U Bhalraam (Raam)
@CardioShades
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Academic Clinical Fellow in Cardiology #EPeeps | Pythonista | Data Scientist | Graphic Designer | @theBMA EoE RDC | UK(J)DC | JATS | Pensions
Norwich, England
Joined September 2022
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Pinned Tweet
After many weeks of development,
@DoctorsVoteUK
is finally releasing SlipSpector® 🎉. This app helps you check if your Statutory Deductions are accurate on your ESR generated NHS Payslip!
(Tax/NI/StudentLoan/Pensions)
It works for ALL NHS STAFF🤯
1/12
8
83
362
Whilst we are all on strike
#DoctorsStrike
,
it is important to spend this time to check if your pay is actually accurate.
@Doctors_Vote
's new Pay & Payslip Calculator is here:
a 🧵 1/9
7
63
2K
@DrEilidhMaria
If your followers want a quick and free payslip generator, they can use the
@Doctors_Vote
one at too! 😀
I'm sure it's the same math underneath it.
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@adi_kumar1
Very glad to hear your daughter is on the mend.
I shudder to think what would have happened if either the GP/Consultant was replaced by a Physician Associate.
I hope you continue to advocate for true medical expertise (Doctors). 🙏
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A worker earning 1£/hr, asking for 3£/hr is asking for a 300% pay uplift. But at the end of the day, ITS STILL 3£/hr.
If we consider a 5% offer, an FY1 would go from making 14.09£/hr to a staggering 14.79£/hr.
Don’t be fooled by their messaging.
#JuniorDoctorsStrike
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@VictoriaAtkins
Great news, but unfortunately an incorrect conclusion. I think you mean:
"The evidence is clear. Doctors are pivotal at reducing the waitlists."
Whatever your plans are, at the end of the day, it's the patient facing staff who bring down the waitlists.
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Let's see..
PAs can't prescribe,
PAs can't request scans,
PAs can't make any autonomous decisions.
PAs carry 0 liability.
Yep. Gets paid double.
#logic
How is this acceptable
@BucksHealthcare
?
Doctors are NOT worth half a Physician Associate.
FY1s, this is how they value you. Look how they value your replacements.
STRIKE.
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Junior doctor Surina no longer works in the NHS.
She has since emigrated to Australia for better pay and conditions.
Here is her video where she shows her getting paid ~double what a UK equivalent doctor would.
#FullPayRestoration
‘I got a taste of the famous 'sharp scratch' I dish out daily to my patients!’
Junior Doctor Surina talks about why she got her
#COVIDVaccine
, and how she’s supporting older patients to stay informed and get protected. 💪
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Bradycardia HR 45 with blood pressure 85/60?
Nah, put that ECG machine away, its time to break out the tendon hammer and get a DANISH exam done.
Then after that, maybe a CXR and 24 hour tape.
Seriously a sad state of affairs. 😕
Poor patient...
#PAProject
#MedTwitter
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.
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Wow! They didn't even have to strike!
BREAKING: Cap on bankers' bonuses to be abolished next week
Read more 👇
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Here we go again. 96 hours. If you still refuse to negotiate
@SteveBarclay
, we may be forced to think about how to escalate EVEN FURTHER.
#JuniorDoctorsStrike
#FullPayRestoration
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@ChrisWoodPhysio
Want us to be happy with PAs?
Step 1: Get them in Uniform
Step 2: Get them on a highly regulated register
Step 3: Severely restrict all autonomous decision making
If they want to be a doctor, they are most welcome to join a medical school closest to them.
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Why is a registrar worth less than a cardiology PA? 🤷♂️
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We have been lending the government a fraction of our pay, yearly, for the past 15 years.
They have now gone too far.
They’ve reached their overdraft limit and we would like to settle the tab.
No interest. Just give it back.
ALL 26.1% OF IT.
NOW.
#FullPayRestoration
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And there it is.
If pausing the PAs bankrupts the RCP, so be it. 🤷♂️
Concerning to hear that some of the
@RCPhysicians
senior leadership is allegedly recommending to vote down an EGM motion without gathering elected councillors views.
