Joe Pick
@isitsleepytime
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Anaesthetic Registrar by day, passable adult by night. Interests include obstetric anaesthesia. @anaes_trainees elected member but all views my own.
West Midlands, England
Joined October 2023
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We are now at the point where the very organisation started by doctors and designed to protect the public, will fight doctors to argue that you don’t need to study medicine to practice it!
Today we have responded to the BMA, strongly rejecting the basis on which they have proposed to bring legal proceedings.
You can read our statement on our website -
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I moved house last year, we had to have some work done. Every single tradesperson at some point sighed and said something along the lines of “well it’s just got so much more expensive since last year”, I accepted and paid. Why doesn’t this apply to healthcare?
#BMA
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Death by a thousand cuts: a tale of how I got some noticeboards installed in a trainee room.
As wellbeing lead i thought it would be nice to hang some notice boards in our trainee room, for regular updates on wellbeing issues.
Seems simple no? Not for NHS front line staff. 1/
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And this is why it annoys me when people who don’t have a clue, want me to be more productive and efficient when I’m working in an environment that makes everything as difficult as humanly possible to action.
Rant over.
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Just had the realisation that not once in my 10 years of working as a doctor has my employer willingly done anything to make my job or life easier/ better. I’m sure this isn’t exclusive to medics, it’s just a sad state when the default is to attempt to exploit you.
#juniordoctors
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@HSJEditor
Agh yes the productivity issues are down to doctors just not working hard enough. Nothing to do with system issues created by the corporate structure that actively work against frontline staff…
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@gmcuk
It is within your remit to determine whether behaviour has an impact on somebodies ability to practice medicine. Again asking, why should doctors have any faith in you as an organisation?
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For those wondering the board is used for regular updates, polls and posters, and has proved popular.
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This is why we need nationally agreed scope of practice, 1 in 8 hospitals are apparently tolerating illegal activity. It’s going to be the Wild West. Why are NHSE and the GMC facilitating this?
@AnaesUnited
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@JimBethell
Let’s just get this clear, you ignored multiple warnings and worries of thousands of medics because one person wrote to you to say they felt bad? I’m sorry you’re getting abuse, but your views lack insight.
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@JimBethell
I’m not entirely sure repeated referencing of
@gmcuk
GMP is quite the flex you think it is.
Can you state on record that you have no pecuniary interest in the professional development of associate roles and you hold no positions in companies that may benefit?
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Hang on a second? This tells a completely different story to what was presented, To mishandle data on something so important is unforgivable for the RCP leadership.
I will just leave this table here to do the talking. The
@RCPhysicians
leadership has attempted to mislead its Fellows at the
#RCPEGM
.
🔗
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I’m conflicted about this case, what do people think?
Tired doctor falls asleep at wheel causing grievous injury.
What irks me is the language used by the GMC legal representatives. Is this an understanding and empathic regulator?
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@SwearySister
Rotational work, non fixed work area clinical commitments outside wards .. shall I go on. We could ask what makes other groups so special they deserve nice settled area and teams. But we don’t because we don’t advance by tearing others down. Reflect please.
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@gmcuk
Why would regulating a different profession affect your regulation of doctors? Considering the current climate it’s verging on insulting and making comparisons.
I’d consider deleting this.
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No sh*t, frontline staff have had their pay and conditions cut year by year, whilst being treated like numbers on a spread sheet. I think people underestimate how much runs on goodwill.
‘Reduced effort’ may have contributed to 10% productivity drop, says NHSE
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@gmcuk
It’s particularly galling to experience you having such an open approach with Associates and yet being a closed book for doctors. What are you going to do to rectify this?
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Doesn’t seem fair to force 18 year olds into national service whilst over 65’s sit at home in their million pound houses that they bought for 50p in 1970.
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@MichelePaduano
@uhbtrust
Hi Michele, this is tragic. I think you are maybe focusing on the wrong thing with the manual machine check. It probably features but realistically this is a failure to clinically assess the whole patient. An issue brought about by taskifying the NHS.
