Dr Thomas Shanahan MRCEM
@tshanahan0584.bsky.social
ED Research Registrar (PGY8) at Royal Perth Hospital | Affiliate Researcher at Monash University | Major trauma & EM research. Husband🏳️🌈🇮🇪🇬🇧 views mine
Pinned
Really happy with outcome of ROPL application for U.K. EM training towards FACEM training.
TS1 complete, primary exam complete; 3 months TS2; half paediatrics requirement; major referral requirement for core ED; 6 months non-ED.
19 Aug I’ll hear if I got into training
TS1 complete, primary exam complete; 3 months TS2; half paediatrics requirement; major referral requirement for core ED; 6 months non-ED.
19 Aug I’ll hear if I got into training
Horrific scenes at Bondi beach. It has a special place in my heart as we stayed there over 13 years ago during our civil partnership.
My thoughts go out to my adopted country, the local community, Jewish people & all those at Bondi beach & 2 the emergency services, responding to the violence.
My thoughts go out to my adopted country, the local community, Jewish people & all those at Bondi beach & 2 the emergency services, responding to the violence.
December 14, 2025 at 2:57 PM
Horrific scenes at Bondi beach. It has a special place in my heart as we stayed there over 13 years ago during our civil partnership.
My thoughts go out to my adopted country, the local community, Jewish people & all those at Bondi beach & 2 the emergency services, responding to the violence.
My thoughts go out to my adopted country, the local community, Jewish people & all those at Bondi beach & 2 the emergency services, responding to the violence.
Reposted by Dr Thomas Shanahan MRCEM
Column: Tuesday’s surprisingly competitive special election in Tennessee, after President Trump won the district by 22 percentage points last year, shows that Republicans may be in trouble with their base for midterm elections.
Column | Surprisingly tough Tennessee election reveals House GOP has base problem
A hard-fought victory in once-safe Republican territory came as polls show conservative support on the wane for GOP congressional majorities.
www.washingtonpost.com
December 3, 2025 at 1:30 PM
Column: Tuesday’s surprisingly competitive special election in Tennessee, after President Trump won the district by 22 percentage points last year, shows that Republicans may be in trouble with their base for midterm elections.
Reposted by Dr Thomas Shanahan MRCEM
The Grauniad headline vastly exacerbated the slightly confused report by claiming "soaring demand" as the cause. This, as you say, distracts from the key actions that would fix the problem.
December 3, 2025 at 1:27 PM
The Grauniad headline vastly exacerbated the slightly confused report by claiming "soaring demand" as the cause. This, as you say, distracts from the key actions that would fix the problem.
Reposted by Dr Thomas Shanahan MRCEM
Media reporting (and parts of the RCN report) seem to conflate "increased demand for urgent care" with "increased pressures on hospitals".
In doing so - they're obscuring the drivers of the problem and leading readers towards ineffective solutions (i.e. more staff, more funding).
In doing so - they're obscuring the drivers of the problem and leading readers towards ineffective solutions (i.e. more staff, more funding).
December 3, 2025 at 12:50 PM
Media reporting (and parts of the RCN report) seem to conflate "increased demand for urgent care" with "increased pressures on hospitals".
In doing so - they're obscuring the drivers of the problem and leading readers towards ineffective solutions (i.e. more staff, more funding).
In doing so - they're obscuring the drivers of the problem and leading readers towards ineffective solutions (i.e. more staff, more funding).
Reposted by Dr Thomas Shanahan MRCEM
But it draws the wrong conclusions on workforce: worsening A&E performance has happened despite 30%+ increases in the number of nurses working in hospitals since 2019.
RCN implies these increases are insufficient due to "increased demand".
But, as we've seen, this is just incorrect!
RCN implies these increases are insufficient due to "increased demand".
But, as we've seen, this is just incorrect!
December 3, 2025 at 12:50 PM
But it draws the wrong conclusions on workforce: worsening A&E performance has happened despite 30%+ increases in the number of nurses working in hospitals since 2019.
RCN implies these increases are insufficient due to "increased demand".
But, as we've seen, this is just incorrect!
RCN implies these increases are insufficient due to "increased demand".
