Ronald MacDonald
@quackophage
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FY doc, BMA rep (DV, SJDC, JDC) • code plumber • musician/composer • SDR, Java, planes, x509, #g àidhlig MØRZM he/him GMC 7998867
IO57qt, Scotland
Joined October 2019
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Last Seen Profiles
Pinned Tweet
docs: there is a problem
management: you didn't tell us about this
docs: we're telling you about it now
management: no you're not
rinse and repeat
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For the record: I realise I am not an F1, nor (as it stands) do I have the requisite knowledge or experience at the moment to perform the same role as an F1.
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@toadmeister
@JuliaHB1
LOL guess what
It's Guantanamo
Literally. Guantanamo Bay. This twatwaffle is using pictures of GUANTANAMO BAY to illustrate how "empty" wards are in the UK.
You could not make this up
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PAs describing themselves as having undergone "medical school training", "holding registration ... from the Royal College of Physicians", selling their services online / on Facebook; we're OK with this?
Can't wait for "GMC-registered" to be added to the list.
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same energy
⛔️ Rebuttal
An infographic with misinformation is currently being shared on social media.
We corrected it for you 😉
🚨 MAPs, share away!
#PhysicianAssociate
#AnaesthesiaAssociate
#MAPs
#UMAPs
#MedicalAssociateProfessionals
#🐙
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12 mins to log into an NHS computer. A cheap, sufficiently sized SSD costs £20 these days. You’d literally make the money back within two or three logins.
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Can someone at
@NHSHighland
please explain why PAs are now supervising doctors at Raigmore Hospital? Is this a joke? Job advert posted 14/12/23.
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@NHSHighland
Sorry, but “posted in error” is for a typo. This is quite deliberately worded, for a PA to “clinically supervise” a doctor or nurse. I’m not satisfied with this explanation: This advert will have gone through multiple levels of approval. Try again.
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Hi
@DrColinM
:
Tbh I’m disheartened and disappointed, though not surprised, by your retweet of
@JimBethell
.
Tim and others have, for months, been trying to engage with the GMC in good faith.
The response is a wall of silence, bar legitimate safety concerns dismissed as “nasty”.
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@toadmeister
@JuliaHB1
You wouldn't generally be described as quick-witted, would you?
Had you gone back to the source, rather than crudely copying and pasting a couple of graphs from The Spectator, you might have heeded the attached "Note on beds data".
Course, it wouldn't fit your narrative 🤷
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In response to quoted tweet, a clinician in
@NHSGrampian
, who wishes to remain anonymous, has sent me the following screenshot from the NHS Grampian intranet.
There it is, in black and white.
"A newly qualified PA will be working at the equivalent level to a Foundation Doctor".
Slow clap,
@NHSGrampian
. You've done it again.
"Intern physician associate" role, ie first year post-qual. £38-46k for 37.5hrs (F1 = £31-35k in 🏴).
Teaching medical students and offering "learning opportunities" for "nursing staff and junior doctors".
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The GMC's minutes from their MAPs Programme Board meetings over the last twelve months make for some hair-raising reading.
"Is it time for us to lead, to convene, or to follow?" asks the GMC of itself.
Some things that particularly stand out:
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The
@RCObsGyn
would like to tell you about the benefits of PAs within Obs & Gyn.
PAs:
- Work at ST1-2 level
- Are a bit more expensive than an ST1-2 [sad face] but
- They don't rotate (unlike those pesky jnrs)
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I jest you not.
I was a bit grumpy after wasting 2.5hrs of my life on the phone to British Gas so - in one of my acts of "constructive bitterness" - invoiced them (£8.91 * 2.5) for my time.
Behold, to my surprise, in the post today:
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@nickeardleybbc
If only there was a way of running Parliament where they didn't have to all be physically present to listen, discuss and vote
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@toadmeister
@JuliaHB1
And I mean ... come on mate, get some up-to-date photos. EXIF suggests it's dated no later than 2012, doesn't even look like the UK and it's certainly not an ICU
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"when I first started as a PA, I had to see my GP [supervisor] after every patient ... now I only see them every two months or more" 🫠
hey
@rcgp
if you're serious about fixing this problem you've created, you better pull your thumb out. quick.
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Precisely three times an
#RCPEGM
has been held in the last 500 years.
Of course cannot watch any of it, even though it literally affects my future career and the careers of many thousands others.