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@SkyNews
For those interested the issue isn’t limited to GP’s, it’s a massive concern within hospitals. Doctors are trying to raise the alarm but the very institutions there to protect patients aren’t listening.
@AnaesUnited
We are commencing a legal case against the
@gmcuk
over their regulation of Physician Associates.
We need your help to fund it.
Writing letters didn't work. Time for action.
#telltheGMC
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Whilst I do understand those with convictions should be processed via tribunal, why is our regulator pushing for harsher punishments in situations with significant mitigation, major reflection and minimal risk of reoffending. A vile system that just lines the pockets of lawyers.
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The lack of respect shown to our highly trained experts is one of the thousand cuts that doctors endure within the NHS. Would a COO or barrister be treated like this? The NHS has forgotten who the talent is.
I don't get a locker. No travel or accommodation expenses (my contract says I have to live close so that I can attend hospital promptly). No funding for assistance. Expensive parking. Buy my own coffee. Shared canteen with patients and relatives so have to queue for ages. 🤔
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We’ve had enough of cloak and daggers and behind closed doors meetings. If you represent us, you should answer to us. Minutes of these meetings should be released. Otherwise these ivory towers need to come crashing down!
Quite the spectacle today - its amazing that Jamie Saunders (PA president, fantasy MBBS) was at the AOMRC meeting, whilst the BMA was not invited.
They’ve invited the fox to the hen house and given themselves a pat on the back for inclusivity.
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@gmcuk
as you are happy to attack tired medics. Presumably you are using your considerable funds to solve the problem? Or are we just using that to pay for private healthcare?
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I don’t agree with regulation by the gmc, I have had no voice in this matter. To find out that they will be paying half of what I pay despite taking home the same as me per hour straight out of university is a disgrace. I feel this is the final straw.
#defundgmc
So we heard today at the select committee debate
@gmcuk
will be charging £221 per annum for PA/AA registration.
Why do I as a doctor have to pay £433?
I would much rather pay £221 as well, and come to think of it, I just might cancel my direct debit right now. 🙂
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@karimbrohi
I’d argue it’s allowing ourselves to be exploited by organisations that has deprofessionalised us.
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It also goes against their promise of no doctor’s money being used in the regulation of Associates. If they use our money they are demonstrating dishonesty, if they use government money they prove they are just an arm of government.
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@BMA_Consultants
I’m happy it’s been rejected, but as a committee you have sold your future colleagues down the river by putting such a pathetic offer to your colleagues and providing such a poor mandate.
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A vital message. The institutions of the uk are doing their utmost to blur the lines. We need to make it safe and work for everyone.
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The GMC needs reform. This needs to start with accountability to the profession it taxes and polices.
Hi
@wesstreeting
You’re certainly saying the right things 🙏 but culture can’t change whilst this toxic generation of unaccountable leadership remains
The first and most important change should be to enable those who care more about outcomes than they do self advancement
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I think I’m actually getting tired of endless egregious goings on. But this one is a biggie. What on earth is going on with health care in the uk.
🚨PLEASE READ🚨: FOI requests reveal STUDENT PAs covering doctor shifts on doctor rotas at
@RBNHSFT
- previously in the news due to the death of Christopher Tucker involving care given by a PA.
All thanks to u/sildenafil_prn (
@MedReddit
)
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Why the NHS needs to improve as an employer, rant no. 1257, the topic of this rant will be excess mileage and rotational training:
As part of rotational training locally to me a doctor may have to travel to hospitals that are up to 52.1 miles from one another. 1/
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The most concerning part of this article is one hidden line. Come next week, through cloak and daggers the medical act will be changed being a doctor will mean even less! The GMC are complicit in any harm that occurs.
@RoshanaMN
@RobLaurensonD4P
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@ReddicalMedge
It’s a system created for the convenience of accountants and managers not the staff actually implementing stuff. Part of my theory about why we need to re-focus on the purpose of the health service.
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Well this is pretty damning. Doctors apparently haven’t even been asked about major changes to the organisation they are compelled to fund, the
@gmcuk
need to stop whatever they are planning.
