Keep hearing that PAs have studied 2 years of medicine
No, they have not
PAs have studied two years of PA studies, an unaccredited & unregulated course
Nobody can explain what PA studies is...
Just as nobody can actually explain what the role of a PA is...
This is not an isolated experience. I know of PAs from different UK locations reporting that they have been told they are having a crash course in medicine, condensing everything Drs know into 2 yrs, like a super-intense medical degree.
Say it often enough and it sounds true.
@Dr_Done_
"Being a safe practitioner is making mistakes and learning from them"
No, it's really not
This is not baking a cake where you can afford to keep making mistakes until you perfect the recipe
Patients are people
They are not guinea pigs for PAs to make mistakes with
Patients are expected to quiz non-doctors to find out what their actual role is
& then patients are expected to decide if they are happy with the "diagnosis" given by the non-doctor?
And they must do this when unwell/in pain/stressed etc
Are patients being paid to do this?
@Dr_Done_
@mrjamesob
“If they’re not happy with the diagnosis at the end they can ask to see a doctor”… alas… the very reason they are there in the first place is because they are not equipped to know the diagnosis
At this point, surely the question should be, does a PA bring ANY value to the clinical team?
There is nothing which PAs can do which is not already safely done (and done better) by other members of clinical team
PAs are also not cost effective
32k isn't a terrible wage. Doctors deserve more. You can live on £32k. MOST families live on significantly less.
How is this even being challenged. Ridiculous.
Physician associates are dependent & require supervision by a GP
Physician associates work under GPs, not alongside GPs
There is no evidence that it is safe for physician associates to see undifferentiated patients in primary care
Meet Megan, a Physician Associate who is a highly skilled professional working alongside GPs to help with:
- Diagnosing & treating certain health conditions
- Arranging tests & analysing results, and
- Performing physical examinations.
Find out more here:
What about fairness & equity for patients?
Patients deserve to be treated by fully qualified doctors
Not PAs who have done a 2 year unregulated course in PA studies
1/
Fairness and equity—two principles that have been brutally stripped away from Physician Associates over the past year. The wound remains raw as the situation worsens. PAs face redundancies, clinic cancellations, and are relegated to paperwork with no voice in the matter.
@IncogAssociate
The guidance is for your supervising doctors
Doctors who choose to supervise PAs/AAs will use guidance to ensure safe supervision
Some doctors may choose to ignore the guidance...
But would be pretty hard to defend that decision if a patient suffers any harm, wouldn't it?
Quicker & easier for GP to just see the patients themselves
Better & safer for the patients to actually just see GP
AND it's more cost effective
No role for expensive physician associates with a 2 year qualification in PA studies (an unregulated, unaccredited course)
GP supervision of physician associates (PAs) must take place immediately after each patient and before they leave the surgery, according to the
@TheBMA
Take the appt with PA
PAs are dependent & MUST be supervised by a GP at ALL TIMES
After seeing PA, you should also be reviewed IN PERSON by their supervising GP
If that doesn't automatically happen, just politely ask to see their supervising GP
Isn't that right?
@rcgp
PAs go to PA school, do PA studies & PANE exam
Doctors go to medical school, study medicine & do MLA exam. Doctors then do postgraduate training & exams.
TWO entirely separate & discrete paths
And NEVER THE TWAIN SHALL MEET
No crossover
No equivalence
No comparison
PAs being given direct access to the Foundation Programme
While Foundation Drs across the country are sat on placement lists, unsure where they are going to live
@NavinaEvans
, why are these posts not going to Drs?
Why are Drs being replaced?
Credit:
@Dr_Done_
@AliJaneMoore
Can we please ask
@VictoriaAtkins
to spend her 3-week Christmas holiday mastering her brief?
Now she knows that physicians’ assistants earn more than junior doctors, she can make a fair offer to junior doctors & stop the strikes.
Patients deserve better.
@PPaauk
Why would FPA have anything to do with defining and setting scope?
