James Steen
@BMA_James_Steen
Followers
7K
Following
8K
Media
640
Statuses
7K
“Just a union rabble rouser”✊🏼| Head of @BMALondon | BMA-Officer-James on Reddit | London Irish ☘️| Chelsea fan | Dog person | Views my own
London, England
Joined October 2022
For those in any doubt. I am not a doctor. I am indeed “just a union rabble rouser” who works for the BMA. And I’m proud of it too. ✊🏼.
@FullFact @BMA_James_Steen Just asking - is James Steen actually a doctor or just a union rabble rouser for the BMA?.
51
48
784
I personally find comfort in knowing the person driving the 400 tonne train I’m sat on at 125mph is well remunerated, well trained, valued, and motivated in their job. I also find comfort knowing they’re well rested as they’re less likely to be moonlighting to make ends meet.
Train driving is a highly demanding, highly skilled job. However, rather than begrudging train drivers what they earn, here's your opportunity to do the job yourself:
405
1K
8K
Ok, I’ll bite;. 1. As has been well documented, there’s a workforce crisis in the NHS, so we don’t have additional doctors to work weekends, so if you wanted them in, you’d have to give them days off in the week, delivery zero additional capacity.
70
647
3K
For the record:. New PA salary: £43,574.Core hours: 37.5/week. Newly Qualified Doctor salary: £32,398.Core hours: 40/week. Disparity:. £11,176 (34.45%).Plus 2.5 hours/week. Hourly rates.New PA: £22.35.Newly Qualified Doctor: £15.58. True Disparity (inc. core hour diff):.43.45%.
'They are there to work alongside doctors not instead of doctors.'. Health Secretary Victoria Atkins reiterates 'regulations' on physician associates after the death of 30-year-old Emily Chesterton.
38
610
2K
The brass neck of this guy.
Tory MP Philip Davies takes £500-an-hour job at slot machine company
54
459
1K
For the record:. My fellow @BMA_JuniorDocs negotiating team members and I can be at @DHSCgovuk building within a couple of hours. We’re happy to meet today, tomorrow, over the weekend, Monday, and in fact all of the above. 🤷🏻♂️. But they won’t meet us. It’s in their hands.
The Government says we walked away from talks - but it was them who walked away. Ministers can’t even explain why they won’t talk to us while strikes are planned, like they did with barristers. Come back to the table with a credible offer and we can end this now.
37
569
1K
So the PA examined and took the history of a patient. And the tribunal determined that the doctor failed in their duties for not examining the patient or taking a history themselves and in addition to the PA. What exactly is the purpose of a PA in this medico-legal context?.
A fitness to practise tribunal (MPTS) determines that a PA's history should be repeated by a doctor and a PA's examination should be repeated by a doctor too. DAUK's report in Pulse explains more 👇
34
388
1K
£66.55 for 3 full qualified and highly skilled doctors to save yours or a loved one’s life is an absolute disgrace!. With pay restored this would be:. 10yr doc = £37.88.7yr doc = £33.09.1yr doc = £19.06. TOTAL = £90.03. We’re not asking the earth! . #JuniorDoctorsStrikes ✊🏼
30
488
1K
And there it is. The GMC was created for the sole purpose of protecting patients from unqualified pseudo doctors by facilitating the safe identification of qualified doctors. Today they boast of their wholesale abandonment of this core purpose. A complete dereliction of duty.
🧵The updated #GoodMedicalPractice2024 uses the term ‘medical professionals’ as a collective term for doctors, physician associates (PAs) and anaesthesia associates (AAs), rather than listing out each individual role for every reference. We haven't removed doctors from the.
19
334
1K
“The Trust did not respond to questions about consent”. I smell the most inevitable of rats. If I was a medical malpractice lawyer, I’d be salivating at this article.
Non-surgeon removed gall bladders at hospital
24
322
973
“Our lazy staff have stopped working loads of free overtime for us!” . Yes - you finally found the biting point for NHS staff. And it only took 15yrs of savage pay cuts, “efficiency savings”, deepening toxicity of culture, daily moral injury, and the targeting of whistleblowers.
‘Reduced effort’ may have contributed to 10% productivity drop, says NHSE
17
257
948
For context. £9.9bn is circa 9 times the value required to restore “junior” doctors pay in full and in one hit. The govt also cut national insurance earlier this month at a cost of another £9-11bn. Doctors - Don’t ever let anyone tell you there’s no money to restore your pay.
The government has written off £9.9bn of the £13.6bn it spent on personal protective equipment (PPE) in the pandemic due to the gear being unusable or having lost its value . Read more 🔗
6
314
843
Genuinely baffled by this. 🤔. A BBC journalist has blocked me. What for you might ask?. Well my only interaction with them is shared below. I asked a perfectly legitimate journalistic question in relation to a news story they had covered. 🤷🏻♂️
55
183
797
2. Wanting to protect “work life balance” isn’t a bad thing - doctors are human like you, and trust me when I say you don’t want to see the studies on the impact of fatigue on medical decision making - would you want a shattered pilot flying your plane, no, so why risk a surgeon?.
