Ali Esfandiari
@AlirezaEsfa
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- ST7 in Trauma & Orthopaedics (Mersey) - BMA rJDC Deputy Chair - DoctorsVote
Liverpool
Joined June 2011
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Pinned Tweet
All we're asking for is doctors to start on £20 an hour
Junior doctors in Merseyside are taking part in the longest strike in the history of the NHS, as they walk out for six days in the ongoing dispute over pay and conditions.
Orthopaedic surgeon
@AlirezaEsfa
is on the picket line outside the Royal Liverpool University Hospital.
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I'm working 24 hours on call tomorrow as the trauma and orthopaedic registrar on call. Operating on broken hips and ankles. On a bank holiday. For £30 an hour.
These people don't know what value for money they're getting out of us.
Strike Hard!
@Warrenphotog
They are trainees. Wasting our money and their own time. We need doctors who are willing to serve patients and not activist students.
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I'm an orthopaedic surgeon. Patients with hip fractures are some of the frailest in hospital, often with many medical comorbidities.
To have a PA lead their medical care is absurd! This should be a consultant driven service.
How can this be justified
@gloshospitals
?
PAs are being paid more than doctors to supervise and teach doctors while eventually leading ward rounds.
This job offer MUST be withdrawn.
Doctors, see how your roles are undervalued. You are slowly being replaced.
STRIKE
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PAs in Surgery:
❌ No PA operating lists
❌ Not to act as first assistants
❌ Never taking referrals
✅ Preparing discharge summaries
✅ Documenting ward rounds
Read the full scope document on the BMA website
"Patients must know who is treating them and the skills and abilities that clinician has."
Today, we have published new guidance on the scope of responsibilities for Medical Associate Professionals (MAPs).
Read more here:
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“I would just say that the nurses and the consultants have come to an agreement”
Misinformation from the BBC's
@peter_levy
brilliantly shut down by
@talthegooner
Nurses in dispute.
Consultants in dispute.
Doctors in dispute.
Time to report the facts, not propaganda
@Ofcom
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Suspected breast cancers being assessed by Physician Associates.
Undoing advances in women's healthcare that we've strived so hard for.
There is nothing "routine and straight forward" about a woman with a breast lump!
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@itvpeston
@VictoriaAtkins
@ITV
I've reflected, and feel we need to extend our mandate for strike action. The only language this government seems to understand is industrial action.
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@bbcquestiontime
Waiting lists have almost quadrupled since 2008. 7 million people on the lists BEFORE strikes started.
Doctors are not to blame for this one, no matter how you try and spin it.
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Strong turnout of doctors outside
@LivHospitals
today fighting for
#PayRestoration
Public support as strong as ever. Time to come to the negotiating table
@VictoriaAtkins
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70% of surgeons feel that PAs are negatively impacting their training.
The assistants are not assisting.
And yet the government is planning to quadruple their number across the NHS. If we want to guarantee that future consultants will be as capable as the ones we have today,
📢 New
#ASiT
Report on Physician Associate Impact on Surgical Training and Patient Care 🏥👩⚕️
🔍 Largest ever ASiT survey: 1,978 doctors across all surgical specialties in the UK.
🤝 Focus: Physician Associates (PAs) impact on surgical training and patient care
📈 73.8% worked
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"The NHS belongs to us all, it does not just belong to the junior doctors committee"
We don't own the NHS, but we do represent half the medical workforce. 98% of which voted to go on strike (again)
The NHS cannot function while it's leaking doctors!
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Key take-homes from the GMC Workplace Survey 🧵
18% of doctors plan on leaving the profession THIS year. It was 11% the year before.
66% say they're leaving for better pay.
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"What is happening now, is they've gone under-regulated for so long... they're given jobs which literally replaces the jobs that a doctor would do"
Worth a listen to the full
@TheNewsAgents
episode for a great interview with
@doctor_oxford
sharing her concerns about PAs.
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What exactly does the GMC mean when they say they're going to regulate PAs and AAs?
