In a hospital near you, someone is trying to use a computer with a missing 'm' key and no space bar.

The WiFi is down, and the Trust has recently moved to electronic prescribing, so there is no alternative but to persevere.

Productivity benefits from the tools to do the work.

'doctor as outsider' - why is 'MAPs' listed in the examples section?

The GMC are keen to reassure us associates won't be treated as doctor substitutes but their own commissioned research has them bizarrely included as such.

They're only adding to the confusion.

The way this PA views their entitlement to clinical roles is v interesting.

Imagine an F2 going 'I'm motivated I want to do advice & guidance, I feel deflated, why won't they let me'?

Ofc mgmt should reply to emails, but when drs struggle to get basic training opportunities...

🚨NEWS RELEASE 🚨

📰👀🏴󠁧󠁢󠁳󠁣󠁴󠁿🩺

An FOI request from BMA Scotland to Scotland’s health boards has revealed a total of 1076 whole time equivalent (WTE) vacancies, compared to 439 reported by official figures.

👀🧵👇 for more details on these deeply concerning figures
1/4

“Does shortage of GPs matter?”
Via The British Journal of General Practice

Summary?
It does when it comes to life expectancy

In the same world?
NHS England Workforce, Training and Education replacing GPs with PAs

Aided by? GP colleagues in senior leadership roles

Ignoring science, governed by hubris

Stop this

bjgp.org/content/early/…

In 2015, Charlie Massey was the Director General at the DHSC.

At that time, GMC council papers made clear that they understood unnamed “others” wanted the PA role to be dramatically expanded in order to substitute “medical roles” (I.e. doctors)

Who were those “others”?

PHEM training was rightly standardised for quality & safety reasons.

It had the effect of narrowing the drs who are able to carry out this work, it's so specialist.

It seems crazy & undermines the point of training to depart from standards of care as a doctor led service.

RIP Stryer. His Biochemistry book (my edition was green) got me through a lot of essays in my first year of medical school.

Flex Maidstone and Tunbridge Wells Hospitals 💙 People on here get very reactionary when ACPs are talked about in the same breath as PAs, but this is why.

Both are being used to actively replace Doctors, with (false) equivalency being touted as an explanation.

ACPs of twitter- do you get it now?

If the consultant surgeon was unaware, what’s the odds on the patient knowing and giving informed consent to the procedure?

Patients have the right to make informed decisions, if they didn’t know the anaesthetist was replaced by an AA, they were not informed when they consented.

Insulting to GPs as true generalists.

Overconfidence is a value?

'They were assessed to be mid-level practitioners approximating to nurse practitioner or generalist doctor. Valued features were generalism, medical background, confidence differential diagnosis and communication'

Askforadoctor This is inherently flawed. Without a broad knowledge base of 1st principles & an understanding of the range of possible diagnoses (mild/severe/common/rare), this can’t be applied in a meaningful way in practice. Therefore, it is unsafe for PAs to assess undifferentiated pathology

NHS England tried to ‘halt new registration for secondary care staff’ for Practitioner Health, whilst ‘undertaking a review’ of staff support

They attempted to halt a project, in order to review it

Why not do the same with the MAP project?

Vital for patient safety to do so

Smoking has real harms.

As does alcohol.

Drugs like cannabis are banned despite being less harmful than both.

There is a lot of inconsistency in the way we approach regulation.

So much latitude given for alcohol despite its harms.

'—as clinical NHS work is so stressful that it becomes intolerable—then that is the problem that needs to be tackled. Adding more, less well qualified staff to do the most difficult jobs may make doctors’ stress worse, as they take responsibility for others’ decisions.'

💯

Official GMC council meetings 2015

Makes it crystal clear the intention of regulation isn't safety, but to allow them to act as 'medical role substitutes' up to ST3 level

The GMCs position as a regulator is untenable

Credit: @medicalmodelwithabriochebun

Prof Colin R Melville

Today we have written to the Chief Executive of NHS England requesting a pause to the further expansion of MAPs across the NHS while significant patient safety concerns persist.

Absolutely love to see this from my new TPD

I find it insulting & degrading the health secretary tries to capitalise on having to reverse a decision her own party forced with budget cuts.

Don't you dare take credit for preserving all the good NHS Practitioner Health has done.

It is offensive for you to do so.

Don't you dare.

For anyone who missed this...

The SAS Doctor pay dispute is not over.

Journalists, the term is 'SAS doctors'.

The fact that you have to explain it is an opportunity to explain it, not to use something else.