Dr Matt Kneale (🦋drmk.link)
@drmattuk
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Former chair/co-chair, Doctors' Association UK (2022-2024). No longer active - contact me here: https://t.co/QUjK0gfAEU
Manchester, UK
Joined February 2009
X/Twitter has played a significant role in the disinformation campaigns that contributed to Trump's re-election. Elon Musk's actions have caused irreparable harm to the platform and society. I can’t continue supporting him, so I’m moving to Bluesky indefinitely.
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Tomorrow, a crucial piece of legislation around healthcare will be scrutinised by MPs. It will happen in a committee room, away from the main chambers, on a whisper. If it passes, it will worsen the health of the UK population. Did you know about it? No?. A thread 🧵.
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I remember one of my on call shifts, being placed on AMU overnight and seeing more than a handful of patients who didn't survive the night. Not one of them had their family present — often just a HCA or nurse holding their hand whilst they went. You should have criminal records.
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When my ballot paper arrives, sometime from tomorrow, I am voting for industrial action with @TheBMA. I entered medicine in 2015 with the anticipation that the career—whilst brutally hard on your emotions, intellect and social life—would allow me a comfortable life.
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Does this grifter have any limits to his depravity? Let the man rest in peace. You have no evidence for this. @gmcuk — you have been told repeatedly that this doctor is spreading misinformation. You had time to suspend someone for using a tube ticket, might you act on this?
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In 2020 I started early as a junior doctor. Graduated early due to the pandemic and straight to ward life. In summer last year, that NHS trust sent debt collectors after me. No communication, just 'we paid you £700 too much, repay now'. Paraphrased obviously. Personal win 👇 /1.
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Today on the medical take in A&E I have been drawing up my own medications, administering them, doing urine dips + MC&S, whilst still clerking patients + arranging investigations. @theresecoffey — you have your head in the sand. We need more nurses and enough pay to retain them.
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This situation is the equivalent, without any degree of irony, of a paralegal being paid more than a senior associate lawyer in many aspects. It is not far removed from a flight assistant out-earning the pilot, whilst having a go flying the plane.
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@gregfoley2002 Rest in peace, and thank you for your efforts to fight misinformation. I'm sorry this horrible virus cost you everything.
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Susan died following grossly inappropriate and negligent care by a PA. We are told time and time again that these cases are rare, but they shouldn't be happening. PAs simply must act within their competence; something that hasn't been happening.
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The natural rebuttal to this is that "doctors make mistakes too". We know, and we try to prevent it at all costs. The difference is that we make mistakes with the gold standard of education and training. How does removing those standards for cheaper alternatives make sense?.
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(1/10) Another patient has died due to a PA. Most concerned about PAs have probably heard of a few key cases already:. -Emily Chesterton, died following misdiagnosis of a PE. -Christopher Tucker, died in hospital following an inappropriate procedure & poor antibiotic management
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Ah, but one further thing — they are not cheaper. A foundation doctor, who might oversee the work of a PA on a ward and prescribe for them, gets paid a salary of £28,274 pa for a 9-5 job. A first day PA would receive £35,392.
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Misusing his position as a cardiologist with expertise on statins, to misrepresent himself as a pharma expert. "His own research" is deeply flawed and he has an agenda. This is deeply dangerous behaviour and I'm utterly shocked @gmcuk are not acting on dangerous misinformation.
BREAKING BBC News:. Cardiologist says likely contributory factor to excess cardiovascular deaths is covid mRNA vaccine and roll out should be suspended pending an inquiry. We did it. We broke mainstream broadcast media 🔥🔥🔥
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. would have survived if she was referred to the hospital. Worse yet, her mother says that she didnt know she saw someone who wasn't a doctor. The title "physician associate" sounds grander than it's supervising General Practitioner.
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It doesn't stop there. We have had deaths associated with PAs, following missed diagnoses like blood clots in the lung or torn blood vessels from the heart. In the case of Emily Chesterton, who died from a blood clot misdiagnosed as anxiety by a PA, the coroner ruled she likely.
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This is despite the fact there is usually no requirement for a PA to do night shifts, weekends or out of hours work. It is despite the fact they are less trained, cannot prescribe, cannot order radiation and cannot sign death certificates.
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I'll do my best to reply to questions tonight, as this is a brief introduction to far larger issues. I've hit the thread limit. I'm sure my colleagues will join in. Thank you, and please do raise these concerns with your MP - NOW - and please share this.
