Dr Andy Breakell
@TheBreakster
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Emergency Doc 🏥 - Pre-Hospital Em Doc 🚑 -Chester FC Doc ⚽️- RSM council 🏛️ ALS doc❤️ - MSK Doc 🦴-Med-Legal Doc⚖️ - Med- Negligence Doc 🏛️ CBRN- Doc 💥
Liverpool, England
Joined March 2021
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@DrEilidhMaria
@DrLindaDykes
It’s pointless ….they are being told and sold they are the “new” doctors.
The medical profession need to think smarter and develop a new registration code / badge / identity ….probably through the BMA ….if your not wearing it …..or don’t show it …your not a doctor !!!
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@ShaunLintern
@theRCN
A negotiated settlement would have been the right way …. not running to the court. I think Barclay has just secured the next 12 months of industrial action by doctors and nurses in one manoeuvre.
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@mmamas1973
1. They should never have been given a physician title …..unnecessary …..they are health care practitioners ….deliberate act to inflate “doctor” numbers. There are excellent health care practitioners aka paramedics for example!! Two health systems on horizon -
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Survey opens today on members views on Physician Associate roles in A&E ……log into your account to make your views known 😎😎👍
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@Dr_Done_
Not in anyone’s lifetime are these MSc level questions.
I’m going to set these questions for the St John’s ambulance 1st aiders on Saturdays home game …..I’m betting they’ll hit 80-90%😂
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@mmamas1973
I think now reading many of these feeds over the last 2 months and wearing my medico- legal hat 🎩 of 20 years…the PA group are not reading risk and where risk lies….clinical education and clinical experience are NOT the same. On balance doctors should not supervise this group.
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@drcolinm
Let’s be very clear - there are:
Medical practitioners = doctors
Nurse practitioners = nurses
Physiotherapy practitioners = physios
Paramedic practitioners= paramedic
All these are medical or healthcare professionals.
A Physician Associate is non of the above.
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@ShaunLintern
This comes under GMC medical practice:
1 Honesty with research data
2 Declaration of vested interests
3 Financial interests and benefits
4 Professional integrity / honestly
Probably need a good clear out of dead wood
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@michaelsearles_
Some comments on here utterly bizarre …..it’s like saying I’m happy for someone to fly my plane with 2 hours in a flight sim - 200 hours of flying time and no pilot training or exams BECAUSE qualified pilots sometimes crash aeroplanes ✈️ ……where has risk management gone 🤔🤔
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That’s a blood good question …..sadly none !!!……..because the direction of flow for MSK training was towards having nursing staff run the injuries area which uncomfortably left both SHO’s and Registrar’s untrained in MSK medicine / Injuries…..never my idea I have to add 😤
@TheBreakster
@parthaskar
@UKGastroDr
@trishgreenhalgh
@OrthopodReg
@RobJimFleming
@eveosh
@UmeshSalanke
@jsbamrah
@DrLKVaughan
@RowanHarwood
@doctor_oxford
How many EM registrars did you train in the same time frame to ensure there is a continuity to medical training?
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@Dr_JSA
This is a very smart move by the BMA and those of us with some legal qualifications can see exactly where this is going and the thought process behind this move. If you want less safety ….go ahead …..fill your boots 🥾 ……but put that in writing please ……oh ….and sign it 👍
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I have read the GMC documents - purposefully really quite complex and a good 2-3 hours of process!!
Could the BMA produce a medical profession response - to be signed by our respective GMC no’s and submit this to the GMC - I think that would send a clear message👍
The GMC is now consulting on how its regulation of PAs and AAs will work.
The consultation is open to members of the public, and we've produced a short guide to be used by clinicians and patients who are keen to provide views.
Read it here: (1/2)
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@HelenRSalisbury
Media article from 2017!!
“The widely-despised Tory Health Secretary revealed his latest ingenious ‘money-saving’ (definitely not privatisation-related) scheme – this time the plan was to replace your local GP with a cheaper, much less qualified ‘physician associate”
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@Xeon4f145d96s1
It just gets worse 😱……she’s “ into diagnosis , treatment and management of diseases”…….so it may have been a good idea to apply to Medical School !!……tough …..yes……but there are no short cuts ….5 year degree and another 12 -15 years to independent practice 👍
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@DrEilidhMaria
@DrLindaDykes
Just as a follow on ….. you copyright the badge and code ….you won’t be able to patent it but anyone breaching and using the badge would be subject to legal prosecution by the BMA legal teams. Probably take about 12 months before most patients would demand to see the “badge”
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@TheBMA
I think this is a good and robust position statement from the BMA - I would remove the title physician to remove the confusion - there is no need to name who you assist as a HCP you’ll assist everyone….and also regulation would be by the HCPC as current paramedics etc …not GMC
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@RCSnews
It’s not quite the robust statement you would expect from the RCS……PA’s are not surgical trainees or qualified surgeons …even after a 2 week suturing course at the RCS - they should be ward or clinic based and named Health Care Practitioners - to avoid confusion with titles.