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"PAs ... should ... share the burden of work that is regarded as rote, such as phlebotomy, performing simple procedures such as ECG recording, test ordering, and results checking." 👏
Renewed my Collegiate membership with
@RCPEdin
.
Remember:
@RCPhysicians
funds
@FPARCP
.
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If PAs continue to breech
@TheBMA
scope, I'm personally never going to supervise a PA. I'll do my part for the profession.
I continue to be fascinated how many leaders across
@NHSE_WTE
@gmcuk
@RCPhysicians
want me to stop raising issues of safety re PAs
Stop it😀
Top tip?
Having meetings within tightening echo chambers won't help to push things forward
Without support from doctors?
Won't work 🤷🏾♂️
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@CorfieldGA
Contract: schedule 10, paragraph 16 :
Employers must allow annual leave to be taken when it has been requested for a lifechanging event, provided that the doctor has given notice to the employer in accordance with paragraph 14 of this Schedule.
MUST.
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Why can’t they get their own Royal College. RCPA (Royal College of Physician Assistants)
I don’t want my monthly contributions, MRCP exam fees and Portfolio fees being used to develop a profession that undermines mine.
#PhysicianAssistants
#RCP
#GetYourOwnGMC
This is statement from
@FPARCP
Where is the statement from
@RCPhysicians
?
Why are
@RCPhysicians
council not supporting and representing their actual paying members-DOCTORS?
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I’m not fighting to save the NHS.
I’m not fighting to conserve the current system.
I’m fighting to save your access to high quality doctors in the UK.
Whatever system you want, you’ll still need doctors in this country. Chasing them away with low pay is never the answer.
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@IncogAssociate
@DocShivSharma
@Doctors_Vote
@Xeon4f145d96s1
@MichelePaduano
@TomStocks1982
@Doc_IonaCollins
@DocAnonX
@DrPhilBanfield
Nice picture. The problem is that if there are no dots to begin with, there's nothing much to connect.
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Us doctors don’t have to strike. We can choose to simply leave.
I stay because I was trained by this great nation and I want to give back to this society.
If doctors do not get FPR, you will witness the greatest exodus of doctors.
Heed our warning.
FULL. Pay Restoration.
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I remember when
@VictoriaAtkins
said she will begin negotiations
"within 20 minutes"
once there were no pending strikes.
@TTOTrainee
@VictoriaAtkins
@TheBMA
@RobLaurensonD4P
Negotiations have not restarted despite the seemingly abundantly clear position the Government were ready.
We are waiting and ready to restart as soon as they are.
We will keep doctors updated with developments.
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We have been "calling for talks to end action" ever since you walked out. Hope you come to the table soon.. 🤔
@VictoriaAtkins
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Well, in that case, they should also let the doctor to not have any further on-calls during the same period to “allow the doctors to recover well from the illness with no extra workload”.
What a malicious was to impose an agenda from Russells Halls Hospital
@DudleyGroupNHS
, pretending to have doctors best interests at heart and blocking locums to retaliate against people using their employment rights.
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"..but I am not a doctor.." Excellent start 👏
Very grateful to you and your colleagues
@parthaskar
.
We need to remove all voting rights from PAs in the RCP; and then eventually dissolve the Faculty of PAs in the RCP.
No doctor wants to fund another's profession.
For Attention:
1st piece of document to establish introduction guidance for Physician Associate.
Lets set the standards re introductions to begin with.
Via
@RCPhysicians
@FPARCP
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Wow.. This is just ridiculous.. 🤯
Using a non-doctor to assess medical students. Who's next? The HCA?
Wouldn't it make more sense to get us to do these assessments so the physician associates/assistants pick up the slack on the wards? 🤔
I hope the
@gmcuk
is watching.
Physician Associates now assessing final year medical students.
Is this a sign of declining educational standards in medicine?
What impact will it have on the quality of doctors we produce?
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VoCaL MiNoRiTy..
EcHo ChAmBeRrr..
Turns out, we were always the majority.
@RCPhysicians
needs to SIGNIFICANTLY restrict scope in a reasonable time frame.
