Katie Bramall-Stainer
@doctor_katie
Followers
4,558
Following
1,436
Media
86
Statuses
1,662
Follow: @drkatie .bsky.social Roles: Chair @BMA_GP England, Chief Executive @CambsLMC , GP @HaileyViewGP . Views my own. RT ≠ endorsement.
Herts/Cambs/London
Joined July 2023
Don't wanna be here?
Send us removal request.
Explore trending content on Musk Viewer
#WWEBadBlood
• 331182 Tweets
The Rock
• 295866 Tweets
Michigan
• 159054 Tweets
#precure
• 111947 Tweets
Vandy
• 102695 Tweets
#ブンブンジャー
• 76785 Tweets
Roman
• 74605 Tweets
Yankees
• 73422 Tweets
Dodgers
• 69583 Tweets
Vanderbilt
• 69313 Tweets
Dark MAGA
• 62374 Tweets
Bama
• 61645 Tweets
トッキュウジャー
• 59171 Tweets
Ohtani
• 52623 Tweets
Shohei
• 52184 Tweets
Watch Sant RampalJi YouTube
• 51285 Tweets
#仮面ライダーガヴ
• 49637 Tweets
#UFC307
• 47881 Tweets
ドジャース
• 44128 Tweets
プリキュア
• 41539 Tweets
Rhea
• 39776 Tweets
Royals
• 27155 Tweets
Goldberg
• 26646 Tweets
ワンダフル
• 25787 Tweets
Gago
• 25734 Tweets
ポストシーズン
• 23867 Tweets
Raquel
• 23111 Tweets
Ashton Jeanty
• 18476 Tweets
Gunther
• 18102 Tweets
いろはちゃん
• 16735 Tweets
ニチアサ
• 14145 Tweets
同点3ラン
• 13470 Tweets
大谷さん
• 11217 Tweets
Yamamoto
• 10260 Tweets
Pinned Tweet
I know
@popbitch
shared it, but I was SO proud to see the cleverest, most articulate man in Britain open my conference on 18 May.
When
#ChrisMorris
speaks, you need to listen.
& when he’s on your side, you know there’s a fight to save GP to be had. 💪
35
21
92
GPC England passed this emergency motion in all parts today:
“That GPC England fully endorses the recent statement by UEMO expressing concern over the increasing trend of "Physician Assistants/Associates" (PAs) being used to substitute GPs in English General Practice, &
(1/11)
9
309
820
Since 2015 we have trained 25,000 GPs across England
Comparing today with back then, how many extra GPs do we have?
Minus 2000
We have GP unemployment in the middle of a workforce crisis
Not a paradox - deliberate breakage of general practice.
#GPsAreOnYourSide
@BMA_GP
10
212
508
I spoke to an old trainee LMC rep today - now an ST3 in Peterborough & still no job
They finish their training next month
Really exceptional GP
Lots of interviews, no success.
“Too many” peers in this position
They have MRCP & MRCGP!
Single parent 🤦🏼♀️
WTAF 🤯
@BMA_GP
24
160
503
OR…
Fund GP at the level you did 15 yrs ago & the public will get access to an expert generalist who knows them & an NHS that feels safe.
Reward the one sector of the NHS with no IA, no deficit, & biggest productivity with investment, hope, & sustainability.
Not PAs.
"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."
234
15
46
12
128
486
We are using the term MAP inconsistently.
PAs are a world away from ANPs , midwives, physios, paramedics, clin pharmacists etc who are registered, revalidated & with clear training and regulatory processes.
1/n
@UKGastroDr
@NHSEngland
@RCPhysicians
@parthaskar
@DrLKVaughan
What would you say about paramedics working in general practice or independent nurse prescribers. Why are we picking on such as small group of professionals. In curious 🧐 really am. It seems like scapegoating one group who we are ‘othering’. 😡
86
3
21
9
91
447
Who to believe? A GP or a politician?
Constructive dismissal of GP 🎯 GP being broken 🎯
Since 2010: 2000+ Practices GONE
Past 10 yrs: 25,000+ GPs trained but 2000 fewer remain
@SkyNews
@BBCBreaking
@itn
@c4news
16
190
424
Yes it’s a cesspit, but sometimes you meet like minds & kindred spirits on this forum
One of them is the legend that is
@parthaskar
- even better in 3D!