2
76
750
The audacity to suggest it’s acceptable for working class communities to have physician associates instead of actual doctors. The working class built the NHS, in no small part to ensure equality of access to qualified doctors, irrespective of class or wealth.
The architect of the PA project in the U.K. Phil Begg explains that PAs were brought in to replace GPs in deprived areas .Listen for yourself .@parthaskar @Dr_Done_ @TheDA_UK @drmattuk @DrAsifQasim @iDrSunny @ExplosiveEnema2 @Ask_foradoctor @DrNeenaJha @quackophage
20
393
749
Over 2700 fully qualified doctors were rejected for post-graduate training in radiology last year. This is doctor replacement by PAs. It is of course not at all surprising coming out of @StGeorgesTrust, but that makes it no more safe for patients or less galling for doctors.
Introducing two special members of our team! Helen Bucknall is our first IR advanced practitioner and Lottie Lewis is the UK's very first IR physician associate. We're privileged to have them both! @StGeorgesTrust @StgRadiology @PPaauk @SCoRMembers @cirsesociety @SIRspecialists
21
360
751
A doctor has to pay circa £750 for 2 DAY course of this type. A Physicians ‘Associate’ gets 2 WEEK course completely free. A new doctor earns >£11,000 / 35% less than a new PA. Make it make sense. Current priorities for surgical training in the NHS/UK need an urgent overhaul.
Why is @RCSnews ✅Training of #PhysicianAssociates in #Surgical Skills ?. @TMitchellFRCS @AoMRC @RCSEd @rcpsglasgow . @TheBMA @ASiTofficial @bota_uk @asgbi @BritOrthopaedic @the_mdu @MPS_Medical @AvMAuk @PatientsAssoc @whichuk @bmj_latest @bbchealth
11
185
774
So now both Sunak and Starmer have or will pledge to “doubling” medical student numbers. Yet neither have committed to restoring doctors’ pay/retention. Result & translation:. UK government commits to train thousands more doctors for Australia, Canada and New Zealand 🤦🏻♂️
19
193
734
This is key. The government is feigning its desire to negotiate. There’s no law of nature or in statute that prevents them from talking to us with strikes called. They talked to barristers on strike 15 months ago. Nothing is stopping them from talking to us except themselves.
“It's still not too late. The Secretary of State - or anyone from the Government - could still come to us today, and if that offer is credible, and if we can resume talks and build on that credible offer, then we can stop our strike action for the rest of this week." [3/3]
5
223
652
So all in all, this is as idiotic, flawed, and shortsighted an argument as it is disingenuous and manipulative in its presentation… . Want a real solution? Commit to full pay restoration now and invest in the future of the NHS workforce - anything less is a dereliction of duty!.
11
56
636
Problem is, they’re not being paid even what you were. They’re on approximately 25-30% less than what you got; what you describe as “not well paid”. So why are today’s “junior” doctors worth 30% less than you were, Patrick?. We’ll park the military doctor disparity for a sec.
When I was a junior doctor I wasn’t paid well, but I accepted I was an ‘apprentice’ and thus couldn’t expect a massive salary. Our junior colleagues need to realise that they are simply doctors in training whose priority should be their patients not income. #JuniorDoctorsStrike.
17
52
662
Are you not CEO over the weekends?. Because doctors are still working and they still need a quiet space to work safely. Do you not have a site manager out of hours?. Perhaps, as an interim measure, doctors can use your office and the offices of your executive team until Monday?.
We will look into this next week.
9
66
663
Before the NHS, only the wealthy could access an actual doctor. Working people had to make do with “quacks” and fake doctors, who were untrained or undertrained, and often made things worse. Working people deserve access to actual doctors. We can’t let this go backwards.
20
244
617
This is lunacy. Patients everywhere report difficulty in securing GP appointments. Yet this practice deems GPs surplus to requirements in a GP service?! 🤯. The replacement of doctors, particularly GPs, is a false economy and is a danger to the public.
22
191
632
“It’s outside the BMA’s remit!” . This assertion is as ignorant of unions as it is inaccurate. 1. MAPs deployment is directly related to doctors’ working conditions. 2. Anything our members care about is within the remit of the union. The BMA is a real union for real doctors✊🏼.
17
112
616
Two things here;. 🔹The government’s position of not talking to us with strikes on is clearly indefensible and untenable. 🔸Mr Barclay finally recognises we’re only asking for Full Pay Restoration - not a pay rise. Well done @GMB, first media outlet to ask the right questions.
