Selvaseelan Selvarajah
@DrSelvarajah
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Just a GP in East London with various roles. #TeamGP #NHS . Views - mine only, not organisations I’m part of. #தமிழ்
London, United Kingdom
Joined November 2013
I am a foreign born. My family sought refuge in 🇬🇧. This country has given us amazing opportunities. This is our country. This is where my wife and I raise our boys. We must all look out for each other. Many are deeply worried. Ensure 🇬🇧 remains an inclusive country.
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#TeamGP OOH today. Patient who I saw as a child with their parent, now with children of their own, wanting to see me because they have great memories of care provided. Concept of family doctor is a powerful for patients. Continuity of care is better for us working in GP too.
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Approx half of all new GP trainees are internationally qualified doctors. Half of all GPs are from diverse ethnic communities. GP practices are rooted in their communities. Many of my colleagues are deeply worried for their safety. Racist thuggery has no place in 🇬🇧.
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For junior Resident doctors, it’s crucial for them see lots & lots of less complex patients. This repeated exposure is an important part of training as they progress towards mastery of their specialty. This is why “freeing up doctors to do more complex work” is quite nuanced.
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Proposals to cut waiting lists. “GPs will also be able, where appropriate, to refer patients directly to these centres without requiring a prior consultation with a senior doctor.” . GPs are also senior doctors @BBCHughPym . Could this be corrected?
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And further changes by RCGP Council today…. Doctors in GP training will now be known as GP Registrars, replacing term Associates in Training. Some legal bylaw changes to make it all official. But, it’s moving forward. Right term to describe highly trained doctors in #TeamGP .
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Dehumanising #Refugees has led to the violent racism on our streets. Under the guise of debating immigration, who seek to divide us have spread hate. I was 13 yrs old when my family fled persecution, arriving in 🇬🇧. Refugees deserve compassion, not dehumanisation.
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This is a major reason for why scope of practice for PAs must not be decided by employers & individual supervisors. Even as an experienced GP, I would never do this. We rely on experienced Paediatricians who specialise in CP to do these medicals for these vulnerable children.
Is the truth finally emerging? @AlderHey corporate risk register 👇. "There is a risk that Child Protection (CP) Medical Examinations completed by Physician Associates (PAs).may not result in successful prosecution due PAs not being recognised as 'Professional Witnesses'."
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At RCGP Council meeting today. Lots to discuss incl PA scope of practice. Despite the leak, can’t share details as paper is marked confidential. Members elected me to represent GPs across 🇬🇧. Already heard from members via the survey. Will always represent their views.
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GPs are looking for jobs. Patients need more GPs, whole person experts trained to manage uncertainty. Surgeries don’t have funds to recruit GPs. GP work load is causing many to leave. What to do about this obvious. Let’s sit down with GP reps to make it happen for pts.
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Medical professionals terminology should only be used to describe medical doctors. Healthcare professionals can be used to encompass all who deliver healthcare to patients. Furthermore, each clinical role should be clearly defined in a language patients can understand.
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Hope all of you had a great #Christmas 🎄🌲and looking forward to #BoxingDay . Back in GP OOH like 1000s of other #NHS staff. NHS 111 & GP out of hours continue to operate during the festive period. We are we here for any of your urgent concerns. 999 & A&E for emergencies.
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Govt will recruit >1,000 newly qualified GPs for 2024/2025- via additional roles scheme. Very welcome news for General Practice & patients. But, is a temp measure. Sustainable way forward is permanent investment in core GP contracts to fund for GPs.
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Motion has fallen. So, additional lay member will not be added to RCGP Trustee board. Many passionate speakers from both sides. I shared my views against the motion. Great to be part of my professional home & be able to speak for members. Thank you to College leaders.
The @rcgp AGM is tonight. You can still register and attend virtually at 1830 to vote down special resolution 4. Don't dilute the board.
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Should all medical degrees in the UK be 4 yrs of academic & clinical training with the 5th year equivalent to FY1 with the students are paid to work? . Could help in the era of expensive tuition fees, enables practicing the profession earlier & possibly faster route to CCT?.
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Thank you for highlighting this. I’ve raised this with RCGP colleagues. Occupational therapists are an invaluable part of community care MDT and we regularly refer to them. But, they shouldn’t be undertaking management of undifferentiated and undiagnosed conditions in GP.
