There is considerable discourse about the UK PA project, so hoped it’d be helpful to distill info into 🧵 s.1: History of the PAs in the UK .2: Comparison of US vs UK PA courses .3: Breakdown of the PA Framework.4: Study of the PARA Content Map.5: Costs of employing PAs vs Drs.1/.

Any MRCP who isn’t having to be part of the @RCPhysicians for training should consider resigning. Prof Kar and others stood up for trainees and votes for MRCPs. This is how they’ve treated him. The College won’t improve, and will only see you as cash cows.

It has demonstrated few improvements, including targeting those who have pushed for the College to behave with integrity. Who does RCP represent now?. What is the College doing to regain respect or relevance with UK divides? Does it not care?. Is it just easier to be Global?.3/3.

I’ve highlighted negative words in 🔴, positive in 🟢. Neutrals not highlighted. Neg - 20.Pos - 14.Neutral - 9.3 Repeats - excluded (Ed, Support, Leadership). This is damning for the RCP, to have lost so much respect from its own Fellows.2/.

We should talk about @RCPhysicians and who they are. They had a Meet the President meeting with FRCPs (MRCP plebs weren’t invited), attended by only 46 FRCPs, who were invited to contribute to a word cloud about what they thought of the RCP.(Img passed on to me anonymously).1/

Take a reality check, @wesstreeting. You’re living off taxpayer money, and using it to replace gold standard healthcare with medically unqualified workers and unevidenced AI, you haven’t gained the public’s consent for this, and you’re using excuses to employ fewer doctors.

And this is in a job where he gets all expenses paid, a second home, etc etc . While doctors have less disposable income due to RPI-linked increasing exam fees, registration/portfolio/training/exam fees, travel, rent, indemnity etc. Who’s really being greedy and demanding, Wes?.

When @wesstreeting talks about how doctors are being unreasonable for asking their pay to be restored to 2008 levels, let’s take into account that over the time doctors had a ~36% pay cut, MPs gave themselves a ~39% pay rise.

Can’t wait for @wesstreeting to explain to the public how he refused to pay doctors fairly and sacked them, and then hired medically unqualified staff at even higher pay than doctors, and so now everyone has to put up with quacks practising medicine on them as NHS has no doctors.

And I don’t mean with just resident doctors. As a senior doctor, I have lost all faith in the kind of politician who affiliates with someone as utterly lacking in moral integrity, honesty, and insight as Dame Clare Gerada.

In aligning himself with Gerada, @wesstreeting has demonstrated that he’s affiliated with the exact ladder pullers who wrecked healthcare in the UK and continue to do so. He has lost all credibility with doctors, along with any remaining goodwill.

Need to mention that PAs have no formal Psychiatry medical training or PG training pathways, so this is the equivalent of letting a random person diagnose and label vulnerable people for life. This is absolutely appalling and people deserve better than this.

Interesting words from @wesstreeting but he pays Physician Associates (medically unqualified people with no ability to practice Medicine) more than he pays actual qualified doctors. Here is the reality of what Streeting delivers to the UK taxpayer

RT @implausibleblog: @wesstreeting Of the 55% turnout.90% voted to strike. 60% turnout in 2024 GE.33% voted for Labour. So if you do the ma….

Royal Colleges didn’t stand up for patient safety until they were dragged kicking and screaming. Even BMA was late to it. But those who did stand up for patients & doctors, at risk to themselves, were @AnaesUnited. Their legal team have been brilliant. Please support and donate.

What is the point of the Royal Colleges if they won’t uphold standards in Medicine, and instead endorse people practicing Medicine without pre-requisite training?. @RCPhysicians should be congratulated on their intention to voluntarily become irrelevant.

This is the kind of pharmacist we need. Someone who you know is dedicated to their craft, and improving their discipline specialist skills to be an asset, rather than try be some cut price jack of all trades. NHS needs to learn to value expertise & efficiency over flexibility.

RT @TomStocks1982: @wendyburn @Megsenmumdr @MHG1910 I know you wouldn’t, I don’t think anyone at any college would think that, but even wit….

Fundamentally, yes, likely a highly directly supervised role with strict national scope exists for PAs. NHS is such that there is likely a job for everyone. But is it a viable role in the NHS, and given funding issues, is that where we should be spending taxpayer money?.19/19.

I think this is an interesting paper, but I view the conclusions with caution. It’s telling that despite being better trained, US PA data only supports PAs under direct supervision. Difficult to extrapolate it to UK, given differences in education & supervision resources.18/

Timley: Mixed results. PAs in teams may represent better staffing. Cost-effective: Did not assess waste, but also cannot easily compare across health systems .Equitable: PA use risks increase in healthcare inequities .17/.