Mark Green
@DrVoles
GP, Berkshire County Chair of @bbolmc, Rep GPC UK. Amateur wine reviewer. Just ran 5K. T1DM. #wearenotwaiting DIY Artificial Pancreas user. @TheOnCallRoomUK
Renaming PAs to physician assistant may reduce confusion, but the rest of the Leng review is a whitewash. No national scope. Prescribing rights. Ordering imaging. Seeing undifferentiated pts in all but name. This isn’t reform. It’s expansion by stealth. bbc.co.uk/news/articles/…
Recently I’ve seen a patient die due to #flathierarchy. If you did a RCA, the sequence of events that led to the patient becoming so unstable could be traced back to a single non-medic overturning and ignoring a pivotal component of a doctor’s plan.
All degree level healthcare professionals have similar skill sets, dedication & work long hours. Nurses, physios, OTs, lab staff, theatre technicians, sonographers, etc etc. Dr's do not work in isolation & it's teamwork. Stop acting like entitle brats.
It also confirmed hospitals have used them as substitutes for drs...no surprise there. Hospitals have been doing same with nursing associates for years, as with many other lesser trained roles. This is taskification of care, now Govt policy in NHS 10 year plan #patientsafety
Physician associates should be banned from diagnosing and seeing untriaged patients, a govt review has found: thetimes.com/article/19cf84…
Leng review PA summary: ✅ Name change ✅Uniform ❌No undifferentiated patients *except minor ailments*?! ❌Scope for expanded role as “advanced physician assistants” with prescribing & IRMER rights 683 patient safety issues reported ALL ignored It’s an utter whitewash
Where’s the apology to patients for failing to act when you knew PAs were replacing Drs? Where’s the apology to staff and patients who raised concerns which you ignored? An apology for Your suspected role in media pieces with Co-ordinated leader involvement?
Neighbourhood Centres, At Scale, Polyclinics, Darzi Centres, Hubs - whatever you call them - what’s the cost-benefit? Will they cost more than funding existing services? Hub appts ave cost £48, Urgent Treatment Centres £85, Pharmacy First £48 GPs £23 ~ £165/pt/pa 7 apts on ave
‘Average salary’ this ‘good wage for the uk’ that I am not average!!! And neither is my job! I have three degrees and people die in front of me at my workplace! Stick your average salary!!
If currently unemployed GPs replace each PA in Primary Care, there will be a great deal more than 20.8M appointments added for a safer & more cost effective solution to patients seeking medically trained help. I think @DrSteveTaylor has figures on additional appointments/GP.
I cannot begin to tell you the absolute burst of emotions that comes when you hear this from @wesstreeting 2 years of my life - trying to say this. Battling so many....challenging @gmcuk @NHSEngland @RCPhysicians @AoMRC Putting reputation on the line, personal insults,…
Physician associates who assist doctors in GP surgeries and hospitals will now be known as assistants. Health Secretary Wes Streeting says this "better describes the role that they do". Read more ➡️ trib.al/aKsx2Nx
@parthaskar is an absolute rockstar. I would like to say that I stood on the shoulders of the legend that is @Xeon4f145d96s1 and some other notable accounts (some no longer active). They should be recognised for their tireless work. Especially at the beginning. It was hard.
I cannot begin to tell you the absolute burst of emotions that comes when you hear this from @wesstreeting 2 years of my life - trying to say this. Battling so many....challenging @gmcuk @NHSEngland @RCPhysicians @AoMRC Putting reputation on the line, personal insults,…
You're happy to see your pet project that undermines doctors continue. Remind me, who did you send from DHSC to the GMC after the 2016 strikes?
“The trouble is the review… avoids the difficult question of how you set that scope, that limit of what PAs can do.” Responding to the Leng Review, BMA council chair @thomasdolphin has spoken to the BBC about doctors’ concerns over patient safety
1/ Now the embargo has lifted, I’ve had time to read the @lengreview in full. While some celebrate minor cosmetic wins, I see the formal entrenchment of a parallel, underqualified medical workforce — built without medical training.
13/ We didn’t just raise concerns - we submitted detailed, verifiable evidence which could have been followed up. DAUK’s submission was ignored in full. Not even cited. That tells me all I need to know about how seriously frontline doctors were taken in this review.
12/ I want to share a tangible concern: what's to stop a PA in gastro from doing scopes? Nothing. Now add credentialled prescribing - and you have non-doctors sedating patients for invasive procedures...
11/ Hundreds of doctors submitted safety concerns — including @TheBMA and @TheDA_UK. DAUK was verifiable, specific and addressed key gaps in the BMA's own dossier. Yet the Leng Review ignored it entirely. Not cited. Not analysed. Not even acknowledged.
They can’t have done. Medical school is min 5yrs then around 10yrs typically as a resident/junior doctor. In that time (5-15yrs) pay has fallen significantly in real terms - see below (chart is admittedly before last year’s settlement that started to address it)
NEW: we need to talk about NHS staff retention. At a time when Britain’s healthcare system is acutely short of workers, *1 in 7* UK-trained doctors are practising overseas. No other developed country is like this, which immediately tells you there’s a problem. Let’s dig deeper:
Cllr Morgan, I was an employer in your area RCT a skilled tradesperson would be earning £23p/hr, why is a @UKLabour denying doctors a decent salary for their skill when council leader are in £80k p/a + 22% pen cons + 20% tax cred & don't forget 70p in every £ spent is tax rev🤔
The replies 😩 Every single one of them would do or pay anything for a doctor to save their lives at the point of no return
I'm not a Resident Doctor. I am privileged enough to pay for a cleaner. I pay my cleaner £25 per hour. Resident Doctors are asking for less than that. My cleaner makes my house smell nice. A Resident Doctor will save your life. #Strikehard
Your doctor: Travels to work unpaid ✅ Likely maintains a car ✅ Pays for insurance ✅ Buys own equipment ✅ Has holiday pay, sickness etc ❌ But has £100k student debt with interest (RPI+3%) ✅ ✅ ✅ Min 5 years of full-time study & therefore lost earnings ✅ GMC fees ✅
Your cleaner travels to your house, unpaid. S/he likely maintains a car, with business insurance. S/he possibly provides her own equipment. S/he likely needs to pay for insurance. S/he needs to cover holiday pay, sickness etc with what s/he charges. It’s a silly argument.