Good morning, a glasswing butterfly sat on a bird of paradise ☺️ Always search for beauty in our world, happy Thursday 🙏

The curious case of Sarah and her sinuses, and what it reveals about the lamentable wrong-headedness among the leadership of England's NHS. My piece in this week's @newstatesman.com www.newstatesman.com/politics/hea...

1/ 🚨 The UK introduced Physician Associates (PAs) as a response to the healthcare workforce crisis. But the journey has been contentious, with lessons for other countries considering similar measures. A 🧵 on the findings from our new paper with Louella Vaughan and Giuliano Russo

Concerns grow over way physician associates are used in NHS @vsmacdonald.bsky.social Health and Social Care Editor In your hospital or your GP surgery,  there could be a member of staff most people have never heard of  – physician associates.

In this poll of 1000 GPs a third said that they were either under employed or unemployed If this was extrapolated to the 35000 GPs currently working this would mean potentially 3500 Full Time Equivalent GPs available now The funding is just not there to employ them ARRS has seen just 68 added

1/5 of the health budget is being directed away from the NHS, and into private healthcare. That's 20%. The research shows that more private use creates worse patient outcomes (Lancet). This is daylight robbery. www.thecanary.co/uk/analysis/...

Anglian Water fined £300,000 for dumping raw sewage, killed thousands of fish, endangered human health Serial offender. 128 criminal convictions since 1989. Since 2010 fined 75 times, £3,952,134. Companies want higher bills, lower sanctions End the privatisation circus www.itv.com/news/anglia/...

“Patients deserve better than this cavalier approach to regulation. They deserve a medical regulator that listens to the medical profession.” BMA council chair Dr Phil Banfield, responds to the outcome of the GMC’s physician associate & anaesthesia associate consultation. bma.org.uk/bma-media-ce...

Just when you thought it couldn’t possibly get any worse… ‘Brexit problem’: UK tap water safety at risk after testing labs shut down www.theguardian.com/business/202...

Vulture auction of Thames Water. Covalis offers £1bn to buy TW, flog assets to generate £4bn. Buyers counting on mega hike in customer bills, asset-stripping. Sewage dumping, cash extraction will continue. Only nationalisation can safeguard water services. morningstaronline.co.uk/article/tham...

www.newstatesman.com/comment/2024... via @doctoroxford.bsky.social You really need to read this and pass it on

So welcome to see @rthonwesstreeting.bsky.social focusing on NHS cover-up culture & attacks on whistleblowers. I urge him to note how doctors (like me) raising sincere safety concerns about replacing doctors with PAs are being smeared & attacked by NHS bodies. www.theguardian.com/society/2024...

During my many years as consultant in the NHS, I was constantly responsible for the supervision of multiple trainees at any one time. I assessed and then trusted their extensive training. Didn't trust PAs or AAs unless they were in the room. Lots of attitude, little knowledge.

GP Crisis NHS Dentistry model? 1990s just 6% of Dentists were private providers (mainly London) now it’s 70% NHS GP contract needs massive funding increase as it’s been cut 20% in 8yrs UK already seeing increasing adverts for Private GP appts £50-£100 #NHS GPs get £115/yr/patient for everything

Saying No in the NHS brings guilt & shame. It shouldn't, but the culture of presenteism, stoicism, the high workload, & our commitment to patient care can often be to the detriment of our own wellbeing. Setting boundaries is key to sustainable careers in medicine. Give people permission to say No.

Exactly, this is heartbreaking & unacceptable & it's happening all the time. Going to work is literally making NHS staff ill, often very ill. The NHS simply cannot keep perpetuating this cycle and I don't know why govt isn't making remedying it an urgent priority - instead it's barely acknowledged.

1/ England has too many #NHS staffing vacancies. While doctor numbers are rising, major structural issues persist: unfilled vacancies, poor retention, and restrictive training caps. The result? A system struggling to meet demand and blocking pathways for junior staff to progress. 🧵 #Medsky

These graphs are absolutely shocking. UK used to be the best in the world for healthcare access. Now so many are stuck on a waiting list. It's just not good enough. Investment and reform is needed.

So much is said about funding for the NHS £/person is a key metric, it’s also true that despite cash terms rises real terms are the same. Comparison with other peer countries is also important, if you underinvest for decades the infrastructure is not going to cope when it’s asked to do more

12% hospital beds have patients fit for discharge - fix 2’ care by funding community care Instead👇🏼 Population ⬆️7% 2012-24 ❌GPs ⬇️7% ❌District nurses⬇️42% ❌Health Visitors⬇️30% ❌Learning Disability Nurses⬇️23% ❌School Nurses⬇️25% ❌Nursing home beds⬇️12% ❌Residential Care home beds⬇️16% ❌Social care cuts

The GMC is a disgrace and a racket. The BMA set it up and should now dismantle it as it now works against its original purpose which was to uphold standards in medicine and stop non doctors practicing medicine.