Susanna Reid presses Steve Barclay on why the Tory govt refuses to negotiate with junior doctors while strikes have been called. Barclay flounders and blusters and finally resorts to claiming the strikes are politically motivated #JuniorDoctorsStrike #GMB
21
176
583
Raising legitimate concerns is not disrespect. Disrespect is starting a newly qualified doctor on >£11,000 less than their alleged “associate” grade who;. 🔹works less hours.🔸has less responsibility.🔹works less unsocial hours.🔸is not regulatory accountable.🔹doesn’t rotate.
GMC calls for ‘multi-disciplinary respect and courtesy’ towards non-doctors #physicianassociates #PAs #ARRS.
10
161
599
Translation;. “We don’t like being publicly shamed online for failing to publish the raw data from our MAPs consultation, and so felt obliged to regurgitate the same corporate communications waffle we’ve been saying for months in the hope you all forget about asking for the data”.
We’re continuing to prepare for the upcoming regulation of physician associates (PAs) and anaesthesia associates (AAs). Here’s an update on how we’re reviewing responses from our consultation and next steps:. ⚫️Our consultation was a structured process designed to gather and.
6
171
586
“it is clearly wrong that a newly qualified doctor… is paid over £11,000 less per year than a newly qualified PA, while the Dr role, remit and professional responsibility is far greater… this is a 35% differential, which is manifestly unjust.“. We move. ✊🏼.
🧵Read our position statement on physician associates and anaesthesia associates which aims to clarify the confusion over roles, supervision and what patients should expect: [1/2]
14
132
562
Blimey. I know I can be hot headed and a bit of a firebrand at times, but take a beat…. Also, FYI:. 🔸Doctors are the BMA. 🔹Doctors are MAPs supervisors. 🔸GMC, NHS England, RCP and your FPA have had 20yrs to produce a patient safety focused definitive scope and still haven’t.
16
120
556
Doctors, . I’m no regulatory lawyer, but I’ve represented many healthcare professionals facing allegations. This seems to me to be incredibly dangerous practise. Are you really ok with being accountable for and your GMC registration being reliant upon a PA’s clinical judgment?.
Oh here is also the list of jobs I was given by the reg level PAs when I was busy on call holding the bleep. So they can go to theatre/clinics ASAP. I had seen none of these patients. And I had to prescribe all these. Not from a consultant or a doctor but a PA.
33
96
565
For clarity;. You’re saying public consultation drove this. The public tells you they want to see GPs and feel fobbed off when they don’t.👇🏼 . Your response isn’t to consider more GPs, but instead to launch a campaign to misrepresent other roles as grander and more specialised?!
@jabberwock951 @LittlePersonDoc @pully8 @DrNickB_ObAnaes @Ask_foradoctor @BDCFT We've done lots of community engagement before, during & since. We are not simply relying on these materials alone. You can see an example of some of the work we've done here and we have been working with local community groups too.
20
205
547
Many of us suspected it. But this demonstrates just how hollow and empty a gesture this man clapping on Thursday nights in the depths of the pandemic really was. From heroes to worthy of derision and unrelenting attacks on their profession in such a short timeframe. Sickening.
'You cannot employ lesser qualified people instead of GPs. the country is not stupid'. PM Rishi Sunak is challenged on the NHS by a member of the public during a campaigning event in Wiltshire. 📺 Sky 501, Virgin 602, Freeview 233 and YouTube
6
154
542
Yes, the following doctors are now in a dispute with Govt:. 🔸“Junior” Doctors.🔹Consultants.🔸SAS Doctors.🔹General Practitioners (GPs). Govt appears to want a war with doctors on all fronts:. Pay / funding 💷.Patient safety 🚨🤕🤒.Replacement by PAs 🔄.Training numbers👨🏼⚕️👩🏿⚕️🧑🏽⚕️.
So is that every major group of doctors in dispute with the government?.
15
247
544
It’s almost like we should never have closed and sold off all the cottage hospitals.
Wednesday’s @guardian front page: NHS will buy beds in care homes to cut hospital waits, says Labour
24
180
517
I hadn’t seen this before today. This is the Royal Australian College of General Practitioners (RACGP)’s assessment of the risks and position on the use of PAs in general practice. This is what professional medical leadership looks like.👇🏼.
25
240
522
For the public. A lumbar puncture is also known as a “Spinal Tap”. It involves the delicate procedure of inserting a needle into your spinal canal. It is terrifying to me that unregulated, under-trained and under-qualified “associates” are doing these.
48
145
521
Except that we did have both, literally just 14 years ago. Kate alleges our pay claim is unaffordable at just over £1.1bn. Kate also advocates for scrapping inheritance tax for the wealthiest 4%, which costs £8bn. Pay is a metric of value, this has always been a pay dispute.
Focus on pay is understandable. In different health systems, doctors rightly get paid more. But the BMA demands salaries closer to mixed health systems while also demanding the NHS stick to its socialist structure. You can't have both.
16
97
500
Unaffordable?!. Govt has spent over £2bn trying to ignore the dispute and strikes. That’s much more than the cost to fully restore doctors’ pay. We’re happy to meet Govt any time, anywhere. It’s Govt’s self imposed precondition of “no talks with strikes called” stopping talks.