PA is not a profession
PAs are dependent & must work under the supervision of a consultant doctor/GP
The supervising doctors will define and set the scope.
Do PAs really not understand this?
Hahahaha This is the most ridiculous thing that PAs have ever done...(and believe me, that is saying something!)
Loving the 50 HOURS of CPD being equivalent of 2 YEARS of GP training...
There's just too much to laugh at!
And the public must think it is crazy that GP practices are given ARRS funding to employ staff...
But that funding CANNOT be used to employ an actual GP!
It can only be used to employ NON-DOCTORS
To the public, it is paradoxical that they struggle to get an appointment with a GP whilst at the same time many GPs cannot find jobs. One key cause of this is that general practices - unlike NHS hospitals - cannot have a financial deficit and must operate within their budget.
@NHSSTW
Physician associates are dependent & require supervision by a GP
Physician associates work under GPs, not alongside GPs
There is no evidence that it is safe for physician associates to see undifferentiated patients in primary care
Keep hearing that PAs have studied 2 years of medicine
No, they have not
PAs have studied two years of PA studies, an unaccredited & unregulated course
Nobody can explain what PA studies is...
Just as nobody can actually explain what the role of a PA is...
@LittlePersonDoc
@RCPhysicians
Yeah, pretty much. We were told we were covering most of the same clinical content and sitting exams from the same question bank. I now know this clearly was not the case.
PAs go to PA school, do PA studies & PANE exam
Doctors go to medical school, study medicine & do MLA exam. Doctors then do postgraduate training & exams.
TWO entirely separate & discrete paths
And NEVER THE TWAIN SHALL MEET
No crossover
No equivalence
No comparison
This is the plan
We'll hear: "PAs don't need to be supervised by consultant doctor/GP"
Followed by: "PAs don't need to be supervised by a doctor, they can be supervised by a "senior" PA."
And finally: "PAs don't need to be supervised by anyone. PAs are independent."
You know precisely where this is heading - we will have ‘lead’ or ‘principal’ PAs or consultant ACPs who will be supervising these PAs soon - citing the ‘loss of efficiency’
Yet this is artificially created loss of efficiency by not creating enough GPs - who don’t need
Well as
@drkeithsiau
says:
"Doctors in general should remain professional on social media as the content we post stays on record and could have consequences."
But why then has
@drkeithsiau
deleted his own content?
For once,
@IncogAssociate
is right
PAs are NOT assistants because they do not assist doctors (or patients)
PAs are NOT associates because they have no association with doctors
Brings us back round to the unanswered questions...
What is a PA? What is the actual role of a PA?
The surgical precision of this sentence is perfection
“MAPs wishing to expand their scope of practice have an established pathway that currently exists to allow them to gain the necessary qualifications: medical school”
Masterclass from
@ASiTofficial
ASiT and the Surgical Specialty Training Organisations have released a joint statement in response to a recently published in The Annals of the Royal College of Surgeons England
What should be the
#priorities
in delivering surgical care?
Share with us your thoughts
🔗
But I'm disappointed because I feel like this is a lost opportunity. There was no engagement with any other stakeholders, there was no seeing any other point of view
This is not teamwork
This is pretending that non-doctors can practise medicine
In case it's not clear, they can't
- It's completely unsafe
- Patients receive less effective, less efficient, lower quality healthcare
- And it's also not cost effective
@suzypuss
@EmergMedDr
This is a masters programme for those who have a health BSc and years of practice. There are guidelines professionally as FCP and are regulated by the HCPC . They have experience and expertise that other professions don’t and that includes medics. Teamwork is not the enemy.
@glambystefania
@manLikeTeaa
@SecretPhysician
Are you telling us that YOU make the decision to stop medications? And then ask a doctor to physically stop the medication?
Something that you as a dependent PA are not trained or qualified to do
Oh, and it's also illegal for PAs to do this
PA explaining what a PA is
Jesus wept
“I’m one of the haematology team.I’m a physician associate. That means I’m not a doctor. I might look like a doctor, I do lots of things that traditionally only a doctor might do, but it’s important for you to understand I’m not a doctor”'.