@RCPhysicians
could have chosen transparency, but didn’t.
Noted.
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So wait, it only cost £1.8m to bring the RCoA to heel? 👀
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Not a great look,
@OReillyGem
.
Appreciate it’s upsetting to be told a package you’ve put together has some issues & easy for me to suggest not taking the criticism personally, but you’ve unwittingly waded straight into a very tense debate and lives are literally on the line.
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The GMC, blinded by arrogance, doesn't realise it's in its final throes. Losing the confidence of the entire profession as well as the public is a terminal event.
Anyone have details for NOK?
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Anyone else read that latest MPTS report re “overdose” of paracetamol?
Found not proven, but yet another name dragged through the mud.
Can
@gmcuk
explain why names of all involved are anonymised *except* the doctor in question, even when cases are thrown out?
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I note you’ve disabled replies.
FYs are similarly fully engaged, caring, arguably better trained, and equally able to “learn skills quickly”.
If you want to see the system improve, then support us to put an end to rotational training. Stop pulling up the ladder behind you.
@GeorgesUrology
@RCSnews
@IntuitiveSurg
Our Physician Associates are outstanding and an absolute asset to the dept . They are fully engaged ,caring,are permanent members of the team , well trained,learn skills quickly . The NHS would do well to embrace them as essential contributors to patient care .
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Emailed to all* Scottish GP practices this evening.
Next: all GP practices in the UK.
Based on the hard work of
@Melissa_S_Ryan
et al. in the BMA Safe Scope for MAPs document.
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@LouiseAllard18
Ah super, you've arrived. The rest of the dinosaurs are just on your first left; mind your step and enjoy your time. See you after FPR o'clock.
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@OmgItsTania
Just finished reading it. The whole thing. Absolute travesty of a hearing, utter joke. Are GMC actively trying to get rid of drs? 2.5 years of this person’s life upside down because they wanted a working computer. FFS.
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Every person in
@RCPhysicians
who was involved in wilfully misrepresenting this data needs to resign. Yesterday.
This is an affront to the profession.
Positions of those in senior leadership completely untenable.
Game over.
I have no words that fully express my thoughts on seeing this data from the
#RCPEGM
. Take a look yourself.
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Call me a cynic, but this is deliberate obfuscation: the phrase “to access general practice appointments” is not the same as “to access an appointment with a GP”, and NHSE know it.
The public demand access to GPs; Chris and NHSE are giving the public PAs instead.
I heard some frustration at the current focus on access to general practice. I completely agree that quality and continuity of care are important too. Patients tell us that being able to access general practice appointments when needed is currently their biggest concern. 19/x
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We thank them by giving them well over £10,000 more than what I'll make as an F1, with a few years' less training and zero student debt to boot. Spare us.
@DeanEggitt
@TheBMA
@BMA_GP
PA’s are valued members of our team. They are used much more in hospitals (as are anaesthetic associates and nurse practitioners). We should thank them - as highly skilled individuals.
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Hi
@LocumPA_Ltd
I'm wondering if you can help?
I understand this video features one of your directors discussing requesting ionising radiation.
Unfortunately
@uclh
couldn't provide a copy of your presentation; they didn't have it to hand.
Do you mind sending across a copy?
💥 PAs ordering ionising radiation
🗣️ A Lead PA bragging at a neurosurgical teaching event that he is allowed under "local policy"
📝According to the British Institute of Radiology this is not be permitted
⁉️
@uclh
- is this true?
@CareQualityComm
@CQCProf
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Not satisfied with totally ransacking medicine, the same folks are toddling off to advise "reforming" vetinary care now.
Couldn't make it up. This has to be satire.
Article from 06/03/24 in Vet Times:
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Me: requests emails between GMC and RCPAs.
GM(AP)C: no; this is vexatious.
???
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linkedin is a treasure trove of associate physician associates these days
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Wondering why the DHSC / Govt is pushing through regulation of MAPs via an SI, with no scrutiny, rather than through a Bill to be heard before Parliament?
It's because they're seeing the tide turn and know they have to act fast 👇
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Dear
@RCObsGyn
:
I get that you’re not a public authority etc., but given the current climate and the context of this request for information, it’s kind of in your interests to be up-front.
One-liner “we’re not giving you the information” just raises more eyebrows…
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Doctors must be allowed to cause Good Trouble.
