Carl Hennigan

And actually, it's potentially some people have been treated inappropriately because we may have over-treated them.

But the primary thing about being a doctor is to always think of that one thing.

And then you are the patient advocate to inform on the next decision.

Now, I got a tweet that was really interesting and I felt this was really important because this is where I go away from the guidance and the guidelines.

Because people were, it was a tweet which said, when do you ever feel confident as a doctor in your decision making?

And it really made me think about this issue.

And I felt actually it took me about 10 years in clinical practice and I started to feel more confident.

But there's always a patient every time I'm doing my urgent care where it makes me feel uncertain, not quite sure about the evidence is in place.

I'm not sure what the best course of action is.

But I think our job is always to consider how much benefit this person will get.

And I think that's where the values come in.

Now, where we failed is compared to our colleagues like in Germany is it's about capacity.

If we'd have had enough hospital beds here and enough ICUs, it wouldn't have been an ethical decision.

It would have been about a decision about evidence.

And so I think we need to get back to the core issues.

We shouldn't be talking about guidelines saying, actually, it's about decisions who we might treat.

We need to say, actually, we need a structure that says how many beds do we need going forward and how many ICU beds we do so we can make sure we treat those people who are likely to benefit and keep those who are not in the home setting.

So, look, this is the point where when I get into these discussions, I always default back to the original definition of evidence-based medicine.

And sorry, folks, as if it's boring, you've heard this before, but this is a beautiful moment to remind people that it's about the integration of the best available evidence

the patient values, which is what we've just heard, and it's about clinical experience and expertise.