We have managed to solve the NHS over lunch (Yes! Lunch! Luxury!) now we just have to get
@NHSEngland
to listen 😂
25
25
356
1. Expert generalist GPs over skill-mix
2. Quality over quantity
3. Continuity over access
4. Autonomous patient-advocacy over banal service standardisation
5. Individuality over uniformity
6. Choice over compulsion
7. Human connection over AI
1/x
14
131
348
“Anyone who thinks that they may benefit from taking anastrazole should see their GP.”
There’s no info or briefing on this.
I would not know what to advise a patient. How many 1000s of women will contact their GP today & feel “let down” that “no one knows anything about this.”?
Tens of thousands of women in England could benefit from a drug that helps prevent breast cancer.
GP Dr Helen Wall spoke to
#BBCBreakfast
about Anastrozole which has now been licensed as a preventative option
43
32
121
35
73
345
Here’s a snapshot of just 20 letters rec’d this afternoon from hospital & other NHS colleagues
Half need us to do something eg refer, order investigations, send info back
It’s not just GP time, but admin & secretarial too - when 95% staff are in hospitals
39
119
324
i) asserts that PAs are neither a safe nor an appropriate substitute for a GP
ii) calls for an immediate pause on all recruitment of PAs across PCNs and General Practice until appropriately safe regulatory processes and structures are in place…
(2/11)
3
62
317
@ChrisHopsonNHS
All I hear Chris, is the creaking of the
@NHSEngland
PR wheel, attempting to justify the lack of core funding & advising a determined blind eye across 42 ICBs.
Show me the evidence & +ve pt outcomes for diluting the GP role within the practice team.
No evidence?
Thought not.
5
75
312
The
@Conservatives
,
@DHSCgovuk
&
@NHSEngland
have decided, rather than being the ‘stepping stone’ year to signal safety, stability, and hope - 2024 will instead signal reduced patient access to GP services as well as likely closures of GP practices across the country.
🧵👇
10
176
284
@ShaunLintern
Thanks Shaun - I know Cuckoo Lane well - it’s a fab practice. Julie and team do a wonderful job, but they’d be the first to explain that they are very much dependent on their GP team, and cannot run the practice without them. Just to be completely clear and transparent.
12
44
256
🩺 Why is it so difficult to see a GP now? ❓
1: We’ve lost the equivalent of 2,212 full time (60+ hrs a wk) GPs since 2015. 📉 🧑⚕️
Assume each GP has a list of 1800 pts (often an underestimate) that’s a whisker below 4 million patients without access to a GP. ⚠️🥼
1/14
As a patient I am very hopeful for
#GeneralPractice
with
@doctor_katie
in charge. Looking forward to more cooperative working between PPGs and partners!
1
5
12
11
162
250
iii) reminds GPs & GPRegistrars that they may refuse to automatically sign prescriptions or request investigations including ionising radiation on behalf of a PA
iv) asserts that it’s entirely inappropriate & unsafe for GP Registrars to be supervised or debriefed by PAs…
(3/11)
2
38
245
GP Referendum: 99.2% vote NO to contract imposition
In past decade:
💥2000 fewer GPs
💥1300 fewer surgeries
💥6,000,000 more patients
⏰ Time to call out the constructive dismissal of England general practice
What patients want to receive & what we want to offer ARE THE SAME:
GPs have voted overwhelmingly to reject the
@NHSEngland
’s 2024/25 GP contract changes, with 99% of
@BMA_GP
members voting ‘no’.
Chair
@doctor_katie
says GPs are at ‘boiling point’.
We’ve been exposing the immense pressure on general practice for years... [1/7] 🧵
2
19
39
9
95
249
@nhse
@rcgp
@ClareGerada
I could see a potential theoretical role for PAs in v carefully circumscribed areas within 2ry care. But not taking training from existing drs in training. & def not undifferentiated 1ry care.
Give me an ANP, clin pharm, paramedic or physio any day. But give me a GP 1st.
4
27
243
This thread brilliantly encapsulates all that’s been done to dismantle general practice in England over the past decade and more
I’m meeting
@wesstreeting
this wk
I sincerely hope it will be the start of a journey to where GPs want to be, & where patients need us to be
👇🧵🔥
16
70
233
The long term workforce plan in a nutshell.
A picture paints a thousand words:
@libdemdaisy
@PreetKGillMP
@wesstreeting
@andrealeadsom
@VictoriaAtkins
@theRCN
@BMA_GP
@rcgp
Patients deserve and GPs need a new general practice deal in England from the next Government.
13
144
229
v) demands that PAs be appropriately and safely regulated by a body other than the GMC
Proposer:
Dr Samuel Parker
Seconders:
Dr Matt Mayer & Dr Ian Hume
Dr Katie Bramall-Stainer, Chair of BMA’s GPC England said:….