❌ Won't set scope
❌ Won't define titles
❌ Won't set supervision standards
✅ Will give them false validation
To be clear - the below message is incorrect and constitutes deliberate misinformation - I did not say Consultant Physician Associates are planned - and indeed it would not be for the regulator to make such a decision.
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These should be the Royal College of Surgeons' next priorities
Vote for your DV candidates if you agree
⭐️ Surgeon led care
⭐️ No PAs in theatre
⭐️ Reduce rotations
⭐️ Protected firm based lists
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@RCoANews
I'm from the BMA, we support 0:1
Not while there are thousands of willing doctors being denied entry into anaesthetic training programmes.
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Why is this PA in theatre while the core surgical trainee is writing discharge summaries?
The PA project has gone too far, time to reign it
Ortho PA:
‘You’ll notice this looks a lot like what a reg or fellow would do, and it is, however I’m not taking anything from the fellows or registrars’
…What about the reg or fellow that could be doing your job instead?
❌ Make it make sense ❌
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@goldstone_tony
@_VivekTrivedi
@RobLaurensonD4P
@Doctors_Vote
@TheBMA
@BMA_JuniorDocs
@NHSMillion
@trentconsultant
@ERunswickBMA
@DrPhilBanfield
Newly qualified PA earning more than an ST8 doctor (with >10 years experience). How did we let it come to this?
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69% of PAs manage emergency conditions.
Strokes, PEs, Chest Pain, Trauma.
If only the British public knew what is becoming of their health service.
Source:
@Dr_Done_
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Fantastic turnout of
@BMA_JuniorDocs
at the Royal Liverpool Hospital picket line today ✊
Strikes have cost the government over £1 billion - it would have been cheaper to restore our pay!
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So the number of orthopaedic surgeons is falling, with a third planning on retiring in the next four years.
And yet each year we're turning away hundreds of appointable trainees?
Whilst T&O waiting lists the longest of all...
Am I missing something?
@BritOrthopaedic
@RCSnews
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@pulsetoday
Associate Specialist - 5 years medical school + 10 years as a doctor
Physician Associate - 2 year basic overview of the human body
How are patients supposed to know the difference with such similar names?
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@JimBethell
It's not snobbery to expect sick people to be seen by doctors. This experiment to infiltrate the NHS with undertrained alternatives is dangerous and we won't stand for it.
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@doctor_oxford
@TheDA_UK
@trishgreenhalgh
@pwhitakerwriter
@parthaskar
@TheBMA
@Doctors_Vote
Patients don't even realise they're not being reviewed by doctors
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Meanwhile MP pay over the last 10 years be like 📈📈📈
BREAKING: Prime Minister Rishi Sunak has hinted he will ignore recommendations for public sector pay rises, saying workers "need to recognise the economic context we are in"
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@VictoriaAtkins
@UKParliament
Present a credible deal, and we'll put it to members. The ball is in your court.
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@UHP_NHS
@DrMinaIp
@BMA_James_Steen
This was not an error. It was an intentional attempt to undermine doctors' legal right to take industrial action.
The email reeks of a toxic culture at your trust coming from the very top level.
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@SteveBarclay
Steve, you've spent £1 billion on covering our strikes... how about you just pay us what we're worth and we can get back to work?
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@TVRJDC
@BucksHealthcare
Doctors for half the price of their assistants... Can't imagine they feel very valued!
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Voting for industrial action because I am not worth 26% less than a doctor in 2008 ✅
#FullPayRestoration
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PAs have no business being regulated by the GMC.
🚨Take Urgent Action Now🚨
The GMC and the government are trying to force GMC regulation of PAs and through the backdoor without scrutiny or debate tomorrow.
This is time critical.
Write to your MP NOW.
You can reply as a doctor, a patient, or both.
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RCR making things clear: Doctors' training comes first.
Trusts and Consultants will will need to consider this carefully before employing PAs in Interventional Radiology going forward.
Trainees are our future.
We must prioritise training opportunities for specialist trainees and ensure trainers have time to supervise them. The training of other healthcare workers cannot compromise the training of current/future doctors.
Full statement:
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The Consultant offer is not good enough. Vote NO to send a clear message to the government.