Doctors know that a 35% increase in salary is non affordable but refuse to sit down with the Health Secretary to negotiate an increase which is. Apparently putting their patients lives at risk is more appealing to them than talking with the Government to agree a settlement.
8
150
508
“Don’t strike in summer, people are on holiday”. “Don’t strike in winter, the health service is under too much strain”. “Don’t strike when it’s sunny, it’s a heatwave”. “Don’t strike when the weathers bad, it’s too dangerous”. So when Nigel? . There is no ‘good’ time to strike.
The trainee members of the @TheBMA striking for 5 days over the summer when consultants are likely to be on leave and unable to.cover them is running the risk of loosing the support of the consultants and severely endangering our patients and loosing public support.
11
96
498
23 doctors from the UK. 👨🏾⚕️🧑🏼⚕️👩🏿⚕️👨🏾⚕️🧑🏼⚕️. For just 2 hospitals in Australia. 🏥🏥. Over just a 4 month period. 🗓️. The mass exodus of UK doctors is real. Time for #FullPayRestoration ✊🏼. 🇬🇧💷 🧑🏼⚕️👨🏾⚕️👩🏿⚕️ ➡️ ✈️ ➡️ 🇦🇺💵💵💵.
Excellent news that 41 more junior doctors will be joining @RoyalAdelHosp and QEH between August and November this year - including 23 doctors from the UK.
20
182
477
In case you needed a stronger argument to scrap the House of Lords, I present to you Hereditary Lord and literal Baron @JimBethell. Attempting here to speak with authority on a subject he clearly has no grasp of, and which he will never personally suffer the consequences of.
Shaking right now!. The PA debate in the House of Lords- @JimBethell said:. “We have to find people from somewhere (to do GP appointments) & they’re going to be some people (Physician Associates) that don’t necessarily go through the 10 years of qualification TO BECOME A GP”. 🚨
28
176
475
I don’t have words for this. This is beyond the pale. Give me the name of this Trust, and the name of the person who sent the email. Via DM and or anonymously if need be. Just give them to me.
What would happen if I sent an email to “all managers” showing them any number of daily mail articles hating on managers even more than they hate on doctors 😳
24
64
482
It’s a fallacy to claim doctors calling for their training opportunities to be protected is any form of entitlement or privilege. Doctors REQUIRE these opportunities to demonstrate competence and to progress through their training programs. MAPs do not.
7
126
452
🚨Junior Doctors of England🚨. Longest strike by doctors in NHS history announced:. START: 7am Thursday 13th July. END: 7am Tuesday 18th July. 5 day / 120 hour strike. #JuniorDoctorsStrikes.#JoinStrikeWin.#PowerInAUnion.#TellThemAgain.#TellThemLouder
14
123
470
🚨“Junior” Doctors🚨. Do not sign prescriptions or ionising radiation scan requests for MAPs as the norm - MAPs should go to their named supervisor. If you’re ever confronted with such arrogance when challenging them - Make sure you document it and contact us for support.
8
177
459
Wow. Sounds a lot like GPs are doing around £1.7bn of unrecognised and unremunerated work every year, at least. Also sounds like the floor for the negotiations has been identified. Add a permanent unlock of ARRS funds and you’ve probably got yourself a ball game.
Exclusive: NHSE leak reveals GP ‘work to rule’ could cost £570m in four months
7
147
461
Insult after insult for actual doctors. A new actual doctor earns over £11,000 (35%) less than a new one of these pseudo doctors / “medical associates”. Now this slap in the face. And FYI, actual doctors’ pay doesn’t catch up with them until 6/7 years into their career.
So we heard today at the select committee debate @gmcuk will be charging £221 per annum for PA/AA registration. Why do I as a doctor have to pay £433?. I would much rather pay £221 as well, and come to think of it, I just might cancel my direct debit right now. 🙂.
9
147
453
If you’ve spent any time around “junior” doctors, you’ll know it was never in doubt. We go again! ✊🏼.
BMA junior doctor members in England have voted by over 97% in favour of extending our mandate for industrial action, and to provide us with a mandate for action short of strike (ASOS). A huge thank you to all of those who voted. Read the full results 👇.
13
89
455
🚨📣Consultant Anaesthetists📣🚨. This is what they plan for you and your patients. They intend to spread you as thinly as they think they can get away with. Whilst you maintain ultimate accountability for everything these pseudo doctors do. It’s time; stand up and say no.
As government passed registration of PAs/AAs by the GMC today one particular clip really intrigued me:. @theresecoffey here talks about having 1:3 supervision for AAs 🤔 . We have to also remember she was health secretary - she’s seemingly marking her own homework here.
17
169
455
Again with this nonsense argument. Yes, doctors make mistakes. The fact that a GP, with minimum of 10yrs gruelling medical training and education can make such a mistake is not an argument for lowering standards by introducing MAPs with just 2yrs of unaccredited training. 🤦🏻♂️.