(4/11)
1
32
216
@nhse
@rcgp
@ClareGerada
The whole point & purpose of ARRS in PCN DES was cos no GPs & no GPNs. But now there are.
Every practice/PCN needs to look at bottom line, factor in supervision costs, pt need expectation & outcomes.
Unconscionable to continue as we are. Drs are unemployed. Disgraceful.
End.
7
42
205
We are not allowed to spend any of the £1.4bn from Government for staff on employing any new GPs or any new practice nurses.
Yes, we are now seeing 1000s of unemployed GPs. This is a national disgrace.
@SkyNews
@BBCBreaking
@itn
@c4news
@channel5
@channel5_tv
4
128
204
@BMA_GP
@Parody_RCGP
@rcgp
@parthaskar
@dave_dlt
@AISMANewsline
@medicaccountant
@MedicsMoney
@BenXGowland
@drgandalf52
@DrGoblin3
@DrSteveTaylor
@msteggy
@DHSCgovuk
@RebuildGP
@NHSEngland
@drmarkporter
@rankine
@NAPC_NHS
@DAUK_GP
@LondonwideLMCs
@michelledrage
@JanjuaAdam
@hughalderwick
@BecksFisher
@IPPR
@wesstreeting
@PreetKGillMP
@karinsmyth
@NHSTransform
@vsmacdonald
@RSylvesterTimes
@denis_campbell
@ShaunLintern
@lauradonnlee
@anguswneale
@amolrajan
@bbcnickrobinson
@MishalHusain
@Marthakearney
Simple stats since 2015
England general practice SOS
💥Over 1000 practices gone
💥Over 2000 GPs gone
💥Over 6,000,000 more patients on the books
💥 Equivalent of 1:2 population seen EACH month.
💥400 million consults per annum
💥7-8% of NHS funding
💥5% of all NHS staff
12
192
189
GPs are expert medical generalists with the experience & medical knowledge to diagnose, treat & manage multiple & complex conditions
PAs are not doctors; they are not regulated; & they cannot prescribe
At best this is confusing - at worst, it can threaten patient safety
(9/11)
2
42
194
A word of caution here, folks:
👉1.9% = a disgrace
👉to match 2019/20 we need 8.7% putting this derisory offer into context
👉
#FPR
for salariedGPs ~ c£450m
👉Total practice income/patient has ⬆️ by only £15 in a decade -
Yes! *£15*
Nice words won’t save General Practice
🧵👇
The GP committee had a good & productive meeting with
@andrealeadsom
She listened to concerns regarding GP funding, ARRS, retention of GPs & the need for GPs to be supported
There are more patients per GP but also a shortage of work for GPs
She told us that GP was a priority
5
8
19
6
110
189
In the bay next to me, a consultant uttered the immortal words, “When you get home, call your GP and get them to issue you a sick note.”
The Meerkat reared up.
The consultant did the sick note.
And 28 days’ meds on discharge, thanking you kindly.
17
14
186
To quote my excellent colleague Matt,
GMC number starts with a "1" ✅
Has never worked in general practice ✅
Graduated 52 years ago ✅
Retired from the NHS ✅
Works exclusively in the private sector ✅
Ideally placed to comment ☺️
Okay, boomer.
I'm sure all of us GPs really appreciate the advice of someone who has no experience of our job, and who....
<checks notes>
"is now retired from the NHS and works exclusively in the private sector."
13
44
220
10
40
186
This is what GPs are up against: the constructive dismissal of general practice in England, removing your access to a GP in favour of a Primary Care Lite model.
The referendum is phase 1 of our fight back, & why you need to join, vote, & win now:
👇
The GP referendum on the 24/25 contract changes ends midday on 27 March.
Vote now and don't delay!
Make sure you're a member to vote - you must join by 25 March to have your say:
7
128
165
6
123
181
General Practice has been broken.
1000+ practices closed ❌
How many GPs lost? 💸
How many patients frustrated?
& Now GPs out of work?! 🤯
Colleagues - it’s time
Phase One starts with GP Partners
Protect Your Practice
Protect Your Patients
Vote YES 💪
Watch this space… 👀
GPC England have voted to hold a non-statutory ballot for GP contractors & partners in England from 17 June - 29 July.
To vote YES for collective action you must be a member and your details must be up to date.
@doctor_katie
#TakeActionSaveGeneralPractice
7
103
144
3
99
180
This is personal for me.