Start with Phlebotomy and Scribing, and build up from there.
@parthaskar
Plans to extend physician associate roles rejected as 87% of doctors worry about patient safety, reports
@staceyitv
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@julianhartley1
This is the current state of the negotiating table.
As you can see..
We are still waiting for the government to join in.
#DoctorsStrike
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90
This is ridiculous.
@TheBMA
has called for the recruitment of PAs to be paused whilst efforts are made by
@FPARCP
to define an appropriate scope.
Why are you still recruiting,
@gloshospitals
??
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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@djnicholl
BMA scope document covers this.
This PA/AA is in breach of scope.👇
They are simply not experts. 🤷♂️
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Full pay restoration only costed £1bn. How many more billions of tax payer money do you want to waste before you give us our dues?
Don’t you feel any guilt for wasting tax payers money,
@RishiSunak
?
#DoctorsStrikes
#BMA
#DoctorsVoteforDoctorsVote
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Today marks a significant milestone:
My official graduation as an
#MRCP
diplomate from the Royal College of Physicians.
A huge thank you to my friends, family, and especially Dr. MacKay, whose guidance was invaluable. Your dedication made this day possible!
🎓🙌
#RCPMembers
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We are also very disappointed...
You've got to try harder...
We are reballoting.
The ball is, and always has been, in your court
@VictoriaAtkins
.
“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
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No Deal.🚨 Our decision to strike comes after careful consideration and the Government's failure to provide a fair offer. We are united for the respect and support our profession deserves.
#DoctorsStrike
#StandWithDoctors
Today is deadline day.
The Government has been unable to provide a credible offer.
The BMA Doctors Committee has voted unanimously to call for strike action.
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🚨 Vote NO to the Consultant Offer 🚨
The BMA Doctors Committee urges a NO vote on the consultants' offer.
This offer risks the future of our profession. See below 👇.
Share with consultants: Vote NO for a fair future.
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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@thomaswoodcock
@TheBMA
We need more Consultants to speak out in defence of DOCTORS and to counter the narrative of "EVERYTHING'S FINE" being sown by
@FPARCP
. It has been my privilege to work with some very talented folk at
@TheBMA
, taking on tasks to PROTECT THE MEDICAL PROFESSION.
Latest MAP survey:
0
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@PaulaMaria84
@adi_kumar1
GP:
5/6 years at medical school
2 years foundation training
3 years GP training
PA:
2 years Masters programme
PAs cannot prescribe medication.
PAs are not doctors.
#AskForAGP
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This cuts through all the PA propaganda released today.
0
11
67
Ah yes. “If you didn’t document it, it didn’t happen”. But even if you did.. it still could have not happened.
#logic
GPs may need to start (audiovisual) recordings for medical defence.
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66
@VishwajeetP4t3l
@TheBMA
's PA/AA guidance for supervisors is spot on. Couldn't have written it better myself. 😊
The quicker it's enforced, the better.
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64
Everything rising with RPI, except for our pay. Strike hard folks..
Hi
@SteveBarclay
, how come hospital car park charges for staff can be increased as per the retail price index, but when doctors, nurses and teachers amongst others ask for this, we're seen as greedy etc?
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FPR will come. 🎁
Trust the process. 🔀
Trust
@Doctors_Vote
. 🦀
Merry Christmas everyone 🎄🎅
pic: /r/DoctorsUK
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14
59
Let's don the PAs in uniform. 🤷♂️
The visual distinction not only clarifies roles for patients and staff; but also subconsciously upholds the distinct qualifications and skillset of doctors, preventing the blurring of professional lines.✨
Thoughts
@parthaskar
@PaulaMc007
?
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@Roddy_Neilson
I would get struck off if I called myself a consultant.
If a PA did it, "it's not a protected term".
Funny that.
1
6
57
@ShivaniM_KC
One day, I'm also hopeful that people will write books on how doctors organised themselves, recaptured positions of power and swung the ship around for the profession.
Change begins with you and I.
What part will you play?
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They are slowly moving. Strikes work. Keep going and FPR will soon be within our grasp.