Just sat over here wondering how this is different to the Emily Chesterton case? Oh wait it isn't.
12
80
465
What’s in a PA studies course that is not covered by a medical degree?!. If, as logic dictates, it’s nothing, surely all doctors should automatically secure the ability to practice as PAs, and we should look at determining at what point a medical student can during their degree?!.
@Molly2323232323 Hi Molly. Thanks for your query. Yes it will be possible to hold both doctor and PA registration if you are able to meet the separate registration requirements e.g. a PA qualification for PA registration, a primary medical qualification for doctor registration, along with other.
12
90
441
Within their national contracts, Resident Doctors’ breaks are paid. Not because it’s nice. It’s because there is recognition that it’s impractical and unrealistic to expect a doctor carrying a bleep not to respond to a patient just because they’re on a break. 1/2.
We are deeply disappointed that @RWT_NHS and @WalsallHcareNHS have chosen to remove paid breaks for locum doctors, ignoring strong opposition from LNC reps earlier this month. Doctors are already overworked and underpaid. We call for an immediate reversal of this decision.
10
103
487
It shouldn’t be controversial to say that medicine should be practised exclusively by those who have studied medicine and are medical doctors. What else do you want to do without the appropriate training;. Nuclear power plant physicist?.Civil engineer?.Barrister?.Airline pilot?.
@ExplosiveEnema2 Another misrepresentation. You are uncomfortable your monopoly is breaking. I am perfectly fine with well trained professionals with a great track record looking after patients.
12
138
471
Sorry, what?!. A physician associate APPRENTICE is paid at Band 5?!. An apprentice, with potentially no previous clinical experience, and maybe not even with a science based undergrad degree…. On the same money as a fully trained, qualified, registered and regulated nurse?!. 🤯
These T.Student PAs salaries are completely funded by ARRS, meaning GP practices have a financial incentive to offer it. 3/n
13
160
449
In 2010 the NHS was ranked 1st in practically every international comparison of healthcare systems. Somehow, we’ve allowed someone’s wallet to reintroduce itself as a deciding factor between life and death. We’ve fallen so far we’re barely recognisable.
14
191
436
The mask slips. They no longer pretend to want to “complement” doctors. They want to break what they consider to be a “monopoly” doctors hold on… being doctors. If you want to be a doctor, stop reading @iealondon’s dystopian laissez-faire propaganda and go to medical school.
Interesting that the founder of @UMAPsUK sees PAs as "competition" with doctors. What happened to not replacing?.
8
137
433
If the King end up requiring surgery, who do we think will administer the anaesthetic and perform the surgery?. An anaesthesia associate or a consultant anaesthetist?. A physician associate learning the procedure on the job, or a consultant surgeon?. 🤔.
King Charles to be treated for benign prostate condition
7
89
428
The NHS is in a perverse situation whereby the following are simultaneously true;. 🔸UK has a significant doctor shortage of circa 50,000 vs European average. 🔹Doctors can’t secure jobs. 🔸GPs face mass redundancies. 🔹Doctors being made unemployed by training bottlenecks.
It’s good to see the BBC reporting on this. Whilst pay restoration remains by far and away the No.1 issue for doctors. The patient safety concerns / a safe scope for MAPs and training pathways / bottlenecks are joint 2nd from my discussions with doctors.
8
227
430
NHS Management:. This work is “vital”, “critical” and makes a “tangible difference”. Also NHS management:. Oh, but we also want you to do it for free during the week and for an undisclosed and non-negotiable rate at weekends. This exploitative nonsense has to stop ✋🏼.
🚨 NEW: Medical students have been drafted onto wards in the wake of the NHS cyber attack. They will work as floor walkers, hand delivering blood tests to and from the crippled pathology labs. Bosses at @GSTTnhs say disruption will last "at least 2 weeks" 1/2
5
112
420
Huh?. I always thought the named supervisor, a senior doctor, would be accountable for alleged failures in supervision. But here we see the registrar being suspended?!🤯. Couldn’t be more important for doctors of all grades to stick to BMA guidance on MAPs; protect yourselves.✊🏼.
⚠️ For those working with PAs. MPTS case published 2017 where a ST3 Junior Doctor was suspended for failure to adequately supervise a physician assistant’. The PA was known as ‘Dr G’. There may have been other issues too - irrelevant. Read the following:.
6
153
415
We’ve seen PA courses that would accept someone like me. So I could be doing endoscopies in circa 25-36 months. I have;. No scientific background.No clinical exp.An irrelevant International Relations BA. Oh, but I do have a white coat I got for a cheap fancy dress night at uni!.
I started medical school in 1997.Qualified 2003.First endoscopy 2007. 10 years.