But, as we've seen, this is just incorrect!
Reposted by Dr Thomas Shanahan MRCEM
The full RCN report is mixed. It's reasonable to highlight high bed occupancy rates as a driver of A&E problems.
If there's nowhere to admit patients to, they're either stuck waiting for hours, receive (unsafe) corridor care, or are forced to leave before receiving treatment.
If there's nowhere to admit patients to, they're either stuck waiting for hours, receive (unsafe) corridor care, or are forced to leave before receiving treatment.
December 3, 2025 at 12:50 PM
The full RCN report is mixed. It's reasonable to highlight high bed occupancy rates as a driver of A&E problems.
If there's nowhere to admit patients to, they're either stuck waiting for hours, receive (unsafe) corridor care, or are forced to leave before receiving treatment.
If there's nowhere to admit patients to, they're either stuck waiting for hours, receive (unsafe) corridor care, or are forced to leave before receiving treatment.
Reposted by Dr Thomas Shanahan MRCEM
The data *in the report cited* is enough to disprove the hypothesis that poor performance is driven by increased demand. (See +3% attendances vs +8,033% in 12 hr waits)
The real cause of long waits in A&E is poor patient flow, driven by operational dysfunction in other parts of hospitals.
The real cause of long waits in A&E is poor patient flow, driven by operational dysfunction in other parts of hospitals.
December 3, 2025 at 12:50 PM
The data *in the report cited* is enough to disprove the hypothesis that poor performance is driven by increased demand. (See +3% attendances vs +8,033% in 12 hr waits)
The real cause of long waits in A&E is poor patient flow, driven by operational dysfunction in other parts of hospitals.
The real cause of long waits in A&E is poor patient flow, driven by operational dysfunction in other parts of hospitals.
Reposted by Dr Thomas Shanahan MRCEM
The poor outcomes in A&E are obvious to anyone who looks at the numbers or has simply been to an ED in the last few years.
But as @policyskeptic.bsky.social has repeatedly argued, incorrect diagnoses of the *drivers* of poor outcomes are obstacles to solutions which will improve performance.
But as @policyskeptic.bsky.social has repeatedly argued, incorrect diagnoses of the *drivers* of poor outcomes are obstacles to solutions which will improve performance.
December 3, 2025 at 12:50 PM
The poor outcomes in A&E are obvious to anyone who looks at the numbers or has simply been to an ED in the last few years.
But as @policyskeptic.bsky.social has repeatedly argued, incorrect diagnoses of the *drivers* of poor outcomes are obstacles to solutions which will improve performance.
But as @policyskeptic.bsky.social has repeatedly argued, incorrect diagnoses of the *drivers* of poor outcomes are obstacles to solutions which will improve performance.
Reposted by Dr Thomas Shanahan MRCEM
Misleading write-up - it's true that there is a crisis in A&E, but this is not because of "soaring demand".
The RCN report itself shows that A&E attendances are only 3% higher than in 2019, while 12+ hour waits are 8,033% higher.
www.theguardian.com/society/2025...
The RCN report itself shows that A&E attendances are only 3% higher than in 2019, while 12+ hour waits are 8,033% higher.
www.theguardian.com/society/2025...
Numbers leaving A&E without treatment triples in six years
Soaring demand has led to ‘shocking’ rise in untreated patients leaving NHS emergency departments in England, data shows
www.theguardian.com
December 3, 2025 at 12:50 PM
Misleading write-up - it's true that there is a crisis in A&E, but this is not because of "soaring demand".
The RCN report itself shows that A&E attendances are only 3% higher than in 2019, while 12+ hour waits are 8,033% higher.
www.theguardian.com/society/2025...
The RCN report itself shows that A&E attendances are only 3% higher than in 2019, while 12+ hour waits are 8,033% higher.
www.theguardian.com/society/2025...
Listening to the Aussie former players / commentators absolutely hammering England after the 1st innings. They sd know better - you cant judge until both teams have batted. Eng excellent bowling attack. Batting was at least at a clip.
