Iona Collins.DOCTOR.

I think I will pin this post.

This is one of the many stalls at the Royal Welsh Show in Builth Wells. Duly donated.

When we discuss hospital beds, we refer to their inefficient usage, insufficient numbers and patient harm. We haven’t talked about planting beds though. A minor detail, admittedly, in context, but small changes accumulate sbuhb.nhs.wales/news/swansea-b… gov.wales/small-grants-w…

I went to the Royal Welsh Show in Builth Wells yesterday and it was huge, with various exhibitions, demonstrations and stalls. There was a boating lake and a Welsh Government building to discuss grants. 1/4 acre land= grant to plant. Worth a look 🍎🍏🍐 gov.wales/small-grants-w…

Yes take care of yourself …sadly the nhs won’t …we nhs workers are sadly very disposable 💜

The NHS is a terrible place to work esp if you a type A personality as many of us are. I’ve lost several friends too early and the common theme is they were all incredibly caring diligent clinicians going the extra mile. Now another friend has had a serious life event 😔

16/ Some think this is justice. But it’s not. It’s a mirror. And some of you don’t like what it shows. Because if you’re honest, you were part of this. Even if just through silence.

12/ Then the messages started coming from the inside. From consultants. Medical directors. People deep inside the system. Not to threaten us. But to help. They confirmed what we feared. They had known all along.

8/ And we got heat for it. Threats of GMC referral. Threats to doxx me. Threats to go after my family. When Professor Melville replied to a tweet, I spiralled. I stared at the screen for hours. It got very dark.

7/ What you saw was me tweeting. What you didn’t see was them fact-checking. Holding stories back until they were solid. They weren’t trolls. They were doing the job the system should have done. I was just a mere messenger.

They have developed an appraisal system and feel PAs are better than Doctors and nurse practitioners Just to remind you again: Doctors have "unrealistic expectations in terms of their career development" 10/n

A further case study, this time from St George's Here they don't even try to be discreet, boldly titling the case study "Substitution of PAs at St George's" 8/n

Roadside apples and figs (parked car deleted for pic to remain anonymous)

Let’s get rid of the term “routine” from medical care and use the term “next in turn” instead. There’s nothing “routine” about chronic pain and illness. But having diagnostics and treatment next in turn sounds reasonable, apart from when urgent action is needed for dangerous dx

Nor should the BMA “stand up for PA”. They should advocate unequivocally for doctors. However, medical institutions should and will be the ones to set clearly defined scope for an assistant occupation that they supervise. Patient safety above all else.

My entire department simply refused to work with them we cited a significant reduction in our own workloads to supervise them (about 30%) & pointed out that theirs would never match that of a doctor l turn over about £6,000 per clinic l do for the trust…

Whether someone is a differentiated patient can become clear only retrospectively. If they’re an inpatient with a new presentation, how do you necessarily know whether it’s related to their current condition they’re in hospital for?