And I’ll be raising it this morning with
@wesstreeting
.
@DanielZeichner
is also aware.
@SKinnock
this is what we need to tackle. The ICB has just had £131 million written off in Trusts’ debt. But could not accommodate the infinitesimal ask of these GPs.
7
74
170
The GP business model is now non-viabile despite accrual of 👉£0 👈financial deficit (hospitals c£1.5bn)
Patients & the public need to wake up 👀 & see what this is:
an intentional, predetermined, strategic, non-evidence based, ideological dismantling of NHS general practice.
5
96
169
@hmtreasury
@VictoriaAtkins
@andrealeadsom
‼️Total NHSE deficit for 23/24?
Estimate: £1.5 BILLION
⚖️Total GP deficit for 23/24?
👉£0
❤️🩹 The hidden cost is human
⚠️ Exhausted burnt-out leaving GPs.
⚠️Practices closing after 15 yrs funding freeze
5
116
164
@SkyNews
@BBCBreaking
@itn
@c4news
@channel5_tv
@Dr_Ellie
@DrRanj
@DrZoeWilliams
@DrRosemaryL
@DrSarahJarvis
@drmarkporter
@DrHilaryJones
@DrAmirKhanGP
@drchatterjeeuk
@BMA_GP
@rcgp
@TheIGPM
@PMA_UK_
@Parody_RCGP
It was
@WessexLMCs
’ Dr Jane Lees-Millais! The profession owes you one, Jane. Thank you. Well played. And how DARE
@RishiSunak
laugh at us and other hard working NHS staff.
The state of the NHS and general practice is no laughing matter. 😔
9
37
162
This is absolutely brilliant from Resident Doctors Committee Chair,
@RobLaurensonD4P
Simple facts
Calmly presented
Professionally delivered
Everybody wants to see a fair deal for our colleagues
This cannot continue after next week’s election
You have the support of GPs 🩺🧡
Oh my, this is is brilliant from
@RobLaurensonD4P
🚨 Strike action has cost the govt £3bn
🚨 Full pay restoration would have only cost £1.3bn
🚨 Re 35% demand - a physician’s assistant is paid 35% more than a fully qualified doctor 🤬🤬🤬
35
964
2K
2
72
160
GP action is taking place to stop local GP surgeries closing
GP action is taking place to stop losing burnt-out experienced GPs from local GP surgeries
We have a 98.3% mandate
All this is true - it’s also true that we remain committed to working with
@wesstreeting
new govt 🙏
“We are not in a position to be able to wait for long-term plans or consumer spending reviews.”
BMA GPCE chair
@doctor_katie
responds to the health secretary’s accusation of ‘sabre-rattling’ by GPs on
@BBCr4today
4
58
112
5
82
161
EMIS outage thoughts…
There’s a ‘gradient’ between GP & rest of NHS front door (A&E, 999, 111)
A&E see ~23m per yr
111 get ~22m calls per yr
999 get ~7m calls per yr
Total c52million contacts
(All off Google
#factcheck
)
Whereas GP…
367m appts per year
Ratio about 1:6
8
60
158
“This distinction must be protected: PAs cannot be used as a substitute for GPs, or in place of a GP when supervising GPs in training.
“The GP workforce crisis is a result of the failure of Government to plan for the recruitment & retention of GPs…
(10/11)
2
33
156
Before you ask! 🫣😆
This does not change our plans for GP action.
It means messaging, tighter.
Aims, clearer.
Manifesto, sooner.
Practices are making decisions to close now. We have a fantastic surgery on my patch. Patient care is suffering now.
On we go. 🙏
@BMA_GP
6
50
157
As I said,
@thomasdolphin
is a dear friend of 20 years, and a more decent individual and all round good egg it would be harder to find.
Did someone received a legal letter? 👀
On the 6th October 2023 I shared a link on X to a Mail Online article entitled ‘Militant union leader at the heart of doctors strikes is a Labour activist who boasted of charging the NHS for a strike cover shift. I accept that my words were misleading as the subject in question
0
5K
4K
2
21
152
"Today’s motion is about finding ways to protect patients by ensuring appropriate processes & regulations are in place. The BMA recognises the vital role that multidisciplinary teams play in the NHS….
(5/11)
1
22
151
@DeanEggitt
@pulsetoday
For the same reason you did, Dean
The only person who didn’t, was Bob Morley who abstained
Voting records are kept by
@TheBMA
Many GPs were facing career-ending indemnity sums - this was the deal, as you well know
Anyway, wishing you well & have a great day 🙏
11
16
148
What fantastic news, but how incredibly unhelpful to have had zero discussion with GPs?
