Mike
@Mike88881221
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🔴NEW: Emails show @gmcuk lobbied the government (@DHSCgovuk) to fund its legal defence against bereaved parents & @AnaesUnited . The legal action challenges @gmcuk's failure to distinguish between doctors & physician associates or set a 'scope of practice' for PAs. @wesstreeting
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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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🚨 NEW: Physician associates at @RoyalFreeNHS illegally requested over 1,000 scans involving ionising radiation over 3 years. A loophole in the hospital's electronic system (Cerner) allowed PAs to request the tests. Senior doctors knew this was happening but did not act 👇
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🚨 Alder Hey Children's Hospital inappropriately used a physician associate to conduct child protection medicals and forensic examinations of abused children over a 4-year period. New FOI responses and a case study written by the PA reveal shocking details 👇👇
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🚨🚨 ALDER HEY STATEMENT: "The physician associate did perform other child protection medicals undertaken for children and young people where it is known or suspected that they have experienced physical abuse and/or neglect". @RCPCHtweets still silent.
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🚨 NHS COVER UP: @ImperialNHS employs Physician Associates in paediatric/neonatal surgery, but has refused to answer FOI requests about their role. Four FOI requests, asking if PAs are replacing doctors, or assisting with operations on children, have been ignored since March 2024
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This is absolute madness. @SwanseabayNHS don't even know the procedures their physician associates are carrying out on patients?! . "this information is not recorded". But they've had SEVEN incidents caused by PAs performing clinical procedures in 6 months 🚩🚩
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@InvCoriolis @JanetEastham @AlderHey Didn’t the initially lie about it too? I swear I saw somewhere that they said PAs did NOT do these exams until a formal FOI inquest was put in?.
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This is so depressing. Currently 42 PAs being trained in endoscopy, with full support from @BritSocGastro - why is there such a race to the bottom in UK medicine? And why is this supported by medical leaders? It simply makes no sense. @ExplosiveEnema2 @drmattuk @iDrSunny
@ExplosiveEnema2 @UKGastroDr @parthaskar @mmamas1973 @iDrSunny @AlisonGeorge10 @BDChadwick @ClinOncDoc @Dr_S_Parker @DrAsifQasim Evidence base in GI is most trainees not getting signed off for full colonoscopy by CCT now. GI SpRs doing GIM. Meanwhile. .
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As a GPST3 currently job hunting, these adverts for PAs are so triggering. No primary care experience required, but being used in a GP replacement role. It feels as if my entire GP training programme was pointless @PrimaryCareNHS @parthaskar @medicalmodelbri @Parody_RCGP
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Update: @ImperialNHS have now published details of their Physician Associates in paediatric surgery. Worryingly, the role includes assisting with operations on children, including assisting with emergency surgical cases 🚨. Are parents informed as part of the consent process?
🚨 NHS COVER UP: @ImperialNHS employs Physician Associates in paediatric/neonatal surgery, but has refused to answer FOI requests about their role. Four FOI requests, asking if PAs are replacing doctors, or assisting with operations on children, have been ignored since March 2024
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What is going on behind the scenes at @NHSE_WTE, @gmcuk & @DHSCgovuk?. Are they planning to allow "PAs to quickly qualify as doctors"?. Action point from the GMC's MAP programme 2024 risk log 👇
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ALDER HEY COVER-UP🔔🔔🔔. This is a scandal in the making. This response by @AlderHey to @LiamThorpECHO @LivEchonews is a deliberate attempt to cover up the truth of what happened in their paediatric safeguarding unit.
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Direct quote - "See patients that would have otherwise been seen by a Consultant or Registrar". I just don't understand how this role substitution is seen as acceptable. Who assessed the risk? Why not recruit more doctors or specialist nursing staff?.
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🚩🚩New data reveals scandal-hit trust @CHFTNHS used Physician Associates to fill medical rota gaps. The trust claimed it could “convert” medical shifts so PAs could cover them, ignoring guidance from @NHSEngland, @DHSCgovuk, and @gmcuk that PAs must not replace doctors
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The more I dig into this story, the worse it gets. More damaging revelations for @RCPCHtweets 👇. Not only did college officers know @AlderHey employed a Physician Associate to perform child protection medicals & assist with forensic exams - they also awarded the project a PRIZE!