The (Junior) Doctors Committee has evaluated the consultant offer and believes
The status quo is better than the offer
The offer means:
❌ Giving more power to anti-doctor *managers* to decide on Pay Progression
(1/3)
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Please to see
@RCSnews
Council strongly prioritising surgeons over PAs
Their scope needs to be defined and severely restricted (if any at all) in the operating room
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Vote for me and the rest of the DV team in the RCS England elections!
Help us change the College the same way we changed the BMA
Want the college to prioritise trainees? This is how you do it ⬇️
🚨🚨🚨 SURGEONS! 🚨🚨🚨
We need your help to take DoctorsVote to the next level. We've revolutionised the BMA, it's now time to transform the Royal Colleges. RCS Council is responsible for determining professional policy issues, including those related to training, standards,
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@Telegraph
Here's a factual take on the ONS data published in the Lancet:
"The causes of these excess deaths are likely to be multiple and could include the direct effects of Covid-19 infection, acute pressures on NHS acute services resulting in poorer outcomes from episodes of acute
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@trentconsultant
I'm almost a consultant, but was denied a say on this deal (which will affect the rest of my working life)
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Great to see support from the West Derby Labour MP making time to visit our picket 🪧
A solid doctor’s picketline this morning at Royal Liverpool.
After wage stagnation leaving many who are also saddled with huge uni debts struggling to survive, they are simply asking for fair treatment. For all they do for us that’s the very least they deserve.
#DoctorsStrike
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@HCSANews
@VictoriaAtkins
BMA rejection surely to follow. The government needs to take doctors' concerns seriously and get negotiating.
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@jhjbevan
Is this a joke? I'm highly educated and trained to perform complex surgery. For £28 an hour.
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Let's get the whole team elected so we can make the RCS work for you
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Ballot for industrial action posted... Because nursery costs me £10,000 a year
#FullPayRestoration
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@drokane
"The expectation is that in time the PA will progress to leading ward round with indirect supervision".
They are short of COTE doctors, but instead of opening up training places (that will lead to more consultants) they are dumbing down their service.
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The government thinks you're worth 26% less than a doctor in 2008.
Let's show them how we feel
#DoctorsVoteYes
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@drmattuk
@RCPhysicians
Also not impressed with how they have changed the original motion - why exactly is a pause in roll-out not feasible?!
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@parthaskar
@RCPhysicians
@NHSEmployers
@NHSE_WTE
@UKGastroDr
@trishgreenhalgh
@DrSarahClarke
@DrLKVaughan
@AntonEmmanuel2
@iDrSunny
@doctor_oxford
@RobJimFleming
@OrthopodReg
@RowanHarwood
Talk is cheap, and I've seen nothing useful come out of that Royal College. Let's see what the scope document shows...
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@julianhartley1
When a genuine request comes through and patient safety is at risk, the BMA comes through and delivers staff back from the picket
We have granted a derogation for one junior doctor for the neonatal unit at University Hospital Lewisham for the day shift on 5th January. The trust have informed us that alternative sources of staffing have been exhausted. Our priority is patient safety.
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@Tjkey
@ABarotchi1
MDT care means utilising expertise from different fields. Orthogeriatricians have a wide breadth of knowledge and understanding of the complex medical issues our patients face. They can't be replaced with someone who just orders a vitamin D and Dexa scan
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@HSJEditor
@BMA_JuniorDocs
43,440 doctors (98%) voted to strike in August, what's your mandate?
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*Twice* as many people support doctors striking compared to those opposed.
No drop in support for us after a year of industrial action. ✊
The public has spoken!
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@rosieICM
@BMAScotland
Know your worth. English consultants are getting BMA rates during strikes, so should you.
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@simonbuckley4
@TheBMA
@goldstone_tony
@AmandaPritchard
@NHSEngland
@theartfu1doctor
Thanks for looking out for your colleagues Simon.
#VoteNo
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DoctorsVote will fight your corner.
We have transformed your BMA, vote for us today so we can see this through.
You could lose it all.