#JuniorDoctorsStrike
Junior doctors in England are set to get an extra salary bump of around £1,000 as government ministers aim to end long-running strike action, The Telegraph can reveal
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@Xeon4f145d96s1
@StGeorgesTrust
@BMA_JuniorDocs
@Doctors_Vote
Doesn’t matter who trusts think should/shouldn’t strike. Every junior doctor, BMA member or not, can withdraw their labour on 13, 14, 15 March.
0
9
52
@IncogAssociate
@itvnews
@staceyitv
Looks like they didn't teach you about the concept of "sampling" in PA school? 😂
"I will only believe results of studies that test 100% of the population" - you
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Militant. adj. def: “favouring confrontational methods in support of a political or social cause”
I think people are starting to see it is you that was the militant one all along,
@SteveBarclay
.
#FullPayRestoration
#JuniorDoctorsStrike
0
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@ElshadKarbasi
This is such a good QI project.
There are so many people who care about patients and ~0 people caring about staff.
My first QI project (2020) was attaching a USB splitter so each of the 2 computers in an office could print to the printer.
0
0
53
Ward walked Ipswich Hospital today.
So proud to see so many already sent in their ballots voting for further strike action and ASOS. 🥹🙏
Every ballot counts!
✉️ ---> 📮
@BMA_JuniorDocs
@Doctors_Vote
@EasternBMA
@EastEnglandRJDC
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You think hiring a professional is expensive? Wait till you hire an amateur…
#PhysicianAssistants
Parents of a woman who died after errors by a GP physician associate, fear spread of new roles will end in more NHS tragedies. Report by
@katlay
#patientsafety
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9
49
@AskJeevesWij
I mean, isn't this common sense?
Why was it proposed that PAs and Doctors have the same number structure in the first place?
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In the interests of patient safety and preservation of training, departments in the UK must cease any further recruitment of PAs/AAs.
The BMA has called for an immediate halt to the recruitment of MAPs (PAs/AAs)
Read the statement below
Doctor or PA? Know the difference
#AskForADoctor
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0.08% of the budget isn’t going to propel the economy into an uncontrollable wage price spiral…
#FullPayRestoration
It’s not unaffordable, don’t let them convince you otherwise.
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@omerdays
Hey, at least they asked an actual medical professional for a decision. (instead of making one for themselves)
This is actually a good thing.
6
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@BBCNews
None of this would have happened if the government came to the table and made a credible offer today.
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2
42
@theveindoc
@CQCProf
I see you are finally seeing the light.
Is this the beginning of your redemption arc?🙏
2
1
40
@EthersonKevin
@amateuradam
@clintonguilty
@DocAnonX
@Xeon4f145d96s1
@noodles_nood
@BMA_JuniorDocs
@SteveBarclay
Please write to
@SteveBarclay
. He is the only person that can stop these strikes. Telling junior doctors not to strike is like shouting at a brick wall. We are going to strike, and HARD. If you really do care, I’d suggest pulling some strings to get
@SteveBarclay
to the table.
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They're perhaps trying to ?maybe nullify all previous survey responses.
I suggest everyone fill this again.
This is the new link to the consultation regarding MAP “Core Capabilities” - now retitled to "Career Development".
The survey is for the most part the same with an added page.
This would make existing links broken (and collected results ?invalid).
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I would feel so dirty each and every day knowing that I wilfully misled a room full of esteemed fellows.
And for what gain? to ruin the medical profession?
If I were her, I would take the 'L' and just resign.
Its the right thing to do. There's no 'confusion'.
Take a step
🐍 The president of
@RCPhysicians
Dr
@DrSarahClarke
has decided to lock her profile due to daily insults and criticism as well as fellows encouraging her to resign.
#RCPEGM
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@SteveBarclay
@BMA_JuniorDocs
@Telegraph
It is exactly this sort of gaslighting that we have had enough of. Deadline's approaching. Pay up. Its the only way to stop our action.
#SchoolboySteve
#DoctorsVotedYES
#BetterCallHunt
0
1
38
The enforcement of
@TheBMA
scope guidance for PA supervision cannot be delayed any further.