@Doctors_Vote
The GMC didn’t inform registered doctors that the 2017 public consultation on PA registration (by the GMC) was taking place. I know this because I have just received confirmation from the GMC via a FOI request. Now why would the GMC themselves not want doctors to have a say??
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They have been terrible, they haven’t listened to the room. They aren’t taking anything on board. They aren’t representing their members.
Vote of No Confidence in Senior Officers of Royal College of Physicians?
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What has happened to allow us to reach this point? It’s why I really struggle to stomach the “plenty of work to go round” argument.
Second job rejection without an interview. Unemployment sounding very real now.
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Wow this is truly concerning,
@gmcuk
should make comment considering they plan to start regulating this group.
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@ruthlt82
What I’ve seen has been looking at people being deployed in roles they aren’t trained to do and asking is it safe?
I’d hope my fellow doctors would share my admiration and respect for pharmacists, incredible group of professionals who provide a massively valuable service.
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@gmcuk
Hasn’t Mr Massey been in position for the best part of a decade? Surely this situation has developed under his stewardship. Why should we trust him to effect positive change?
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@DrEilidhMaria
All reflections as poetry from now on please.
There was an old man from a home,
His lungs were all filling with foam,
It was a really doozy,
So I gave him some fruse,
And now he’s well enough to go home.
Fin
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What’s your least favourite procedure and why is it putting an NG tube in an intubated patient?
#anaesthesia
#whywontyougointhehole
#happyvalentines
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@craig_smithUK
I actually kept working in exchange for a pay cut, then when I asked not to get a pay cut I was painted as greedy.
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@Plyons251
As an FY I saw a consultant surgeon call the chief exec and tell them that unless they sorted his parking space out they could find another on call consultant for the weekend. It’s pathetic how we are now treated.
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So the whole process of
@gmcuk
regulation was sold to the lords on the principle of national scope? Why are they now using doctor’s money to fight against their own lobbying!
This needs a pause and for the GMC to sit down and actually talk to doctors.
@tcgannon
Briefing to House of Lords by
@gmcuk
, aimed at smoothing the passage of the AAPAO, reveals the assurances given to their Lordships of how Scope of Practice for Physician Associates would be set.
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@JimBethell
@ShaunLintern
@14CuckooLane
Hi Jim, just chipping in again. Can you clarify again that you have no pecuniary interest in the de-doctoring of health care? In particular the promotion of associate roles. Or that any business you are associated would benefit? Again a simple no and we debate in good faith.
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This house believes that having a wellbeing page on the intranet doesn’t actually mean the corporate structure of the NHS is doing very much about staff wellbeing.
@SecretNHSCEO
@mouseter_chef
@VirtueOfNothing
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Over the last few days I’ve encountered the phrase “gold plated pension”, rapidly becoming aware that these people don’t really understand what gold plating involves…. I’d prefer a solid gold pension please.
#juniordoctors
#bma
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Firstly funding, I don’t have access to any easily accessible funding. But why would 40-50 resident doctors require any capital for basic improvements in their working lives.
I had to contact the guardian of safe working, who collects money from situations where there are 2/
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I urge anyone at this conference to discuss the iceberg, as the gmc are busy rearranging deck chairs and jumping onto lifeboats.
The main hall is filling up as we get ready to start
#DEMEC2023
in Manchester
Looking forwards to an important conference for
#MedEd
If you’re here please come say hello at
@gmcuk
stand. I’ll be nearby during all the breaks.
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@gmcuk
You could just listen to the people that pay for your existence, and not regulate associate roles?
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@Vocal_GenX
I don’t think threatening violence against people for a situation you’ve completely made up in your head is fair. I think you should apologise.
Congratulations to your son and wishing him the best.
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I struggle to recognise this GMC that is concerned with being warm and personal. It’s at odds with what countless doctors under investigation experience. In addition why does warm and personal trump safety and clarity?