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@LawrenceDunhill
@gmcuk
There are so many horror stories now on Twitter about the PA grade and medical cover it’s difficult to separate fact and fiction …I now read they are main cover for Neonatal ITU😱😱……and the GMC lead is only concerned re-their mental health and nothing re- safety/ Quals etc🤔
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@ShaunLintern
@katlay
From the Gov point of view …..PA’s are a gift from heaven:
Stuck in the NHS
Can’t work abroad ….non recognised
Can’t work in the private sector
Can’t set up private practice / enroll with BUPA etc
Ceiling on pay ….this will fall as the market is flooded
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@DHSCgovuk
Seems a reasonably simple list but:
Sinusitis - viral/ bacterial / fungal / allergic?
Sore Throat - bacterial / viral ?
Earache- risky
Insect bite - inflammatory v infection
Impetigo - bacterial
Shingles- viral
UTI - could be complex🧐
So diagnosis is key in this game🤓
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The first public anti- PA demonstration I’ve seen ……and right outside the flagship RCP “The Spine”…..embarrassing for the RCP and the Conservative Gov. If your going to replace doctors with first aiders have the temerity to put it in your party political manifesto’s 🤓
I hope this is the first of many: public demonstrations arguing against the dangerous experiment of the UK’s
#PAProject
and now-obvious agenda to use PAs as doctor-substitutes rather than doctor-capacity-multipliers. ⬇️
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@RishiSunak
The treatment for a UTI is pretty straight forward - the correct diagnosis / and the correct antibiotics …..that’s a wee bit more complex and the gold standard is a laboratory culture and drug sensitivity test. The urine dip test has a 50% failure and blood white cell is no use.
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@mmamas1973
A twitter post from the College of Psych’s has put out a robust statement on the PA role - I would have expected the nervous dithering to have come from them!! ….non of it….they have put the RCS and RCP to shame….now let’s get physician removed from the name badges for clarity
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@doctor_oxford
@DrLindaDykes
Let’s be very clear about this - this project is all about deception and giving the public a watered down service for the same tax burden. Conservative ministers have refused to consider a title change thus reinforcing the believe that without the deception - the project will die
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The Australian Medical groups have looked at their data and drawn the same conclusions - they have effectively closed the PA project as too costly - to risky and poor value outcome compared to fully trained physicians / surgeons….UK forging ahead with the project full steam 😂😂
Lessons from the US. Drs performed better and cost less. So they reversed their model of ANP/PA led care to deliver for patients. From the American Medical Association
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@iDrSunny
@trentconsultant
Can you imagine if :
Non pilots wanted
As a non pilot you will be flying on the emergency pilots rota …….good luck !!
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This is just a re roll out of the Lord Darzi community poly clinic idea from circa 2000. A fantastic idea that went nowhere….no one wants to work and be flogged all day Saturday and Sunday….also undifferentiated emergency cases need emergency physician input and training.
This week I saw first-hand the difference that the
@AustralianLabor
government is making in Australia - with urgent care clinics that relieve pressure on GPs and A&E departments.
@Keir_Starmer
’s
@UKLabour
government will adopt this approach with new Neighbourhood Health Centres.
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@goldstone_tony
@clifford0584
Essentially training numbers have flatlined for 10 yrs as demand for doctors have peaked. I said 6 months ago if you want a great career in medicine or surgery ….look abroad for training while you still can.
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@RobLaurensonD4P
@JeanetteRCR
It’s 10 years of medical training to reach the basics …..for a very good reason. There are no short cuts to quality training and safety. Hundreds of doctors need specialist training places …..it’s cheaper to flood the NHS with medical replacements but is that its future 🤔🤔
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@natalieben
@TheBMA
The BMA have just published safety guidelines for PA practice …….the bar has been set …at a reasonable level taking into consideration no medical degree, no postgraduate College exams and no independent clinical experience …..let’s see if patient safety is really important🤔
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@doctor_oxford
@ShaunLintern
@RCPhysicians
Good for you …..that was a disgraceful stance last night by the RCP and one that’s going to be difficult to bounce back from.
