decades. Another example of the luxuries that we now take for granted but which have long been creating repercussions which affect us all, whether it be directly or indirectly.  

As we see yet another ‘winter crisis’, rather than wait for the next shake-up or the next cash injection from the powers that be, the best way to heal the NHS – perhaps the only way – is if we take some ownership of the problem ourselves rather than relying on someone else to heal it for us.


One Week


I don’t think I can be alone in thinking how much energy must be wasted by the numerous office buildings and shops lit up at night with no one in them. It’s a thought I’ve had many times over the years but, as soon as all the unnecessary illuminations are out of sight, the thought always recedes.

Perhaps partly as a result of that, I’ve had a fairly simple idea in the back of my mind for quite some time, written down on a scrap of paper hitherto ignored or put to one side. The idea is based on the fact that we, as humans, are actually capable of some quite impressive feats individually but when we get together are collectively capable of the extraordinary. Unfortunately, often this is driven not out of simple curiosity but out of necessity – the codebreakers at Bletchley Park during WW2 for example or the incredible collective effort that made the Dunkirk evacuations possible or more recently the rapid development of covid vaccines.

The collective ability to deploy such ingenuity and hard work is always available. It is simply hiding in plain sight, sometimes deployed elsewhere and other times not at all.

In January, as some of you may be aware, the first One Week event took place. It was designed to utilize some of this unspent community effort by giving it a focus (energy consumption) and some coordination.

Energy is something that is very topical at the moment and many people have no choice but to limit their usage as much as possible. But, thinking back to the office buildings, this is not the case across the board. As the idea grew, I knew there was certainly more I could be doing to bring my energy consumption down and of course many people are already making sure they turn lights off and are saving energy where they can. One Week, however, asked people to go above and beyond their usual in that endeavour.

While the general message for energy saving is quite widespread, it tends only to skim off the tip of an iceberg of potential savings. The idea behind going all out for one week is to make a significant impact all in one go.

For the last week, I have tried to lead by example. At home I have had the lights off most of the time. I have used appliances only when absolutely needed and when not in use everything was unplugged (a minor inconvenience, but just for one week!). It’s thought that around 10% of a household’s energy consumption is from appliances that are plugged in but not in use.

To go the extra mile, the television remained off for the whole week, which gave me a chance to do other things (candlelit dinners, board games, reading by torchlight). The overall feel was a nice change if I’m honest. And that’s part of the design. To provide a bit of a change, bring people together, all in the knowledge that others are doing their part too.

I also made the decision to have cold showers for the week which is not for everyone I know but actually I found this far less challenging than avoiding hot tea or coffee for those seven days – that was a real slog!

One of the most rewarding parts of the week was seeing how enthusiastic some of the schools that took part were. Of course, while a lot of energy can be saved in one go, a key side effect of the event is in raising awareness of our need to save energy and there is no better place to start than with the younger generation. 

At the GP surgery where I work, we managed to save a total of 172 kWh of energy compared to a normal week (a kWh is the amount of power needed to power a 1,000 watt appliance for an hour) – about 11% of the usual consumption and enough to boil 1,720 kettles – a good achievement I think.

I managed to save a further 20kWh from home. I have calculated that if all businesses in the UK saved 11% of their energy consumption for a week and all homes saved 20kWh power, it would save 907 million kWh of energy which is equivalent to 1.4 million barrels of oil.

The saving in just that one week therefore equates to

  • the CO2 emissions produced by 138,497petrol vehicles over a year
  • the CO2 emissions produced by 1.6 natural gas fired power plants
  • the greenhouse gas emissions avoided by 175 wind turbines over a year
  • the carbon sequestered by 10.6 million tree seedlings grown for 10 years.

Hopefully that shows that the small gains made by us as individuals can have a significant collective impact. Particularly if you consider that I’ve not even included the energy consumed by transport which accounts for 40% of the total UK figure. Not quite as easy to measure but, for one week, it’s just as easy to reduce.

One Week is a project that I have developed gradually in snatched moments of my own time. It’s been fun and at the same time quite eye opening. It gives people a chance, if embraced, to take some ownership of the problems we face rather than relying on answers from elsewhere and is also a good chance for us to perhaps readjust some of our perspectives on the elements of our lives that we progressively take for granted. Having been just another person, vaguely aware of climate issues and the ins and outs of energy beforehand, it has certainly had that effect on me.

And don’t forget, it can be fun and may even spawn some new habits. You don’t have to take a cold shower to make that difference. Everyone will have their own ways of saving but simply saying ‘I do that already anyway’ is not enough unless you are living completely off grid. It’s only for one week after all. One Week doesn’t always have to be about energy. It can be applied to any problem to which a simple collective solution is applicable. As the slogan goes, large numbers in small sacrifices for huge rewards. It’s a chance to recapture a bit of that Dunkirk spirit of old. So if there is anyone out there that took part, I’d love to hear from you via the ‘contact’ page on the website: Likewise, in order to make the next one even more successful, I would welcome all the suggestions, ideas, contacts and advice I can get.

Ready Player Two

This book has taken me a couple of years to pick up, not in small part due to my trepidation in light of the negative reviews. Ready Player One is one of my favourite books of all time and I desperately didn’t want it ruined by reading a shoddy sequel. Having read Ernest Cline’s appalling ‘Armada’, I was worried that this would be of a similar quality. Hence its long stay on my shelf, untouched. 

However, for whatever reason I went for it and I was massively relieved to find it was actually really good. I disagree with those who say it was terrible. I thoroughly enjoyed it all the way through. Back to the same geeky adventures from the first book. It’s not as groundbreaking of course as the first book but still, I don’t think it deserved the panning it received. 

If pushed to describe in just two words… comfort read.