Kat W @kat_casablanca Twitter profile

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Kat W

@kat_casablanca

4 years

Just found my old MRCS notes, over 10y old now, but anatomy stays the same!

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Kat W

@kat_casablanca

2 years

@TheBlondeRN Try being in the UK and asking who the Prime Minister is. It changes every 5 minutes, who can keep up?

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Kat W

@kat_casablanca

11 months

I had a lovely 4th year med student in theatre today, and found out she was born in the year I started university. I do not know how to process this sudden awareness of my advancing age.

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Kat W

@kat_casablanca

5 years

My housemate is an oncologist, and for some reason I have started talking to her in immunotherapy terms for day-to-day objects "Are you taking out the recyclinib binumab for the binmanitib?"

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Kat W

@kat_casablanca

4 years

@memoirsoftlp @drphiliplee1 This is the best thing I've read all week. "Pushed the consultant in front of me to take the blow". Poetry should be written about this 😐🐦🥺😵🙌👩‍⚕️💥 🤯

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Kat W

@kat_casablanca

4 years

@cliffreid One of my fave stories is when I (neurosurgeon) was referred a "patient with clipped aneurysm that has bled" from ED. My response upon looking at the scan "I can't see anything apart from the bullet in the brain". GSW lower on a UK ED's differential than rebled clipped aneurysm!

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Kat W

@kat_casablanca

4 years

The questions the government are now pondering about coronavirus trends are mirroring my own reflections on life. - Am I past my peak? - Would I know my peak if I was in it? - If my peak has gone, will I get another one? - Should my peak really have been bigger?

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Kat W

@kat_casablanca

4 years

I've been meaning to do it for a while - here is a list of all the online neurosurgery teaching I know about this week. Please feel free to pass on, I'll send a new one out each week - if you know of any teaching/resources, tweet me to add.

weekly education (1).pdf

drive.google.com

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Kat W

@kat_casablanca

4 years

Interested in the UK neurosurgery consultant numbers and the number of trainees CCTing? Wish there was someone who helped the SBNS, SAC and BNTA find out? Well, you'll want the Workforce Planning Committee and this graph-full article then: @e1v1m1

UK neurosurgical workforce planning. What changes have occurred in the consultant body 2014–2018?

Introduction: The British Neurosurgery Trainee Association aimed to investigate the amount of trainees qualifying through the British national training scheme and the rate at which potential consul...

www.tandfonline.com

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Kat W

@kat_casablanca

4 years

Me, speaking to mother on the phone: "and that's it, nothing exciting in these coronavirus times. I just go to work then go home" Mother, absolutely apropos of nothing "you could have a baby. That would cheer me up" @BirdCalledPriya it never stops. Never. Stops.

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Kat W

@kat_casablanca

4 years

I told a referring ED reg over the phone that I'm a consultant and he started calling me ma'am. I have never felt so old. Or weirded out. Is this what the queen feels like?

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Kat W

@kat_casablanca

4 years

In my FRCS(NS) exam I was asked if I knew the name of a rule that was, in essence, common sense. I said "I don't know a formal term, but if someone can slap their name on something and take credit for eternity, they will", thus creating the Whitehouse Law of Eponymous Egoticism.

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Kat W

@kat_casablanca

2 years

Had a minibreak to Hay-on-Wye, and picked up these little first edition beauties!

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Kat W

@kat_casablanca

3 years

Losing a sense of smell/taste (thanks COVID) has really made me reflect on patients who have this after head injuries, pituitary surgery, or the elderly. It is a really odd experience that can impact on a lot of areas esp social acceptability 1/5

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Kat W

@kat_casablanca

3 years

The sun sets over a beautiful Liverpool at the end of a full @NANSIG1 Neurosurgery Careers Day. Thanks for inviting me to speak and see your fantastic student presentations and posters. Hope you all learned plenty too!

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Kat W

@kat_casablanca

3 years

The National Neurosurgery Finishing School is in full swing! There's some great teamwork going on.

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Kat W

@kat_casablanca

3 years

I've sneaked in some Welsh tartan to the Dundee SBNS 🤫 🤭

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Kat W

@kat_casablanca

5 years

Sadly, yesterday was my last day @NorthBristolNHS . It's been a great few years and I shall miss my whole neurosurgery family, far too numerous to mention individually. You are all wonderful and care so much. @young_andrea it was an honour to be there, please look after my boys!