I’m not a member but I’ll no longer attend ANY RCP events …..I’m council for the Royal Society of Medicine and I’ll promote CPD and promotions here.
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@TheBMA
@trentconsultant
The important thing about this safety statement from one of the major health unions is that it can be used in court…..as best safety practice….sure NHSE and RCGP may ignore it ….but if negligence is found …..related to this breach …..it would be difficult to defend 😎😎👍
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@Roddy_Neilson
@drcolinm
1/2
It’s becoming a laughing stock around the globe!! 🌏
There can be no FTP panel because every College and every sub speciality within will need to write a scope.
So a locum PA could be a GP on Monday and assessing complex back pain for Orthopaedics on Wednesday.
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@pulsetoday
The pilot analogy is a good one…..you can’t short cut training and you can’t short cut for depth of experience….that’s what your paying a doctor for - it’s why it takes 10-15 years just to get started!! ….if you do …..serious harm can be the result.
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@VictoriaAtkins
I’m sorry …I must have missed the party political manifesto that offered to flood the NHS with under qualified staff and then regulate them through a body that perpetuates the myth of qualification.
I’m not sure anyone in the UK has actually voted for this 😡
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@Dr_Done_
Seriously though …..what is the point in this 😂 This has no CPD value!!
I’ve just attended RSM Emergency Dermatology 21st Dec in London…..it was 4 hours of excellence …..yes 4 hours just on urgent skin…..nothing else…..that’s CPD top up!!
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@gaslad
And that folks is why the medical degree and post grad exams are held in such high regard both here and abroad. For an exam that doesn’t matter 100% pass rate keeps the cash flowing in , keeps the courses full and keeps everyone’s “stress” levels stable.
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@Kit_Yates_Maths
The lateral flow plate immunochemistry test was our best friend at the A&E front door - cost £1 … 96% sensitive for Covid - took 2 mins to get result!! You could sieve and sort out higher risk patients and separate from Covid+ cases …. We don’t have that anymore🙁
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@BMASevernJDC
@gloshospitals
A post graduate diploma ….no degree …..god knows where your knowledge of acute and chronic medicine , frailty and MSK medicine comes from …..great hours…..get to lead the medical team …..and a pay bonanza…..no wonder the PA courses are oversubscribed😂
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@MrTimLane
@DrPhilBanfield
@trentconsultant
Top Plastic Surgeons house on the market - California…..I recon a bid of £25 million will be accepted🤔
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@DrShanHussain
If we look at the facts :
Royal College of Physicians just published 2021 data showing 50% + of Consultant medical jobs unfilled ….fact
NHS pension agency - excess claims submitted for early retirement last 6 months - system under strain….fact
So something is happening - fact
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@Ask_foradoctor
I have to agree totally with the PA sentiment on this ….its degrading and embarrassing to spend the 1st 3 minutes explaining who you are not….BUT that’s the price you pay for persisting with a title “ physician” which means “doctor” as described on the RCP website !!
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@danielgoyal
I’ll just say a few words in defence of those doctors who do private practice:
1 Its not about money but providing an excellent bespoke service
2 You don’t receive rude emails from management …. You are the management!!
3 Appointments and surgery when you want 8 am or 8 pm
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@nedwards_1
Has anyone costed out as a serious business case - a multi disciplinary community team / physios / pharmacy / nurses/ GP’s … covering 10 hour days / 7 days week / 365…. throughout the UK/ to maintain people unwell in their own homes / residential homes and care homes ??
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@ShaunLintern
@katlay
Massive mistake on whoever thought this was ever a good idea. These are health care practitioners and should never have been labelled physician - should be regulated via HCPC not GMC. It’s clear why the Gov want to flood the NHS with these PA’s.
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@DrLKVaughan
@Medicalrepublic
Some American colleagues in New York and California have bounced this news article my way for comment : 😬😬
“Danger to patients and conflicts of interest as government continues to push for expanded use of ‘associate’ roles – with help from the Royal College of Physicians”
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Met a young guy at the football club last week who was a St John’s volunteer….on a Med Science degree with 2 options PA or Grad Med entry….wants to be football club doctor…..advised to take short cut PA route to instant⭐️dome…No…..bloody Nooooo……there are no short cuts😡!!
