United Kingdom
Joined March 2020
Nel retweeted
Consultants don’t want to strike, but after 18 months without formal negotiations, they cannot wait any longer. These strikes are planned to take place on 25 and 26 November, with Christmas Day levels of cover provided. There is still time for the Government to make progress.
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Replying to @benking01
@benking01 Now 2502 hours - 1.7 days . They won’t be seen until tomorrow 11:13pm. Even after waiting 2 days they might not even see a medical Dr but a PA or tACP/ACP. Disgraceful. #nhs @YvetteCooperMP @JanetEastham @ShaunLintern @andyburnham @DannyBeales
Surely not? Current longest waiting time in Plymouth's Derriford Hospital A&E is 38 hours (at 2am) Of course, the most urgent cases will be seen first, but A&E can be a scary place to end up, at the best of times 😔
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Nobody can tell me that this isn’t partly due to the 52 tACP/ACPs working in #Nottingham A&E on the ‘tiered’ rota When you replace @BMAResidents with 52 non-medically qualified nurses, physios , Paramedics, ODPs, radiographers etc playing Dr? This is the result @parthaskar
🚨 EXCLUSIVE: Leaked emails expose rift at scandal-hit @nottmhospitals as desperate A&E staff whistleblew to CQC over dangerous A&E overcrowding and false reporting of waiting times data. Insiders warn of unsafe care being normalised. ​ Full story: thetimes.com/article/867ac5c…
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Replying to @ShaunLintern
Direct result of collapse of clinical hierarchy and rampant Doctor substitute in Nottingham. Of 2 factors, former more significant than latter but feed off each other. Leads to aimless, directionless flow across hospital. Treackle instead of liquid flow. ED (A&E) dysfunctional.
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A reminder of the letter released by @NHSEngland when they accepted the @lengreview recommendations in July 2025. This would’ve kept patients safe . Why is this being torn to pieces now by the Clinical Advisory Group ? @parthaskar @DrLKVaughan
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The #NHS also called the “jewel in the crown” Now- Built on a model of “don’t come to see us” And if you do? “Please leave quickly” Whether it be primary care or specialist care It’s called demand management OR not enough resources to deal with the need of the population.
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#nottingham A&E department has 52 nurses, paramedics , physios , radiographers playing Dr on a tiered rota. Apparently this is exciting and innovative. The results speak for themselves @ShaunLintern
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I will say this- again. In a safety critical 'industry' like healthcare? Lesser trained staff usage-at scale-will cause harm. You will 'get away with it' a lot of times. Yet all it needs is 'one miss'. And the higher training reduces the chance of that 'one' - it's what training is all about. If you don't understand that? You fail safety issues And you fail as an educator and trainer. Thank you @JanetEastham for continuing to raise the issue. The irony? Every single person responsible for such decisions regards 'what the public can have' - reaches out to a doctor when they need help for their loved one. 'Cake for me. None for you.'
Dylan Cope died after an A&E nurse practitioner mistook his abdominal pain for flu, having ignored his GP’s referral for suspected appendicitis. His family thought she was a doctor. A coroner found he would have survived had a senior doctor examined him. telegraph.co.uk/news/2026/10…
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“People with a medical degree should work on doctors’ rotas” In 2026? That’s controversial in the NHS. When you want to see a doctor? You should see one Not people using titles and alphabet soups to obfuscate their actual training- and hoodwink. Period.
Today I learnt that saying only people with a medical degree should work on doctors’ rotas is an extreme, polarising view 👀 Which is weird because I always thought that should be blatant common sense… …or else what’s the point of medschool? 🤷‍♂️
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I’m getting DMs from Barnsley GPs telling me that they don’t trust the PA’s assessments and requests for treatment, therefore they rarely use the home visiting service . #Barnsley GPs and patients DM me . Tell me what is going on please. @HealthCareBNSLY @BarnsleyHF
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Serious questions for you to answer @andyburnham @DHSCgovuk @DianaJohnsonMP @PauletteHamilto @JoshFG @YvetteCooperMP @karinsmyth Would you be happy with this for your own family members?
Why aren’t complex patients on often polypharmacy not being looked after by an actual GP. PA aren’t allowed to prescribe so how do they manage these patients? Has the practice decided housebound people are not worthy of a skilled GP? Totally ignore Leng review & GMC reg.
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People of #Barnsley If your Grandad or Nan are sick at home , they could end up being assessed examined and diagnosed by an assistant instead of a qualified GP @YvetteCooperMP would ask for a Dr for her family members though …
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Urgent care Psychiatry PAs - Trusts will do whatever they want The result of your inaction @rcpsych @subodhdave1 because you’ve refused to set a scope for PAs in psychiatry - (despite Leng highlighting how important a scope is due to ‘ grey areas’ in psych )
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"It seems to me that a decision has been made to replace doctors and to remove distinctions between doctors and other professions. It's no coincidence that the NHS continues to struggle with efficiency, productivity, and safety problems while we progress further towards a blended workforce without the necessary training supervision or regulation." Via @bmj_latest bmj.com/content/393/bmj-2026…
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Replying to @DHSCgovuk
@DHSCgovuk wanting to regulate private aesthetic practitioners & clinics (not a bad idea) whilst NHS Trusts who they themselves are responsible for using medically unqualified & unregulated people practicing Medicine & Surgery in the name of advanced practice @karinsmyth
.@karinsmyth visited Dr Leah Clinics to see how cosmetic treatments being carried out the right way, by qualified professionals in a safe clinical setting. Meanwhile, our crackdown intensifies on cosmetic cowboys - with new proposals to: 🩺 restrict high-risk procedures to qualified health professionals 🚫 ban cosmetic surgery and other treatments for under-18s ⚖️introduce unlimited fines for rule-breakers
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If they want further progression & training pathways, they should do GEM. What happens to Medical Trainees when PA/AAs are doing yet more RC credetialled training whilst on the job? What's the point of PA/AAs if they're only using it as a stepping stone to become alternative Drs?
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Indeed Imagine if Nurse Owen Dickson is stopped from doing invasive procedures in his private aesthetic practice due to this regulation from @DHSCgovuk but he can carry on doing ERCPs in NHS theatres because neither @nmcnews nor @gmcuk regulate his“consultant advance practice” 🙄
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Slimy politicians try to rewrite history One of the key people in decimating the NHS over the last 25 years and pushing it aggressively towards the forced privatisation. British public need to hold charlatans like this to account Forever apathy will get the country nowhere
It was a disastrous mistake in 2004 to scrap family doctors. I tried and failed to bring them back. Will this government do any better?
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@YvetteCooperMP must make all healthcare safe not just cosmetic surgery Ask to see a real medical doctor. Be aware there are physician assistants/associates , & ACP, advanced clinical practitioners who are standing in for trained doctors who don’t know what they don’t know.
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