The GMC’s neutering of a doctor for doing what is fundamentally the right thing speaks more of the GMC than it does the doctor.
Only folks bringing profession into disrepute are the GMC themselves.
BREAKING: Doctor Sarah Benn found guilty of professional misconduct after being imprisoned for upholding vital sign.
Full Story Here:
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"...trained against the medical model, similar to that of a GP, the only difference being that you cannot prescribe ... just like a GP or a junior doctor ..."
the only difference 🤡
tiktok:
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On the subject of sellouts, here's the cool £300,000 the DHSC spent on buying the RCOphth. Bargain.
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You are now over a week and a half late responding to an FOI, asking for minutes of your Financial Accountability Group.
2/2 While we’ve said we plan to set initial fees for PAs and AAs close to the current fee for the FPA voluntary register, this is subject to change.
PA/AA & doctor fees will differ as we take a range of factors into account when setting fees and align them with the cost of
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Hey
@DHSCgovuk
/
@RCPhysicians
, that's a lot of emails. What have you two lovebirds been getting up to? Not scheming anything, are you...?
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“regardless of what anyone has to say about PAs, I’m going to keep seeing undifferentiated patients regardless”
Alright pal 👍
#AskForADoctor
So I guess this weekend, I'll go into the ED and carry on assessing patients and supporting my colleagues. And reminding myself that they know my worth and are delighted to have me there.
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“The horse has bolted but don’t worry: we’re undertaking a public consultation as to whether to close the stable door”
[answers by fax only please, 12:30-13:00 every third Tuesday]
Today, we’ve launched our public consultation about the rules, standards and guidance needed to implement the regulation of physician associates (PAs) and anaesthesia associates (AAs).
Legislation has been passed for us to regulate PAs and AAs. We’re now consulting on proposals
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"meet your doctors*"
[*for the purposes of NHS LTWP, "doctors" includes PAs]
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Does Ulster University
@UlsterUniMed
have some super-duper course that allows you to - and I quote - "practice medicine" as a PA? Or just another typo?
Source:
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In light of their most recent paparazzi hit-piece, I'd like to jump on the bandwagon and take this opportunity to re-re-remind you of a story that the Sun perhaps, ahem, rather we forget they published just a couple of years ago.
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Came across OD in street earlier. Had Naloxone (thank you ScotGov) so no problem. But want to know how long it took the first member of public to stop and ask if I wanted help?
25.
25 minutes.
25 minutes. For someone to stop. On a busy Tuesday evening. In central Edinburgh.
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In no other respectable profession would those at the top fawn over any opportunity to virtue signal and tell us we should be paid less than we are worth.
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I'm assuming
@DrSarahClarke
just didn't find the time to read any of the multiple surveys undertaken by
@TheBMA
,
@TheDA_UK
and others.
Inane "silent majority" rhetoric has no place in this debate. Shutting down concerns with "unreported contexts" and "both sides" is unbecoming.
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Call me a cynic, but the GMC are now four days late responding to a key FOI (below):
Tomorrow, a crucial piece of legislation around healthcare will be scrutinised by MPs.
It will happen in a committee room, away from the main chambers, on a whisper.
If it passes, it will worsen the health of the UK population.
Did you know about it? No?
A thread 🧵
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10. The Risk Log also recognises that course providers could fall short of the GMC's standards ... but it's OK, because the course providers have been allowed to mark their own homework 🤡
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@julianhartley1
Let’s quit with the disingenuous “both sides” bollox. Your old mates at DHSC / Govt are the ones refusing to come to the table & I’m quite sure you could fix this with one phone call. Quit tweeting and pull your finger out. Relevant ⬇️
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Slow clap,
@NHSGrampian
. You've done it again.
"Intern physician associate" role, ie first year post-qual. £38-46k for 37.5hrs (F1 = £31-35k in 🏴).
Teaching medical students and offering "learning opportunities" for "nursing staff and junior doctors".
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@toadmeister
I originally replied to your story because the ** premise ** was incorrect. You misconstrued the data. It was some time later that I noted the image was of Gitmo.
You ** still ** have not heeded the explicit note in the data you cite:
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@Zaeem_Mahmood1
@Xeon4f145d96s1
@RupraRoshan
@goldstone_tony
@misspaulalondon
@TheBMA
careful mate, after two degrees she's a ... [checks notes] ... lawyer? ... I think?