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@DrLatifaPatel
@TheBMA
I don’t quite understand why “we remain concerned” !!!…….it needs shutting down as an idea before the seeds have been sown and shoots appear.
You need a degree in the UK at the moment to escort someone to the toilet…..let’s call an idea that’s awful ……awful!!
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@RoshanaMN
The introduction to the poster is again fraudulent and misrepresenting …..it says PA’s are medically trained HCP’s …..they are not!!!
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@shalabolic
@DrLKVaughan
I think another important point - if you really are dedicating your time and efforts to the PA project - fine ……leave the RCP umbrella and move over to the PA college board …fight and fund raise from there ……..don’t use medical members funds to prop up your business plan😡
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@deeleyc6
@DrLindaDykes
@SandipP64097927
@msteggy
@DocMeezbah
It is really bizarre that I can offer 25 years of inner city Emergency Medicine / Sports Medicine / Forensic Medicine/ MSK medicine and some military RAF medicine…..and be told to “jog on - not experienced enough for GP”….but a 2 year non medical MSc in PA ….I’m straight in 🤔
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@pulsetoday
I bet those passengers on the Hudson River event ….thanked God the pilot was not an Associate Pilot Baggage Handler 👍
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@DrLindaDykes
Hi Linda - NHS England have just produced a statement stating that PAs should not be seeing undifferentiated patients as per the BMA statement. …more details to follow!!
I’ve now moved mainly into Sport and Exercise Medicine ……I think football club medicine is closed to PAs👍
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@ShabaNabi
I think the question I would ask is:
What are the PA’s doing that you , the paramedic or the advanced nurse practitioner are struggling with..???…..other than an extra pair of hands …..would an additional paramedic or practice nurse not have filled the role ??
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@JimBethell
@HelenRSalisbury
So that’s 3 doctors you have listed …..would you care to ask those doctors when they last examined a patient or worked a 10 -12 hour clinical “take” or shift …..or visited and worked in the A&E department with real patients at the other end ??
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@ShivaniM_KC
Broadly yes….
The NHS will be the training ground for acute medicine / A&E and Acute Paeds….before doctors leave for abroad
No need to stay in UK for training in Plastic/ Ortho/ Urology surgery….that can be private or abroad / similar for medical ologies
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@natalieben
@JanetEastham
Not just about replacing doctors on rotas:
NHS England has promised 'clear guidance' for GP practices on the safe scope of practice for physician associates - and said BMA advice that they should never see undifferentiated patients will feed into the new guidance.
🤔……..💡
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It’s like every day another crack pot idea trumps the crack pot idea from the day before😂…..don’t hold back on the degree certificate though….you may as well complete the whole deception👍
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@_VivekTrivedi
They didn’t provide a Consultant pay restoration pathway - they tweaked some pay but unfortunately tweaked contract terms too- I doubt they ever had any intention of restoring pay - but are quite happy to fund non medical workforce expansion ….at a significant cost it seems!!
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@UKGastroDr
@walsh_joe
@FPARCP
Honestly …which self respecting professional introduces themselves as who they are and then spends 5 minutes explaining who they are not….what utter lunacy🙃…..remove the title “physician” ….remove the confusion ….the Medical Act is crystal clear🏛️
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@ShaunLintern
@thetimes
@Ldn_Ambulance
Anyone would think this was a new idea ….I mean seriously !!!! …..the 2008/9 health plan was to have thousands of community carers / advanced paramedic practitioners / GP’s / community nurses/ physios etc etc all travelling around in teams / cars and keeping paitients at home !
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@AlisonGeorge10
@DrLindaDykes
@rcgp
@KamilaRCGP
A reasonable safety template published by the BMA on MAP working alongside doctors.
Let’s see who wants to make this less safe for patients and put that in writing……and with the next serious clinical incident …..they can explain their reasons in the Civil or Coroners court😎
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@ShaunLintern
@BMA_JuniorDocs
But what can Barclay offer ??…. he can only offer 5% and some cash back for Covid stress. Inflation may not actually fall below 5% in 2024….. if the other health union members accept 5% ….. I think we’re in for the long haul here …. and that’s before the Consultants join in!!
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@DrDLittle
@RCRadiologists
The direction of travel seems to suggest flooding the NHS with lower quality medical substitutes. It may be partly about money , but it’s definitely about control. This will be a work force with no union - poor pay bargaining and no real scope to progress or work abroad.