November 21, 2025 at 9:53 AM
Listening to the Aussie former players / commentators absolutely hammering England after the 1st innings. They sd know better - you cant judge until both teams have batted. Eng excellent bowling attack. Batting was at least at a clip.
Reposted by Dr Thomas Shanahan MRCEM
"Record numbers of overseas-trained doctors are quitting the UK, leaving the NHS at risk of huge gaps in its workforce, with hostility towards migrants blamed for the exodus"
Slow clap to the anti-immigrant rhetoric
Slow clap to the anti-immigrant rhetoric
Overseas-trained doctors leaving the UK in record numbers
Medical bodies warn that hostility towards migrants is behind a 26% rise in departures last year that imperils NHS
www.theguardian.com
November 21, 2025 at 6:31 AM
"Record numbers of overseas-trained doctors are quitting the UK, leaving the NHS at risk of huge gaps in its workforce, with hostility towards migrants blamed for the exodus"
Slow clap to the anti-immigrant rhetoric
Slow clap to the anti-immigrant rhetoric
Really happy to find out today the below paper got accepted as meeting the FACEM research requirement!!! Another requirement ticked off before starting in February
www.sciencedirect.com/science/arti...
www.sciencedirect.com/science/arti...
External validation of the Dutch prediction model for prehospital triage of trauma patients in South West region of England, United Kingdom
This paper investigates the use of a major trauma prediction model in the UK setting. We demonstrate that application of this model could reduce the n…
www.sciencedirect.com
November 21, 2025 at 4:15 AM
Really happy to find out today the below paper got accepted as meeting the FACEM research requirement!!! Another requirement ticked off before starting in February
www.sciencedirect.com/science/arti...
www.sciencedirect.com/science/arti...
Reposted by Dr Thomas Shanahan MRCEM
New post just out:
"The Reality Trap"
On Reform's struggles running councils.
What it tells us about how they'd fare if they won a general elections. And about how broken our system of local government is.
(£/free trial)
open.substack.com/pub/samf/p/t...
"The Reality Trap"
On Reform's struggles running councils.
What it tells us about how they'd fare if they won a general elections. And about how broken our system of local government is.
(£/free trial)
open.substack.com/pub/samf/p/t...
The Reality Trap
Reform's struggles in local government
open.substack.com
November 16, 2025 at 9:06 AM
New post just out:
"The Reality Trap"
On Reform's struggles running councils.
What it tells us about how they'd fare if they won a general elections. And about how broken our system of local government is.
(£/free trial)
open.substack.com/pub/samf/p/t...
"The Reality Trap"
On Reform's struggles running councils.
What it tells us about how they'd fare if they won a general elections. And about how broken our system of local government is.
(£/free trial)
open.substack.com/pub/samf/p/t...
Reposted by Dr Thomas Shanahan MRCEM
The first report of the All-Party Parliamentary Group on Emergency Care has revealed the scale of corridor care in England, and the harrowing impact it has on patients.
The report, built on research compiled by RCEM through data, surveys and patient testimony, is here: rcem.ac.uk/press-rel...
The report, built on research compiled by RCEM through data, surveys and patient testimony, is here: rcem.ac.uk/press-rel...
November 10, 2025 at 7:30 AM
The first report of the All-Party Parliamentary Group on Emergency Care has revealed the scale of corridor care in England, and the harrowing impact it has on patients.
The report, built on research compiled by RCEM through data, surveys and patient testimony, is here: rcem.ac.uk/press-rel...
The report, built on research compiled by RCEM through data, surveys and patient testimony, is here: rcem.ac.uk/press-rel...
Reposted by Dr Thomas Shanahan MRCEM
November's EMJ podcast has dropped, featuring...
🐱Garfield the cat (guest appearance) & @drsarahedwards.bsky.social
🫀 Resuscitation manikins & diversity
🧠 Functional neurology
👶 Serious bacterial infection in infants
🚁 Sedation in HEMS
🍎 lnkd.in/ebTjEkSw
🎧 lnkd.in/ekZij7MD
🛜 lnkd.in/esHRsMBz
🐱Garfield the cat (guest appearance) & @drsarahedwards.bsky.social
🫀 Resuscitation manikins & diversity
🧠 Functional neurology
👶 Serious bacterial infection in infants
🚁 Sedation in HEMS
🍎 lnkd.in/ebTjEkSw
🎧 lnkd.in/ekZij7MD
🛜 lnkd.in/esHRsMBz
November 5, 2025 at 12:10 PM
November's EMJ podcast has dropped, featuring...