We told the GMC that AAs and PAs cannot legally be considered part of the ‘medical profession’; and we wanted to know why Good Medical Practice refers to them 29 times as “medical professionals”. They replied:
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@GMCharlatan
@MFTnhs
I appreciate they need a way to discuss workplace issues, but as we are regularly told they are not doctors. The JDF is in my opinion a sacred place, we don’t allow anyone, including consultants, to attend. I’d be pretty annoyed if non doctors attended.
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For anaesthetic inclined people, I am standing for AoA committee. If you like the look of my statement please consider voting for me, I would also strongly encourage people to check out
@hasyourregtried
who i had the privilege of working along side at
@AnaesUnited
#pickpick
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@gmcuk
I absolutely feel for those affected by the accident and really do wonder how I would feel in their shoes. But does a confrontational process such as this benefit anyone and take into account any of the issues?
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The GMC are deaf to the concerns of doctors and the risk their inaction presents to patients. Time to
#tellthegmc
We are commencing a legal case against the
@gmcuk
over their regulation of Physician Associates.
We need your help to fund it.
Writing letters didn't work. Time for action.
#telltheGMC
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I get hold of the boards finally. But I have to then contact estates via a portal, there are 2 separate estates depending on what building it is. I have submitted to the wrong portal. But don’t worry I have to fill out a form. They generate a work form. 5/
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It costs £70 to hang one notice board. Remember I don’t have access to a budget. I go on my hands and knees begging to theatre managers to get approval for payment and they take pity on me. 6/
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Success, it’s approved. I have to then speak to the person (very nice and friendly) in corporate to order the boards. They are unfortunately delivered to the wrong place. 1 month of chasing and I have to reorder. 4/
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5/ what point am I trying to make? who knows really! But maybe it’s something that summaries to, why for scope do medics experience such rigidity and difficulties when we are being told by other professional groups and our employer that this isn’t necessary.
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@gmcuk
Very sad that as an organisation you are so unwilling to listen to the people that pay for you.
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@DocShivSharma
@Doctors_Vote
@Xeon4f145d96s1
@MichelePaduano
@TomStocks1982
@Doc_IonaCollins
@DocAnonX
@DrPhilBanfield
Does this fall under the guise of innovative and unique? Getting people who have never been to medical school to examine medical students. Are registrars allowed to apply?
@AstonMedicine
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@DrNeenaJha
@DrCarolineMWF
Neena so sorry to hear about the awful experiences you have had in the last few years!
I do hope people remember the real damage that has been done by this government come Thursday.
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@pulsetoday
They treat us like children that can’t be trusted to act like professionals if someone buys us a bottle of wine to say thank you. It’s clearly written by choir boys who can’t trust themselves.
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The job is generated but they can’t tell me a date. They turn up when I’m on nights and I get a call in the middle of the day asking me where we want it put. 7/
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Scope creep debate, what do people think? I had a colleague during ACCS who wasn’t anaesthetic stream. They were a better doctor than me. They were after a year a better anaesthetist than me. In terms of sheer knowledge they were streets ahead of their peers.
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Breaches of contact and exception reporting generates a fine for the trust. Ethically a little dubious as as anaesthetists we don’t really exception report. Therefore don’t generate fines. 3/
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@VictoriaAtkins
One would argue it’s cynical to run down a clock on negotiations. You had your opportunity to get in the room and you failed. It’s representative of your party. I hope it’s reflected next week.
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For those of you concerned about the expansion of associate roles without robust mechanisms for safety, this article is worth a read.
Richard making a very balanced argument that what the GMC is doing is bad for patients and bad for associates.
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@sparklysister
@moribunddr
Maybe the discharge team need to learn a new skill beyond annoying staff?
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Same trust —> different site, have to get a separate ID card. On top of this is then have to get a band 7 in theatres to add me to a list to access theatres or use the toilet during the day…
I think the pertinent question is, why?
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@DocDoLi
I think that’s the problem, I could see 1000’s of medics tomorrow morning making exactly the same mistake. This was unlucky. But our regulator is seemingly ignoring this.