This sort of public messaging is incredibly unhelpful to GPs and frustrating for their patients.
Come on,
@NHSEngland
- it’s a recurrent pattern.
@bbcR4today
3
20
153
@JimBethell
Escalated to whom,
@JimBethell
?
We’re consultants in family medicine, expert generalists in complex multimorbidity
Adept at spotting pathological needles in haystacks of politically-stoked expectations of self-limiting conditions
I would welcome the chance to discuss 1/n
5
29
152
Objective metrics desperately needed for safe services in a new substantive GP contract:
1. A recommended max number of registered patients : GPs ratio, assuming an 11 hr working day (08:00-19:00) rather than 55 hr working week
Or minimum numbers of GPs per unit of population.
9
49
148
I and
@msteggy
(Chairs of GPC England and the Sessional GPs Committee,
@BMA_GP
) were concerned & disappointed to read this where
@ShilpaPatelGPP
asserts that enabling practices to use ARRS funding to employ additional GPs would be ‘ridiculous’.
1/n
The Pharmacist speaks to Shilpa Patel, lead prescribing pharmacist and partner at Brighton Health and Wellbeing Centre.
@BrightWellbeing
@ShilpaPatelGPP
1
0
0
13
63
152
Speaking personally, the GMC is paid for by doctors, for doctors
I believe
@The_HCPC
is ideally placed to regulate non-doctor allied health professionals
It would also be less confusing for the public
@BMA_GP
Our policy is very clear on this, from GPC England in September ‘23
Doctors … becomes ‘medical professionals’..
Dumbing down by stealth - and without appropriate consultation.
No doubt justified by HMG adding PAs into the GMC regulatory system 🙄
#GoodMedicalPractice2024
@parthaskar
@VictoriaTzB
@DrSteveTaylor
@doctor_katie
Your thoughts?
4
45
103
6
51
151
This is disgraceful
How pathetic
@wesstreeting
@SKinnock
There’s a real opportunity here for the taking, to root out the toxic narratives of the old govt still present within NHSE culture
@libdemdaisy
& colleagues will also be integral to pushing for change too
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
?
33
148
310
15
66
152
Less than the cost of an apple a day keeps doctors away… 🍏
4
88
148
Dear Colleagues
I know you’ve been rejoining the BMA in your thousands.
On behalf of my team & committee, THANK YOU.
The referendum is not a ballot.
It’s not industrial action.
It’s not subject to the Trade Union & Labour Relations Consolidation Act. But that’s the point.
The GP referendum on the 24/25 contract changes ends midday on 27 March.
Vote now and don't delay!
Make sure you're a member to vote - you must join by 25 March to have your say:
7
128
165
1
74
145
“Recently, we have seen some examples in the media that suggest there is a potential blurring of the line between doctors & non-medically qualified professionals, leading patients to think they’ve seen a GP or other medically-qualified team member - when they haven’t…
(8/11)
1
27
142
Patients need to know & understand what each healthcare professional can & cannot do, & where their expertise is relevant. This is crucial in helping patients understand the care they’re being given…
(7/11)
1
22
140
@DrRobgalloway
The 1000s of fewer inpatient beds will be a critical metric. How many at your Trust have been lost since 2018, Rob?
7
14
134
98.3% Yes
1.7% No
Turnout 67.7%
🏃♀️Marathon, not a sprint
🕯️Slow burn, no big bang
❌No strike
🕰️More time with patients
🧮Quality not quantity
Focus on your practice
Focus on the patient in front of you
Whilst practices still close
2,000 since 2010!
We must act to save GP
6
47
138
In General Practice, patients have long benefited from having access to a wide variety of healthcare professionals that can input into their care, from physiotherapists to diabetes nurses…
(6/11)
2
18
127
@BMA_GP
@HealthFdn
@BecksFisher
@DeepEndGP_YH
@dave_dlt
@TheIGPM
@PMA_UK_
@MedicsMoney
@RebuildGP
@Parody_RCGP
@NASGP
@TheDDA1
@nwlmcs
@NottsLMC
@LondonwideLMCs
@CambsLMC
@WessexLMCs
@SSLMCs
@DrGoblin3
@VictoriaTzB
GPs, I suggest you join
@BMA_GP
very soon.
15
22
126
The Govt has failed to put rules & regs in place in line with recommendations
@NHSE
has incentivised NHS employers to employ unregulated, vaguely & variously trained people as well as giving them a title that is designed to hoodwink the public into thinking they are doctors.