1/13 First Contact Practitioners: a fallacy @NHSWTE workforce policy in primary care? .Can 1/2 master modules and 75 hours of supervised workplace practice prepare allied health professionals to ‘assess and manage patients with undifferentiated and undiagnosed presentations’?
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GP surgeries are exclusively contracted to #NHS provide care for registered pts. We cannot charge pts for those services. We have fewer GPs. Fewer practices. GP contract cut in real terms. Sickness ➡️ prevention . Hospital ➡️ community . Needs viable #TeamGP @wesstreeting
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We have lost 1700 FTE GPs. We have 2000 fewer GP surgeries. Patients are struggling to get appointments. This ICB has decided not to allocate funds for GP retention. In other industries, every effort would be made to retain highly trained professionals.
Thanks v much @LSCICB for this gut punch to GPs in Lancashire/S Cumbria.I’ve had GPs contact me thinking they just don’t matter & considering throwing the towel in when the ICB just tosses you aside. Thoughts @NHSEngland @wesstreeting @pulsetoday ?
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In General Practice, ST3 GP registrars in the last few months before qualifying as a GP can be remotely supervised. Even that is only if they are progressing well towards independent practice. For all other doctors in training in GP, direct or near supervision is appropriate.
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@parthaskar @mmamas1973 @DrAsifQasim @iDrSunny @ShrillaB @sasbanerjee @DrLKVaughan @HilaryWMedic @UKGastroDr @RowanHarwood Thanks Partha. Thanks for raising this @TomStocks1982 . I have passed this on to a Consultant in same dept to forward to the supervisor. Patients & their loved ones place utmost confidentiality from their caregivers. That sacred privilege needs to be recognised from the start.
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RCGP updates its position on PAs and scope of practice. Thank you to the College team including leadership for facilitating varied and respectful discussions so that elected representatives like me can reflect the views of the members.
RCGP governing UK Council has today voted to oppose a role for Physician Associates working in general practice. You can read more here.
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No clinician in the 21st century should be working without defined regulation, uniform & rigorous standards for training, exams, supervision and scope of practice. As for comment about GPs, we are whole person experts who take a wider holistic approach to patient care.
The war on Physician Associates is putting the interests of doctors above the interests of patients, argues @cjsnowdon .
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Probably not the best example to illustrate how patient care could be improved by the new proposals. Several patient journeys, unnecessary investigations adding to cost. Would’ve been ideal to say patient to see GP, who can decide with them, about the best course of action.
So this is the new great idea🤔.I’m pretty sure if Sarah had seen a GP she wouldn’t have needed to have a CT scan, no need to speak to the ENT registrar & yes it could be managed in the community .Why does NHS England always underestimate the skills of GPs.
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The far right cannot dictate how the rest of inclusive 🇬🇧 lives. We may have our challenges but our diversity is our strength. We are stronger together. #NHS including General Practice cannot survive without our colleagues from all over the world. Hate has no place here. 🙏🏾.
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Short sighted policy to address justified concerns about training places & jobs. IMGs are a vital part of NHS with years spent working. UK citizens training abroad could come under this. Importantly, this isn’t BMA policy. It’s policy of a branch. DOI: BMA UK council member.
Competition ratios are terrible. Your UKRDC passed the following policy:. "This committee resolves to prioritise lobbying for a method of UK graduate prioritisation for speciality training applications and on the issue of training bottlenecks during this session." (1/2).
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Digital #NHS : @wesstreeting . Let’s start with electronic prescribing for hospitals. Currently: Prescriptions recommended by hospital. Letter arrives 2 weeks later. Pt books appt with #TeamGP to ask for those meds. Patient & GP time wasted. Safety issue too.
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If we are to rescue the #NHS , we need to start with rescuing #GeneralPractice first. Vast majority of patients contacts and #patientcare starts and ends in #TeamGP . No solution to the troubles of the NHS can be found without supporting it.
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This is why I chose to become a GP trainer. 😎. Absolutely spot on present from our GP ST2 doctor. GP trainer - trainee relationship is a close one where you get work together and bond long term. Great privilege for me. Many of them end up becoming future colleagues.
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Thank you to Prime Minister @Keir_Starmer for inviting many of the #Tamil community members to celebrate #ThaiPongal at Downing Street along with @Uma_Kumaran @wesstreeting MPs amongst others. The diverse communities of 🇬🇧 enrich our nation and strengthen us.
