I’ve seen this do the rounds a few times and whilst ditching qualifications is bonkers, it’s not quite as simple, or indeed novel, as many might think. A warp speed tour of markets, their failures and why medicine is very much a lone wolf in this conversation 🐭 and 🧵

COMMUNITY CARE - COLLAPSE NHSE failure is talk but absolutely no support Health Visitors ⬇️30% Learning Disability Nurses⬇️23% School Nurses⬇️35% GPs ⬇️ 7% District nurses ⬇️42% UK population ⬆️7% - 2012-23 Amanda Pritchard NHS England Wes Streeting MP

There are places where PAs are rejecting the 2 week wait cancer referrals of GPs. We have entered an era of the taskification of medicine so it can be done by tick box algorithms and soon AI.

How dare you list your date of birth as 5th July NHS England Workforce, Training and Education. The NHS born on that day was an organisation with a mission to provide quality care, for free, to all. You are destroying that NHS while you hide in plain sight under its’ reassuring banner.

In 2015 an audit found that PAs were more suitable to resolve each of these types of conditions than a GP Back pain 64% Bleeding between periods 44% Chest Infection 65% Breast pain 54% Constipation (over 5) 74% Diarrhoea 67% adult + child Source - RCGP e-learning website

RCGP and the The BMA knew and approved the First Contact practitioner university courses . As early as 2016 their logos and input were all over the introduction of this. Thankfully General Practice has woken up from its slumber . csp.org.uk/system/files/0…

If RCGP have finally come to the realisation that First Contact Practitioners seeing undifferentiated patients is unsafe then are to going to remove these courses too and the AHPs already working in FCP posts in general practice ?

Yep yep yep

Often I meet patients with complex morbidity, with med lists approaching or exceeding 20 different medications, and wonder if these patients existed 40 years ago. Did today’s consultants deal with this as House Officers? Also why soaring healthcare costs are unsurprising to me

These patients did not exist 40 years ago (sadly the lack of medicine and treatments meant many didn't live as long to teach this level of complexity) We also kept people in hospital for longer, and kept many conditions under outpatient specialist care for life. #teamGP

Steve Taylor Amanda Pritchard NHS England Wes Streeting MP Im tired of being ‘led’ by non-clinical managers who have never spent a single day in direct patient care. No one should be leading the NHS who isn’t a clinician. Sorry. But the Sainsbury’s management culture has failed the NHS.

I got my dolphin centre badge when I was a teenager, once ate 6 Krispy Kreme doughnuts at one sitting and could name all 4 zones of the crystal maze. Which bit of my relevant professional qualifications should I add that too?

@mstotty88 Seb Tim Ricketts For every one in clinic we have 100 in the community. But it just takes one smart comment from a “colleague” to say your GP should have done x,y,z and that brings disaster. Combine that with a toxic racist regulator and you will be part way in understanding our predicament.

This is a PA They’re paid a starting salary of £44K out of your tax They have only 2 years training, they can’t prescribe medicines or request x rays. Real docs have supervise them for your safety, in addition to our own work. S/he thinks paying a doctor £11K less isn’t bad.

And so, things must end. Sadly, this account will be closing soon. If you wish to send me a message please do. It's been a pleasure. A real pleasure. I hope that I have put General Practice first. I hope that I have had an impact. Much love.

A ballot of GPs in England to take collective action against NHS England closes tomorrow. It almost certainly will see GPs vote yes in a move that could bring the NHS to its knees.

Mic drop.

Partha S Kar 🇮🇳🇬🇧🏏🎥 As newly elected King Leader of the RCGP I would like to formally invite you to give a talk at RCGP HQ. Title: Gaslighting and Accountable leadership Non-members & Trainees: £0 IMGs: £0 SAS Doctors: £0 RCGP members: £100 RCGP fellows: £500 RCGP executive: £10,000