4/n
1
23
127
Don’t worry, the CXR is a Google image. Better than breaching GDPR by having SystmOne uploaded!
"We've got to recognise that England is a global exporter of GPs."
@doctor_katie
speaks to
@ITVAnglia
about the urgent need for action to address the growing GP shortage.
Watch from 11 minutes in 👇
7
31
98
6
14
124
#EMIS
Dear
@NHSEngland
@NHSDigital
In major situations like this, silence is unacceptable - even an acknowledgement of the understanding of the issues will be helpful - these must be public-facing too
Monday does not look good…
@BBCHughPym
🚨 Looks like all GP practoces using EMIS are down today due to the global IT outages. How many GP practices is that? All? Most?
34
119
212
6
45
127
A shout of profound support & virtual hugs to every GP GPN PM & practice staff members…
Who may be feeling unsafe in their home, workplace, town, community & country at this foul and febrile time due to the actions of moronic animals, and the scum goading them.
🫂😞🕊️
@BMA_GP
0
30
125
9
63
125
PAs are HCSWs with a degree and 2 yrs training in the medical model.
Cos of no legislative/regulatory structure it’s impossible to be clear what they can/should do.
Clearly there are some of concern. There may be others well aware of their limits.
2/n
2
16
118
The only sanctions are against the employer who puts themselves forward as professional supervisor if they fail to provide adequate oversight.
This mess is not of the making of one person or one College, it’s an ideological political manoeuvre.
3/n
2
17
118
We’ve all worked with some Dr Hiltons in our time.
I’m sure he’d claim that he was mercilessly bullied and “it never did me any harm”.
Especially heartening to see our allies coming out and speaking up. 💪
Together we are breaking the toxic cycle by calling this sh*t out.
My god. Hilton doubling down in tomorrow’s
@thetimes
- calling sexual misconduct “trivial”. The fact he refers to women as “girls” speaks volumes.
245
439
2K
8
38
119
The profession is lucky to have such good writers as
@pwhitakerwriter
for the
@NewStatesman
Many of the current ideologies of NHSE are inherited from the last govt
@wesstreeting
@SKinnock
&
@karinsmyth
now have an opportunity to take a different course to safeguard our NHS…
My essay in this week’s
@NewStatesman
on the evolving PA scandal, and the devaluation of medical expertise in the present day NHS.
29
199
470
3
39
117
So glad that
@wesstreeting
’s first visit was to a GP surgery with my old friend
@Dr_Ellie
We trained & qualified as GPs together in 2007-8 in Haringey
Since then funding into the GP contract has diminished by >50%
GP isn’t broken - it’s been broken and it can be fixed 💪
‘It’s absurd that GPs can’t find jobs at the same time patients can’t get a GP appointment’
@wesstreeting
NHS England have failed patients & GPs, by funding alternative roles whilst cutting GP practice funding by 20% in just 8yrs
Change at NHSE needed
14
634
1K
3
32
114
8. Relationship-based care over flawed dashboards
9. Senior-led triage over 1000s online consults
10. Face to face over remote
11. Your known family doctor over “working at the top of your license”
12. Valuing your salaried GP colleagues over “adjusting the skill mix”
2/x
1
17
113
@SteveBarclay
I’m sorry you felt the need to target
@BMA_GP
in your speech, when your minister
@NeilDotObrien
knows how constructive & pragmatic I want to be.
Speak to your local GPs on our patch - online access is a natural progression, but it needs to be safe for patients.
3
49
114
Something to consider the next time you see a social media post with a photo of an empty waiting room, berating the practice for being lazy?
A full surgery morning & afternoon, prescriptions, visits & another pile of tasks - are on top of this:
3
24
111
Schrodinger’s GP:
We are either sat on our arse doing nothing, or the structural bedrock of the NHS depending what the mail feels on any given day.
Own your part in getting us to here
5
10
136
3
17
110
Govt: “GPs & their practice teams are hugely valued!” 🤥
Actions speak louder than words
GPs will see ✂️ total practice £ per patient which has risen by just
👉£15 👈
in over 10 YEARS
That is why:
⚠️ 1000 practices lost
⚠️ 2000 fewer GPs
⚠️ 6,000,000 more patients
👇
6
63
111
Strength in pluralism - not one size fits all.
Individual bespoke population care delivered by expert generalist GPs, not some standardised fast-food franchise McPrimaryCare knock off.
Fund GP-led continuity of care - when you know the people, not just the patients.