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Absolutely horrifying. The Physician Associate at @NCAlliance_NHS was “signed off” to insert ascitic drains by a specialist nurse, who thought the PA was a doctor. There must be a pause of physician associate expansion. This isn’t safe.
'My wife died because the NHS used cheap labour'
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UPDATE ‼️ Thanks to those who sent DMs with more information about the situation @alderhey - more details are rapidly emerging. It appears Alder Hey deliberately misled children, young people, and their parents/carers. See the patient information sheet given to patients/parents
🚨 Shocking new revelations in the Alder Hey Physician Associate scandal 🚨. @AlderHey employed a ‘physician associate’ instead of a doctor to assess children following sexual assault and abuse. Hospital management knew about this - but did nothing 👇👇.
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This exchange between an @AlderHey consultant and @alderheymeded highlights everything wrong with the organisation's culture that allowed a Physician Associate to work far beyond their training & perform child protection medicals. "Other specialties have it so good". @IanByrneMP
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🚨 Shocking new revelations in the Alder Hey Physician Associate scandal 🚨. @AlderHey employed a ‘physician associate’ instead of a doctor to assess children following sexual assault and abuse. Hospital management knew about this - but did nothing 👇👇.
🚨 Alder Hey Children's Hospital inappropriately used a physician associate to conduct child protection medicals and forensic examinations of abused children over a 4-year period. New FOI responses and a case study written by the PA reveal shocking details 👇👇
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In 2023, @gmcuk awarded a four-year £2.8 million contract for private medical insurance (£700k per year) 💰. The tender documents show the actual spend on private medical insurance in 2022-23 was £642k for 1066 staff. This is equivalent to 3690 x FY1 fees or 2006 x PA fees
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Oh my god. They knew. @RCPCHtweets @RCPhysicians. This is horrendous. @AlderHey should be ashamed. @RCPCHtweets is still silent with their head in the sand. Urgent action is now required. We must pause PA expansion.
🚨 EXCLUSIVE: NHS children’s hospital let physician associate examine abuse victims.Alder Hey Children's Hospital tonight admits PA was removed from safeguarding team over concerns that their findings would not stand in court.
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I am just astounded at @RCPCHtweets silence. Why are they so reluctant to call out the inappropriate use of physician associates within paediatrics? This doesn't need a survey or a working group. It's not right, and @RCPCHtweets should be advocating for children.
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I find this letter from @AoMRC incredibly depressing. It attempts to downplay the current situation, even though more evidence of inappropriate use of physician associate roles is emerging daily. "this conversation is almost devoid of factual information" - gaslighting 101
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Surely we need to pause the rollout of physician associates until clear rules are set on what they can and can’t do?. Without rules, hospitals like @AlderHey will use them in highly inappropriate roles like child safeguarding medicals. Is this not common sense? @gmcuk.
'She thought she was a doctor.'. Marion and Brendan's daughter died as a direct result of being treated by a Physician Associate when she thought she was seeing a doctor. Emily had a blood clot in her calf but was sent away with a beta blocker & a diagnosis of long Covid. She
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The physician associate performing child safeguarding medicals was NOT SUPERVISED @AlderHey ! Shameful response by the trust. @LiamThorpECHO @LivEchonews.
Growing controversy around use of healthcare workers in NHS, but Alder Hey insists staff member was supervised during work.
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After the @rcgp published their scope of practice guidance for Physician Associates, @gmcuk CEO held an emergency meeting with @NHSResolution. NHSR is refusing to disclose details, citing concerns it could ‘affect claims NHSR might be asked to indemnify’. What is being hidden?
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In West Wales, @HywelDdaHB is using ‘nurse anaesthetists’, anaesthesia associates with non-medical prescribing qualifications, to prescribe anaesthetics. Patients having an anaesthetic may not be seen by an anaesthetic doctor at any point in their care 🤯. @Jeremy_Miles
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🚨 ANOTHER hospital involving Physician Associates in child protection cases? 🚨. Worrying FOI response from @BlackpoolHosp. It suggests PAs can be used for "initial history taking +/- initial examination" of children referred with suspected abuse + dictating medical reports👇
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Hi @gmcuk, your website says you are "independent of government". Why did you get involved in helping the government pass the Anaesthesia Associates and Physician Associates Order?. This doesn't look very independent to me. @doctor_oxford @drmattuk @ExplosiveEnema2 @iDrSunny
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.