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The
@gmcuk
state that doctors already had their chance to have their say re MAPs way back in 2017 (publishing results in 2019).
However I see only *one* tweet from then with a link to the consultation (screenshot below); does
@gmcuk
still think this is a representative sample?
GMC as the regulator: The Department of Health & Social Care held a public consultation on who should be the regulator of PAs and AAs. They decided in 2019 that it would be the GMC (2/8)
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"Social media is problematic and this is where most of the discussions are taking place, so we need to take a role in restoring calm without getting involved in back and forth in this space" - GMC, October 2023.
Not doing a great job then, eh
@GMCUK
?
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If you are working with trainees and “raise concerns” to their supervisor without speaking with the trainee yourself, you’re a coward.
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Absolutely explosive.
Read to the end. He has the receipts.
@RCPhysicians
better be drafting some answers.
Way back in 2015 when Twitter/X and social media was not as big a thing as it is now, back in 2015, there were lots of concerns how
#PAs
where being pushed forward by
@RCPhysicians
whilst junior doctor strikes were on the horizon 1/x
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.
@tweeter_anita
asking Jr Docs to call into BBC R4 re strikes “…or a registrar or senior medic having to cover for them” - again demonstrating that non-medics have no idea what a Jr Dr is - and that it includes regs.
High time to get rid of “Jr” Dr title.
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@NHSHighland
Or as Dr Johnston phrases far more elegantly than me:
@DrEilidhMaria
@Xeon4f145d96s1
@quackophage
Have a read of the full job description. This is only an error because they got caught out. Not a copy and paste error.
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8. Finally, the GMC commit the "low initial [Annual Registration Fees] for PAs and AAs".
Given they're on >1.3x my salary as an F1, I do wonder whether they could make the same commitment to me? Somehow I doubt it.
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Trying to submit an FOI to find out more about Rutherford Health plc and Somerset NHS FT. Not going well so far. Apparently my name is “made up”.
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@JimBethell
@drcolinm
To be fair, you would know all about being “plain nasty” wouldn’t you?
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Utter car crash.
@MathesonMichael
apparently "has heard" of issues regarding PAs, but "doesn't buy" that patients are potentially confused by them, states the GMC should regulate them regardless.
Doesn't seem to know what a "med reg bleep" is.
And it only gets worse...
UPDATE: We are disappointed that the Order that will make the GMC regulator for PAs/AAs in 🏴 passed through the Health Cttee at the
@ScotParl
this morning.
This was despite the concerns we have set out that the GMC is not the appropriate or right regulator for these roles.
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What confidence does it give anyone, that nearly 30 consultants can write to Healthcare “Improvement” Scotland
@online_his
and, after an “investigation” that merely asks management whether all is ok,
@online_his
just close the case?
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3. Indeed, they were specifically briefed on That Story during the summer, but have opted to keep an arm's length from the issue: "try recruit the Colleges to do a bit of Good Vibe PR instead". I wonder what the victim's family would say?
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"it's just a mistake" ... no: any PA referring to themselves as an "associate physician" knows exactly what's up
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I have it on good authority that the reason the RCoA were so sticky about standing up against AAs was precisely due to the promises they'd made; they couldn't be seen to pull the rug from underneath the same profession they'd been paid ££ by DHSC to support for so long...
@drmattuk
@RCPhysicians
This is going to be bigger than
@RCoANews
isn’t it…
Show me the money
@quackophage
!
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CQC "Mythbuster" in collaboration with Dr Parle.
"Physician associate is the only clinical profession in the UK which has a national skills and knowledge test."
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HELLO
@RCPHYSICIANS
! ANYONE HOME? HELLO?????
DO I NEED TO GO DOWN THERE WITH A BIG PLACARD? OUTSIDE YOUR WINDOW? WOULD YOU LIKE THAT?
I’M ON ANNUAL LEAVE & WANT AN EXCUSE TO VISIT LONDON
TTYL 😘😘😘
Hi
@RCPhysicians
.
I asked you for the below information quite a while ago and you’ve yet to acknowledge my request or indicate that you have any intention to reply.
You’re going through the motions, holding an EGM next week but doing feck-all to demonstrate any transparency.
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who would have thought
that we need an anonymous pizza
to do what the
@gmcuk
and
@CQCProf
won't do
and hold NHS trusts to account re MAPs?
