Chris Orchard

[Carol Deans (she/her) 💙 @CarolDeans]

Fantastic to see not one but two of our @FrimleyHealth nurses winning awards. 👏@richel_oliver @Dementia_Nurse_ @CarolineHutton5 @HootonPhillipa @WMDLove @NickySeargent @geris_lucy @corchard1

[Morten Morland @mortenmorland]

A reminder from the archive:

[Dr Phil Hammond 💙 @drphilhammond]

Thank you for asking me this question

I generally refrain from comparing medical scandals because they are all tragedies in their own way.

The Bristol heart scandal arose because the unit had demonstrably worse results for paediatric cardiac surgery than other units, but was telling parents the UK average mortality rates rather than the unit’s actual rates. To compound matters, the problems in Bristol were widely known amongst the profession, the Royal College of Surgeons, the Society of Cardio Thoracic surgeons, the Department of Health specialist commissioning group etc. Everyone knew apart from the parents, until a very brave whistleblower called Steve Bolsin spoke up. The public inquiry, which finished nine years after I broke the story in Private Eye, concluded that around three dozen babies might have survived if they’ve been operated on elsewhere over a set period. Over a longer period, Professor Bolsin puts the number at around 170. The real tragedy of Bristol is that it made 198 recommendations, many of which have been subsequently repeated in all the other health scandal since, most notably the Mid Staffs inquiry and more recently the infected blood inquiry. The UK is a world leader in public inquiries, and then we ignore the findings so we can have another public inquiry.

The physician associate scandal may not progress to a public inquiry because so many people have raised concerns early, both here and elsewhere. Various Royal Colleges and the GMC have egg on their face and are reversing, or may shortly be reversing, their positions. Far more NHS staff are speaking up for patient safety and, with a new government in charge, constructive changes are more likely to happen and people will continue to speak up if they don’t.

There have been some well publicised disasters where PAs have either voluntarily or forcibly been put in positions that were beyond their competence, and serious harm and death has resulted. However, this clearly doesn’t just apply to PAs. In the Bristol Inquiry report, it was estimated that around 25,000 people die every year in the NHS from either substandard care, or failure to access care. More recently we seem to have settled on a number of 11,000 avoidable deaths a year. Only a tiny fraction of these will have anything to do with PAs.

I guess what I’m saying is that we need to look at patient safety in the round, and speak up forcibly about every aspect of it. My big lesson from Bristol was that how you raise concerns matters as much as the concerns you raise. I did it in a very aggressive way, that made people pull up the drawbridge and probably delayed constructive change and adversely affected the mental health of surgeons trying to do the hardest operations on some of the sickest children. There are plenty of competent PAs out there doing their best in very difficult circumstances, and suicide rates are high enough amongst NHS workers without making things worse.

If we see everything through the prism of patient safety, safe staffing and skill mix levels, it gives us something to unite around as healthcare workers. As Steve Bolsin famously said about the Bristol case, “if you want to prevent future scandals, never lose sight of the patient.” And the lesson from Bristol for PAs out there is that you have to be very explicit and honest with patients about who you are and what your levels of expertise are. If you give misinformed consent, there is no defence. And hospitals and professional bodies that misrepresent the expertise of PAs are equally culpable.

Does that answer your question?

[Dr Rachel Clarke @doctor_oxford]

💥 NHS STAFF 💥

Please consider signing this open letter to @VictoriaAtkins & @AmandaPritchard at @NHSEngland expressing your dismay at their extraordinary decision to cut @NHSPracHealth funding for hospital staff.

Please share widely 🙏

Letter here:

https://t.co/jLlh8ejXpu

[Adam Kay @amateuradam]

This is disastrous, hideous news. NHS England are hacking back the mental health support for hospital staff. One doctor takes their life every three weeks. One nurse takes their life every single week. These numbers will now INCREASE. @VictoriaAtkins - please do the right thing.

[Dr Phil Hammond 💙 @drphilhammond]

Shit life syndrome is by far the biggest determinant of ill-health. We all need decent jobs, diets, a living income, green space, shelter, security, friends, clean air, purpose & kindness. If we focus on these, the economy & NHS will thrive. If we don't, chronic illness will win

[AIRTeamFHFT @AIRTeamFHFT]

I’m asking for a favour🙏a little of your time. This video may be a little long but OMG worth the watch. Please share widely to raise awareness https://t.co/SgofIC9T8I you won’t regret it @ARNS_UK @ActionPFcharity @asthmalunguk @PCRSUK @BTSrespiratory @FrimleyHealth @FHFTAPN

[Joanne King @joanne_king1]

I’m asking for a favour🙏a little of your time. This video may be a little long but OMG worth the watch. Please share widely to raise awareness https://t.co/3rQ5i6xYQi you won’t regret it @WAM_CCG @BandA_CCG @Dochayter @respfutures @lungoxfordahsn @lornawilko @maxinemcvey

[Dame Jane Dacre @DacreJane]

A sobering report. The NHS workforce needs more support. We’re down to the marrow in the health service – we’re beyond the bone’: Almost half of UK doctors say their mental health worse now than during pandemic – Channel 4 News https://t.co/hQcjgQKLeN

[Have I Got News For You @haveigotnews]

Live scenes as Rishi Sunak nips to Londis on the way back from Scotland :

[AIRTeamFHFT @AIRTeamFHFT]

Fancy a new challenge as either a Respiratory Physio or a Physio Assistant? Then come join the AIR team. We will provide training, are a super friendly and welcoming team. Please just get in touch if you have any questions. Links to apply in comments...

[Sadiq Khan @SadiqKhan]

The experts are clear - cleaning up our air and tackling the climate crisis will save lives - here and across the world.

[David Oliver @mancunianmedic]

BBC reporting a national guide dog shortage
But the government have proposed to

Shorten guide dog training from 2 years to 6 months

Provide an apprentice route for fast track dog training

Have guide dog associates to be supervised by actual guide dogs

Introduce guide cats

[Joanne King @joanne_king1]

Worrying report from @ALUK but not too surprising. Would urge people to sign up to the campaign, people with respiratory conditions shouldn’t have to choose between life saving medications or eating / heating. Please join @AIRTeamFHFT @FHMedicalMatron @WAM_CCG @BandA_CCG

[RS Archer @archer_rs]

For the first time since the disastrous Brexit support for rejoining the EU has risen to 75% in the UK. Among those under 25 years old it's nearly 100%.
Will the Labour Party now embrace rejoin and lead the country back into Europe?

[Breakthrough T1D UK @BT1DUK]

5 facts about #Type1Diabetes:

💙 An autoimmune condition
💙 Not caused by a poor diet
💙 Affects ~ 400,000 people in the UK
💙 Can be diagnosed at any age
💙 Currently no cure, but we’re working on it

❤️ & retweet this post to raise awareness of #T1D.

#GBDoc

[Shaun Lintern @ShaunLintern]

Rishi Sunak told MPs today NHS workforce plan is fully funded. It is not.

Govt has committed £2.4bn only for expansion of training places & costs for first 5 years. It doesn't cover costs over later years or the massive increase in salaries for new staff = many billions. #PMQs