As such I have taken the decision to suspend my involvement with PA training and service ole development until clearer evidence of role scope and safe supervision is developed by other services I trust. /12
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9
37
Update ✨:
Initial release has seen over 2000+ hits to the site, 📈
and over 40 work schedules uploaded!! ✅
Lots of great feedback too!! 💭
@Doctors_Vote
thanks you for your support. 🙏
YOU have quickly noticed and pointed out that RotaReader is not adequately taking `blanks`
2
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36
We will continue to strike and strike until they understand that we will not accept anything other than FULL pay restoration.
#DoctorsVote
🚨The BMA Junior Doctor Committee will be calling a 96 hour strike applying to shifts starting between 06.59 on Tuesday 11th April and 06.59 on Saturday 15th April. 🚨
This is an escalation to convey how serious we are about full-pay restoration. Anything less is a pay cut.
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@DocShivSharma
@Doctors_Vote
@Xeon4f145d96s1
@MichelePaduano
@TomStocks1982
@Doc_IonaCollins
@DocAnonX
@DrPhilBanfield
Definitely need to add:
"Not allowed to assess medical students" to the scope set by
@FPARCP
Can't even believe this needs to be stated 🙄.
@UKGastroDr
@parthaskar
1
2
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@ExplosiveEnema2
The lines have literally been unblurred by
@TheBMA
.
I was 11 years old when the first PA started practicing in the UK. I'm 31 now. Still no scope.
Good on
@TheBMA
for showing that if you want something ACTUALLY done, you got to do it yourself.
0
2
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@DrNeilStone
Yes, Motion 5 will need to be rerun at the next EGM.
@UKGastroDr
#RCPEGM2
1) Call for the ORIGINAL wording for Motion 5 (pause COMPLETELY).
2) VONC RCPL executive.
It'll be 90+% for both I'm sure.
Looking forward to the "re-vote".
This time, let's get the motion right 😉.
1
7
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@ElshadKarbasi
@Doctors_Vote
have released a new pay calculator at . You should definitely check it out to make sure you're paid properly!
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If you run it, and AI tell you that you should give our doctors Full Pay Restoration, will you also call it militant and having a political agenda?
#DoctorsStrike
#DoctorsVote
#FullPayRestoration
AI has the potential to transform patient care, that’s why we recently pledged £21 million for its swift rollout across the NHS.
Great to see it in practice.
@ChelwestFT
is using
@SkinAnalytics
to cut down unnecessary appointments and focus on the most urgent cases.
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@Doc_IonaCollins
The supervising consultant will be struck off if a PA makes a significant enough blunder. PA holds 0 liability. Perhaps Consultants will need to learn the hard way.
4
2
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@ShaunLintern
How does it feel to witness junior doctors’ collective good will being exploited!?
#disappointed
0
0
32
@parthaskar
We cannot give up.
We need to keep trying to fix this.
Apprenticeships, MAPs, PAs all pose a significant danger to both doctors and the public.
Get organised and put on the pressure. At least if we didn't succeed, we know we tried our best for the profession.
0
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@ChrisWoodPhysio
If someone kills someone, you send support to the victim.
Sending support to the perpetrator sends the wrong message.
Just saying.
1
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If you liked the progress we’ve made towards pay and want us to continue, you’ll have to vote for us again.
Vote DoctorsVote. Vote for your future.
#DoctorsVoteforDoctorsVote
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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6%?
FY1s : 14.09£/hr --(+6%)-> 14.94£/hr.
Another 5.06£/hr to go
@RishiSunak
@SteveBarclay
.
#DoctorsStrike
#WorkforceCrisis
1
8
28
@AnalysisDrawer
Physician Associate role was never about patient safety. It was always about doctor welfare.
Instead of spending time thinking:
"how can I help my patient", ask instead:
"how can I help the doctors in my team".
Make this fundamental shift, and you will be on the right path.
2
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@vass_vassiliou
@TharushaGunawa4
I love it Prof.. but will the infection control nurse feel the same way? 😂🧥
6
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Turns out.. you didn't even need a master's degree to be called Physician Associate.. what a mess.