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@chriscraigCCC
The sort of thing you would expect if you’d marked your own maths paper…….when you were 10 yrs old !!
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@mmamas1973
@ShaunLintern
This will probably go to a negligence lawyer - may be the start of a new wave of cases to hit lawyers desks ? It could have happened to a doctor BUT you have your training and membership / fellowship exams as some defence….if your untrained and unqualified …it’s indefensible ⚖️
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@gem1509
I think the popular response from PA’s is “ anyone can make a mistake” and “ mistakes aren’t that common in PA group” …..but there are only a few thousand PA’s!!….. I’ve dealt with 2 PA negligence cases ……the UK Gov are thinking of “flooding the NHS” with thousands more!!
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@BMA_James_Steen
Your absolutely right - what on earth are NHS England thinking / who is driving this massive pay booster for relatively unqualified staff !! I’ve seen locum PA positions offered at £48,000 - £60,000 for 9-5 positions …..Locum PA agencies setting up to milk the tend…crazy!!
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@Xeon4f145d96s1
@BMA_JuniorDocs
I think the choice of title was ill thought through. It’s confusing in hospital environments at the best of times - physician implies a medical / surgical degree from a medical school - they should be titled clinical assistants or hospital practitioners. I wonder about indemnity?
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@gem1509
Had a group get together with some eminent negligence lawyers in London last month ….they are currently sharpening their swords !!….best practice / protocol / Trust guidelines / Nice guidelines etc etc ..all open to interpretation …what’s not is qualifications and experience!!
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@ShaunLintern
@thetimes
@Ldn_Ambulance
The paramedics are filling a massive social care chasm…they are cheap labour and work long hours. This will be the next group quitting for a more stable work life and better pay elsewhere🤔
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@geriatricgiant
@gmcuk
Short answer is no you won’t !! See the Bawa Garba case and the judicial sum up. Having said that - there would need to harm done. My general take on this is your more at risk doing a risky procedure in an unsafe area than a delay or missed diagnosis but it’s all high risk🥺
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@UKGastroDr
@DrLindaDykes
Physician doesn’t need to be in the title….its only purpose is to confuse health care rolls. I’ve seen badges with “Associate Physician (RCP)” which sounds like one step from Associate Professor!! The Physician title keeps the courses full and the pay above most health workers.
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@shalabolic
@DrLKVaughan
Thanks for this detailed thread on last nights RCP “ whitewash”…..I’m not a member but I attend a significant no of CPD acute medicine sessions …..NOT anymore!! ….if you can’t represent coal face doctors …..don’t expect those doctors to support you. I’ll help the RSM now 😎
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@19MW98
@DrLindaDykes
This is the sort of letter you wish you just hadn’t written.
The airline pilots unions have a major input into flight safety…..the BMA has every right to highlight doctors vulnerability to prosecution and wider patient safety issues. The BMA have set a reasonable safety bar😎
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Retirement bucket list 1 ….finish setting up golf simulation centre in garage ✅……2 …..enter the open 🤔
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An economic study shows the folly of paying lesser qualified associate staff more than the doctors and surgeons who supervise them. The Australian Medical Groups came to the same conclusions and have all but closed the Physician Associate project
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@Xeon4f145d96s1
Well done to the College of Psych’s !! No ambiguity here …..quite a robust message and clear …..unlike the dithering RCP and RCS….
an easy win now is the removal of Physician from the title …replaced with medical or surgical health care practitioner …..simple 👍
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@mmamas1973
@DrLindaDykes
@doctor_oxford
The conflict of interest is a massive factor too…..it’s like being on the board at Man City and using club money to fund and support a new Academy at Man U …..your backside would be skidding out the door so fast 💨……I won’t attend any further RCP London CPD events 👍
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@AnalysisDrawer
It should mean no further recruitment
The PA diploma will be treated as another health care exam similar to an MSc in sports medicine for example and will be considered for access to medical school/ nursing / paramedic / physio training….by respective Universities.
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It was only a matter of time before our Emergency Department hit the headlines …. but not as a flag ship new hospital sadly… we welcomed Steve Barkley a few weeks ago …he gave A&E a miss☹️
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@RobLaurensonD4P
When I qualified in medicine …some juniors always planned a 12 month stint abroad …..before returning and plotting a dedicated career in the NHS……..that mind set has suddenly changed to …..get the degree ….complete 2 year foundation and then look at options outside NHS!!