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Happy new year. Back to usual in #TeamGP . On triage with another senior GP. Working with an amazing multi disciplinary team & Resident doctors. Each vital for patient care. Our model is, a senior GP triages & books/signposts patient with appropriate clinician/service.
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@DrJSherrington @Derriford_Hosp Sorting out parking for staff who work unsociable hours and on calls is one of the simplest ways #NHS can value the staff. On the grand scheme of things it’s a lower cost, higher return in value added measure.
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General Practice is struggling to deliver for patients. Yet, we are the first port of call for 1.4 million patients a day. We have fewer GPs and practices. Without support for NI hike, like rest of #NHS has, GP practices are at risk of closing.
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Welcome request by AoMRC. There is evidence from RCGP, RCP & BMA surveys. GMC has also done a survey. Not yet shared publicly. FOIs from NHS employers too. So, there is plenty of evidence base to start from. Discussion needs to be about national scope & supervision.
Well. In a surprising turn of events, the UK’s Academy of Medical Royal Colleges (@AoMRC) today responded to mounting concerns about the substitution of doctors with PAs by ‘spontaneously’ urging @wesstreeting & @NHSEngland to commission a 'rapid review' of their safety. 1/n
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Good morning from #TeamGP . Morning coffee with oat milk ✅. Morning dad joke ✅. Ready for on call/triage session with our amazing team @BBB_Health . Usual reminder that the vast majority of patient contacts in the #NHS takes place in GP. We need more GPs & funding for them.
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Study about GP working hours. GPs work in sessions. Not hrs. This is used to criticise GPs as PT workers. A sessional length has gone from 5.7 hrs to 6.2 hrs. So, 6 sessions or 3 days in GP is FT for other workers, but seen as PT for GPs.
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Back in med school when we had to assemble a human skeleton, I hid one of the arm bones as a joke. No one found that humerus. #dadjokes.
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This is welcome news @wesstreeting . Many of us have raised concerns about creating two tier medical training. If we want to widen participation in medicine, and there is a desperate need to do so, there are many other measures one can take.
Medical apprenticeships are something the BMA has expressed significant concerns about, and we welcome plans to halt these. We will be watching developments very carefully and will continue to fight for improved medical student funding and WP initiatives.
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The @rcgp have released scope of practice documents for Physician Associates. College has consulted with members, stakeholders and Council members to produce this guidance.
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Avengers: “What’s your super power?”. Me: “Hindsight.”. “Yeah, that’s not going to help us.”. “Yes, I see that now.”. #dadjokes.
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Great to see this statement from the BMA. All organisations must take a similar public stance to support the deeply worried diverse #NHS staff that keep it all going.
We are horrified by this weekend's racist attacks on people, shops and community buildings. BMA is anti-racist and anti-fascist, members will need to organise with others to keep our communities safe for colleagues and patients. 👇.
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I am a health tech enthusiast. There is a lack of understanding about what #TeamGP does, its role in #NHS & holistic care required. Tech is a great enabler for patient care and augments clinicians. It is not a replacement for GPs & tackling social determinants of health.
This report on the future of the NHS from the Tony Blair Institute @InstituteGC is dreadful. Rather than implement the obvious solution to increase primary care capacity (employ more GPs), the TBI wants to replace GPs with “AI-powered chatbots”.
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@DrNighatArif Half of all GPs are from diverse ethnic minorities. All are welcome to use #TeamGP but we have zero tolerance for racism.
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We are not going to sort out #NHS by focusing only on primary care initiatives outside of General Practice core work. Most new investment in the last 5 years has done just that. Not made it better for patients. Not made it more efficient. Not made it cost effective.
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I’ve been an RCGP member since 2007. Council member since Nov 2023. It’s the GPs professional home. As I always say to anyone who will listen, an organisation is only as resilient as its members & those who represent the members. Join & contribute if you have the energy.
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#TeamGP have been absorbing more & more work for less & less funding in real terms over last decade. Result: . 300 more pts FTE GP. 20% more pt contacts . Loss of ~1700 GPs . ~1000 fewer practices. Let’s safeguard General Practice for patients.
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Been asked to share this from several FB doctors forums. An O&G doctor from Colchester has been missing since Friday. Police incident number is on bottom of poster. Hope she is found quickly.
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General Practice operates on £0 deficit. Unsustainable practices aren’t usually rescued; contracts transferred. #TeamGP is also recording ~20% more activity since 2019, with 1700 fewer GPs since 2015. Reform needed in #TeamGP is mostly about ever reducing share of funding.
