I think it’s also worth adding that this is the first time the College as a whole has been asked about physician associates. Until now “College policy” has been in fact the ideas of College officers only
Time for a profound change before the
@RCPhysicians
AGM on 25/3/24
#RCPEGM
Emphatic
In spite of data shenanigans (which may have influenced some votes)
It’s time for a pause
It’s time for scope
It’s time to look at rotas
Much kudos to many who have kept raising the issue at personal risk and battling national orgs
You know who you are
#RCPEGM
@gmcuk
Thanks; as far as I can see, you’re comparing dentists (four year standardised training; clear scope of practice & professional standards for decades) and PAs (two year training, standard unclear; no nationally agreed SoP etc)
Not sure what
@GDC_UK
or
@TheBDA
would make of that
@DrLKVaughan
@gmcuk
Given the recent shenanigans, this doesn’t sound like paranoia
The GMC’s foundational principle was so that people could know who was - and wasn’t - a registered medical practitioner. That seems to have been cast aside, which is concerning
I was impressed by the degree to which consensus was established in the post-EGM working group under
@HilaryWMedic
: our clear recommendations have not been accepted in practice
Training, the lack of leadership & especially patient safety remain unaddressed concerns
@RCPhysicians
Today over 80 Fellows of
@RCPhysicians
(with >20 Professors of Medicine, 3 elected RCP council members) have signed an expression of concern outlined below around the actions of the leadership of
@RCPhysicians
that continue to place patients at risk from harm.
In the March EGM,
@RCPhysicians
When I was a SHO in Leeds, we had a "physicians' assistant", who took blood, did ECGs, filled in forms that we signed, all to give the junior doctors time & headroom to do other things; this version of a "PA" was really helpful
#RCPEGM
3/14
@anon_opin
When I worked in Cymru/Wales, I came across a number of (usually older) patients who spoke very little / no English; and many more whose English was rusty, because they didn’t use it.
There is a need for bilingual signs - and for opportunities to learn Cymraeg
@wesstreeting
Many thanks for adding your voice to the concerns around physician associates.
My thoughts are here, if you have time; most of the debate that I’ve seen has been respectful, thoughtful, and focussed on protecting patients and staff; I agree: as hominem attacks are unhelpful
@RCPhysicians
@j59dd
@ihi
@NHSEmployers
@TheBMA
If we conclude the PA experiment hasn't worked & needs to be wound up, we need to determine what to do what to do with the staff we've trained as PAs: do we use the money from PA schools to put them through grad entry medicine alongside other GEM students, for instance? 14/14
@RCPhysicians
@j59dd
@ihi
The conduct of the
#RCPEGM
has been discussed at length; suffice to say, I found the College officers performance highly persuasive: as a result of their non-answers, non-data and filibustering, I'll be voting in favour of all the motions
#RCPEGM
7/14
Thomas Linacre was the first President of
@RCPhysicians
; it was said of him that"He was a detester of all fraud and deceit". We need (to be seen to be) intellectually honest - and to be clear about financial or intellectual conflicts of interest
#RCPEGM
2/14
@RCPhysicians
@j59dd
@ihi
@NHSEmployers
@TheBMA
If we conclude that PAs *do* add to the MDT (something the RCP Officers were unable to enunciate), then their scope must be clearly agreed and defined before the end of 2024 (no mean feat - because we need 40+ medical speciality curricula / scopes of practice agreed by 31/12/24)
@gmcuk
I’d wait and see whether the
@RCPhysicians
wants to follow your lead first
…unless you can provide answers to the questions the College officers were unable to answer?