@NHSE_WTE
Here we go...
The pathway already exists. It's called GEM-graduate entry medicine.
But why not just use the fully trained GPs who are currently unemployed because ARRS funding doesn't include GPs?
Doctors & medical students also need an apology as they have missed out on teaching & training opportunities
Doctors have been forced to supervise PAs/AAs & mop up the messes made by PAs/AAs
& also PAs/AAs have been paid more than doctors-for working less hours & no on-calls
While we pause recruitment of PAs, as called for by
@rcgp
, it's worth asking how we got here. We need an apology, both to patients harmed & to PAs, from people who led them to believe they could be “medical professionals” after a two year training course
GMC states that the doctor ‘must be confident that the colleague [they] delegate to has the necessary knowledge, skills, & training to carry out the task, or that they will be adequately supervised to ensure safe care.’
MUST be confident
So nothing can be delegated to PAs/AAs
Just imagine if all the time, energy & money which is currently being spent on PAs & AAs was actually invested in doctors...
Just imagine if ALL consultant doctors supported their 'junior' doctors in the same way as they support PAs/AAs...
#ThePAProject
#nhs
#patientsafety
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
)
ARRS funding is given to GP practices to employ staff
Except the funding CANNOT be used to employ GPs
So GPs are unemployed
Patients are unable to get an appointment with a GP
All because ARRS funding MUST be used to employ anyone except actual GPs
Designated prescribing practitioners (DPPs) and pharmacy technician apprentices to be eligible for ARRS funding for PCNs, says
@liz_fidler
at
#cpcongress
I'm confused
So
@rcgp
is able to say that non-GP doctors cannot see undifferentiated patients in primary care because they don't have the necessary GP training
But
@rcgp
has no say when it comes to non-doctors seeing undifferentiated patients
What is the point of
@rcgp
then?
Our concerns re: care of undifferentiated patients are well known and we’re discussing these with a wide range of stakeholders and will continue to raise our concerns. RCGP is responsible for setting the curriculum and examinations for GPs and not any other roles.
Change the names back to anaesthesia ASSISTANTS and physician ASSISTANTS
This has been tabled by
@ClaudiaWebbe
Is your MP going to sign and support this motion?
Tag your MP and let's find out...
So when more patients are harmed or die, because of PAs working in primary care
How many individuals, departments and organisations will be culpable?
This is a KNOWN risk
And it's documented
There will be no excuses
And they will have no defence
HEE and Dep of Health know of the risks of PAs in primary care, yet pushed ahead
1) lack of supervision
2) increasing scale of risk of harm
Yet they pushed ahead and continue to do so.
How PAs in primary care are not completely paused and how the
@rcgp
aren’t calling for
Which is why all medical students have a case for compensation
In fact, all doctors who have trained and qualified in last 20 odd years that PAs have been in UK also now have a case for compensation
When are
@rcgp
going to address the issues of non-doctors working in GP roles?
Why are non-doctors replacing qualified GPs?
Surely jobs for the unemployed & under-employed GPs is the optimal solution?
Following recent discussions on X we’d like to clarify that RCGP isn’t responsible for training course content or for keeping records of FCPs, but we’ll raise this in our next meeting with NHSE.
Hearing a lot of talk about how PAs/AAs have been misled & should be compensated
I would argue that medical students and doctors have been misled, and treated appallingly
In fact, they have been and continue to be treated far worse than PAs/AAs
Will doctors be compensated?
What do I think about AAs?
I wish I’d been one.
I’d be at least £50k better off with amazing training. I’d be spending my life giving anaesthetics in daytime hours.
They’re living the dream while medics are in the bin. Medics must stay in the bin &
#BeKind
. Or else.