There’s despair in GP-land – but hope too.
Innovation in general practice in England is outlined in a
@TheBMA
publication, featured in our latest edition.
@BMA_GP
chair
@doctor_katie
says it is designed to ‘spark a thought or start a conversation’. [1/5]
3
8
16
3
36
108
0️⃣5️⃣ working days left for
@DHSCgovuk
@NHSEngland
to offer safety, stability and hope for GP practices across England for 2024/25….
⏰⏳🙏
@BMA_GP
@DavidGWrigley
@Sammyyrra
@DrPhilBanfield
@ERunswickBMA
@TheBMA
I’ve created this video to help people understand the financial distress GP practices are under. Please share widely to create awareness and start conversations about how we save General Practice.
#TeamGP
#NHSCrisis
3
135
135
2
114
98
NHS Digital data underestimates hours GPs work
A ‘session’ measured as 4hrs 10mins suggests a GP doing 6 = 25hrs/wk
In reality much longer
See
Also
Extremely poor research being used today to knock GPs using recorded data in
@NHSDigital
for working hours
This is primarily based on sessions worked but a session is counted as 4hrs 10mins
6 sessions then 25hrs
But GPs are working 5-6hrs per session
3
32
56
3
63
106
Fantastic to see
@rcgp
getting behind this too with their statement today.
Increasing alignment can only bring positives to our hard-pressed colleagues 💪👏
For the sake of patient safety, it's vital the role and responsibilities of physician associates are set out clearly.
Our new guidance does this, and we encourage employers to adopt it immediately.
Watch
@DrPhilBanfield
set out why this is so vital.
30
217
560
4
26
103
No.
Guidance from
@FPARCP
on prescribing for PAs in GP
"If the duty doctor is very busy, the PA will send an urgent message via clinical system so that the GP/supervisor can issue between patients"
THIS IS NOT HOW PRESCRIBING SHOULD WORK!
Not discussing scripts is so dangerous!
37
80
296
5
11
100
Really great to meet a Twitter friend the other night who I admire so much!
@CraigNikolic
who does wonderful things in NE London general practice 🥰
5
4
100
I have been advised by
@BMA_GP
colleagues that we do not anticipate receiving the result until late Tuesday/early Wednesday.
As we await the figures - I just want to thank all of you who voted, nagged, took interest, attended a roadshow, logged into a webinar & supported this!
The non-statutory ballot for GP Partners/contractors is now closed. Our external partner Civica is preparing the result, which will be announced shortly.
0
5
14
5
18
98
I am immensely proud of
@thomasdolphin
. After over 20 years of friendship, trust me, he is one of the best. An amazing doctor, and a principled, kind man.
This is exactly how essential care continues to be provided during strikes. Tom didn’t cross a picket line. He wasn’t supposed to be on strike at the time. Generously, he donated his fee to the strike fund. [2/2]
If you'd like to donate, you can do here:
62
371
2K
6
17
98
Thank you
@SKinnock
- really positive to be given such a length of time to be able to articulate what I needed to - and the potential solutions.
I look forward to a positive working relationship with you, and wish you all the best with your brief!
It was great to meet with
@doctor_katie
on Thursday, to listen to her committee’s concerns about GPs and to discuss the essential work that they do. We are committed to moving healthcare out of hospitals and into the community, with GPs at the heart of our plans.
73
65
323
4
23
97
This is why NHS GPs are less likely to work over 3 days in practices
Those 3 days = 37 hours
It’s too much
It’s unsafe
You’d work the other 2 days in a different setting which is safe
This is where GP is broken
So we will have to start properly pushing back
@BMA_GP
7
22
99
Looking forward to meeting DHSC & NHSE regarding the 2024/25 contract for GPs in England this week
We’ll be putting the contract to the profession, in a referendum
We know that the 2024/25 contract needs to
🧷 1. Feel safe
🙏 2. Bring stability
🤞 3. Engender a sense of hope
We have re-entered talks with the Government over the GP contract changes. Whatever the outcome, you will be asked for your thoughts on the final contract in a referendum on 7th March.
Make sure you're a member to have your say
18
43
65
8
48
98
We have now published our
#GPsAreOnYourSide
video from
@BMA_GP
complete with additional subtitles which can be activated for screen reading:
👇
👆
It’s also on
PS: it is 💥💥💥
Let’s make it go viral 🦠
10
88
96
13. GMS Continuity of service provision over APMS Caretaker danger money
14. GP-led services over false economy of subsidised inferior patient experience
15. One GP appointment over half a dozen pass the parcel until you get a diagnosis
16. BMA advice over redundancy
3/x
1
14
95
Yesterday we wrote to
@NHSEngland
to make clear our dispute.