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Kat W

@kat_casablanca

4 years

@Cromerty @CymraegDoctor He's gone too far this time.

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Kat W

@kat_casablanca

4 years

Neurosurgery handover this morning: "Patient fell over drunk celebrating VE day and sustained head injury" "Patient fell over drunk celebrating VE day and sustained head injury" "Patient fell over drunk celebrating VE day and sustained head injury" Be sensible, people!

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Kat W

@kat_casablanca

2 years

Thank you to all those who organised, presented at, or just came to Cardiff @The_SBNS . It was inspirational, educational, and most of all, great fun. I am looking forward to collaborations with friends old and new! Now I need to give my brain (and feet!) a rest...

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Kat W

@kat_casablanca

4 years

Sandra, one of T4 neurosurgery's ward receptionists is a crocheting machine and has made all these wonderful pumpkins to make reception look nice! Good on you Sandra!

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Kat W

@kat_casablanca

10 months

Starting up Day 2 of the Cranial Approaches Course in Bristol. Such great anatomical learning you can never get in "real life"!

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Kat W

@kat_casablanca

3 years

And, for 2021, the National Neurosurgery Finishing School is over! Now go - lead, manage, reflect with confidence! Thank you to everyone who taught and participated, it was great! @iyer03 @neilhop76 @drmanoshan @PaedNeurosurg @adampwilliams13 @ukneurodoc @EvelynBarkerNHS @1N3uro

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Kat W

@kat_casablanca

3 years

@RCSnews @RACSurgeons Having the title "Dr" means that everyone assumes you are a male if they do not know you - patients, other doctors and staff alike. I frequently see emails talking about female doctors where male pronouns are used by third parties, assuming it is a man. I find "Miss" empowering.

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Kat W

@kat_casablanca

1 year

Many thanks to @The_SBNS and @STGNeurosurgery for a fantastic SBNS! I didn't get many photos due to chatting and intensive learning, but here's one by dear @drzoejam pitchside at Twickenham. I look v excited considering I'm on enemy territory (🏴󠁧󠁢󠁷󠁬󠁳󠁿 Cymru am byth!)

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Kat W

@kat_casablanca

5 years

I'm really looking forward to my operating list tomorrow. Not just due to the usual enjoyment of using my skills to make people better, but also because it's the only place in the hospital with air conditioning!

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Kat W

@kat_casablanca

3 years

A lovely morning for twiglet-tree-spotting in London

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Kat W

@kat_casablanca

4 years

Looking forward to seeing my old boss on TV tonight in a show on awake craniotomies to try to preserve function as much as possible during resection of tumours. A great example of doctors/nurses/psychologists and patients all working together.

Wessex Neurological Centre

@CentreWessex

4 years

Tonight, 9pm @Channel4 - second episode of ‘Brain Surgeons: Between Life and Death’ looks at awake brain surgery - who’s tuning in? @BrainTumourSurg @figarist40 @UHSFT #brainsurgeonsbetweenlifeanddeath #teamWNC

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Kat W

@kat_casablanca

2 years

Popped to the picket line yesterday to make sure my colleagues were warm and ok. So many nurses have supported me over the years (inc this lot) and taught me so much, I wouldn't be where I am without them. They are the foundation of the NHS, and are not remunerated appropriately

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Kat W

@kat_casablanca

3 years

Does anyone else review for a scientific journal, and after spending hours correcting grammar, recommending more appropriate graphs/stats representation, critically analysing/rewriting the discussion, think that you should probably now be included in the authorship?

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Kat W

@kat_casablanca

4 years

Gave my work desk a wipe down today, couldn't believe the dust since I cleaned it when I started. Then realised I've been a UHW consultant for 4 months! Can't believe how time has flown (and how I really need to clean more often)!

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Kat W

@kat_casablanca

5 years

The National Neurosurgery Finishing School starts today! Bristol is nippy this morning but looking beautiful in the dawning light. #NNFS @BristolGrand

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Kat W

@kat_casablanca

4 years

Me to my partner "Yay! Today starts the first annual leave I have taken in 15 months ... "By the way, this weekend I will be watching over 14 hours of webinars. Please deliver tea to the office upstairs and don't use up the wifi" @WifeSurgeon it doesn't stop after residency

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Kat W

@kat_casablanca

3 years

Mr David Porter, Richard Edwards and Peter Whitfield have been guiding us through the world of medicolegal work, and how to remain professional and a trustworthy doctor. Many sobering thoughts and reflections - thank you so much all. @1N3uro @PaedNeurosurg

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Kat W

@kat_casablanca

4 years

@BrainTumourSurg is giving a talk for the @RCSEd on Surgery in Eloquent Areas, 3rd March. Registration details attached - something to look forward to (and I'm chairing!)