<ends>
Two years of PA studies is NOT equivalent to two years of medicine
& two years of PA studies is most certainly NOT equivalent to a degree in medicine
If you're saying that it is, you're going to be paying out a lot of money to compensate medical students & doctors
PAs being given direct access to the Foundation Programme
While Foundation Drs across the country are sat on placement lists, unsure where they are going to live
@NavinaEvans
, why are these posts not going to Drs?
Why are Drs being replaced?
Credit:
@Dr_Done_
@AliJaneMoore
@ColinaCoco
PA is not a profession
PAs are dependent and require supervision.
The mistakes of PAs are carried by the supervising consultant/GP
So no, PAs do not 'bear the weight of responsibility that sometimes our errors cost lives'.
And no, it's not bullying, it's about patient safety
Is
@DrSarahClarke
aware that countless doctors are currently unemployed or about to become unemployed in August?
Doctors, you know, the actual paying members of
@RCPhysicians
How is
@RCPhysicians
supporting unemployed doctors?
I have it on good authority Dr Sarah Clarke was heard saying “but they [PAs] won’t get jobs” in response to recommendation number 16.
I’d urge all councillors to go check out
@ExplosiveEnema2
’s profile banner.
The RCP’s job is patient safety firstly and *doctors* secondly.
The
#RCPEGM
went well
Thank you
@RCPhysicians
for confirming what we already knew:
- RCP is knowingly responsible for PA/AA debacle
- RCP has no interest in sorting out the mess they have made
- RCP has no interest in protecting
#NHS
patients
BUT RCP WILL BE HELD ACCOUNTABLE
You can fit many cut up pieces of a tennis ball into a tube
But none of these pieces of a tennis ball can actually function as a tennis ball
So exactly like trying to use ARRS roles in primary care to try & replace GPs
Completely POINTLESS
Slice up the tennis balls and you can get more in the tube - efficient use of space and increased productivity. But you won't be able to play tennis! Be efficient, be productivity but more importantly be effective - do not forget your purpose...
Why would FPA have anything to do with defining and setting scope?
PA is not a profession
PAs are dependent & must work under the supervision of a consultant doctor/GP
The supervising doctors will define and set the scope.
Do PAs really not understand this?
NHS Employers acknowledges that today’s BMA guidance on scope for another professional group was developed without input from FPA or MAPs. MAPs are not BMA members. Employers responds to BMA guidance on the role of MAPs | NHS Employers
Why are PAs here to stay?
No such thing as guaranteed jobs in NHS
Just ask the many doctors who are currently unemployed or about to become unemployed in August
Just ask the many doctors who have been made redundant or are about to be made redundant
I’m sure that’s something we can all agree on.
The conflict arises in what exactly the scope of MAPs should encompass, and how this will impact on the education of doctors in training. PAs are here to stay, so the question becomes, how do we best utilise this workforce?
This is statement from
@FPARCP
Where is the statement from
@RCPhysicians
?
Why are
@RCPhysicians
council not supporting and representing their actual paying members-DOCTORS?
PAs MUST not see undifferentiated patients in primary care
This is a red line
@rcgp
Defining scope & safe supervision does NOT change this
@KamilaRCGP
, make sure the guidance is watertight because
@RCGP
boat is already close to sinking...
RCGP will need to be totally free of COI when it comes to suggesting Physician Associate scope & whether seeing undifferentiated patients is safe for patients
Chair of Trustee Board at RCGP may still benefit financially from PA training
Transparency is critical for all concerned
Get ready for Medicine 2024!
At past events, we’ve been joined by 1,400 delegates for interactive learning, networking and wellbeing activities.
Join us on April 25–26 at the RCP at Regent’s Park in London and online for another insightful conference.
But PAs and AAs have never wanted to be doctors
And PAs and AAs would never want to train be doctors
And PAs and AAs would never draw any false equivalence with doctors
So where are all the PAs and AAs rushing to tell us what a stupid suggestion this is?
"If we want to tackle the crisis in GP numbers, we should establish a pathway for physician associates to go on to train as doctors and for newly qualified doctors to go straight into five years’ training as GPs."