I said I would send out an FOI to find out more information and would share when I heard back. (As apparently it’s my job to chase illegal prescriptions and not the CQC’s). Thank you
@JanetEastham
for investing this properly and thoroughly.
A short🧵.
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"Physician Associates could save the NHS".
Not a spoof, but a real blog post by the MSc PA Studies programme lead at Uni of Bolton last week:
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Contract signed between RCoA and DHSC published, now available here:
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Hi
@Telegraph
, you continue to publish these pieces, and nowhere in the byline or article body is it stated that the author is a director of Rutherford Health, contracted to undertake the testing. Failure to disclose conflicts of interest is dishonest to your readership
@IpsoNews
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This is - genuinely - a slide out of an ancient PowerPoint presented by a certain PA and medical leader, Jeannie Watkins, some seven years ago.
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He'd rather unmention/untag himself and mute the conversation in his notifications, than address any concerns.
Noted👍
It's the little things, innit.
Hi
@DrColinM
:
Tbh I’m disheartened and disappointed, though not surprised, by your retweet of
@JimBethell
.
Tim and others have, for months, been trying to engage with the GMC in good faith.
The response is a wall of silence, bar legitimate safety concerns dismissed as “nasty”.
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(Genuine) life goal to have some of my work mentioned in the esteemed organ that is
@PrivateEyeNews
(for good reasons rather than bad!)
Thanks to
@drphilhammond
for the mention re GMC investments in the latest issue, much appreciated
Not a subscriber? 👉
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Oh Lord
@JimBethell
.
This article is truly comedy gold.
Nobody dragged what little was left of your integrity through the gutter better than yourself.
"Secondly, where was the voice of the large majority of perfectly reasonable doctors? The briefings from the NHS are insipid. Leading doctors give dog whistle speeches that played into the shroud-waving safety narrative."
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Dear
@RCObsGyn
:
I get that you’re not a public authority etc., but given the current climate and the context of this request for information, it’s kind of in your interests to be up-front.
One-liner “we’re not giving you the information” just raises more eyebrows…
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Tonight will obvs be rephrasing and resubmitting request, but this is poor optics at best.
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@NHSGrampian
"As the PA develops within their given specialty they could progress to the equivalent level of a Specialty Register (sic)".
And that, folks, is enough internet for one day.
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@campbellclaret
@MattHancock
Baroness Harding: "You need to follow these instructions". Unless your name is Dominic Cummings?
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11. The GMC sees opposition from doctors as a "critical" risk to their plans for implementation.
But it's OK, all under control, apparently, they have a "communications strategy" [where?]
[also note who they've been liaising with ... time for some more FOIs, folks?]
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2. July 2023 minutes suggest the GMC were already very aware of issues being raised by doctors. No "silent majority" here.
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@allisonpearson
@TomChivers
@djbradshaw64
@NeilDotObrien
Nobody disputes you cite “actual official data”: the issue is that you then skew and misrepresent it. Therein lies the most (if you’ll excuse the pun) virile component in all of this - untruth coated in a veneer of pseudoscientific respectability.
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Copies of all correspondence / minutes / etc here:
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@D__Melb
I see no names other than than of the PA among the comments in public review. No CQC registration. Only one director on CH (the same PA). Something makes me think the prescribing isn't the only issue here...
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Hadn't even spotted this one, credit to
@Jo_McGinn
:
By "[teaching] other medical stuff", does
@RCObsGyn
mean that boring old "nitty gritty" stuff?
The
@RCObsGyn
would like to tell you about the benefits of PAs within Obs & Gyn.
PAs:
- Work at ST1-2 level
- Are a bit more expensive than an ST1-2 [sad face] but
- They don't rotate (unlike those pesky jnrs)
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@JimBethell
Do you have any undeclared interests? You sure seem to have wholeheartedly bought into a scheme you clearly know nothing about.
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I listen to these podcasts so you don't have to*
[*I actually don't, I dump all recordings into a tool that auto-transcribes them all and makes them searchable]
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SDEC PA "lead specialist providing specialist advice" lolz
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We don’t do this for fun.
We are fully cognisant of the potential for blowback and retaliation from our regulator: indeed, the GMC has form.
To that end, the very least we deserve is for our concerns to be heard and responded to in good faith.
Whose side are you on?
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