14
86
418
PAs don’t bring “excellent work life balance” to the workforce. They take it. Their cushy hours load a disproportionate burden of unsocial hours on “junior” doctors. That’s like me saying “I bring my salary to the BMA”. And how exactly is OOH ED work better for training?! 🤔
Another way in which Drs have been opened up to exploitation by NHS employers. Rather than incentivise Dr workforce to work out of hrs/unsociable hrs with fairer pay, they are being coerced into working unsociable rotas under the guise of "training".
11
99
410
3. If they’re relying upon the same arguments made by Jeremy Hunt when he was Health Secretary to suggest people die more at weekends, they’ve been fairly comprehensively debunked!.
1
28
382
“Doctors’ career paths are also changing, with more doctors than ever before choosing locally employed roles”. The audacity to call this a choice with training bottlenecks holding thousands of doctors back. Galling but unsurprising from an organisation so detached from reality.
We're pleased to share the second in our annual series of #StateOfMed reports – Workforce. This focuses on the changing shape of the medical workforce across the UK. This year’s report shows that the medical register continues to grow, as does the diversity of the doctors on it.
8
132
425
🚨“Junior” Doctors of England🚨. 📣 New strike dates announced 📣. After proclaiming they would meet us within 20mins of strikes ending, Govt burnt nearly a month after our January strikes ending before offering to meet us. And even then, no new offer 🤷🏻♂️. We go again! ✊🏼.
Doctors, we pulled out all the stops to avert this round of strikes. We asked the health secretary to extend our strike mandate for four weeks so we could keep talking in good faith. But she declined, leaving us no choice but to announce a 5-day full walkout from 24-28 Feb.
6
107
391
Absolutely abhorrent. This trust apparently spent £3.5m of all our money to attack NHS staff. Doctors, and everyone working for the NHS, need to see this. Next time your local NHS management try to guilt or otherwise coerce you into doing extra work, remember this.👇🏼.
This is the Litmus strategy that @MSEHospitals have signed up to. Deliberately slashing your pay then trying to "grip and control" you. No thought given to staff or patients. Know your worth. Do not pick up locum shifts for insulting rates.
20
170
425
Today we entered into a formal dispute with @GSTTnhs. Doctors at GSTT deserve the same procedural protections as doctors working elsewhere in the NHS. BMA members look to your emails for a message from us and to complete a short survey. #InjuryToOneIsAnInjuryToAll ✊🏼
16
95
394
Utterly shameful shilling for the Govt from @NHSE_Danny on @BBCRadio4. How on earth could you think it’s appropriate to try to defend the Govt’s ludicrous self imposed restriction not to talk to us with strikes called?!. You’re the CEO of @NHSEmployers not a Govt spokesperson.
10
70
378
An alarming response to legitimate questions from fee paying medical students. We’ve also had reports of censorship and suppression of open discussion on university platforms. Therefore, next week we will start to obtain the views of BMA members at @StGeorgesUni. We move.
We have recently seen discussions across social media about upcoming graduation ceremonies for our Medicine and Physician Associate programmes. Read our full statement in response to these discussions here:
10
96
385
Junior Doctors of England - You all absolutely smashed it! ✊🏼. Turn out - 77.49% 🤯.Yes vote - 98.06% 💪🏼 . Let’s go….
Junior doctors have voted YES to strike action in England. This is a giant step forward for junior doctors and #PayRestoration. Thank you to everyone who worked so hard for this. Keep an eye out for next steps. #BMADoctorsVoteYes
7
57
375
This government has had 20months to resolve this dispute, and hasn’t. Victoria Atkins has personally had over 200 days as secretary of state for health to resolve this dispute, and hasn’t. No concrete commitment on restoring doctors’ pay from PM?. No cancellation of strikes 🤷🏻♂️.
NEW: Health Sec Victoria Atkins tells me she "wants to do a deal with junior doctors" but refuses to commit to do so before the election.
6
121
375
Don’t even get me started on the disparity between new doctors and new PAs working in central London. London Weighting:. All Doctors (FY1 to consultant): £2,162. PA at Band 7: £7,746.
22
98
380
Hang on. So not only is it no longer a requirement for the undergrad degree to be in a health science, but not even scientific?!. So me, with my International Relations BA, could waltz into a PA course in Sept, and covering Consultant on-call at your local hospital in 2yrs?! 🤯
@jobbinggasman @RCObsGyn @parthaskar @iDrSunny @HelenRSalisbury @carolvorders @natalieben @djnicholl @doctor_oxford @Dr_BellaR @Dr_Done_ @Xeon4f145d96s1 @DrLindaDykes @mmamas1973 The presentation also states that people who have done non-scientific degrees eg law, are accepted onto the two year PA training course. This means two years of clinical training alone produce a PA.
19
118
376
97.6% in favour of strike action.✊🏼. Yet another huge mandate!🗳️. Solidarity with doctors in Northern Ireland! ✊🏼.
WATCH: Ballot result announced Chair of NIJDC @FiGriffin2 gives an update on today's results of the ballot for industrial action for junior doctors across Northern Ireland.