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Sorry to keep going on about this, but a reminder that @RCPCHtweets: . 🔴 Knew in 2021 that @AlderHey was using a physician associate for child protection medicals.🔴 Awarded the project a prize.🔴 Included physician associates in their child protection audit. No apology yet.
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🚨 NEW: According to child protection audit data from @RCPCHtweets, @WestSuffolkNHS also uses physician associates to perform child protection medicals. @RCPCHtweets has serious questions to answer, as they appear to be endorsing this practice and also about @AlderHey 👇
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New documents show that @gmcuk is on track to spend around £10 million of taxpayers' money on regulating physician associates and anaesthesia associates 💰. There are under 5,000 physician associates on the current voluntary register and around 200 anaesthesia associates.
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It looks like the @gmcuk will ignore most of the responses to the recent PA/AA consultation 👇. Source: GMC update to Health Education and Improvement Wales MAPs Oversight Group (July 2024)
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‼️ Yet more evidence of unsafe use of Physician Associates by NHS Wales and @WGHealthandCare . PAs have been involved in Do Not Attempt Resuscitation (DNACPR) decisions, with PAs initiating DNACPR forms. The email below is reportedly from @CwmTafMorgannwg👇 (h/t @Dr_Done_)
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Pharmacists, is this right?. @AneurinBevanUHB seem to allow PAs to administer emergency meds, either "verbal order" or without any prescription. Also, an incredibly complex protocol. If a patient is unwell, they need a doctor assessment? Not someone following a flowchart.
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🚨 RCPCH FINALLY SPEAKS - and sits squarely on the fence. Who wrote this @RCPCHtweets? You appear to be suggesting that physician associates can support child protection work and medical assessments. The FFLM is very clear - they should not be involved.
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I now believe @AlderHey misled safeguarding partners @LiverpoolLSCP @MerseyPolice. The Liverpool safeguarding guidelines clearly state that doctors/paediatricians should perform Child Protection Medical assessments (S47), but Alder Hey used a Physician Associate instead.
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It is now clear there was a catastrophic failure of governance and leadership at @RCPCHtweets regarding the promotion of physician associates in paediatrics. In December 2023:. 🔹Unsure how many PAs in paediatrics.🔹No idea what paediatric PAs are doing.🔹No workplace plan
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Thank you to @bmj_latest and @AdeleWatersRx for covering the Alder Hey story. It is concerning that the @RCPhysicians knew about this situation in September 2023, but they seemingly took no action. Was this information shared with fellows during the EGM? Or was it withheld?
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Update from @gmcuk to external stakeholders: "looking at what action they can take" in response to "social media issues". They are likely collecting social listening data & tracking accounts (👋). Source: GMC update to Health Education and Improvement Wales MAPs Group (Oct 2023)
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🚨 NEW: Patient charities wrote to @gmcuk raising concerns over Physician Associate regulation. 🔹PA/AA consultation was too complex and inaccessible for patients.🔹Unclear who is responsible for setting scope of practice.🔹Lack of transparency
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Extraordinary response by @NHSLanarkshire (University Hospital Hairmyres) to the @RCoANews anaesthesia associate scope of practice consultation. Aiming at @AnaesUnited . "nasty and vocal smear campaign of a small group of anaesthetists, including college members"
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Am I reading this right? . The @gmcuk's primary defence is that the @AnaesUnited claim is "out of time", even though the GMC hasn't yet finalised the rules for PA/AA regulation?. It seems. weak.
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Tomorrow marks a watershed moment: the @gmcuk begins regulating non-doctors. I’ve never been a fan of the GMC, but seeing its purpose redefined in this way fills me with sadness for what it means for the future of the medical profession. Source: GMC council papers (13 Dec)
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🚩🚩 More evidence of dangerous and illegal use of Physician Associates by NHS Wales and @WGHealthandCare . @BetsiCadwaladr admits Physician Associates routinely request X-rays. This is a serious breach of IR(ME)R. They also perform flexible cystoscopies and cardioversion.