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Kat W

@kat_casablanca

4 years

My 7 year old niece this morning wanted to play "Executive Board Meeting". Many people were fired.

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Kat W

@kat_casablanca

5 years

Hello lovely neurosurgeons. Interested in my job? Well, here is the advert for it. Lots of operating, great boss, good experience of running a highly-efficient service. (Don't be too intimidated having to live up to the amazing skills of the person who had the job before 😅)

Paul Grundy

@BrainTumourSurg

5 years

A great job opportunity! Senior RCS fellow in neuro-oncology surgery Closing date November 10th. Post starts January. @RCSnews @The_SBNS @BNOSofficial

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Kat W

@kat_casablanca

1 year

Educational SHO trip out to welcome the newbies - where better for neurosurgeons to go than to watch Barbie?! Welcome to Cardiff!

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Kat W

@kat_casablanca

3 years

If a team could win the National Neurosurgery Finishing School annual commissioning bid based upon strongest pun, it would defo have been Strokémon.

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Kat W

@kat_casablanca

4 years

A year ago I removed a brain tumour then had an phone discussion with a colleague from a different specialty about the surgical nuances and ramifications of the diagnosis for treatment options. Imagine when my surprise when this was the sign off of documentation of that call:1/x

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Kat W

@kat_casablanca

9 months

The National Neurosurgery Finishing School is well under way! Difficult decisions, coaching and understanding personality - so many new/improved skills!

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Kat W

@kat_casablanca

3 years

A great option. I used once when my dear trainee inadvertently quite widely opened the sinus - remember also to use copious wash and drop the head to allow some gentle bleeding, preventing air going into the sinus and air embolism. A good FRCS(neurosurgery) question @e1v1m1

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Kat W

@kat_casablanca

3 years

Get submitting everyone, and you will get to visit us in Cardiff - croeso!

SBNS

@The_SBNS

3 years

The Abstract line for the SBNS spring meeting is now open! Closing date 1 December 2021. To submit an abstract and find out more about the meeting visit :

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Kat W

@kat_casablanca

2 years

Told one of my patients I liked her slippers and she got me a pair. 🤗😍 So sweet, now I just have to wait til December to wear them!

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Kat W

@kat_casablanca

4 years

@ProfBrianCox The Colleen Rooney School of Politics

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Kat W

@kat_casablanca

2 years

Neuro theatres are embracing the Christmas spirit in a truly multinational way. Nadolig Llawen i bawb!

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Kat W

@kat_casablanca

3 years

It's here, it's finally here! 🥳🤗👏

The 2021 WHO Classification of Tumors of the Central Nervous System: a summary

Abstract. The fifth edition of the WHO Classification of Tumors of the Central Nervous System (CNS), published in 2021, is the sixth version of the interna

academic.oup.com

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Kat W

@kat_casablanca

3 years

Thank you everyone who came to #BNRG2021 . It was a pleasure hosting you all and watching the talks/reading the posters. However the best bits are always the meals - this is where new collaborations are formed, ideas are hatched, and progress starts! Plus, y'know - food!

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Kat W

@kat_casablanca

2 years

A great day teaching cranial approaches in @CavMedEd . @AmrNeurosurgery did a stellar job of organising, and thanks to Liz Williams - worth her weight in gold, if not more! (See Amr's tweets for all the people to thank for their help/funding/resources) @mrsc2471

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Kat W

@kat_casablanca

4 years

@1Finches @memoirsoftlp @drphiliplee1 😍 I knew that if I asked, Twitter would come through. I can not express how happy I am right now

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Kat W

@kat_casablanca

5 years

#NNFS Mr Porter unravels the medicolegal world. Lessons for the day: document contemporaneously and legibly; be thorough; and communicate well with your patients.