🐱Garfield the cat (guest appearance) & @drsarahedwards.bsky.social
🫀 Resuscitation manikins & diversity
🧠 Functional neurology
👶 Serious bacterial infection in infants
🚁 Sedation in HEMS
🍎 lnkd.in/ebTjEkSw
🎧 lnkd.in/ekZij7MD
🛜 lnkd.in/esHRsMBz
🐱Garfield the cat (guest appearance) & @drsarahedwards.bsky.social
🫀 Resuscitation manikins & diversity
🧠 Functional neurology
👶 Serious bacterial infection in infants
🚁 Sedation in HEMS
🍎 lnkd.in/ebTjEkSw
🎧 lnkd.in/ekZij7MD
🛜 lnkd.in/esHRsMBz
Great opportunity for a research special skills #ED registrar job at Southern Adelaide Local Health Network - Flinders.
There is a great research team in SA and lots of efforts to develop research opportunities for #ACEM trainees.
jobs.acem.org.au/job/3106/eme...
There is a great research team in SA and lots of efforts to develop research opportunities for #ACEM trainees.
jobs.acem.org.au/job/3106/eme...
Emergency Medicine Special Skills Registrar Positions - ACEM Training Year 2026 (Flinders Medical Centre Emergency Department, Flinders Drive, Bedford Park SA, Australia)
Southern Adelaide Local Health Network – Flinders Medical Centre – Emergency Medicine
Total Indicative Remuneration Package: $106,225 - $172,348 MDP2 (pro rata) | Full Time, Contract in-line with SMOE...
jobs.acem.org.au
November 5, 2025 at 11:38 AM
Great opportunity for a research special skills #ED registrar job at Southern Adelaide Local Health Network - Flinders.
There is a great research team in SA and lots of efforts to develop research opportunities for #ACEM trainees.
jobs.acem.org.au/job/3106/eme...
There is a great research team in SA and lots of efforts to develop research opportunities for #ACEM trainees.
jobs.acem.org.au/job/3106/eme...
Reposted by Dr Thomas Shanahan MRCEM
Dean of the Royal College of Emergency Medicine Professor Simon Carley responds to the first phase of the Medical Training Review into postgraduate training of newly qualified medics, published by NHS England last week: rcem.ac.uk/press-releas...
RCEM responds to NHSE’s Medical Training Review - RCEM
Tuesday, 28 October 2025 - Dean of the Royal College of Emergency Medicine Professor Simon Carley responds to the first phase of the Medical Training Review (MTR) into postgraduate training of newly q...
rcem.ac.uk
October 28, 2025 at 10:27 AM
Dean of the Royal College of Emergency Medicine Professor Simon Carley responds to the first phase of the Medical Training Review into postgraduate training of newly qualified medics, published by NHS England last week: rcem.ac.uk/press-releas...
Reposted by Dr Thomas Shanahan MRCEM
A plan which outlines NHS England’s priorities for the next 3 years ‘offers no meaningful roadmap’ to reduce dangerous long waits in Emergency Departments.
Our response to NHS England’s Medium Term Planning Framework 2026/27-2028/29: rcem.ac.uk/press-releas...
Our response to NHS England’s Medium Term Planning Framework 2026/27-2028/29: rcem.ac.uk/press-releas...
NHSE’s three-year healthcare plan ‘offers no meaningful roadmap’ to tackle long waits in EDs - RCEM
Tuesday, 28 October 2025 - A plan which outlines NHS England’s priorities for the next three years 'offers no meaningful roadmap’ to reduce dangerous long waits in Emergency Departments.
rcem.ac.uk
October 28, 2025 at 9:48 AM
A plan which outlines NHS England’s priorities for the next 3 years ‘offers no meaningful roadmap’ to reduce dangerous long waits in Emergency Departments.