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Thank you to the Faculty of Forensic & Legal Medicine (@FFLMUK) for this clear position statement 👇. @RCPCHtweets still can’t bring themselves to say what happened at @AlderHey was wrong. Incredibly poor leadership by the college.
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Ok, this is unsafe. What on earth is going on at @AneurinBevanUHB?. Chest drains, ascitic drains, nerve blocks, central lines, arthrocentesis. 🤯. @RuthJonesLabour & @jessicamordenmp - this is your patch, do patients know about this?. @Doc_IonaCollins - who can I send this to?!
Pharmacists, is this right?. @AneurinBevanUHB seem to allow PAs to administer emergency meds, either "verbal order" or without any prescription. Also, an incredibly complex protocol. If a patient is unwell, they need a doctor assessment? Not someone following a flowchart.
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💯 It is clear the @RCPhysicians delayed the EGM and tried to influence the outcome - remember the emails between the then President & @CMO_England . @DrAsifQasim @trishgreenhalgh @djnicholl @parthaskar @Xeon4f145d96s1
Our open letter to @HouseofCommons @UKHouseofLords #HealthSelectCommittee @LaylaMoran - that parliament was misled by the delay to the @RCPhysicians EGM - calls for a delay in the planned December start of MAP registration by @gmcuk . @doctor_oxford @DaganLonsdale @TYoungstein.
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Hospitals such as @CHFTNHS have pushed the physician associate role beyond what can be considered safe . 17 PAs trained to insert chest drains despite being unable to prescribe analgesia/local anaesthetic or request chest X-rays 🚩. @RCPhysicians needs to set limits/'red lines'
To be clear; I have given my view to Ben, Hilary & the wider council that PA scope guidance from @RCPhysicians needs to be on general principles - with a particular focus around supervised & safe PA practice within IP teams. Detailed scope on specialist services (eg asthma.
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🚨 Still awaiting a response from @RCPCHtweets . Two hospitals, including @AlderHey, responded to their child protection audit stating they use Physician Associates to provide a “medical safeguarding opinion” . But RCPCH standards require a ST4+ doctor?👇
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It is disgraceful that @gmcuk's extensive social listening was only uncovered following a Freedom of Information request, which the GMC stonewalled for as long as possible. It took intervention from @ICOnews before they would respond. Even then, they missed the ICO's deadline.
@drmattuk @Mike88881221 Hi @drmattuk and @Mike88881221 like most organisations we reflect on social media posts we’ve been tagged in, or those which are receiving high levels of interest. This helps us identify topics or issues to communicate with our audiences – whether that’s via social media or other.
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Extraordinary email from @gmcuk to @scotgovhealth . When trying to justify GMC not setting limits on PA practice. "We are not aware of any other examples of supervision guidance produced by professional bodies which is viewed as mandatory and enforced accordingly". @AnaesUnited
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The physician associate clearly outlined their role - minimal supervision, acting on the safeguarding on-call rota, and examining abused children. they even boast about visiting the morgue!
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This is incorrect. See example from University of Leeds. Limited anatomy. No mention of physiology, immunology, histology or other basic sciences. Only a few weeks experience in each specialty before starting a band 7 role. Madness. @iDrSunny @Adam_Skeen @drmattuk @TomStocks1982
@Statsjamiefact @pa_StephenNash @Adam_Skeen Adam’s opinion is wholly ungeneralisable. Many if not most PA courses have a vast focus on physiology, anatomy, immunology etc. though content has previously been shown to vary prior to QA by GMC.
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Health bosses at NHS Wales and @WGHealthandCare encouraged Welsh hospitals to ignore @TheBMA Safe Scope of Practice document for Physician Associates. As a result, no national limits have been placed on PA practice in Wales, leading to hospitals using them in unsafe roles 👇
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It appears @AnaesUnited must have touched a nerve, as the @gmcuk blocked their website from being accessed by GMC staff internally 🙄. @mouseter_chef @LondonAnaesth
Did you know? @gmcuk employs social media specialists to monitor criticisms and shape their strategy. The extent of this is outrageously far-reaching. Thanks to @Mike88881221 for uncovering this through FOI. If I’ve tagged you, the GMC has been tracking you. Congratulations?.