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Kat W

@kat_casablanca

2 years

Cancer nurse specialists provide great support to patients and are fantastic liaisons between members of oncology MDTs. I have been blessed to work with fantastic individuals over the years esp my current team @CAVUHB , but also @UHSFT inc @POODIEGIRL , and @NorthBristolNHS . 🌟🌟🌟

BNOS

@BNOSofficial

2 years

Today is #NationalCancerCNSDay We celebrate the amazing work and care provided by our CNSs in neuro-oncology 🙏🥂

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Kat W

@kat_casablanca

6 years

If you suspect cauda equina syndrome, just do the scan now and keep the patient NBM. Don't waste time and effort chasing a neurosurgeon, just do it. Nice synopsis @saspist

Richard Edwards

@PaedNeurosurg

6 years

@saspist This is a great piece of work @saspist - well done!!!

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Kat W

@kat_casablanca

4 years

I can't believe this. Such a lovely, lovely guy who worked so hard. Condolences to his family and all those who worked with him. His loss shall be felt throughout the hospital.

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Kat W

@kat_casablanca

3 years

@drrob22 I can't believe it, he was such a brilliant bloke, this loss will ripple through all RGH. I've just been looking through old texts so will leave this sign off from him: "Don't work too hard, and remember; he who drinks Australian, thinks Australian. Good night."

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Kat W

@kat_casablanca

3 years

It's been so long since I've been able to go to Sicily to see family, I'm really appreciating pottering in the greenhouse, trying to tame the grapes and inhaling the aroma of the tomato plants, I can almost imagine I'm there... #GardenersWorld #10MinuteEscapism

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Kat W

@kat_casablanca

4 years

One of the SHOs have me this mug as a parting gift - look how cool it is! Or he is subtly hinting that I need to brush up on my anatomy 🤔... Either way, thanks and good luck in the future! Keep up the good work!

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Kat W

@kat_casablanca

4 years

I can't help but feel somewhat responsible for this coronavirus business. I had 2 holidays planned this year to China and Venice. Do I now add "holiday curse" to my long-term "Welsh rugby curse" status?

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Kat W

@kat_casablanca

5 years

Totally going to show my students this.

Dr Shashikiran Umakanth

@shashikiranu

5 years

Glasgow Coma Scale to assess students in a classroom. A practical scoring system for the "serious" medical teacher ;) #medtwitter #edutwitter #MedicalEducation #spoof

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Kat W

@kat_casablanca

4 years

A nice summary of COVID-19 in the context of neurosurgery

Neurosurgery Publications

@NeurosurgeryCNS

4 years

#NEUAdvanceAccess #COVID19 The Risk of COVID-19 Infection During Neurosurgical Procedures: A Review of Severe Acute Respiratory Distress Syndrome Coronavirus 2 Modes of Transmission & Proposed Neurosurgery-Specific Measures for Mitigation-Iorio-Morin et al

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Kat W

@kat_casablanca

4 years

Making vegan Welsh cakes adapted from a school recipe on a "bakestone" my grandfather had made out of a massive old rotating sawblade from a steel pipe manufacturer he used to work for in Newport. Mae Dydd Dewi Sant yn dod!

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Kat W

@kat_casablanca

5 years

What better person to talk to neurosurgeons about leadership in action than the SBNS President? Mr Neil Kitchen foresees the future...

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Kat W

@kat_casablanca

3 years

@DGlaucomflecken Whoa, another neurosurgeon blast? That came out of nowhere. Never said it wasn't true tho.

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Kat W

@kat_casablanca

4 years

@DrAdamLawton That's amazing. My nephew is 5 and has a billion toys. His class were told they could take one favourite thing into school. He took a stick, and sellotaped a small box on the bottom. No reason was given for this.

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Kat W

@kat_casablanca

6 years

This week I reached the peak of 15 years of medical/surgical training, when I walked into a room and a patient's hiccups, from which he had been suffering for 2 hours, stopped. I have never known someone so appreciative. A new skill, perhaps?

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Kat W

@kat_casablanca

9 months

And the National Neurosurgery Finishing School 2023 is done! I feel shattered yet rejuvenated, terrified yet excited. Thank you to our speakers for continuing to support, and to all the trainees for engaging - a pleasure working with you all. Good luck and have a nice rest!

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Kat W

@kat_casablanca

6 years

Mr Edwards helps demystify capacity, the consent process and Duty of Candour at the Neurosurgery Finishing School @e1v1m1

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Kat W

@kat_casablanca

3 years

So, when a post op/trauma patient has anosmia, it can vastly change a life (eg career as a chef, baking hobby) and may lead to social stigma, isolation, hygiene problems, poor dentition, and dangerous situations. Important for consent and understanding problems the elderly face.

