Andrew Clarke

ICM/AIM Consultant @TeamACCU @NHSBartsHealth

[Dr Rachel Clarke @doctor_oxford]

Oxford Professor @trishgreenhalgh's team has examined the evidence for the safety of deploying physician associates in the UK.

TL:DR - it doesn't exist.

Her systematic review is out today.

A hugely significant piece of work that has major implications for the #LengReview.

[Dr Rachel Clarke @doctor_oxford]

Thank you for highlighting, Andrew. It beggars belief that @gmcuk is 'celebrating' the replacement of vital training programme posts with ad hoc, non-training, frequently-abused (by trusts) 'locally employed doctor' posts.

We desperately need fully-trained & valued doctors.

[Andrew Clarke @andyc8803]

@thevorch @emily_fri Interesting…What is a “discovery round”? 😀

[Royal College of General Practitioners @rcgp]

We're calling for a halt to recruitment of PAs in general practice following our consultation with over 5,000 GPs, until they are regulated & practices are in a position to implement our forthcoming guidance on scope of practice, induction & supervision. https://t.co/Zoa7GTbjmJ

[Andrew Clarke @andyc8803]

Using medical students without reimbursement is unacceptable

[Shaun Lintern @ShaunLintern]

🚨 NEW: Medical students have been drafted onto wards in the wake of the NHS cyber attack. They will work as floor walkers, hand delivering blood tests to and from the crippled pathology labs. Bosses at @GSTTnhs say disruption will last "at least 2 weeks" 1/2

[Andrew Clarke @andyc8803]

@StevenMathern @icmteaching @thomaswoodcock @iceman_ex @norfolk_tim @DrRJWebb How much fluid do you remove with CRRT for you to see haemodynamic instability ? Even if you remove 250ml/hr it is a little over 4ml/min - I doubt the fluid removal was the haemodynamic problem if the patient is oedematous

[Dr Asif Qasim MA PhD FRCP @DrAsifQasim]

@TrinCollCam Medics Dinner last night - good fun but real concerns from medical students:

- GP attachment supervised by PA not GP
- Reporting to PA not doctors for hospital attachments
- Impact of PAs reducing training opportunities for doctors
- 6 years med school yet PAs do two lighter years for higher pay with less debt

We need to resolve these issues for this next generation of doctors

@drmattuk @TheBMA @BMA_JuniorDocs @mmamas1973 @djnicholl @trishgreenhalgh @TYoungstein @mark_toshner @Xeon4f145d96s1 @Dr_Done_ @ExplosiveEnema2 @MedCrisis @medicalmodelbri @AlisonGeorge10

[Led By Donkeys @ByDonkeys]

Esther McVey, Minister for Common Sense, and her husband talk a lot about wasteful public spending. But how careful are they with your money in their own lives? We’ve found out. 👀

[Flex @NotAdoctor0000]

The Royal College of Nursing CEO is a nurse. The Royal Pharmaceutical Society CEO is a pharmacist. College of Radiographers CEO is a radiographer.
Yet the RCP CEO is a nurse? Perhaps doctors should retain control of their institutions to ensure they advocate for us.

[Andrew Clarke @andyc8803]

An appalling situation for new doctors starting out in their career.

[Dr Done @Dr_Done_]

Med students/new F1s are being shafted again

See the below email confirming 99 have been put in a ‘placeholder group’ in East of England due to no places

Meanwhile HEE is pushing trusts to recruit PAs to a foundation program - guess where?

THIS IS INCENTIVISED REPLACEMENT

☠️

[Dr Done @Dr_Done_]

Med students/new F1s are being shafted again

See the below email confirming 99 have been put in a ‘placeholder group’ in East of England due to no places

Meanwhile HEE is pushing trusts to recruit PAs to a foundation program - guess where?

THIS IS INCENTIVISED REPLACEMENT

☠️

[platinumpizza™ @Xeon4f145d96s1]

Yesterday 6pm, the RCPEGM was leaked by an anonymous account onto YouTube. Having watched it, these are some of the most jaw-dropping moments I heard, some not even factually true. Everyone should watch it for themselves though and make up their own mind. Link at the end.

[Ryan Boyle @NeilsCub]

Too frustrated to tweet much more. The take home message from my perspective is that the role of PA is so ill thought out and poorly defined that it is not ready for regulation. We are in danger of losing a generation of medical trainees #RCPEGM

[Dr Rachel Clarke @doctor_oxford]

Please read this excellent piece.

Partha’s right. This is indeed a seminal moment for UK medicine.

Is the rigour of a medical degree required to practice medicine - or not?

Does MRCP mean anything - or not?

Are the standards trainees must meet necessary - or not?

Well?

[Phil Smith @PhilSmithIsBack]

There is going to be a narrative in the next few days, as there obviously has been already, that people are targeting people, not being kind, being cruel, and somehow the leadership of various organisations historically are victims of this #PA debacle 1/x

[𝗗𝗿 𝗔𝗷𝗮𝘆 𝗠 𝗩𝗲𝗿𝗺𝗮 @UKGastroDr]

When discussing concerns on the expansion of the PA workforce & role, I have heard stated:

“Concerns are only being raised by a vocal minority on SoMe”

“Those complaining have not worked with PAs”

“Most teams who include a PA work well together”

“PAs help with training time for junior Doctors”

The truth is, we don’t really know if these statements are true or false as there is a paucity of data.

To address this, @MeganLizi @sarahlogan76 & myself have created a survey which will be circulated to every Doctor who is a subscribing member of the @RCPhysicians (not fellows or non-Doctor members).

It is crucial that members participate in the survey, whatever their views, so that when the data is presented at the EGM (13/3/24), fellows will be better informed prior to voting on proposed motions.

[Dr Rachel Clarke @doctor_oxford]

.@DHSCgovuk claims physician associates are not being used to replace doctors. Yet the evidence is plain as day.

They’re being put on junior doctor paediatric rotas. Some are accused of illegally prescribing medication.

A national cost-cutting experiment in doctor substitution.

[Andrew Clarke @andyc8803]

@WilliamAird4 What was the relevance of Hep B status ?

[Dr Matt Kneale (🦋drmk.link) @drmattuk]

1/ On the 20th November 2023, fellows of the @RCPhysicians requested an Extra-Ordinary General Meeting to address this urgent matter, in line with Bye-Law 4.3(2). This requires the College to organise an EGM within 8 weeks of the request.

[Dr Rachel Clarke @doctor_oxford]

Yes. I really can’t say this more bluntly. As someone who will doubtless need more & more healthcare as I age, I am terrified about the patient safety implications of how physician associates are being used in place of doctors in the NHS. Genuinely horrified.