@IncogAssociate
@RCPhysicians
Why?
Because
@parthaskar
has forgotten more than you will ever know...
Stop embarrassing yourself
@IncogAssociate
You claim to be a lecturer in PA studies
Each one of your tweets highlights exactly how & why this PA mess has occurred
@Statsjamiefact
@SaraTon08500527
It’s not representative of the experience of the majority. Courses were not standardised any more than medicine but quality assurance is underway with GMC regulation approaching.
@UMAPsUK
Hahahaha This is the most ridiculous thing that PAs have ever done...(and believe me, that is saying something!)
Loving the 50 HOURS of CPD being equivalent of 2 YEARS of GP training...
There's just too much to laugh at!
Over the past few days, we’ve had questions and comments about a recording of one of the workshops from our 2022 conference. We’ve been reading and reflecting on all of these and wanted to share our response:
🔵We recognise that there are differing views about the role that
scapegoating
noun [u]
blaming Physician Associates for issues that predate Physician Associates.
the act of blaming a person or group for something bad that has happened or that someone else has done:
E.g. the scapegoating of PAs for the problems faced by UK doctors.
It's not difficult
@RCPhysicians
PAs are dependent & MUST be supervised by a named consultant doctor or GP, at ALL TIMES
Essentially, wherever the supervising consultant doctor/GP is, there too shall be their dependent PA...
If that's not possible, then there's no role for PAs
We have significant concerns that the
@RCPhysicians
draft PA guidance for safe and effective practice fails to fully address patient safety issues and the role’s impact on doctors’ training. We've offered to help strengthen the guidance in our response 👇
Ladies and gentleman, your future MAPs union.
@UMAPsUK
sent this as a professional press release. No, really.
Some notes:
- I don't have a website?
- My "locum wallet lining" has seen me earn less than I earned as a salaried FY1!
An example of how UK healthcare is viewed from abroad.
Our primary care system is seen as an example of how not to run a service.
A sad state of affairs.
@drmattuk
@JanetEastham
@TheDA_UK
@TheBMA
This is why
#ThePAProject
must end NOW
This is not a game
This is affecting
#NHS
patients every single day
Real people & their families are suffering
Sadly, what has happened in the past cannot be undone, BUT action MUST be taken to prevent further patient harm & deaths
All patients who have been harmed by PAs now have proof that PA care was inferior
The bereaved families whose loved ones have died because of PAs now have proof that PA care was inferior
We have an answer from the GMC
According to them, PAs study medicine, just not the same as a doctor who studies it for 5 years.
Whats different? The time and the content.
Are you telling us that YOU make the decision to stop medications? And then ask a doctor to physically stop the medication?
Something that you as a dependent PA are not trained or qualified to do
Oh, and it's also illegal for PAs to do this
@manLikeTeaa
@SecretPhysician
Take things into context. The responsibility ultimately relies on me for that task to be done!!! If I don’t tell the doctor to do it and my patient deteriorates who’s fault do you think it is ? The doctor I didn’t make aware of? Please relax.
How can
@rcgp
allow physician associates to continue seeing patients?
Now that
@rcgp
has (finally) recognised the huge risk to patient safety, the use of PAs in primary care MUST STOP TODAY
Protect patients from harm
PAs MUST NOT see another patient in primary care
@iDrSunny
PAs go to PA school, do PA studies & PANE exam
Doctors go to medical school, study medicine & do MLA exam. Doctors then do postgraduate training & exams.
TWO entirely separate & discrete paths
And NEVER THE TWAIN SHALL MEET
No crossover
No equivalence
No comparison
The end is not in sight..
@gmcuk
have said they will REGISTER AAs and PAs
However,
@gmcuk
have also said that they will NOT REGULATE AAs and PAs
This is becoming a bigger and bigger mess by the day...
Since the inception of Anaesthesia Associates (then anaesthetic practitioners) , AAs have been told by many we need regulation and registration, thankfully the end is almost insight, it been a far too long time coming. (This should have been done years ago)
@gmcuk
Will
@gmcuk
be running a similar webinar for doctors?