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Statutory instruments are meant for technical pieces of legislation. They are almost always passed, in as little as 15-20 minutes. They were not intended for complex, controversial legislation like the regulation of potentially dangerous medical replacements.
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As a result, and an effectively unrestricted scope of practice, MAPs have been used in inappropriate roles—especially in the last few years. We have seen notable examples such as PAs involved in neurosurgery. Some of these say they are learning anatomy on the job.
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Let's be clear: Dr Malhotra lost the respect of the profession when he forfeited evidence-based medicine, proceeded to review his own academic work, and went beyond his remit to sell false truths on social media and in the media. He no longer holds an NHS consultant post.
Let's be clear: Dr Malhotra is a respected cardiologist & advocate for evidence-based medicine. He speaks his mind & challenges the status quo, regardless of who it may upset. #MedicalCommunity #Science.
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The question on everyone's lips in the medical profession is why these roles have been given such rapid prominence and power, despite lacking an evidence base proving their efficacy?.
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A first year doctor in the NHS works under a tight framework, so much so that they cannot fully register with the GMC for another year. To become trained to expert level, you would work for at least 5 further years to be a new GP or double that for a specialist in hospital.
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Everyone in my trust has been granted "wellbeing hours" as a thank you for COVID-19 efforts. It equates to about 4 hours per year. When I say everyone, I mean everyone except doctors. I found out this was a thing third hand from the nursing staff in A&E. Boy do I feel valued.
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MAPs are not regulated. They have voluntary registers at a few Royal Colleges, but no statutory process to ensure they do not act dishonestly or recklessly to harm the public.
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Tomorrow is all but a certainty — I hope that this introduction is raising some eyebrows amongst the public reading it. If you have butterflies saying "this can't be right" I assure you it is, and you, your family and friends are at risk of losing professional doctors.
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I can't believe it's even remotely controversial to suggest the roles and responsibilities of a barista and a doctor are not on par, and do not require the same remuneration.
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They usually undergo about 2 years of training following a previous degree, unlike doctors who do at 5-6 years (sometimes 4 years with a previous degree). There are edge cases here but this is predominantly the case.
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Legal commentator David Allen Green has commented on them in depth, raising concerns about a lack of parliamentary scrutiny yet significant legal impact. They have been used for broad COVID regulations.
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Physician Associates and Anaesthesia Associates are a relatively new role, which the Government is relying on to meet the aims of the Long Term Workforce Plan. Together, along with a smaller separate surgical role, they form a group called Medical Allied Professionals (MAPs).
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Concerns ranging from illegal prescribing, missed diagnoses including deaths, and replacing doctors on medical rotas. Why would institutions meant to protect the value of a doctor support these changes? That is a question that needs a deep dive, and some good journalism.
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Further, doctor is regulated with the General Medical Council, meaning that a rogue doctor who acts well outside their scope of practice and causes harm could be held to account. They could be deregistered at a legal hearing, in a purpose that protects the public.
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A PA or AA undergoes relatively high levels of supervision for about 12-24 months, but then usually becomes autonomous. With the caveat that they must always be overseen, even if indirectly, by a senior doctor.
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Moral of the story?. 1. Know your legal rights to your data. 2. Demand proof. 3. If you do have to repay, you are in control as to how you do it. They can't take it all in one go. 4. Involve senior management early in disputes. Escalate continuously. Here's to a happy ending!.
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I say everyone's lips, but this is not exactly true. Multiple high level "leaders" of the medical profession have been involved in building this expert. Almost all of them refuse to acknowledge any concerns on safety — despite @TheDA_UK discovering over 680 concerns from doctors.
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Whoever did this has a future in NHS ward management - straight to Band 8, do not pass go, do not collect £200.
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As has become public knowledge, I'm initiating legal action against the General Medical Council due to their inaction in the face of harmful anti-vaccine rhetoric from registered doctors. It's about public safety, professionalism and integrity. Thread👇.
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Did you know? @gmcuk employs social media specialists to monitor criticisms and shape their strategy. The extent of this is outrageously far-reaching. Thanks to @Mike88881221 for uncovering this through FOI. If I’ve tagged you, the GMC has been tracking you. Congratulations?.
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My 1st FY1 on call I assisted with a cardiac arrest (we successfully brought them back), needle decompressed a tension pneumothorax before the reg put in a drain, and on top of this had responsibility for jobs for all acute medical patient that night. £14/hr? 🤣 It's an insult.
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The GMC don't want the world to see the responses to the public consultation on PA/AA regulation. Let's release it for them. Request your data by SAR and share en masse. #PAProject #ReleaseTheData . @PeterStefanovi2 @carolvorders @doctor_oxford.