You can find all our candidates for each region here:
Vote here:
Please rank all our candidates in the order provided, you don’t need to fill all the spaces.
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The sheer lack of respect shown
This is what we are negotiating with
Sunak just can’t help himself.
Belittling and infantilising junior doctors at every opportunity.
Can’t imagine Biden referring to a baby as a resident doctor.
I guess he’ll say anything to justify paying fully qualified doctors just £15 per hour.
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As the training lead you should know better than to sign off the expansion of an unregulated, untested role.
This is why we need scope to be set at a national level.
It's time for the Royal Colleges and Trusts to implement the BMA Scope document
@ExplosiveEnema2
@RCHTWeCare
@FPARCP
@BritSocGastro
@UKGastroDr
@parthaskar
@DrAsifQasim
@DrLKVaughan
@DrSteveTaylor
@AlisonGeorge10
@Dr_Done_
@Doctors_Vote
As the training lead for
@RCHTWeCare
, and having signed off this PA, let me respond.
Non medical endoscopists provide a significant and important contribution to endoscopy procedures in the UK whether we like it or not. They all have to go through a robust certification process
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🚨🚨 Vote for me and the rest of the DV team in the RCS England Elections!
Elect people you can trust to deliver
4 priorities to make the college work harder for it's members ⬇️
The DoctorsVote manifesto for RCS England
It's time to change RCS England to a College that prioritises surgeons
📥 Voting Open Now! For full MRCS members only
📧 - search your emails for "Civica Election Services" for your personalised codes
☑ Vote for
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A reminder to Consultants that this deal is only worth an extra 5% (a third of which comes from scrapping your CEAs)
You are worth more
#PatCullen
Consultants in England 📢📢📢
It's time to VOTE in our referendum on the Government pay offer.
Vote online using the links you've been sent by email.
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🏴 English doctors on strike
🇩🇪 German doctors on strike
🇮🇹 Italian doctors on strike
The profession is finally standing up for itself
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Last chance to vote!
Choose a candidate who's going to work for your rights instead of working on their golf swing!
Are you in the Liverpool division? Please vote for me!
I want to replicate JDC's attitude across the rest of the BMA. Less talking shop. Less pointless professional association stuff.
In the NHS, either you are at the table or on the menu-and Drs right now are the main course.
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@pulsetoday
I'm sorry but we can't just blame politicians for this one. We've been let down by doctors in leadership positions who have facilitated this absurdity.
@DrSarahClarke
@ClareGerada
@KamilaRCGP
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"Doctors are fleeing to Australia — who can blame them?"
Right wing media supporting those on strike. You've really got to question what the government's game plan is here!
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@kidswhoshowjump
I'm sure they are brilliant! But what we are talking about here is someone with a 2 year degree, who can't prescribe medications or request x-rays, leading a ward round of some of the sickest patients in the hospital
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And yet inadequate staffing is seen as the biggest barrier to good patient care
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@foxinsoxuk
@trentconsultant
The deal solidifies the last decade of pay erosion with no concrete commitment to future increases.
You have just passed another 6 month ballot for industrial action, I'm not sure why you are concerned about a loss of appetite?
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@amreeeves
10 times your basic salary. With a decade's experience behind you treating sick children. This is why we are striking
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@SkyNews
There's a well established, robust national procedure for derogations that's proven to be safe during all of our strikes last year. But then again I'm sure
@ConfedMatthew
knows that
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➡️ PAs to be renames Physician's Assistants as originally intended
➡️ PAs to only work under named doctors who consents to their supervision
➡️ PAs to be registered with HCPC rather than GMC
New
@TheBMA
policy passed today at ARM
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Doctors of Liverpool!
@Doctors_Vote
needs you to take 2 minutes to vote for our ARM candidates:
1. Zeem Mahmood
2. Zachary Thomas
We've revolutionised the doctors committee, now help us transform the rest of the BMA
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@SteveBarclay
You like to villainise the BMA but we represent the viewpoint of 98% of doctors.
Stop wasting time and get round the table!
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Meanwhile satisfaction from working as a doctor is dropping fast - only half now satisfied with their day to day work
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We've not called any strikes, despite still having a mandate to do so...