8
104
382
@HSJEditor @theRCN Does the BMA represent nurses?. What about the radiographers and unite who both rejected pay award for 23/24 and I think remain in dispute?. What about unison’s disputes up and down the country on bandings 2/3?. Are we expected to list every dispute in the health service?.
10
26
385
Let’s look at this decision process:. 1. Assesses patient ✅.2. Acknowledges they don’t know ✅.3. Seeks advice from qualified doctor ❌. So close. This is what you get when you crank overconfidence up to 11, but leave both depth and breadth of knowledge at 3:. Dangerous hubris.
Attempted to hide identities as much as pos. Sent this and found it too damning not to share. PT presents around 3pm. A doctor doesn’t appear to be contacted for support or help, and instead a Facebook group of PAs (PAAUK) consulted instead. PT in HB sent to a&e not until 6pm.
11
104
386
4. And if you still think spreading the existing woefully low number of doctors we have over 7 days is a good idea, you should know it’ll cost the NHS a lot more for no additional capacity - all cohorts of staff attracts unsocial hours payments and doctors don’t work in isolation.
1
21
365
Great turn out at St Tommy’s picket early this morning in the bracing cold wind! ✊🏼. #DoctorsStrikes #Solidarity #TellThemAgain #ThereIsPowerInTheUnion
8
91
367
“A PA would not typically go on the tier two rota for about three years.”. 🤯🤦🏻♂️. They should never be on the tier two rota whatsoever. Who carries the risk when a Dr calls this team for advice, the PA issues it and the proverbial hits the fan I wonder?!🤔
25
63
380
General practice is now formally unified on the issue. Both the BMA’s GP Committee and RCGP assert that the deployment of PAs in general practice is unsafe and the role should be phased out.
Our GP committee has passed a motion stating the role of Physician Associates in general practice is fundamentally unsafe. They are calling for an immediate stop to PAs managing undifferentiated patients with a longer term phasing out of the role entirely.
7
148
381
The Lords was always a long shot, but thank you to the peers who saw the truth of the matter and spoke up for patients. Looks like we’re going to have to fix this ourselves then. ✊🏼.
Extremely disappointing that Peers have tonight waved through legislation that will blur the lines between PAs and doctors, with potentially dangerous consequences for patients. We thank Peers who urged Government to heed the warnings of the medical profession.
11
84
370
After the longest 20 minutes in history (3 weeks, 2 day, 29mins & counting) . Yet another car crash interview 🚗💥 . Patronising ✅.Condescending ✅.Infantilising ✅.Lie about who ended talks ✅.Move the goalposts ✅.Pretend pay claims are unreasonable ✅. Are we stuck on repeat?.
“I very much hope they’ve had time to reflect and they're able to come back with reasonable expectations”. Health Sec @VictoriaAtkins says junior doctors' “unreasonable demands” are stopping a pay deal being agreed. Watch tonight ⬇️.💻 LIVE 9PM @itvpeston.📺 1045PM @ITV. #Peston
12
86
371
So the Irish starting salary of €210k is more than double the starting salary in England, and their top salary of €252k, is circa £98k higher than the top salary paid to NHS Consultants in England…. I wonder why doctors are leaving the NHS and UK?! 🤦🏻♂️.
15
120
364
Over £3bn spent trying to ignore the doctors’ strikes for a year. A new 6 month mandate for strike action secured, that was never in doubt. It would cost £1.1bn net to treasury to implement full pay restoration overnight. And we’re not even asking for it overnight.
The British Medical Association says the Government has wasted £3,000,000,000 on junior doctor strikes — more than double the cost of settling their whole claim. Failure to negotiate is costly.
4
170
363
As a lay person and patient, this scares me. If any Trust allows a MAP to be part of my treatment, or the treatment of my loved ones, without fully informed consent, including explicitly explaining their limited training, I’m going to sue them into the ground and press charges.
Susan died following grossly inappropriate and negligent care by a PA. We are told time and time again that these cases are rare, but they shouldn't be happening. PAs simply must act within their competence; something that hasn't been happening.
8
123
369
Isn’t it funny:. 🔸MP pay review body can get its act together and issue pay rises prior to April. 🔹DDRB, NHSPRB and others never publish prior to June/July. AND:. 🔸MP pay review body is binding on Govt / Parliament. 🔹 DDRB, NHSPRB and others are only “recommendations”. 🤔.
MPs awarded pay rise to £91,346 by independent body . Read more🔗.
12
122
366
Not elitism. Doctors can and do care about more than one thing at once. 8-12hr waits = a patient safety concern. MAPs operating unsafely = a patient safety concern. MAPs being mistaken for doctors = a patient safety concern. Doctors’ pay and conditions = a serious concern. See.
6
96
368
Vexatious and malicious attempts to besmirch a senior doctor’s reputation and good standing. When they can’t refute your arguments intellectually, they’ll seek to silence you through personal attacks and misappropriating the “Be kind” agenda. Stand by your convictions firmly ✊🏼.
