Luke Mordecai
@Shr_Nottingham
Consultant Anaesthetist @uclh. co-director @AnaesUnited. Views my own
I’m doing some book keeping as a diversion for the next time someone tries to talk to me about basic science. An #anaesthesia 🧵 of 🧵’s regarding some of the things I think about during my day job. (Thank you to everyone that has contributed to the discussion) 1: Alfentanil
I don’t normally geek out about #anaesthesia but given the ongoing Remifentanil shortage in 🇬🇧 I thought I’d post my alfentanil TIVA recipe. IMHO it’s elegant, precise and allows for absolutely minimal anaesthetic poly pharmacy. (Very boring for non anaesthetists…..) 1….
Not terribly proactive post @lengreview but another college stepping up for safety You mention a “clear scope of practice”? We’ve written to your President about this exact issue numerous times without reply! Perhaps you’d be interested in our case now?? @AnaesUnited
The introduction of Physician Associates in the NHS has raised serious concerns among some of our members. We support several changes the Leng Review has proposed, but there's still work to be done to define how PAs work with our specialties. Read more: rcr.ac.uk/news-policy/la…
Let’s for a minute assume this is true Certainly presents a Hobson’s choice for GP partners employing PA’s Amend the PA role as per government decree & risk legal consequences Or Carry on & potentially expose oneself to gigantic clin neg suits? #Nofreelunches #mealdeal 😉
Seems that both HR consultants and UMAPs share the concerns about the legality of the current action. Employers should think very very carefully before acting on the request. Good luck being able to prove genuine consultation with no predetermined outcome...…
The @AoMRC has decided to publicly position itself against resident doctor strike action Whether this is within its remit is debatable but it is likely to go against the views of the members of the Royal Colleges it represents Nothing learned from the ill advised “devoid of…
The same @AoRMC that supported the proliferation of PAs? - now undermining residents for their honours The most serious failure of leadership is the failure to foresee. Who are our ‘leaders’ and who do they represent?
Logically this seems dangerous but apparently there’s no evidence to prove it…. So I guess it must be safe? 🌞 It’s a tricky concept to grasp, but absence of evidence is not the same as evidence of absence
What you are talking about is a proportionate means to a legitimate aim. The Leng review did not find a patient safety risk so that is out the window. Arguably, saying it now becomes a malicious falsehood... but please, keep clutching at straws and showing your desperation. Froth…
"We do not accept the recommendations of the Leng Review" says PA Group. And that is why AU are fighting for the GMC to enforce a defined scope of practice. Please help us achieve our target crowdjustice.com/case/stop-misl…
My 6 year old throws more constructive tantrums than this Every time @UMAPsUK issues a press release it makes the ongoing employability & feasibility of assistants more problematic It really is time PA’s found a constructive spokesperson to work with the medical profession
I’d like to talk a bit about the Leng Report, and thank Prof Leng and her team. It’s quite extensive, and addresses various parts of the MAPs issue, so I wanted to discuss various parts in isolation than go through it chronologically. But, please do also read the report. 1/
Every single word of this @Parody_RCGP 🫡 I’ve fought as hard as most against the direction the associate project took but the @lengreview isn’t a victory It’s an admission of guilt from a broken system & it’s absolutely not to celebrated It’s to be learnt from (hopefully!!)
1/n I want to say something about PAs. I don’t know yet if this will be long or short cause I am not psychic. What I do know is this: the situation has become a mess. Not just administratively. Not just professionally. But emotionally. And it’s going to leave scars.
#LengReview #PhysicianAssociates #NHS - government accepts all recommendation. Implemenation report in the autumn You can read full response in Hansard hansard.parliament.uk/lords/2025-07-…
Are we really going to have to do this all again?? You can’t (shouldn’t) substitute people that aren’t doctors into a job that requires an experienced and specialist doctor! This doesn’t even need explaining 🙄
To say that I am shocked about this job advert is is an understatement @nottmhospitals I hope you realise how complex and vulnerable Haem patients are, and how utterly dangerous this is, letting medically unqualified people play registrar in an extremely complex speciality 1/
To say that I am shocked about this job advert is is an understatement @nottmhospitals I hope you realise how complex and vulnerable Haem patients are, and how utterly dangerous this is, letting medically unqualified people play registrar in an extremely complex speciality 1/
Doctor substitution is becoming increasingly problematic no where more so than @RCollEM Unless you want to be a giant liability sponge, IMHO a career in Emergency medicine is now a total waste of MBBS
Time to recognise the dedication and brilliance of our new Advanced Clinical Practitioners, MRCEM and FRCEM diplomates who are lining up for their moment on the stage! It's going to be an inspiring day #rcemdiploma
🧵on governance….I have previously been an elected Council member of @RCPhysicians & member of Board of Trustees….I am now an elected Councillor on my district Council so I know A LOT about the governance mechanisms of organisations. I also know a LOT about whistleblowing …
This is the EGM youtu.be/G0Qu6BKDy98?si… Please look at the support that many of the currently leaders of @RCPhysicians are giving to the unsafe practice of medicine by PAs. These are the same individuals now trying to take credit for the leng report- despite trying to block…
So now, how will we address the issue that our assistants are paid more than us? Our pay erosion is so complete, that rebanding is the only realistic solution left on the table.
The dust is settling on @lengreview with mixed reactions I think it elegantly walks a tightrope & made the one change that really matters Changing the name back to assistant was paramount If you want to know why 👇 x.com/Shr_Nottingham…
I’ve seen a lot of people say @lengreview recommendation of changing Associate back to assistant doesn’t go far enough IMO it is the single most important change and it blows the doors off the entire project as well as asks some very embarrassing questions This is why 🧵
Wow- this has been what we have been arguing for for the last couple of years, placing patient safety first. There is no place for individuals with no medical training (PAs) to be seeing unselected, acutely unwell patients, or delivering medical advice for on call quarternary…
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
.@Shr_Nottingham great interview about PAs on @IainDale’s show Clear and objective description of the problem Iain please stop saying this is just about 6 deaths. It isn’t It’s about inadequate training for highly skilled roles
It looks like @lengreview recommends @RCPhysicians and other colleges should establish Faculties for PAs We have to ensure the abject failures of the RCP in hosting the FPA for a decade from 2014 are not repeated Faculties for Physician Assistants must have robust framework…