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Impressive mental gymnastics from the @gmcuk here. GMC: We want to regulate Physician Associates to "expand the medical workforce". Also GMC: Physician associates don't study medicine. @drcolinm how can you expand the medical workforce with staff who don't study medicine?
@iDrSunny Hi Sandeep. Unfortunately this reply on our Facebook messenger service isn’t correct. We don’t describe PAs as 'studying medicine' and we're sorry for the confusion this has caused. We have information about what's involved in the education and training of PAs on our website.
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Why are the government and @wesstreeting spending public money to fund @gmcuk's legal costs? . In 2023, the GMC made £2 million in investment income💰. Read the entire email exchange here:
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Even more alarming information from @CHFTNHS about the unsafe use of Physician Associates 🚨. PAs can perform invasive surgical procedures on patients despite their inability to prescribe analgesics, anaesthetics, or drugs to manage complications. Local scope is unsafe @gmcuk
🚩🚩New data reveals scandal-hit trust @CHFTNHS used Physician Associates to fill medical rota gaps. The trust claimed it could “convert” medical shifts so PAs could cover them, ignoring guidance from @NHSEngland, @DHSCgovuk, and @gmcuk that PAs must not replace doctors
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This is why Physician Associates working in general practice must follow the @rcgp scope of practice and be properly supervised 🚨. General practice is not “easy”. How many more incidents like this have happened?. Source: @NHSEngland patient safety reporting database (LFPSE)
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I note @RCPCHtweets was also silent when @TorbaySDevonNHS was forced to admit they used Physician Associates to cover doctor shifts in their paediatric department. Does anyone know why @RCPCHtweets are so reluctant to say this is wrong? .
I am just astounded at @RCPCHtweets silence. Why are they so reluctant to call out the inappropriate use of physician associates within paediatrics? This doesn't need a survey or a working group. It's not right, and @RCPCHtweets should be advocating for children.
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I feel like a lone voice trying to raise the alarm. Any ideas @ShaunLintern @AliJaneMoore @mjauk @Rebeccasmt @Emmajourno @JamesTitcombe @drphilhammond @eleanorhayward?.
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Hi @gmcuk, me again. You describe yourself as "independent of government" . But in this e-mail, you agree to share "intel" with the government to help pass the Anaesthesia Associates and Physician Associates Order. What is going on?. @doctor_oxford @iDrSunny @drmattuk
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.
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Hi @gmcuk, many stakeholders raised concerns about how you were conducting your consultation. Patient charities wrote to you, expressing their concerns. @HealthwatchE @NationalVoices @PatientsAssoc . Did you listen to them?.If not, why not?.Can you explain?. @doctor_oxford
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.
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Concerning FOI response from @CV_UHB neonatal unit - using under-qualified staff?. - Very dismissive of @TheBMA guidance ("not of clinical relevance").- Says department follows @gmcuk, @NICEComms and @RCPCHtweets guidance, but no neonatal PA guidance exists from these orgs
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@ShaunLintern @wesstreeting Hi Shaun, @AlderHey and @WestSuffolkNHS both used Physician Associates to perform child protection medicals. I appreciate the debate can be toxic, but those of us trying to raise legitimate concerns are mostly being ignored.
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@gmcuk Why did you lobby @DHSCgovuk to fund your legal defence against bereaved parents and @AnaesUnited? You should be independent of government.
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@thomasllewis @AlderHey I’m submitting a freedom of information request for full details of supervision. “Flying solo” suggests there was minimal, if any, supervision. I hope I’m wrong.
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I do worry about the lack of insight demonstrated by the @gmcuk. Their official blog hosts an article stating PAs are medically trained (which is incorrect) . How many patients, doctors and employers will have read the article over the last 6 years? Hundreds, if not thousands.
