Medical Whispers

This gets worse. Not content with contributing to the death of #joannesellars by PAs , Loomer Road Surgery employs tACPs /ACPs from any AHP, nursing or pharmacy background to act as GP substitutes too. Experience in primary care : Desirable jobs.nhs.uk/candidate/joba…

Owen Dickinson, a self confident incompetent nurse ‘ consultant ‘ was involved in the death or harm of 68 patients at @RotherhamNHS_FT performing procedures that ONLY experienced Drs or surgeons should do . bbc.co.uk/news/articles/…

A total of 96 shifts were filled by ACPs in the last 12 months. These were cover for FY2 doctor shifts. Happy days

@anaesthetic_spr We don't have money for supernumerary roles. Lets get more training places in EM for our future generation of consultants and specialists

PAs and ACPs should not work beyond the level of an F1 and should remain in supernumerary roles in ED. Change my mind.

Someone spent more than 15 minutes explaining to the ACP in ED why they needed to give IV hydrocortisone to a drowsy, hypotensive, and hypoglycaemic patient who was not responding to IV fluids and was at risk of an Addisonian crisis. ACPs know nothing about niche presentations and tend to treat everything as sepsis/dehydration.

Doctors are being replaced in the NHS By various staff including ACPs If you value the NHS and excellence in healthcare - for your and your loved ones, then fill out this survey from the BMA with regards to ACP scope creep if you are doctor Deadline Thursday bit.ly/ACPSurvey26

Frightening

Controversial take: The @BMAResidents is doing fantastic work; but when will industrial scale scope creep (particularly from ACPs), start being at the top of the agenda rather than a convenient addendum? This is the biggest issue for both patients and doctors.

@parthaskar @PhilipSteart @lengreview @DrLKVaughan @DrAsifQasim @DrSelvarajah @iDrSunny @somsuj @Rezaidi @ShivaniM_KC @COPDdoc @respirologist @DrSteveTaylor Old news that

@PhilipSteart @lengreview @DrLKVaughan @DrAsifQasim @DrSelvarajah @iDrSunny @somsuj @Rezaidi @ShivaniM_KC @COPDdoc @respirologist @DrSteveTaylor Uni of Ulster now as far as I hear

The whole fiasco of the PA exercise - summarised in the tweet and the events described Glad a few of us played a role to stop this juggernaut However it’s put? That #NHSLongTermWorkforcePlan trajectory cited in 2023 is over post @lengreview And many are the better for it on grounds of safety However much all national organisations tried. Ask for a doctor- Get a doctor.

This is scandalous: Did you know that Consultant ACCPs (physios, podiatrists, pharmacists, and nurses) work as ICU consultants and can: 🚩 Lead a critical care ward round 🚩 Lead a resuscitation or intubation with confidence 🚩 Supervise doctors and other trainee ACCPs

As someone that has trained first as a nurse and then a doctor i have serious concerns about the way non-doctors are undertaking part time training courses and then undertake roles that are traditionally doctor lead. This is in the context of the UK being an under doctored nation compared to similar European countries. We urgently need to address the use of non-doctors in doctor roles. We also need to discuss the cost of training these staff. Who have their course fees paid and are paid while working. Why can't this funding be allocated to what the public actually want. Doctors.

@TheBMA 10 years too late

We are exploring the use of advanced practice roles by NHS employers. To help inform our work, please complete our survey, which is open to all UK doctors and medical students. surveymonkey.com/r/MVXCB99

🔴 Advanced Clinical Practitioners can work as a “salaried/locum GP” without even being fully qualified ACPs. ⭕️The Master’s degree that physios, paramedics, and other AHPs are bragging about is only a DESIRABLE criterion. Poor and unsafe healthcare for the public.

Of course there’s no equivalence and in a functioning system there shouldn’t ever need to be It’s just the current buzzword being used to excuse doctor substitution in plain sight Let’s just tell it like it is!

Not only are these quacks coming for your jobs, they’re claiming to do it better than you with about 3 weeks training. This should enrage every single doctor, this whole situation should spark a downright refusal to work alongside these people.

Advanced Clinical Practitioners (ACPs) are increasingly being used to assess and manage patients in settings that were historically doctor-led. This is doctor substitution, not simple task support. ACPs can enter advanced practice from multiple base professions, including nursing, physiotherapy, paramedicine, and other allied health roles. These backgrounds involve very different training models, particularly in diagnosis and management of undifferentiated illness. Doctors, by contrast, are trained from the start around: Differential diagnosis Managing uncertainty Risk stratification Escalation and safety-netting This training is continuous, structured, and assessed over many years before independent practice. Despite this, ACPs are now commonly used to: Assess undifferentiated patients Initiate investigations and treatment Make early management decisions Often do so before resident doctor review, particularly in acute and primary care settings This represents functional substitution of the doctor role, with diagnostic responsibility being exercised by clinicians who have not undergone the same depth or standardisation of diagnostic training. This is not a comment on individual capability or professionalism. It is a question of how much diagnostic risk the system is willing to transfer, and whether that transfer is being made explicit to patients. That is a policy decision. Patients deserve clarity.

There have been many discussions over the past week regarding what ACPs do, and many conflicting and (sometimes deliberately) conflating views. Two major branches have been discussed here: What Adv Practitioners do What they are 1/

Are patients fully informed and consented for this when they turn up to your ED? Otherwise patients are being used as guinea pigs in a highly unethical experiment

The learned helplessness of doctors: - I couldn’t do anything about trainee numbers in AnE - so instead to cover the gap, I filled it with ACPs and tACPs - but they aren’t doctors but they are covering the gap - yet unable to tell us how the SOPs are different to doctors - would love to see the business case - other units being even more rogue in the NHS and disingenuous to the public aren’t my problem, whilst I’ve not actually been honest to the public that they get worse outcomes because I feel forced to use ACPs instead of doctors

Over the last 30 years the NHS has been intentionally collapsed by politicians and DoH and corporates We are all paying more for worse services This is intentional By 2035 we will all be paying 2-3x of what we’re paying now for healthcare in the UK

There is no comparison or equivalence between fully qualified doctors (GPs) & non-doctors (ACPs) ACPs do not have the knowledge, qualifications, skills & experience to practise medicine It's unsafe There is no regulation of ACPs as they try (& fail) to practise medicine