Why have you not arranged to meet us?
Something tells me the government doesn't actually care about settling the doctor retention crisis
Junior Doctors continue their strike today.
That means more disruption for patients and staff.
My message remains the same. Call off the strikes and come back to the table.
Let’s start 2024 right.
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@parthaskar
@RCPhysicians
@trishgreenhalgh
@UKGastroDr
@DrLKVaughan
@RowanHarwood
@FPARCP
@DrSelvarajah
@NHSE_WTE
@VirtueOfNothing
@OrthopodReg
@doctor_oxford
Disappointingly tame statement. Thanks for your efforts Partha but there's obviously big resistance at the college.
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Without DV the BMA would still be the useless union of 2016!
Vote for our ARM candidates so we can continue our work:
1/n
📢 Attention all BMA members!
The Annual Representative Meeting (ARM) election for divisions is now open.
We need your help to shape the future of the profession.
It’s time to make your voice heard.
#DoctorsVoteforDoctorsVote
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Government stalling tactics won't work with this union.
See you on this picket line!
📢 CALL TO ACTION: FEBRUARY STRIKES 📢
📆 Strike dates: 24th February (07:00) - 28th February (23:59)
In the face of continued government stalling and their refusal to engage in meaningful discussions on pay erosion, we are compelled to take a stand.
🚨 Here’s what you need
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"Our resolve is as strong as ever"
My interview with
@LiamThorpECHO
on the Doctors' strikes this week
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Thanks to everyone who voted for me along with the rest of the DoctorsVote team.
We've achieved so much as a union in the past year, you've given us the power to march forward as one ✊
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@Thornton_health
We are all employees, with the democratic right to take industrial action when other means to negotiate have failed. You demean yourself with comments like this, showing a lack of insight and understanding of your colleagues' issues.
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2 days in June to shape the future of the BMA.
⬇️ Join us
Doctors, we need your help in restoring our profession.
Read this to find out how you can get involved:
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Is
@RCSnews
planning on implementing the same scope of practice for PAs?
We've already seen them preparing their own logbooks, this needs to be shut down ASAP!
@TMitchellFRCS
@BrennanSurgeon
@Vivien_Lees
PAs in Surgery:
❌ No PA operating lists
❌ Not to act as first assistants
❌ Never taking referrals
✅ Preparing discharge summaries
✅ Documenting ward rounds
Read the full scope document on the BMA website
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The government will not negotiate unless we hold the threat of strikes.
Return your ballots so we don't end up like
@theRCN
#TellThemAgain
A re-ballot of junior doctors in England will take place from 7 February to 20 March to extend our mandate for strike action, and provide us with a mandate for action short of strike (ASOS).
Vote
❌ YES for strikes
❌ YES for ASOS
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We're stuck in a vicious cycle. Ask most doctors and they'll tell you the NHS is on a cliff edge 📉📉📉
Donate to the Strike Fund if you can. Support your doctors if you care about the NHS.
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The BMA Old Guard are upset that they can no longer wine and dine using your membership fees.
Help us disrupt their party - vote for DoctorsVote ARM candidates here:
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Sometimes you do wonder where priorities in Britain lie... Free market economy for some, post-pandemic pay cuts for doctors
👏👏👏👏👏👏👏👏👏👏👏
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And almost half of doctors are struggling to provide patients with the care they need every single week.
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Does
@TheBMA
actually think that BMJ Learning is the top benefit of its membership??
We are a trade union first and foremost, I think that's something to be proud of!
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📉 20 points down in the polls
⚕️ NHS the country's main priority
😷 400 patients a week dying because of delays
Time to make doctors a credible offer
@RishiSunak
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@kidswhoshowjump
I work closely with nurses (ward, theatre, A&E, trauma), physios, OTs, orthotists, etc. All have a role and we work well together for our patients.
But I don't think this advertised job role is appropriate for a PA nor safe for patients.
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UK medical training used to be the envy of the world, now they feel sorry for us.
The brain drain needs to be addressed urgently.
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