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@zebrzyna
@Xeon4f145d96s1
@Doctors_Vote
@BMA_JuniorDocs
Who is the chief exec there? Embarrassing and vile that they would rather see patients dying than develop systems to fairly pay doctors for extra work in their spare time.
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There is money apparently, it’s just been used to train replacements. This is ideological. This genuinely feels like death by a thousand cuts at present.
£1.8m given to one College. And presumably £millions too to other Colleges; and to the GMC and Trusts, so that they will all fall into line.
How much public money is going into Associates, and when will the public finally have a say in whether they want them?
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I’m going to have to ask the inhabitants of the north midlands to please avoid needing emergency surgery on Sunday night please.
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@KatPaton13
I think it’s because it’s part of a narrative that’s been used to suppress pay for years. A “look how much worse some people have it so be grateful”.
I do get people live on far less. But add in expenses and it’s not far to UC threshold. Which isn’t a helpful comparison.
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What in fresh hell is this? Deeply concerning thread. I’d like to think I’d stand by anything I say on social media, but a coordinated effort to document the posts of BMA reps by our employer is sinister!
Here’s a thread alleging how the Department of Health
@DHSCgovuk
has been sort of spying on me and other elected BMA reps during industrial action by doctors.
Let’s dive in! 🧵
1/n
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@DrEilidhMaria
This is just so demoralising. What was the point in the last 16 years of my life?
We are forced to jump through hoops, burdened with assessments. Snowed under with debt. Forced to miss out on events, miss our families, kids growing up.
Apparently for nothing.
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@FrankCoffey26
The difficulty is frank, society/ education isn’t holding up its side of the bargain. You are asking the most academic to jump through more rigorous hoops with worse conditions to reach the same outcome. Either it’s needed or docs have been lied to.
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@ShaunLintern
They do realise they have treated staff like crap for the last few years? And as far as I’m aware it’s still frontline staff actually providing services. Ultimately healthcare staff have decided they are worth more than the public seem willing to pay. You get what you pay for.
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The GMC heinously attempting to influence the will of the fellows of the RCP.
Not fit for purpose, Mr Massey has a lot of questions to answer.
#telltheGMC
18 votes to keep the PA register open, following the recommendations of the SLWG.
17 votes for it to be closed.
12 fellows abstained.
Is it right for the
@gmcuk
to try and lobby fellows in a democratic
@RCPhysicians
vote - whilst commenting on the employment prospects of PAs?
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@Dr_Done_
I think why this resonates with so many people is it could very easily have been any of us. Particularly hits home as I’ve been commuting an hour post nights thanks to rotational training!
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I know we are known for our love of caffeine but even I think an anaesthetic department of 40 trainees might struggle with 12kg of coffee.
#slightmiscalculation
#wellbeing
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@cannula_service
@tcgannon
how is this representation. One of our giant issues is not being given a voice, and here associate roles are given 50% as much as doctors. With non medical people feathering their nests at our expense! This isn’t good enough.
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@UKGastroDr
@RCPhysicians
It didn’t seem like that safety guidance had any consideration of scope. The concept of locally decided scope is a terrifying one. Who has been whispering in their ears?
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@ollieburtonmed
@gmcuk
I think we’ve established that the GMC seem to think the phrase “practicing medicine” is now completely meaningless. Again a shock that the very people who are supposed to defend standards have been complicit in trashing them.
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Over 2/3 of the money required for legal action to be initiated, raised in less than 2 hours. Doctors are angry, patients should be too!
#telltheGMC
We are commencing a legal case against the
@gmcuk
over their regulation of Physician Associates.
We need your help to fund it.
Writing letters didn't work. Time for action.
#telltheGMC
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@jkcyriac23
@gmcuk
What an innovative and novel way to try to intimidate people… we’ve certainly never seen this before. Grow up.
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@IncogAssociate
@DHSCgovuk
@NHSuk
@NHSE_WTE
@gmcuk
@RCPhysicians
@FPARCP
I mean if so much effort hadn’t gone into obfuscating roles and blurring boundaries then this wouldn’t need to occur. Sadly this is the point we’ve reached.
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