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Exceptional piece by @doctor_oxford today in @guardian. @RishiSunak & @SteveBarclay are hiding in plain sight. They ignored our call for parliamentary recall. Make no mistake, this is a deliberate and systemic demolition of our National Health Service.
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I am astounded that @gmcuk is spending doctors' fees to defend my judicial review. A doctor that is spreading harmful COVID-19 misinformation should be well within the remit of a regulator, and yet it not only declines to investigate but will defend such action in court. 🧵.
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There is an experiment within the NHS to reinvent what a clinician is. There is a move away from rigorous, academic and experienced doctors towards a new role, with shorter training, lesser standards and (presently) zero regulation.
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Lawson-Short says he and his fellow PA students received just 15 days of education in each hospital specialty. They were then expected to work in paediatrics, assessing acutely unwell children—a huge responsibility for someone with such limited training.
"I really do see it from both sides—there are no winners out of this.". Former physician associates who have made the move to medicine speak to @Erin_Dean_ about the realities of the PA role.
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At least Andrew Wakefield didn't have social media to push his MMR/Autism lies. Yet people were seriously harmed by his actions. He was struck off by @gmcuk. One cardiologist has been given a dangerous platform to lie to the masses — people are being harmed. The GMC is silent.
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For all those feeling hopeless about the state of British medicine after today's House of Commons discussion around MAP regulation, fear not. There are avenues and @TheDA_UK, @AnaesUnited, @OphthConvergent, @TheBMA, @Doctors_Vote are all working hard to establish these. Some.
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I have been subjected to immense stress and threats to my livelihood due to vexatious police & GMC referrals by Mr Nash, the leader of a PA union-in-waiting, all of which have thankfully been dismissed. He has faced no consequences, leaving me anxious about what he might do next.
Came across this interesting video and who did I see popping up on my screen ? The one and only @UMAPsUK Stephen Nash!. 💔He’s heartbroken regarding the plight of junior drs .👀 no evidence of safety concerns .🤺taken legal advice regarding the @TheBMA scope and PA redundancies
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. as well as last year's Public Order Act changes.
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Slightly disappointing to see @DrSarahClarke denouncing spending on locum doctors on @BBCNews. Not only that but supporting PAs as an alternative to more doctors. The answer is to pay us more to retain staff, increase med student numbers, as well as NTNs for ST training.
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Some absolutely staggering news from the GMC today which, unfortunately, I can't yet share. I know this is like fuel to a fire at the moment, but there will be more on this soon. Let's just say, you won't be happy where your fees are going.
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Family of film make-up artist call for inquest after treatment by physician associate which led to death. @JanetEastham @TheDA_UK @TheBMA.
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I've recently received evidence (kept anonymous for privacy) raising serious issues around the role of PAs in primary care. The details provided here are alarming and bring into question patient safety and clarity around prescribing.
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I'm happy that there was no further action, but it goes to show that you can never, ever trust NHS admin to say you owe them money. Fight it, always. I know several colleagues who in 2020 were subjected to the same bullying tactics and didn't have the strength to fight this.
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Physician and Anaesthesia Associates seem rather unhappy with us sharing patient safety concerns. They are so concerned about their professional reputation, however, that they are starting to work on shutting down concerns by unionising.
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It's still a bit crazy to me that just over a year ago, there were probably less than 10 people—myself included—vocalising about the risks and harms from the PA role. A year later, and the majority of the profession is finally fighting back and aware of the harms.
Thank you for asking me this question . I generally refrain from comparing medical scandals because they are all tragedies in their own way. The Bristol heart scandal arose because the unit had demonstrably worse results for paediatric cardiac surgery than other units, but was.
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I get that the discussion around physician associates can take its toll and for some people it feels "a bit much". The thing is, they represent the biggest threat to patient safety, pay and conditions compared to any other single issue.
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We gave the MHRA (@MHRAgovuk) an opportunity in February to discuss MAPs illegally prescribing controlled drugs. Whilst we were promised a response from June Raine this never came to our inbox. This week, I will take it directly to West Yorkshire Police.
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Imagine that you run a small business, or are self-employed, and you need to file a tax return. Now imagine if your accountant said, "Great! We'll send your case to someone who's done a short course in basic arithmetic. They can handle the simple stuff." /1.
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Short and sweet. Not much more need be said. "Plan to pump 10,000 fake doctors into the NHS is insane and dangerous".