Our response to NHS England’s Medium Term Planning Framework 2026/27-2028/29: rcem.ac.uk/press-releas...
Our response to NHS England’s Medium Term Planning Framework 2026/27-2028/29: rcem.ac.uk/press-releas...
My poster at the ANZ Trauma Society Trauma Conference in Wellington. Great few days learning about cutting edge trauma research and practice. Enjoyed catching up with colleagues, meeting up with the trauma in older people community of practice and thinking about future collaborations.
#ANZTS25
#ANZTS25
October 23, 2025 at 10:23 PM
My poster at the ANZ Trauma Society Trauma Conference in Wellington. Great few days learning about cutting edge trauma research and practice. Enjoyed catching up with colleagues, meeting up with the trauma in older people community of practice and thinking about future collaborations.
#ANZTS25
#ANZTS25
Reposted by Dr Thomas Shanahan MRCEM
"We have a debt crisis so I've joined the party that was in power for 14 years and under whom debt massively grew."
"Commentator of the Year"
"Commentator of the Year"
September 28, 2025 at 8:41 AM
"We have a debt crisis so I've joined the party that was in power for 14 years and under whom debt massively grew."
"Commentator of the Year"
"Commentator of the Year"
Reposted by Dr Thomas Shanahan MRCEM
I do think this has been a week in which new levels of 'why don't senior Labour politicians understand we can ALL hear them' have been reached. Why would Andy Burnham do a 'I'm gonna hike taxes on London and the south, you're all rich!' Why would Steve Reed use 'regional politician' as a putdown?
Talking Starmer vs Burnham, Liberal Democrat conference and all that on this week's FT Political Fix podcast:
Does Starmer have a northern problem?
A look-ahead to the Labour party conference in Liverpool
www.ft.com
September 26, 2025 at 2:21 PM
I do think this has been a week in which new levels of 'why don't senior Labour politicians understand we can ALL hear them' have been reached. Why would Andy Burnham do a 'I'm gonna hike taxes on London and the south, you're all rich!' Why would Steve Reed use 'regional politician' as a putdown?
Reposted by Dr Thomas Shanahan MRCEM
New paper out in @age-and-ageing.bsky.social: Maintaining independence at home after a fall: a process evaluation of the MAINTAIN multicomponent intervention for people living with dementia. Read it here: academic.oup.com/ageing/artic...
Maintaining independence at home after a fall: a process evaluation of the MAINTAIN multicomponent intervention for people living with dementia
AbstractBackground. People with dementia who have a fall can experience both physical and psychological effects, often leading to diminished independence.
academic.oup.com
September 26, 2025 at 4:24 AM
New paper out in @age-and-ageing.bsky.social: Maintaining independence at home after a fall: a process evaluation of the MAINTAIN multicomponent intervention for people living with dementia. Read it here: academic.oup.com/ageing/artic...
Happy to have my TS2 rotations confirmed for next year - 9 months MMC Clayton ED and 3 months Casey anaesthetics. Now need to just find a place to live.
September 22, 2025 at 9:14 AM
Happy to have my TS2 rotations confirmed for next year - 9 months MMC Clayton ED and 3 months Casey anaesthetics. Now need to just find a place to live.
Reposted by Dr Thomas Shanahan MRCEM
Reposted by Dr Thomas Shanahan MRCEM
What Factors Could Create a More Comfortable Waiting Experience for Patients on Emergency Department Ramps? A Scoping Review - Binnie - 2025 - Emergency Medicine Australasia - Wiley Online Library onlinelibrary.wiley.com/doi/abs/10.1...
<em>Emergency Medicine Australasia</em> | ACEM Journal | Wiley Online Library
Ambulance ramping is the situation where patients who arrive by ambulance are forced to queue for access to an emergency department (ED) cubicle. Despite efforts to address the problem of ambulance r...
onlinelibrary.wiley.com
September 1, 2025 at 8:01 PM
What Factors Could Create a More Comfortable Waiting Experience for Patients on Emergency Department Ramps? A Scoping Review - Binnie - 2025 - Emergency Medicine Australasia - Wiley Online Library onlinelibrary.wiley.com/doi/abs/10.1...