In the news

Turkey told Russia to stop flying into their airspace on numerous occasions months ago 'or we'll retaliate'
They do, so they do!

At least Turkey have the balls to have a go and fuck them off unlike Northern Europe pussying about!

"Ooooh, look there's a Russian submarine off the coast of Scotland" "How long's that been there?"
"Fuck knows, I wouldn't worry about it"

Eek. Is it too late to leave NATO?

geez russia+trukey... #netflixandchill

"Ooooh, look there's a Russian submarine off the coast of Scotland" "How long's that been there?"
"Fuck knows, I wouldn't worry about it"

Meh. Faslane, Vladivostok... They're all pretty crowded.

And with no UK naval search aircraft, they can stay as long as they like...

I've seen records suggesting there are individual patients with 100's of A&E attendances in a year who seem to be using it as a hostel/accommodation and never does a CCG actually have enough info to query the £1000's of cost they are paying for or put them in the place they need to be.

The records may suggest that but the narrative is usually a lot more complicated and changes from person to person. There are a lot of people out there whose lives are incredibly chaotic. They have a complex collection of life issues, mental health issues and physical health issues that mean their needs are quite complicated to address. They often go through a rapid cycle of getting into a bad state, coming to the attention of the police or, occasionally, adult social care, being determined in need of some kind of medical care, taken to A&E, cleaned up/patched up/dried out/detoxed, discharged because A&E have no further remit and sent home and, if they're lucky, they might manage a brief bit of stability before it all starts again.

Even if you could design and set up a "place they need to be", there really is no way of ensuring that they will stay there. There's no legal grounds for detention and disengagement is the most common point at which the multitude of interventions that are attempted will fail. The individual isn't using A&E like a hostel but at the point that it beomes necessary to pick them up from whatever situation they've managed to get into, it's the most appropriate place to take them.

Also the patient confidentiality isn't an issue. There's a lot of panels, conferences, groups and the like who have been given a clear mandate to openly discuss and share information. They regularly review these cases and plan interventions and consider what options are available to the assorted agencies that are or can be involved with patients/clients like this. The one person not on board with the whole process is the patient themselves. If you can work out how to solve that part of the equation, you'll be heralded as a saviour by vast swathes of agencies and organisations who offer support to complex and chaotic people every day.

Oh wait, was that adult social care?
Another bit that's been devolved to the local government and axed?

Yet the Government have agreed to splurge an extra $18 billion on 138 F-35 Fighter Jets?!? WTF?

Is that why the entire countries getting all kind of cuts? I couldn't find any reasoning for the cut.

@Fox
meanwhile, some dudes are seen driving around the MCR ring road.

looks like putin will be having turkey for christmas...

#igotnuthin

Adult social care, like children's social care, has long been a part of local government. Given the similarity of the remit between the two then I can't see why that isn't the most appropriate place for them.

But the responsibility for these patients doesn't fall solely to adult social care. Groups that discuss cases will often comprise of adult social care, children's social care, adult safeguarding in the NHS, children's safeguarding in the NHS, police, mental health services, drug and alcohol treatment services, drug and alcohol charities that provide a local support service, mental health charities that offer a local support service, council housing services, housing and tenancy support services, domestic abuse services... The list continues.

One pilot is dead, shit is extremely real.

The Russian jet essentially cut a tiny corner on an invisible border, I know the Russians generally don't give many fucks about stepping on toes but I do not understand who thought that shooting this jet down was a good idea.

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Is there any indication that Turkey knew it was Russian? Turkey has shot down Syrians aircraft.

Yeah. I get it.
But it will be people with many hats on rather than many people with one hat on making decisions here.

Local govt is responsible for environmental health. Not much budget around for that.

I'm all for streamlining and making things efficient, and making data flow better and to the right departments to make decisions/do something. However, I don't think there are many people left to do anything.

Thus far Russia is being quite reserved. Calling it a "very serious incident."

George Galloway, on the other hand:

https://twitter.com/georgegalloway/status/669107799356514304

As someone who has spent a year working on one of these panels, it's many people, one hat. There is, very rarely, some double hat wearing but it's usually to cover an absence between related departments.

As for environmental health. Yes local authorities do that, but it's a pretty small part of their function as a whole. Children's social care is probably the largest part and that won't account for a full half of it. There's still a lot of people left and, despite the mounting pressures and demands, they're still acheiving a lot. Mind you, we need to avoid losing any more people and resources because there's pretty much no more redundancy left in the system.

I'm talking about contracting and information infrastructure supporting it where patient data is pseudonymised and the contracting mechanisms do not seem to allow patient pathways and interactions to be tracked over time by commissioners. Or if they are commissioners are not asking us any questions at all about frequent flyers or multiple admissions.

The rubbish we deal with is Barnet CCG saying patients registered with an Enfield GP between their referral for treatment and their admission to hospital so they don't have to pay for that admission.

Finland, Norway, Sweden, the Baltics.... all have Russian infringement on their sovereign territory on a regular basis. Annoying, but of no actual consequense.
Would have been nice if Turkey could have checked with them first before getting carried away with macho hubris.

See my point about disease earlier.

Ah well that is fucking shit then. More so because the blood and guts workers are sharing information so, in theory, it should be feasible to pull that path of interactions out of the shared data.

Well actually it's already been done for you on a handful of the worst cases in the form of a serious case review. All of the involved agencies will have submitted a chronology for that.

I'm unashamedly telling everyone I talk to this today #rep

I wouldn't Russian with that joke - they may find it offensive.

NATO should quit stalin

Putin thinks Turkey Moscow-er in fear before him.

Its Assad day for puns.