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We are giving £30,000 towards the @AnaesUnited GMC legal challenge. It is one of the most important legal battles in UK medical history. Please give generously, and push the Royal Colleges to get off the fence and fight back.
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At least with a new pay deal, a new FY1 doctor on £36,616 will outearn their assistants. Oh bother.
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@dave43law @MartinDaubney The GB News parade came out so quick to say the Nottingham attacker had a "history of violence" - but instead it turned out he has no criminal history. Just call it what it is: racists lying to make an agenda.
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Received a report from a consultant (staying anonymous publicly for now) that they have been forced off social media by their employer due to public comments made about patient safety and MAPs. @LordPhilofBrum - Is this the sort of patient safety culture you envisaged?.
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For the second time in a decade, I believe the Government—or an arm's-length body of it—has underestimated @doctor_oxford's persistence on matters of safety and principle. Running down the clock only delays accountability and increases your culpability, @gmcuk.
Day 43 of asking.
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In the spirit of PAs who now do only 4 weeks of university days per year, with the rest distance learning, I'm going to become a pilot through my home studies on Microsoft Flight Sim. Very excited to fly an Airbus A380 near you soon!.
@JimBethell I want to thank Lord Bethel. After his spirited speech to the Lords, I have found my calling. I am retraining as an #AstronautAssociate. Medicine might be going down, but I’m going up, up and away friends.
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St George's Trust's new Physician Associate job advert raises serious concerns. The role description appears to overstep @TheBMA scope boundaries for PAs potentially putting patient safety at risk. 🧵 /1.
@geshNHS remove this job advert immediately! .THIS IS NOT SAFE FOR CANCER PATIENTS!.No experience necessary in oncology ? .What local medical training and exams would a PA have to undergo to allow them to do this work ? .Where is the local training plan?.@ClinOncDoc @parthaskar
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So far waiting 14 hours for a hospital bed - patient experience this time. Told likely no movement overnight so approaching 24h most likely. It isn't fun, and I've developed a whole new sympathy for patients.
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Elected BMA reps are obliged to ask you to support the deal, as it was a condition of the negotiations. Read between the lines. I'm not an elected rep, and can tell you that you should be rejecting a 4.05% uplift. Strike again. Reject the deal.
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Sorry, did I actually just read this from an Emergency Medicine consultant?. It is hallmark of ensuring that a doctor meets a minimum required standard of competency and training. It provides fundamental knowledge and education on which your entire career was built upon.
@Caesarnots96696 @mouseter_chef @First_Neptunian @GMCharlatan @PepperNutty @iDrSunny @parthaskar @JanetEastham @drmattuk @doctor_oxford @implausibleblog @Xeon4f145d96s1 @ExplosiveEnema2 @AnaesUnited @medicalmodelbri @chriscraigCCC I just don't get this obsession with a medical degree in this day and age. Never have, probably never will. Somebody, some day may convince me.
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As a taxpayer, can I just ask where the work is in this timetable? Feels awfully like a medical student role with a few small aspects of a HCA or admin assistant. For the cost of a registrar. .
Update: @ImperialNHS have now published details of their Physician Associates in paediatric surgery. Worryingly, the role includes assisting with operations on children, including assisting with emergency surgical cases 🚨. Are parents informed as part of the consent process?
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@NickTriggle I tried to reach out when I saw you were writing on this topic. It's unfortunate we didn't speak before publication. I have. corrections, to put it mildly.
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Fantastic news for @AnaesUnited, the Chesterton family, and the public! DAUK calls for an immediate pause on the expansion of physician associate (PA) and anaesthesia associate (AA) roles following a landmark High Court ruling.
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Massive statement. We can now say that Anaesthesia Associates and Physician Associates in General Practice will have their scope of practice set by doctors at a national level. When will @RCPhysicians join the conversation and do the right thing by the public?.
RCGP governing UK Council has today voted to oppose a role for Physician Associates working in general practice. You can read more here.
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Having faced multiple false allegations in the last 24-48 hours, I want to assure donors to my crowdfunder that funds raised have been used responsibly and in line with the stated purpose of seeking legal advice. I have consulted with legal professionals, including top counsel at.
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Speaking of the NHS's abhorrent treatment of whistleblowers, Usha Prasad — a cardiologist turned whistleblower at Epsom & At Helier — is now facing a cost order to repay the Trust's £180,000 costs!.
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3 years homeopathy + 2 years PA = FY1 equivalent. Got it.
@LittlePersonDoc 3 + 2 makes 5. Come on now. Just because you repeat it enough times does not make it true.