Q: what does a PA add that other members of the MDT do not? (Esp nurse practitioner / extended role AHP)
@RCPhysicians
@j59dd
@ihi
@NHSEmployers
@TheBMA
It seems to me that we need to address evaluation & impact (3 & 4), in order to deal with scope of practice (1), but that until such time as we have, we need to be cautious about the pace & scale of roll out, to protect medical staff
--> FRCPs please vote 'FOR'
#RCPEGM
12/14
@RCPhysicians
I understand that the original call for the
#RCPEGM
was in November 2023: pursuant to bye-law 4.3(2), such an EGM should have been held within 8 weeks of the original request to the President, something the Secretary of RCP Council (the Registrar) should have ensured
#RCPEGM
4/14
@RCPhysicians
@j59dd
@ihi
Motion 1: Physician Associate Scope of Practice: this needs to be addressed: at present, the SoPs produced by
@NHSEmployers
&
@theBMA
are vastly different, the latter being closer to that of a band 4 assistant (or associate) practitioner
--> FRCPs please vote 'FOR'
#RCPEGM
8/14
@RCPhysicians
Clinical concerns raised at the
#RCPEGM
: as I'm sure
@j59dd
will know from his time at the
@IHI
, this is often the tip of the iceberg: we need to take such reports seriously & not ignore them or put money ahead of safety; I expect him to act accordingly
#PtSafety
#RCPEGM
6/14
@RCPhysicians
@j59dd
@ihi
@NHSEmployers
@TheBMA
At the same time, because we have painted ourselves into a corner by not sorting this before, we've 3000 PAs wondering what's going on & why their band 7 jobs now don't look anything like what they signed up for: critically important that we deal with the issues 13/14
@RCPhysicians
@j59dd
@ihi
@NHSEmployers
@TheBMA
Motion 5: Caution in pace & scale of roll-out: with the differences on PA scope of practice (motion 1), medical practitioners find ourselves with a trade union that will not cover us to supervise PAs performing more than relatively simple tasks
@RCPhysicians
@j59dd
@ihi
@NHSEmployers
@TheBMA
Motion 2: Accountability of medical practitioners: a useful reminder that registered medical practitioners are responsible for decisions we are asked to endorse
--> FRCPs please vote 'FOR'
#RCPEGM
9/14
Very serious question from the floor: what due diligence has the
@RCPhysicians
done to ensure there is patient safety?
I am unclear as to the answer from officers
#RCPEGM
@trentconsultant
@LeylsTurk
An observation: had the English NHS run a test & trace service like the NHS in Cymru/Wales, I’ve seen it would have cost ~£2-3bn. The difference between that and and its current cost would give all 800000 staff something like a 15-20% pay rise.
It’s affordable for all staff.
@RCPhysicians
Views of
@RCPhysicians
Council can be attached to a the EGM motions (4.3(4)); each motion has a direction on which way to vote, beginning "We therefore recommend": unclear to me who the "We" is (I gather these don't seem to have been endorsed by Council)
#RCPEGM
5/14
@RCPhysicians
Good to know. Please answer:
Which officer(s) was(were) responsible for misrepresenting survey data to Fellows?
Which officer(s) was(were) responsible for signing off on the presentation give to
#RCPEGM
?
Thank you!
@DrSarahClarke
@RCPhysicians
I was under the impression that candidates for
@RCPhysicians
positions couldn’t canvass on social media.
Also, as I recall, you weren’t elected by the Fellowship, but only by Council, to a (de facto) interim position (hence the need for this election).
Have I misunderstood?
If true, very disappointing: akin to releasing an abstract, but not the full paper, Prof
@trishgreenhalgh
?
Madam President,
@DrSarahClarke
, the integrity of the
@RCPhysicians
is being called into question: please send the full survey results today, at least to all FRCPs
#RCPEGM
I'm hearing that RCP senior officers are possibly going to release the *actual findings* of the MRCP survey AFTER the FRCP vote has closed. What do they take us for? What are they hiding? How can they reassure us that they're not trying to rig the vote?
#ReleaseTheSurvey
Please take this pandemic seriously; COVID isn’t “just ‘flu’”; and what we’re seeing isn’t “just winter pressures”.
Follow the rules; keep your distance (>2 metres); wear a mask; wash your hands properly
....then I won’t see you like this
#NHS
#Covid19UK
@silv24
The
@RCPhysicians
only allows FRCPs to attend and vote at General Meetings - or to stand for & vote for Council & Officers
I think the governance needs to change to include consultant MRCPs and (esp) junior doctor MRCPs
#RCPEGM
@sarahyoung____
Depends on why you want to leave and what you’d do instead. You have the intelligence, flexibility, hard work ethos etc that other employers / sectors would want.
What’s in your personal (whole life) PDP?
Alternatively: what makes you want to leave? What would make you stay?
Recommendations for a timescale for the
@RCPhysicians
, following the
#RCPEGM
votes
In short: we need to move fast, both for our junior doctors and for the 3000
@FPARCP
members whom this affects
@DrNeilStone
*England* is opening up; Wales isn’t at present. Therefore we have an observational study taking place at a population level between
@BorisJohnson
&
@fmwales
.
The next 2-4 weeks will give us a clue, but my guess is we’ll have lots more COVID cases, hospitalisations & deaths.
@JolyonMaugham
@GoodLawProject
“Privilege just means ‘private law.’ ...He just doesn’t believe the ordinary laws apply to him. He really believes they can’t touch him, and that if they do he can just shout until they go away. …Shout at people, get your own way, ignore the rules.”
From
@terryandrob
, The Truth