After the "confusion" yesterday, might be helpful to provide information to your actual paying members...
There is NO EVIDENCE to show that PAs and AAs are safe.
There is NO EVIDENCE to show that PAs and AAs are cost-effective.
In fact, there is NO EVIDENCE to show any benefit at all from PAs or AAs.
@RCPhysicians
@NHSEngland
A PA has no business clerking patients in ED, seeing pts in GP or managing patients in resus. You need to define the scope of work and limit how trusts use them. They are a amazing resource but to help doctors with admin and as runners not play doctors and risk and cost lives
@mmamas1973
@RCPhysicians
Writing a document with the FPA logo, I've been pushed aside, ignored, sniggered at by doctors...
Pop the RCP logo on & I've been left to lead the RCP as the new president, asked for advice by RCP Council...
Amazing how
@RCPhysicians
logo changes your whole life & existence
This is beyond belief now
@RCPhysicians
need to get their act together before the EGM tomorrow
No way that
@DrSarahClarke
can chair the EGM now
Thank goodness for the integrity of the fellows listed on this letter
Tomorrow (13 March), there will be an Extraordinary General Meeting of the Royal College of Physicians on Physician Associates. We called this meeting because of concerns about patient safety. Please read and circulate our STATEMENT OF CONCERN about how the EGM is being set up.
@Megsenmumdr
In all honesty I don't understand the concept of locum PAs - how can the level of supervision you need be defined by someone that doesn't work with you regularly?
@rj_quick
@WalsallHcareNHS
@uhbtrust
@RCSnews
Would be a far better investment to spend this time, energy, resources &money on training actual doctors to perform surgical procedures
Could
@WalsallHcareNHS
&
@uhbtrust
explain why they decided not to invest in actual trainee surgeons? You know, the future surgical consultants
@MerseyPensioner
members held
@C_MPartnership
to account over replacing doctors w cheaper, unqualified staff & the lack of accountability of this board which holds power over what rationed postcode lottery of services are on offer. Services cut to make profit
@rcgp
The comments in the
@rcgp
report are absolutely terrifying
(Eg 3 week old baby sent home instead of being sent to A&E, missed cancer etc)
Have ALL the comments been included?
If not, please could you ensure that all comments are included as an appendix to the report
Just imagine how doctors who are unemployed or being made redundant must feel...
PAs/AAs should be grateful that they only gave up 2 years of their life to do PA studies
@fascinatorfun
Would you be surprised to learn that all those who work for
@GMCUK
are given private medical cover?
So none of those working for
@gmcuk
will ever have to see a PA or AA
This may be an own goal from
@AoMRC
Excluding
@TheBMA
paves the way for
@TheBMA
to take a much harder stance
Expect
@TheBMA
will be issuing further guidance advising doctors to stop supervising PAs/AAs altogether...
We are extremely disappointed
@AoMRC
has excluded
@TheBMA
from a meeting to discuss MAPs and doctors in training despite the inclusion of other key stakeholders including
@NHSEngland
,
@gmcuk
and ATDC. [1/3]
News from Down Under!
The Health Minster has 'backflipped' on the expansion of PAs.
Thanks to
@ama_qld
@RACGPPresident
for holding the line!
The people of rural Australia deserve high quality care delivered by DOCTORS.
Will
@gmcuk
be running a similar webinar for doctors?
After the "confusion" yesterday, might be helpful to provide information to your actual paying members...
Thanks for getting in touch with us. Yesterday we ran a webinar for PA students to give them information on professional standards and on the registration processes, in preparation for regulation. It was open to all current PA students and invites were sent out via course
Later today
@rcgp
will formally announce that JMR will be taking over from
@KamilaRCGP
as RCGP chair
Some have questioned the wisdom of appointing someone who is clearly anti-GP
But as history shows, that's actually one of the essential criteria for the role