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Kat W

@kat_casablanca

2 years

Our wonderful Speech and Language Therapist, Esyllt, who is instrumental in our awake surgery and helping us navigate the fine line between tumour removal and avoiding deficits. (Although I do think a lot of it is because she just loves chatting to people!) @EsylltGlynJones

Cardiff & Vale Adult Speech & Lang Therapy

@CAVUHB_SLT

2 years

Listen to @BBCRadioCymru tomorrow at 10am to hear about the role of the Speech and language Therapist in awake craniotomy @EsylltGlynJones shares her experiences & promotes the work of the neuro-oncology team @CV_UHB @RCSLTWales @RCSLTWales

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Kat W

@kat_casablanca

4 years

I am crazy proud of myself for arranging a lunch date with a colleague in Welsh today: "Dych chi'n mynd i fwyta cinio yn yr ysbyty yfory?" "Ydw" "Yn Y Gegin gyda fi?" #ShwmaeSumae @PhilippaGoogle @CAV_LenRichards @CV_UHB

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Kat W

@kat_casablanca

6 years

Sadly this is my last visit to beautiful Edinburgh in my role as @e1v1m1 BNTA exam rep. It's been an amazing experience and a great opportunity. For those who get their results soon, if you need to talk to someone, feel free to contact me. Check out

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Kat W

@kat_casablanca

3 years

But the eventual winners, due to some great team working and reflection, with beautiful patient pathways, are TIA!

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Kat W

@kat_casablanca

4 years

#MeAt20 doing my ERASMUS in Rome's Sacro Cuore Policlinico Gemelli. Feels like a lifetime ago!

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Kat W

@kat_casablanca

4 years

St David's Day preparations well underway Dydd Gwyl Dewi hapus!

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Kat W

@kat_casablanca

4 years

Seems like an awkward place to give birth...

M&M, MD, MPH

@mahad_minhas

4 years

Please don't ask women if they plan to have a baby during a job interview.

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Kat W

@kat_casablanca

4 years

My concern about @MattHancock saying that NHS workers waste PPE, even if it were true (it isn't), is that people will now try to conserve PPE by under-using it, thus risking infecting themselves; or not changing it between patients, risking infecting others. #thinkbeforeyouspeak

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Kat W

@kat_casablanca

4 years

Even now, I find it absolutely hilarious, but I did spell my surname and tell him I was a neurosurgeon. It shows how some subconsciously can't equate being female with being a surgeon, rather with waiting on tables. #WomenInSurgery

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Kat W

@kat_casablanca

4 years

#TipsForNewDocs Try to plan any big bills (eg insurance renewals, car tax etc) not to happen in July/August. If you want to pay your GMC bill/indemnity/future college membership fees annually, they will come out around this time of year and take up most of your pay packet!

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Kat W

@kat_casablanca

4 years

Updated for more teaching next week -with a journal club by the SBNS President Elect himself! Let me know if you know of any more and I'll add them in. @e1v1m1 @The_SBNS

Kat W

@kat_casablanca

4 years

I've been meaning to do it for a while - here is a list of all the online neurosurgery teaching I know about this week. Please feel free to pass on, I'll send a new one out each week - if you know of any teaching/resources, tweet me to add.

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Kat W

@kat_casablanca

4 years

In my various DIY/baking projects I have found myself thinking "I wish I had some surgical instruments to poke/dissect/manipulate this". Seek and ye shall find on the internet - wax carving instruments!

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Kat W

@kat_casablanca

9 months

A hugely insightful talk at the National Neurosurgery Finishing School by @chrischirp , covering communication of data, dealing with the media, and a little bit of rocket science thrown in! Thank you so much for talking to us.

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Kat W

@kat_casablanca

5 years

Classic British nightmare situation. On a train, my book is in my bag overhead, but I rather sit here in complete silence staring straight ahead than have to ask the person next to me to move... for 2 hours.

