Dr Heather Robertson

Acute Physician. Medicine, health and skincare blogger. Medical myth debunker

[Mamas A. Mamas @mmamas1973]

Safety fears as non-medical staff / PAs learn neurosurgery ‘on the job’ https://t.co/mJpIV3JWe6 from medical secretary via a two year's PA masters to amputating limbs- with no medical training and no surgical training

What is happening to medicine in the uK? The last time things like this were happening were during the Napoleonic wars 😳

[Mamas A. Mamas @mmamas1973]

The consultants enabling this should be struck off for placing patients at risk. This is a national scandal - far bigger than anything else in medicine @BBCPanorama @MailOnline @thetimes @C4Dispatches @guardian @Telegraph

[Dr Roddy Neilson @Roddy_Neilson]

Why? It’s not as if there aren’t enough medical graduates, the ones that have trained for years rather than months, that could do the job better, more quickly and with less supervision.

[Dr Roddy Neilson @Roddy_Neilson]

I also want to be sure when I personally need medical care, the individual providing it isn’t pretending they’re medical/nursing qualified when they’re not.

[Dr Roddy Neilson @Roddy_Neilson]

This may upset some people. My job as a consultant is to treat patients and to educate trainees in my specialty. It is not to give validation to unregulated, dubiously qualified individuals who believe normal training in healthcare need not apply to them.

[James Steen @BMA_James_Steen]

Doctors,

I’m no regulatory lawyer, but I’ve represented many healthcare professionals facing allegations.

This seems to me to be incredibly dangerous practise.

Are you really ok with being accountable for and your GMC registration being reliant upon a PA’s clinical judgment?

[Meme Doc On Call @MemeDocOnCall]

A fun thread of all the people who met #Rishi

Jane - palliative care consultant. Thinking about her opiod conversion chart and how much it would take to get Rishi to stop talking

[World Health Organization (WHO) @WHO]

@DrTedros "The worst thing any country could do now is to use this news as a reason to let down its guard, to dismantle the systems it has built, or to send the message to its people that #COVID19 is nothing to worry about"-@DrTedros

[Lakota Man @LakotaMan1]

Absolutely

[Dr Heather Robertson @AerMedical]

@Medic_Russell That’s terrifying.

[Prof Shafi Ahmed PhD FRCS @ShafiAhmed5]

Lucy Letbe has been found guilty of murdering 7 babies and attempted murder of another 6 babies in the neonatal unit of Countess of Chester Hospital, making her the biggest killer of children in modern British history.

I have been thinking of this constantly over the last 24hrs and my heart goes out to the babies and poor families. I am trying to understand how this was allowed to happen and try to make some sense of this horrific case.

In my clinical experience this case sadly doesn't suprise me. There have been many recent cases that have similar underlying causes.

A few thoughts:

Whistleblowing

Although the @NHS openly encourages openness, transparency, a duty of candour and whistleblowing in various directives. Whistleblowing is including in the documents NHS Improvements raising concerns (whistleblowning) policy for NHS staff and Freedom to Speak Up.

However, in practice whistleblowing is actively discouraged. Whistleblowers are marginalised, bullied and isolated. It's a common finding and was obvious in this case. Sadly concerns raised by the clinicians in this case were dismissed. The doctors were brave yet not listened to and I am full of admiration to all of them in particular Dr Ravi Jayaram.

Internal reviews

The knee jerk reaction is for the leadership usually the Chief Executive , Medical Director and Chief Nurse to order internal reviews. In my experience the terms of reference for these reviews are limited and designed to protect the hospital and it's reputation rather than deal appropriately with the problem. Also the selection of the reviewers is biased by the leadership and the review itself is often compromised by direction from the leadership team. The reviewers often have undue pressure from the leadership.

External reviews

These are usually better but also can be compromised by the choice of reviewers and again there is often limited terms of reference and pressure on protecting the organisation.

The 2 external reviews in this case were not designed to examine whether Lucy Letby or any other member of staff, was responsible for the deaths and both recommended that several deaths be investigated further. Unbelievably the Chief Executive instructed senior doctors to write a letter of apology to Letby on for repeatedly raising concerns about her.

Non Exective Board

I am not sure how the board in this case could oversee this case and not raise suspicion and hold the leadership and CEO to account better.

Toxic Culture and Incompetence

There is a serious lack of good and effective leadership in the NHS with appropriate experience and qualities to run the service and deal with these difficult problems. In addition there is a well recognised toxic culture that percolates throughout the NHS.

Reward for failure

Despite overseeing this case the CEO, Director of Nursing went on to get further senior positions in the NHS. The medical director remained in post to "oversee" the case.

The NHS has a habit of rewarding bad leadership with promotion.

We have ALL failed the babies and families in their case.

I have never felt more ashamed and saddened of working in the NHS and am seriously now thinking about leaving.

[Joanna Hardy-Susskind @Joanna__Hardy]

bear with me here: the new X icon is actually completely adorable if you change the settings to baby pink. Instead of aggressive masculinity it’s just this little teeny tiny kiss to speak to the little imaginary internet friends that live in your phone 🥰

[Dr Heather Robertson @AerMedical]

@Microbedoc2 They really hate us

[Dr Heather Robertson @AerMedical]

@foreigncorr1 @fascinatorfun I remember during the commonwealth games, the city became absolutely spotless. No litter, beautiful planters, roads mended etc which is exactly how it should be all the time. Instead the council have chosen to let it decay and run to ruin

[chris evans @notcapnamerica]

He acting like he can’t hear her 🤣

[Roshana 🦴 @RoshanaMN]

The Consultants of Dorset hospital have written a letter to @SteveBarclay

They strike tomorrow

This letter is incredible

I challenge anyone to refute a single point in it

Worth a read for you too @wesstreeting

[Zach London @zach_london]

I administered the Montreal Cognitive Assessment (MoCA) to the image-generating AI program DALL-E this morning. Thing really went off the rails.

Let's see how it did. 🧵

[Dr Heather Robertson @AerMedical]

@Shitlawns Where’s the water going to go when it rains? The whole ‘garden’ is an impermeable barrier

[Dr Heather Robertson @AerMedical]

@gasdoc2857 @AcmeDR @FlyLoganair @Shortbread @Tunnocks And the strongest tea you have ever encountered