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@RupertMyers @IsabelOakeshott And yet right wing rags and their commenters (hi Isabel) love to stir this story up over and over. The question is why?. Handed your phone over yet, Boris?.
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Astounded that the initial target has been met in just over 7 hours. #MedTwitter you have absolutely smashed it. I have extended slightly because we are unsure on how much will be required but, in any event, the response has been phenomenal. Thank you ❤️.
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@HSJEditor Alistair, you're stuck in the dark ages I'm afraid. When most of the medical profession tells you something is dangerous, perhaps you ought to listen.
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@Dr_Done_ @carolvorders Sorry to tag you again but this is why doctors are leaving in droves. Not just having our working conditions eroded at every level, but huge numbers of staff with less training/responsibility going into huge value posts. Postgrad PA Vs consultant neurosurgeon. .
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I did make a small adjustment, but yes that is comic sans on the surgery's wall. And yes, that is disgraced former health secretary Steve Barclay. You're not fooling anyone @fhussain73 — it is clear what your motivation is for pushing PAs. I'll leave a relevant quote below.
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P.s. I won't name the trust but obviously you know if you worked with me between March 2020-August 2020. If this affected you and you were bullied into repayment, please message me and we'll fight it.
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And that, ladies and gentlemen, is grassroots. I suspect Mr Massey is going to have a rather frustrating Monday.
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@Randall87454048 We should always be open to hearing good quality evidence - that is science. The science, however, shows that long COVID is a bad thing and that the risk of it increases with every infection. You're not mad. We don't know much about long term effects.
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Just posing the question again, asked multiple times over the last year:. What does a PA bring to the MDT that a doctor cannot, and to a greater degree of competence?.
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People have asked me to set up a crowdfund, so I've done so here. If you are able to give, thank you. If not - no worries (but please share this thread!).
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Rates are being cut locally to less than F1 locum rates, shifts being left unfilled, the cost of living is increasing at alarming rates with nursery fees, utilities, rent etc on the rise. I am in debt, I have no savings. No, really. I'm still not working the strike dates.
📢 STRIKE DATES ANNOUNCEMENT📢 Junior doctors in England to take further #PayRestoration industrial action. The first strike action will take place from 7am on 20 December to 7am on 23 December. The second will take place from 7am on 3 January until 7am on 9 January.
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One of the dumbest things I've seen from a medical management POV. We don't keep patients because we enjoy their company, it's because their health or social support is not at a safe enough level for discharge. This is dangerous and needs immediate backtracking. Which trust?.
Really?!. REALLY?!. #JuniorDoctorsStrike #JuniorDoctors #medtwitter #Infantilisation #fullpayrestoration
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We've secured an important step forward. Thanks to public support, the GMC has been forced to reconsider its flawed decision not to investigate Dr. Aseem Malhotra's concerning statements about COVID vaccines.
(1/2) A judicial review, brought by Dr Matt Kneale and the Good Law Project, will no longer take place. This was agreed on by all parties. After Dr Kneale asked us to carry out a review of our decision to close concerns he raised about Dr Malhotra, we identified an error for.
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I have my first meeting with a solicitor this coming week - thank you again for all the support🩷.
People have asked me to set up a crowdfund, so I've done so here. If you are able to give, thank you. If not - no worries (but please share this thread!).
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Today's the day UK medicine will be put on life support. In a short while, the House of Lords will most likely follow suit and withdraw care altogether. Most doctors have been palliated and stifled by mistreatment for years. Most of my colleagues are quitting or moving abroad.
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@mercer_felicity @carolvorders She lives rent free in your head, Felicity. Spend more time focusing on your husband's terrible policy choices and less time worrying about someone calling out corruption 👍.
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If you were outraged by the PA/AA issues so far, you're not going to like what's coming. We have barely scratched the surface on wrongdoing; unfortunately it takes time to get these things to a workable, releasable position.
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The fact that grieving families are having to join a legal case just to ensure proper supervision and regulation for PAs & AAs is beyond belief. How is the GMC still evading responsibility?.#NoMoreEmilys #PAProject. @TheDA_UK.@TheBMA.
Our legal case against the GMC has been joined by two families who have suffered tragic bereavements following care delivered by Physician Associates (PAs). Statements are being prepared in which both will give evidence to the Court.
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1/5: Alder Hey Hospital allowed a physician associate to conduct medical exams on abuse victims, despite the risks of evidence being dismissed in court. This could let child abusers walk free.
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