@Mike88881221 Hi Mike. Our blog is a platform where we host articles from a range of voices, covering various topics. In the example you’ve shared, this is a blog from 2018, before we were asked to regulate PAs and AAs. Our website is the source to go to for the latest information about our.
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This is really worrying, @sashnhs have used ‘local scope’ to enable their PAs to perform ascitic drains, pleural procedures and lumbar punctures independently.
The @RCPhysicians PA Scope Co-Authors are both staunchly pro-PA Consultants from @sashnhs. One is the head of @KSS_PAS . Check out what they were promoting PAs **CURRENTLY** do at their Trust. Any surprise that the draft scope allows for all of that to continue?
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The failure of the @gmcuk @RCPhysicians and @RCPCHtweets to set any form of scope of practice for PAs working in paediatrics means hospitals have used them in highly inappropriate roles, compromising patient safety.
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Despite the trust’s repeated claims that Physician Associates do not cover doctor shifts, the data reveals this happened 65 times in just six months. This raises serious concerns about patient safety @CareQualityComm . @harpreetkuppal @Kate_Dearden.
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@RCPCHtweets What do you think @AoMRC? Still no evidence? Just social media noise. What a disgrace.
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After @TheBMA called on the government not to use taxpayers' money to support the GMC in its defence, senior @gmcuk and @DHSCgovuk officials discussed their strategy. This email suggests the government WILL fund the GMC's legal defence ("pickup the costs of new professions") 👇
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Why do you allow physician associates to be involved in child protection medical assessments @BlackpoolHosp? . Unnecessary duplication of history and examination. Initial accurate history taking is vital, and a senior paediatrician should be involved. not a physician associate.
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Physician associates at @CHFTNHS were previously investigated after illegally prescribing controlled drugs, including opiates and sedatives, to patients. The trust has refused to disclose if any disciplinary action was taken against the staff involved
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A freedom of information request to the trust revealed Physician Associates at @RoyalFreeNHS requested 742 CT scans and 325 X-rays between 2021-2023. Physician associates are not allowed to request scans involving ionising radiation. Source:
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As the @RCPhysicians continues to tear itself apart over the "physician associate issue", this devastating excerpt from the June 2024 RCP Council minutes feels all too relevant.
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@gmcuk @drmattuk Hmm. You told @NHSEngland you would no longer engage with PA/AA discussions on social media. I think some more reflection is required
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Credit to the @RCPCHtweets for listening. However, they should have asked their members a long time ago, before they encouraged physician associates into paediatrics.
Today RCPCH has called for a pause in the recruitment of Physicians Associates (PAs) into paediatrics. This follows our survey of College members on their views and experiences of PAs working in paediatrics. Read our statement:
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A preventable death. If only @TheBMA scope of practice for Physician Associates had been followed. Tragic.
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.
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Concerns have been raised in the House of Lords about a PA potentially misleading the courts about their role when providing expert evidence about a case of non-accidental injury.
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NHS managers in Wales seem more focused on managing the narrative around Physician Associates than tackling their risky deployment in Welsh hospitals @WGHealthandCare. From the Health Education and Improvement Wales risk register 👇 (zero mention of patient safety concerns)
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Thoughts @BAPS1953 @pstrnuk @TriPS_PaedSurg? This presentation was presented at an @RCPCHtweets event. they didn't object.
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Here is the @gmcuk's communications playbook for the next few weeks. How many of these can you spot?. No mention of safety concerns. No mention of doctor substitution. No mention of setting safe limits for associates. Released via FOI, download here:
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Even their own FOI response clearly states they used a physician associate to perform joint paediatric forensic medical examinations with an FME - this is not "basic" or providing "support"
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🏴 Yet more evidence of unsafe use of Physician Associates by NHS Wales / @SwanseabayNHS. All stroke patients deserve high quality care, regardless of their eligibility for thrombolysis/thrombectomy. PAs can't even prescribe aspirin. @StrokeWales - can you look into this?.
Would @SwanseabayNHS please clarify if PAs are clerking stroke patients in hours? . Are SHOs prescribing for them?
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In a case study written for @RCPCHtweets, Alder Hey proudly boasts about using physician associates instead of doctors on its "first-tier on-call rotas." .
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