I thought I might share my predictions for the NHS. What NHS, do I hear? Quite right, the whole thing is going bonkers. The process by which everything cascades down to somebody with an increasingly narrow range of skills will probably mean that my cat will be learning to do hernias soon. But the collapse could come earlier than anticipated, as mandatory and ‘expected’ training courses combine with appraisal / reaccreditation / revalidation, and any time left for patients finally falls by the wayside.