‘Offer GPs the consultant contract’ to reform primary care
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Sacked my fruit delivery driver today. I hate to let the mango but he was driving me bananas. #dadjokes.
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My mate failed his driving test today for pulling out in front of a Mr Kipling lorry. Lucky it had exceedingly good brakes. #dadjokes.
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If national insurance for employers is not refunded for General Practice as well, there is a risk many practices will be forced to close or reduce services. GP has had funding reduced in real terms. GP practices are exclusively contracted to the #NHS for their core incomes.
Darzi 'We need to shift resource from Secondary to Primary & Community.'. Streeting 2 weeks later. ⬇️.Only happy to refund NI for hospitals. What will he have to say in a few weeks I wonder. ?.Because currently, this budget looks worse for General Practice so far.
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Seeing reports of Muslim colleagues worried about coming to GP practices wearing visible clothings that display their faith. Colleagues are frightened. Islamophobia is driving a lot of riots we are seeing currently. Not acceptable for our fellow citizens to be live in fear.
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Access to GPs is deeper than just can I see my doctor today. Continuity is crucial for patients and GPs - both long term and episodic. Focus needs to be on outcomes for patients rather than just appt numbers. Plenary interview @jacoblant @KamilaRCGP @RCGPAC #RCGPAC #RCGPAC24
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Often introduce myself as “Dr Selva” if seeing patients 1st time. Ask them how they want to be addressed. Modern #TeamGP is multi disciplinary so clarity of roles is crucial. Once pts know me well, many do call me Selva, brother, mate etc. That’s a sign of respect in East End.
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📣GP Contractor Non-Statutory BALLOT RESULT 📣. ~8,500 GP partners voted in the ballot. Turnout 67.7%. *98.3%* voted YES.*1.7%* voted NO. The profession has given @BMA_GP 🏴 an overwhelming mandate for collective action commencing today. @doctor_katie @DavidGWrigley.
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@jobbinggasman @iDrSunny @DrNeenaJha @AnaesUnited @BMA_James_Steen @wesstreeting @Dr__Sarmy @ClinOncDoc @Doc_IonaCollins @Dr_Done_ @dr_woodall @rcgp @JatinderHayre_ @ExplosiveEnema2 @GMCharlatan @InvCoriolis @medicalmodelbri PAs not only need to work under clinical supervision when on duty, they also need to have named educational supervisor for ongoing CPD. GMC states clinical scope needs to be appropriately determined by the supervisor. Hard to ensure all of this if it’s a locum PA post.
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Not to boast but I’ve just completed a jigsaw under 2 weeks and it said 2-4 years on the box. #dadjokes.
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My grandad always said “in the good old days, you could just leave the back door open. ”. Great man! . Terrible submarine captain!!. #dadjokes.
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Saw a patient who thinks he is a goat!. "Hmm, how long has this been going on?". "Ever since I was a kid. ". #dadjokes.
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The ENT doctor kept me waiting for ages at the laryngitis clinic. About four hours, roughly speaking. #dadjokes.
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Step in the right direction. Great to see @wesstreeting recognising pressures in General Practice in delivering for patients. Important to invest permanently core GP contract given #TeamGP is crucial to achieving #NHS 10 yr plan.
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Understand why this idea came about. It’s much more sustainable and cost effective in the long run to address causes of obesity incl obesogenic environment and supporting people to learn new skills. We can’t inject our way out of this problem.
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On the very first day of my levitation course…. I went straight to the top of the class. #dadjokes.
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#TeamGP - continuity of care is a foundation. When you know these patients for a long time, you become a keeper of their stories and tribulations. Very fulfilling for us. Safe for patients. This is the magic of General practice. Focus needs to be on this quality.
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This is obvious to those of us who work in General Practice. These tools have been developed in hospital settings and don’t transfer well to unwell children in GP. These may augment care but we mustn’t rely on them fully. History, examination and clinical acumen crucial.
Researchers have warned GPs not to use paediatric risk scores to assess sick children after showing they do not work in general practice.
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My mate has opened a shop selling casserole dishes in Jamaica. Pyrex of the Caribbean. #dadjokes.
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They hacked my email password again. That’s the third time I’ve had to rename the cat. #dadjokes.
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The funeral of the Tupperware inventor is a bit delayed. They are still trying to find the right lid to fit his coffin. #dadjokes.
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