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@ShaunLintern
The most effective “inquiry” will be to prosecute the individual managers for corporate manslaughter and gross negligence and then the NHS Trust for criminal negligence.
All the relevant evidence will be laid bare by the prosecution and defence lawyers and will be public.
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@ExplosiveEnema
So why is this job not open to a medical graduate / SHO …..?? Who would settle on 50k per year for a 4 day week …..work through MRCP exams ….develop a research interest and possible MSc and create a platform for a really interesting career 🤔🤔
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@manLikeTeaa
I think this just highlights the clinical negligence risk the PA group expose themselves to. Seems a group less educated than Paramedics and much less experience than an Advanced Nurse Practitioner ….. paid more than both….acting as doctors …..but barely educated to 1st Aid.
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@DrLindaDykes
2/2
Medico legally a doctor or surgeon should only supervise clinical staff with a defined scope of practice eg physio / advanced nurse practitioners etc …an option would be to pull all clinical supervision for PA’s until scope defined , hand responsibility to employing manager
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@TomStocks1982
@walsh_joe
Without a robust scope of practice - you can’t register with ANY regulator!!
1.If the scope is the whole of medicine and surgery ….then close down medical schools
2 If a PA MSc gives you full scope the so does an MSc in Sports Medicine
3 No scope = No fitness to practice panel !
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@Dr_Done_
There is no doubt about it ….strength in numbers …….call out a crack pot idea for what it is …..learn to say no!!…..and mean it. The only issue with this is the next directorate meeting won’t include the infidels and will be pushed through “other means” to get the outcome.
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@nedwards_1
It is basically the Darzi poly clinic pathway ….I thought that was a great idea …..in fact hospitals were planned at the time with significantly reduced beds as the community was going to blossom 🤔….not sure why the plan was ditched but the management task and cost likely
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@MedCrisis
@walsh_joe
Mistakes can happen - but stepping out of your training / qualifications and experience will lead to litigation. So which defence organisation provides indemnity insurance cover / do they know what these guys are getting up to and what is the cost of this - mine is 3k per year!
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@k_eagar
@clifford0584
@mmamas1973
@parthaskar
@RowanHarwood
@CliffJonesGP
@UKGastroDr
@DrLKVaughan
@Trisha_the_doc
@trishgreenhalgh
@AntonEmmanuel2
@MRCPandFRCPs
@morefluids
The next chapter in this saga will be trying to “lock” medical students and doctors into the NHS after medical school…….because the numbers leaving or at least expressing an interest in leaving the UK are significant and rising.
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@caspertown42
@alisonleary1
@K_G_Spearpoint
@JaneEBall
The data hides the long term problem with this - retention!! At the coal face I see many A&E nurses quit after just 2-3 yrs to either travel or work other jobs. You need retention for 20 + years or it’s just like bar staff - plenty enter / plenty leave …no one stays / no career!
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@ShaunLintern
@HMAnderson39
The reduction in waiting list numbers was never going to happen without a record smashing NHS productivity drive.
Staff numbers have increased but are either too junior or non medical to hit waiting lists- management structures are chaotic - bed capacity at peak = throw towel in!
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@parthaskar
@DrLindaDykes
@RCPhysicians
@doctor_oxford
@UKGastroDr
@DrLKVaughan
@OrthopodReg
@RobJimFleming
@RoshanaMN
@eveosh
@Rezaidi
@trishgreenhalgh
@doctorhelgi
I can only hope this is a robust and frank discussion about the credibility of medicine in the UK …..not directed by those sad enough to feel an MBE will somehow enhance their own credibility ….if you want an MBE …..go into politics!!🤓
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@trentconsultant
Mike ….do you know who decided that they were entitled to use the name “ physician associate” without a medical or physician degree?? …. Physician assistant / nurse assistant I can accept but some are calling themselves “ College Physicians”… it’s becoming a free for all 😱😡
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Official opening of the new West Lancs Golf Club shop….lots of refurbishment at the club still ongoing …. can’t wait until spring ⛳️😎
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@ShaunLintern
@GMC
The fact is this:
1 The GMC is not the Coroner
2 The GMC letter has no effect on the decision by a litigation lawyer/ Judge
The trial judge in any litigation will take into consideration “the chaotic state” of the NHS but will no doubt conclude that this is “ normal for NHS”
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