The Covid Corruption Commission - there are going be a lot of lost phones...

I strongly suspect that the main reason it’s got better in England relative to Scotland is that NHS England has been playing so many tricks with waiting lists. I got referred to 3 specialities last year & had to fight v hard not to get booted off the lists (through admin tricks, not clinical review)

It is incredible that we are having to argue in the U.K. that non doctors cannot ever safely replace a doctor. What is wrong with people that this is countenanced. I doubt it has even worked out cheaper in financial terms.

Such nonsense being talked about the Scottish NHS today, to justify draconian cuts. Anyone who thinks a 2.5% rise in staff costs was excessive, in a year where inflation was 3.3%, is not a serious person. Healthcare costs are rising across the developed world. Why should Scotland be different?

Also lol at the widespread reporting that NHS Scotland spends *60%* of its budget on staff. The horror!!!! (Until relatively recently it was 70%. And healthcare was probably better when it was. Good healthcare is inherently labour intensive, whatever the pharma & tech bros would have you believe).

The Gov’t has acknowledged a safety issue with the employment of physician associates & has ordered a review of their role in the NHS If you are not yet with the issues involved watch my last report Gov’t now needs to say how NHS will keep patients safe during this review youtu.be/zgBrrMmx4yg?...

🧵 Well. Here is the GMC on X, responding to revelations (via FOI requests) that they're been secretly employing social media specialists to monitor doctors' criticisms of their actions regarding physician associates & shape their tactics accordingly. I'm one of those being monitored. 1/n

The #NHS must prioritise patient safety. @drdavidnicholl.bsky.social examines the risks of employing Physician Associates & Anaesthesia Associates without proper regulation or defined roles. #Healthcare #PatientSafety eastangliabylines.co.uk/news/health/...

Before my debate on Thursday on the review of physician associates/anaesthetist associates, a very useful overview @bylineseast.bsky.social @peterstefanovic.bsky.social @everydoctor.org.uk @thedauk.bsky.social @assocanaes.bsky.social eastangliabylines.co.uk/news/health/...

GP CRISIS GPs unemployed @rthonwesstreeting.bsky.social has been told this enough £100m for ARRS GPs has seen just 88 employed so far Potentially 3000 GPs available for work now if funding was given to GP practices PCNs & ARRS (additional roles) isn’t working & a restrictive employment practice

As the African proverb puts it, ‘If you think you’re too small to make a difference, you haven’t spent the night with a mosquito.’ One person can stop a great injustice One person can be a voice for truth One person’s kindness can save a life Each person matters Keep going 🦟

“Joy is not made to be a crumb”

In October, NHS England experienced the highest number of appointments in general practice ever recorded. Policy Fellow, Jake Beech interprets today’s data and points to what government can do to further strengthen primary care. Read our full response ⬇️ https://buff.ly/49d730H

The average number of patients to GP is 2300, a safe limit is considered 1800 There are some areas this is so much worse & disproportionately affects areas of deprivation Closures of practices mean other GPs struggle as it’s virtually impossible to close a list We need a safe limits for all #MedSky

Left: Helen Whately, "We handed over to Labour much lower debt than we had inherited" Right: Peter Kyle, "There are facts in public debate.. Debt was £800 billion in 2010, it was £2.6 trillion in 2024"

Kemi Badenoch tells Keir Starmer that "we had a Budget in March this year and tractors were not blockading the streets of Whitehall afterwards." Anyway, here's the 'go slow' protest by farmers that blockaded the streets around Parliament following the Conservative Government's last Budget in March

I joined twitter to fight for our NHS. Now I've joined Bluesky to do the same. Who's with me? 💙

Community Neighbourhood Centres - over 6000 GP practices underfunded (20% cut since 2016), overlooked & still there providing 30million appointments a month (5m more than 2019) @rthonwesstreeting.bsky.social wants to reform them 🤷🏻‍♂️ Fund them and they will do the rest

Hunger is a violation of basic human rights – we should be outraged by UK's food bank crisis. Work doesn't pay. 38% of universal credit claimants are at work. 1% has more wealth than 70% of the population combined. Must redistribute income/wealth. Tax the rich. www.bigissue.com/opinion/food...

Palantir’s troubling history of surveillance, wrongful detentions and attacks on the NHS – as well as one of its founders’ previous comments about our health service – mean it shouldn’t be anywhere near our patient data. Write to Wes Streeting ✍️ goodlaw.social/ss1q

Repost if you believe there is enough money to go around - and that the real issue is billionaires greed and political corruption.

KFC drops pledge to stop using ‘Frankenchickens’ in the UK. Ditched voluntary pledge to improve animal welfare. Corporate pledges mean nothing when it comes to profits. Only legally enforceable requirements can hold corporations to account. www.theguardian.com/food/2024/no...