🚨Trusts hiring PAs who haven't completed any PA degree
@RCSEd
which site is responsible?
Given the evidence we need
- Pause on recruitment
- Audit of every site utilising PAs looking at qualifications, safety, job role, scope, rotas, & impact on Drs training
#AlwaysGetsWorse
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@veggieequallife
Doctors can't find training jobs?
No problem.
PAs can't find training jobs?
BIG problem apparently.
#RoyalCollegeofPhysicianAssociates
0
5
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@UKGastroDr
@RCPhysicians
@FPARCP
Doctors' RCP fees are currently allocated to their profession.
There's a whole faculty allocated to them.
They have a vote in physician affairs.
They have a conference.
Resources that could be allocated for the betterment of physician training and education.
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We (
@BMA_JuniorDocs
) will be sitting next to the phone on July 5th.
@RishiSunak
has made mistakes.
It's best you don't repeat them.
#FullPayRestoration
There is a deal to be done with junior doctors, if only we had a government willing to negotiate.
With Labour, we will.
We will start talks urgently, to end the chaos and begin to rebuild our NHS.
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@Xeon4f145d96s1
@juniordoctors_
can you please look at the submissions’ IP addresses and see if they are all coming from one person?
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“…thank you for your service Surina. Australia is glad to have you here and pleased to pay you well. Hope you enjoy your stay and that you continue to do valuable service to the community wherever you are.” -youtube comment
If only the UK valued its doctors just as much…
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This app is fully free to use. We are not extracting/keeping any data from your payslips for the moment.
As this is the first release, we expect a few bugs to show up. We rely entirely on your active feedback to make this app better. 🙏
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🚨 Patients deserve better! The lines between doctors and Physician/Anesthesia "Associates" are actively being blurred, putting patient safety at risk.
Doctors are taking legal action against the GMC.
#DoctorsNotAssociates
We are commencing a legal case against the
@gmcuk
over their regulation of Physician Associates.
We need your help to fund it.
Writing letters didn't work. Time for action.
#telltheGMC
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@VictoriaAtkins
@DHSCgovuk
You're very welcome.
Unfortunately, I'm unable to pay my bills with thanks, given the current exchange rate of
" 1 Thank = £0.00 " - (as of today)
If you could thank us with FPR instead, we would be most grateful. 🙏
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Be safe, doctors…
Last thing you want is to be struck off as a result of a PAs actions.
Refuse to supervise any PA activity not in the green column of
@TheBMA
’s MAP scope document.
With the recent GMC ruling about responsibilities of junior doctors in supervising PAs, I would strongly recommend all doctors finding themselves in this situation to follow
@TheBMA
scope of practice guidelines.
If your Consultants want these roles in their department they
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Our stance on FPR is also final.
We waited 15 years.
We are just getting warmed up. 🙆♂️🙆♀️🙆
I urge the BMA to end its strikes immediately.
They only harm patients and put immense pressure on other NHS colleagues who must cover extra work, on top of their own.
These fair, independently recommended pay rises, which start this month, are final 👇
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@NHSHandSan
You are incorrect.
PAs basic pay is based on 37.5hr weeks.
Doctor's basic pay is based on 40 hr weeks.
adjusted to 40 hours:
Day 1 PA : £46,658
Day 1 Doctor : £32,398
Difference?
FORTY-FOUR (44) %.
Why is the assistant's salary higher than the doctor they are assisting??
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Read this long thread to find out how
@RCPhysicians
played a central role in causing the mess we live in today... 👇
It's shocking...
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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NHS England has ORDERED all hospitals to stop using Physician Assistants to cover doctor's shifts. 👨⚖️
🔴NEW: NHS England orders hospitals to stop using physician associates to cover doctors’ shifts after
@Telegraph
investigation reveals that the practice is widespread.
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This is how you punch up. Put pressure on the government. Only they have the power to end this dispute. Thank you
@trentconsultant
.
@tivaisgreener
@SAS_gas_Thomas
Yep that’s right. Close the unit. It’s absolutely the right thing to do. And get the CEO to phone Steve Barclay and let him know.
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