11 'complaints'-all from PA colleagues to @RCPhysicians .Reviewed by RCP. Decision:. "No current grounds to proceed with investigating these complaints further". An excerpt from one of them. My concern is about safety based on lack of scope/regulation etc. Don't make it personal.
10
98
371
We’re happy to meet them today. Our negotiating team can be at DHSC in no time. We were happy to meet them yesterday. We’ve been happy to meet them everyday since May when HMG collapsed talks. So please stop with the “both sides” nonsense. It’s HMG who’s not playing ball.
Bosses of leading hospitals in England have written to PM and BMA: “profound concerns at the risks ongoing strikes pose to the care and safety of patients” and each escalation “testing the limits of what can be managed safety” - urging Govt and BMA to restart negotiations.
5
97
368
The arrogance of this policy…. Who the hell are this govt to say how long it should take to study and qualify as a competent doctor or nurse?! 🤦🏻♂️. These are long-standing evidence based professions; their education and training should remain the same!
21
87
360
Minimum role specific education, training and standards for comparison:. Cardiology Registrar (doctor):. 🔸5-6yrs medical school to obtain a full medical degree. 🔹Minimum 4yrs postgraduate training and exp. 🔸MRCP passed. 🔹GMC registered. PA (not a doctor):. 🔹2yr PA course.
7
189
361
This is a lot of words to not even include a proposed solution. Also;. 🔹Rest facilities and the doctors’ mess are not offices for clinical work. 🔸If the hot desks are acceptable spaces, how was the decision reached that the matron couldn’t but doctors could work there?.
@juniordrtruths We had to move some office space around in our ED and Acute Medical Unit to create room for medical and nursing colleagues while urgent remedial works were carried out in an adjacent clinical area. That included the office in the picture, which had previously been temporary space.
4
58
361
Wow. So the reception team, who literally work in the practice alongside both, don’t know the difference between a GP and a PA. What chance does that give the general public?! . We’re not even in the same ball park as informed consent with this stuff. 🤦🏻♂️.
Patient: I would like to see a doctor please . Appointment given with a PA . Patient: this is with a PA, could I have it with my GP please? . Receptionist: ‘they are doctors… they do the same thing’. Other patients also completely unaware. This is a huge problem.
13
119
352
Shocking tweets. BMA consultant membership in England isn’t 40%, add another 20% points and you’re closer to the mark. And do you really want to pull at that thread?!. Conservative share of electorate:. 2010: 21.1%.2015: 24.4% .2019: 29.3%. Brexit ref:.37.47% voted leave.
The rejection of the government’s pay offer by consultants is extremely frustrating. Barely more than half of the 40% of consultants who are members of the BMA voted for this but it’s patients who will pay the price as usual. We urgently need both sides round the table. [SB].
5
106
345
I’m receiving multiple reports from F1s being intimidated and having their careers threatened for completely innocuous social media posts. Just 2 weeks into their careers. These local “leaders” should watch their backs - we see you. The NHS is not how it’s presented here.👇🏼.
Today is #ResultsDay, and if you’re thinking about what to do next, here are three reasons why you should join the NHS.
13
97
360
“Onslaught”?!. That’s how @StGeorgesTrust responds to the revelation that over 1100 potential criminal acts were undertaken by PAs, seemingly facilitated by the NHS Trust in question?!. 🤦🏻♂️🤯 . We’ll remember this next time we represent a doctor facing misconduct allegations here.
1/4 It is sad to see the very public onslaught on Physician Associates. We are a unit with a proud history of teaching, training and investing in our junior doctors at all levels. We are an @RCSnews accredited fellowship training centre in Robotic surgery (@IntuitiveSurg).
11
57
353
5. What impact do we think demanding arbitrary weekends for no gain will have on a medical workforce already abandoning the NHS due to a ridiculous pensions taxation regime, burn out and being run into the ground?.
2
23
330
If this is what triggered the letter, then we’re well and truly through the looking glass. This is a perfectly polite and helpful message to colleagues, reminding them of their regulatory responsibilities and confirming the LNC is aware. Where does the hurt arise from?! 🤷🏻♂️.
Said hurtful comments this letter is referring to is just a foundation doctor reminding other doctors about BMA guidance re PAs. Shameful from @MFTnhs
8
61
346
£3.5m to advise an NHS Trust to cut doctors’ pay for extra hours?!. Ironically, that’s equivalent to more than 21,000 hours of EXTRA consultant activity?!. How many of their 160k waiting patients wouldn’t still be waiting if they’d spent our money actually clearing the backlog?🤔.
@MSEHospitals have been advised by a private consultancy firm (cost >£3.5mil) to cut rates for doctors working overtime & if that makes wards unsafe or the trust unable to tackle their 160k patient waiting list, to hire costly agency staff instead. This is waste @WesStreeting.
9
154
367