The General Practice ANP

I had to go anon as the “good” people of X didn’t want healthy debate, they wanted to intimidate and threaten my job security/reputation! The gloves now off!

[The General Practice ANP @theGPANP]

1/9
Back on X while recovering from surgery. Partner was away for a family emergency. I was in pain and at times on codeine. In hindsight that wasn’t the best time to post. I should have reread or stepped away first.

[The General Practice ANP @theGPANP]

@Megsenmumdr @RCEMpresident Sorry - the coroner did NOT find this!

[The General Practice ANP @theGPANP]

@Megsenmumdr @RCEMpresident Please don’t use the death of a child to try to spin your argument. Had the coroner said “ACP was seeing something they were not skilled in or competent to see” this would be a different matter, but the coroner didn’t say NOT find this.

[The General Practice ANP @theGPANP]

@Megsenmumdr @RCEMpresident I haven’t read the coroners report, but I’m pretty sure the coroner didn’t say the child sadly died due to being s/b ACP. Children die after being s/b Drs also, patients deteriorate. The issues with this case were around communication and accurate information recording

[The General Practice ANP @theGPANP]

@Burnt2020 @ConsUltaNT_ACP Oh, and the BMA is trying to undermine those people who have spent THEIR lives coming nurse/physio/pharmacist etc as ACP, in some of our cases 20 or 30 years - but they still come with their pitchforks

[The General Practice ANP @theGPANP]

@Burnt2020 @ConsUltaNT_ACP I’m pretty sure the point of the thread is to highlight that other professionals can diagnose and make critical decisions without Dr oversight and the ludicrousness of the BMA’s argument!

[The General Practice ANP @theGPANP]

ACPs are the risk… oh, how about not letting incompetent doctors practice? How this Dr was allowed to work for as long as she did is unfathomable!
Pretty sure the BMA probably represented her as well…
Shows hie much the BMA values patient safety!
https://t.co/nG52TOAlw0

[The General Practice ANP @theGPANP]

@TheBMA I can’t imagine FICM won’t have huge support for ACCPs, especially as this is now hitting the national press. Strangely, given my handle, I’m not so familiar with RCGP as an org, but I suspect the idea of losing ACPs in GP would strike fear into many!

[The General Practice ANP @theGPANP]

@TheBMA RCEM disagrees with you! Oh; and information your “report” was created using, has HORRENDOUSLY leading questions. The only possible outcome was going to be what you “found”

https://t.co/YweD0JHu5Y

[The General Practice ANP @theGPANP]

@DW8674 @ConsUltaNT_ACP literally got to this GIF before I did!

(Not to mention the carnage that would’ve happened in the recent RD strikes!)

[The General Practice ANP @theGPANP]

Finally, the first (I’m sure of many) sensible voices to chip into the ACP debate. Are the current structures in place perfect? No. Does work need to be done? Yes!
Are we unsafe…? RCEM says not!

https://t.co/YweD0JHu5Y

[The General Practice ANP @theGPANP]

@Megsenmumdr @parthaskar @snickalous @cleggy261 @rheumipainmask As a rule, I would see undiagnosed patients as opposed to undifferentiated (although they do slip in). Earache, back pain, abdo pain, ? UTI, cough.
Rarely would I get patients booking in with multitude of Sx on my list, but sometimes the history shows they do have these.

[The General Practice ANP @theGPANP]

@IsobelS77082097 @Megsenmumdr @cleggy261 @rheumipainmask Granted, by this time I would have identified recurrent infection (or need to have recurrent Abx), requested appropriate Ix and then handed over to a GP to review once appropriate Ix had been reported!

[The General Practice ANP @theGPANP]

@IsobelS77082097 @Megsenmumdr @cleggy261 @rheumipainmask Any patient needing recurrent Abx needs further Ix for underlying cause, this is pretty basic, be that skin, chest, urine infections etc.
Depending on what issue is I would be often wanting more Ix than just bloods!
But you have to assess risk on an individual patient basis!

[The General Practice ANP @theGPANP]

@iDrSunny @ConsUltaNT_ACP Regarding your comment to @ConsUltaNT_ACP regarding statistics… has this Nurse managed to teach you something about stats or did really understand it anyway, just chose to ignore? (Surprised you’d make yourself look so ignorant with regards to stats tho - hope no investors read)

[The General Practice ANP @theGPANP]

@ConsUltaNT_ACP @iDrSunny I also followed the link and answered the questions for this (I was unable to submit as not GMC registered)
The multi-choice questions were leading, and there was only ever going to be 1 outcome from this, the BMA had an agenda and they wanted kindling for the fire!

[The General Practice ANP @theGPANP]

@ConsUltaNT_ACP @iDrSunny But to be fair - results can neither be confirmed or refuted!
In my humble opinion, the massive difference in responses in the 2 questionnaires though is telling!

[The General Practice ANP @theGPANP]

@ConsUltaNT_ACP @iDrSunny Huge sample of population who voted regarding pay - suggests results consistent with population findings (although there will still be some selection bias).
3% response rate with huge selection bias means the findings are fundamentally flawed and more research needs to be done

[The General Practice ANP @theGPANP]

@ConsUltaNT_ACP @iDrSunny I see both sides - random 3% sample could give a reflection of the total population. However; this sample wasn’t random and there is massive selection bias (ie those who think there is a problem more likely to respond)

[The General Practice ANP @theGPANP]

@amnerisuk @rheumipainmask @Megsenmumdr @cleggy261 Our practice is close to a large teaching hospital and I v often have Drs of varying specialities and grades added to my list. I would really hope, if ever my care was substandard, then one of these would have complained and highlighted my mistakes.

[The General Practice ANP @theGPANP]

@amnerisuk @rheumipainmask @Megsenmumdr @cleggy261 In relation to the other question - I always apologise, explain my role (and limitations), offer to “see if I can help” but if they’d prefer to arrange for a GP. I then also re-iterate to reception to let patients know who they are seeing and not using “Clinician”

[The General Practice ANP @theGPANP]

@amnerisuk @rheumipainmask @Megsenmumdr @cleggy261 Reception now tell patients (admittedly before they used “Clinician”), but whether or not it’s registered with patients is another matter!
I’ve said before - correct patients 3 times if they call me “Dr” after which o give up.