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Kat W

@kat_casablanca

4 years

@AmrNeurosurgery @drtintin99 @WisamSama @Carter65Michael @PaedNeurosurg @ukneurosurgeon @AlexAlamri @clairekarekezi @DrKatrin_Rabiei @sparklingcsf @Cmfundisi @RiversNeuroBoss @NeuroChirGlobal @chrisuff @BranGSmith @PascalJabbourMD @FaithCRobertson @MedCrisis @hormone_doc @CnpDr @sheffneurosurg @jayjayamohan @eacp @saspist @CrispinWigfield @WillGBSingleton @micauberti @RawVeganDoctor @AlexClinPsych @mollygill92 @BabaBrinkman @anilkseth @hubbardstephen @nickhaden @sanj_jeyaretna @mnowell100 @SayalParag @aswinchari @gsmckenna @hani_marcus @traumakhan @ShehanHett @Pituitary_Surg @drmilanmakwana @NeuroAlx @Samuel_Jeffery Operating withdrawal symptoms. Over-compensate with DIY.

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Kat W

@kat_casablanca

2 years

To those in the UK who don't do it already, you can claim back taxes on subscriptions since 2018 for: MPS and MDU GMC BMA SBNS RCSEng/Edin/Ire (couldn't see Glasgow, but please check) ASiT Altogether costs about £2375 per year, so do it! @The_SBNS

Claim tax relief for your job expenses

Claiming tax relief on expenses you have to pay for your work, like uniforms, tools, travel and working from home costs.

www.gov.uk

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Kat W

@kat_casablanca

3 years

A wonderful after-dinner speech for the National Neurosurgery Finishing School by the fantastic Neil Hopper @neilhop76 . Remember his words - treasure your ward staff - HCAs, porters, caterers - they are the ones who see/look after patients day in, day out!

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Kat W

@kat_casablanca

4 years

On International Women's Day, my greatest educational accomplishment when a trainee takes in one of my little tips, and reflects on it in their DOPS. So proud right now!

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Kat W

@kat_casablanca

5 years

The Aberdeen FRCS course is an intense reality-check for candidates, with great tips for how to get through the exam and maximise revision. However, in their spare time, the assessors like to enjoy themselves by answering questions like "how many people can fit in Pete's car?"

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Kat W

@kat_casablanca

5 years

I love the Welsh language, but sometimes I do feel like it's making it up...

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Kat W

@kat_casablanca

5 years

When your nephew asks to cuddle your brain stress ball whilst watching a film, you know you're indoctrinating successfully...

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Kat W

@kat_casablanca

3 years

Thanks to Nitin Patel for a fantastic talk about indemnity, insurance and what they mean in a medical career; at the National Neurosurgery Finishing School

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Kat W

@kat_casablanca

6 years

Thank you Andrea Young for a fantastic after-dinner speech at the Neurosurgery Finishing School. Inspirational. All optimism for the future at NBT! @e1v1m1 @NorthBristolNHS

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Kat W

@kat_casablanca

4 years

Just "attended" an Endocrinology Immunotherapy webinar instead of in person. Learned lots, it worked perfectly. Could it be that coronavirus is the solution to the carbon footprint created by medical conferences/education? @RickyFrazer1 Also got to do it in a onesie. Winner!

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Kat W

@kat_casablanca

3 years

@flowerindafield I fainted as a student watching varicose vein surgery. The consultant said "she'll never be a surgeon" as I connected with the ground. I'm a neurosurgeon now, so don't worry about it. My recommendation - eat before an op. I always have a stash of nuts in my office just in case.

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Kat W

@kat_casablanca

1 year

After a fantastic Manchester @BNOSofficial conference I popped into the beautiful John Rylands Library @TheJohnRylands . Absolutely incredible - I would be here so often if I lived in Manchester, got tonnes done!

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Kat W

@kat_casablanca

5 years

Best bunting ever for a neurosurgical female? Leaving decoration from @RuthieLB - brains, Kats and unicorns! Amazing!

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Kat W

@kat_casablanca

3 years

Let's get learning!

Caroline Hayhurst

@Pituitary_Surg

3 years

Good luck to all the students starting the MSc Neurosurgery tomorrow with @diplomamsc @AmrNeurosurgery @kat_casablanca @joseph_merola

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Kat W

@kat_casablanca

4 years

And to think, one month ago I didn't even know that Zoom existed...

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Kat W

@kat_casablanca

5 years

I'm going to stop using the term "elderly" for my patients. I think I'll use "life-experienced" instead.

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Kat W

@kat_casablanca

2 years

@drtintin99 @DoctorMayJay Many of mine are because the letter went to the wrong address or was late, transport issues, traffic, or patient is admitted to hospital for a completely different reason. Chasing up fines, checking which are "genuine" or not, and secretarial abuse will cost far more than £10.

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