Today we write to ICBs, & warn to plan for system consequences.
Listen to the 99.2% of GPs who said “No” in our
#GPreferendum
Enough is enough.
ICBs, talk to your LMCs. Listen to what they have to say.
@BMA_GP
2
53
95
Who’s got two thumbs & was Golden Patient on the Trauma list today
@uclh
?
💥Me! 3 hrs in Mr Oddy’s theatre. 🦴🛠️
Still in recov as no beds, but getting 1:1 care 😎
UCLH funded Platinum level service. Awash w staff. Estates/equipment to die for. Everyone noticeably unhurried..
GPC England has spoken: the current 24-25 contract offer is woefully inadequate and puts patients and staffing levels at risk.
Watch the video update from
@doctor_katie
on our next steps, and why GPs should join the BMA to ensure you have your say.
23
232
401
31
17
92
Public spin:
🤡Greater access for GP appointments!
🤡More support for community pharmacies!
🤡Common sense approach!
Reality:
🧐Duplication of work
🧐Driving up inefficiency in GP
🧐Rushed incentive with no IT support
🧐 “GP to kindly…”
This is totally crazy from
@NHSEngland
!!!
Who comes up with this nonsense.
GPs do not have time - that is why this scheme is setup - right?
If I need to check every minor illness record & take risk I may aswell see the patients.
@doctor_katie
@DrSelvarajah
@Parody_RCGP
40
54
168
6
40
91
Hearing
@SKinnock
w
@Sammyyrra
explain pivots from
hospital > community
analogue > digital
illness > prevention
Big Q: HOW
Problems laid out by Darzi are stark
But:
💥 General Practice can’t wait for 2025 - it’s collapsing now
💥10 year plan priority = new GP Contract
@BMA_GP
7
40
93
Contrary to the wording, I &
@BMA_GP
GPC England did not give
@uk_biobank
permission to support this letter, as
@rorycollins
knows
Sadly, this now affects my trust in how you’ll gain patient consent for their health data if you ignore mine so freely
GPs: this is not contractual
12
65
86
A 10% drop in GP capacity would roughly equate to a c60% hike in traffic to others
The 33% increase in 999 calls yesterday reported by
@Ldn_Ambulance
suggests GP activity dropped by c5%
Which is impressive, given we reverted to pens paper & prescription pads…
Food for thought
6
22
90
Delighted to be back in Liverpool for
#LabourPartyConf24
Meeting friends from >25 years in Labour circles
Excited to share our
@BMA_GP
solutions as to how we move care closer to home & bring back the family doctor 💪
@wesstreeting
@SKinnock
@karinsmyth
@GwynneMP
3
11
88
Convalescence is….
Tabby cat ✅
Coffee ✅
Dihydrocodeine ✅
Flowers from friends ❤️🩹✅
Frustration 💥✅
Reflecting on accessibility/being on the other side 😬🫣✅
13
0
85
As ever, my colleague and friend
@HelenRSalisbury
says it better than I ever could!
👇👇👇👇👇👇👇👇👇👇
@BMA_GP
@GPonlinenews
@pulsetoday
@HSJnews
@Parody_RCGP
@PatientsAssoc
@HealthwatchE
"The down-skilling of general practice is often euphemistically referred to as a 'diversification of the workforce,' but it’s hard not to see it as a deliberate attempt to deprive patients of expert medical care."
@HelenRSalisbury
11
207
359
6
37
85
I’d be delighted to meet you
@SteveBarclay
I’m not just Chair of
@BMA_GP
I’m also CEO
@CambsLMC
caring for practices across all your constituency
#FenlandGroup
#Cornerstone
#MerchefordHouse
#NorthBrink
#Trinity
#Clarkson
#ParsonDrove
#GeorgeClare
#PriorsField
#NewQueenSt
#Jenner
1
16
75
17. Total practice income over high-bureacracy low-trust hoop-jumping
18. Patient QALY long term over QOF annual targets
19. MPIGs above overwhelmed services in deprived populations
20. General practice over “primary care”
We have a choice.
4/x
1
11
84
@nhse
@rcgp
@ClareGerada
**Clarification**
In a post on this thread, I said Clare Gerada’s son was in PA training. I’ve now been advised this is not the case, & would therefore like to apologise to Clare & family for any offence & confusion caused for the genuine error & any misunderstanding on my part.
11
16
81