Natalie

@jabberwock951 I consistently refer to this when members of the MDT decide that the advanced dementia pt needs tight BP/BM control and I’m trying to stop them falling.

My favorite guideline is the NICE guideline on multimorbidity, because it tells you not to blindly follow guidelines.

@medicalmodelbri @gmcuk @NHSEngland @rcgp I don’t understand this at all? How are PAs who by definition, must always practice under a supervising doctor allowed to perform private medicine in any aspect, completely unsupervised? I genuinely do not understand. Nurses are autonomous so I get that but PAs aren’t, so how?

@umaps_uk this is your representative for primary care, Mr Zaki What medical qualifications does he have to be offering this service ? This sums up your whole so called ‘ profession’ - pure QUACKERY . @gmcuk @NHSEngland @rcgp do you endorse this ?

@AlternativeMUFC I've lived my best hate watch life tonight. Man made Dalot look like Maldini, we can wait.

I'm on holiday at the moment, we arrived today, for some much needed family time, but I've naturally brought my laptop. I'll do my best for a Comms. We deserve one. I can't promise a bumper 10 minute drop, but I'll crack on where I can to deliver the goods. Cheers x

This is a great policy if your aim is to increase the number of British citizens with HIV. What a wally.

Realistic and reasonable about what the country can afford?!😂 You’re paying assistants to doctors more than you’re pay doctors; Day one pay in central London: 🔸Newly qualified Doctor: £20.36 / hour 🔹Newly qualified Physician’s Assistant: £28.86 / hour That’s 41.75% more.

“Moaning minnies” “Juvenile delinquents” “Organ grinder” “Monkeys” Just a few e.g. of the vile language @wesstreeting has used to publicly insult resident & senior doctors Dear Wes - here’s a reminder of the NHS workplace bullying criteria…it seems you’re ticking a few boxes

@RespectIsVital Why would nurses do that? They can do a skimpy part-time 1/2 day a week ACP course fully funded by @wesstreeting @DHSCgovuk @NHSEngland & immediately earn band 7 salary rising to band 8a on completion with no robust exams, assessments signed off by chums, way more than Drs can!

This nonsense is partly why I decided not to do IMT. The college are doing a brilliant job of actively driving doctors away from it.

I’ve been doing this GP malarkey for nearly 20y now. It struck me today that the only way I can carry on practising the way I used to is if I do it at my own personal expense. It never used to be like this - there was enough time in the day for bereavement visits, wellbeing checks, proactive care, time with colleagues to discuss patients & build relationships. General practice today is decision making at the same speed as a shoot-em-up game. Today was just me for 55 same day requests for appointments, clinical supervision of three members of staff, medical student education, paramedic education and all routine needs for a population of 1250 patients. We’re fortunate to have personal lists - though the new contract doesn’t value the continuity at all - and that matters to me deeply. Leaving work at 7, I decided to pop in to a patient of mine that I’ve known for 14y. In their 80s, they’ve just had joint replacement surgery and are having a bit of a wobble. We had a chat, they felt better, we have a plan & I’ll check in next week. This is the kind of GP I want to be. My day would have been less frantic, I’d have eaten/urinated at a sensible time, and I’d would have been less snappy with the children whom I saw briefly before bed if there hadn’t been so much nonsense crowding my day: 25 mins on hold trying to get through to a specialist (and failing), an insurance company slyly demanding a conversation with me about a non-urgent issue because it saves them money, dealing with consequences of private tests not requested by me but with the inevitable ‘see your GP’ as disposition, missing discharge medication, delayed follow-up, inappropriate ‘GP to’ as the heart failure team have a waiting list - and much more. Commissioning gaps, poor clinical pathway planning, govt targets on access over quality, media perpetuation of entitlement over responsibility and disproportionate investment & expansion of specialists over general practice have caused this. This is not ‘part time’ GP working - as a partner that’s never a thing. This is expectations from everywhere without resourcing to match. We want to deliver the things we did 20y ago - that’s why we went into this. If you want your family doctor back then you need to support us - because we want to be that too. I’m a GP, but also a Mum, wife and daughter of aged parents. I can’t do this at my own expense any more, and nor should I have to. Arguments of laziness and greed always abound, but really what we need is a properly resourced service. Please stand with us - a fight is coming.

In another display of how @wesstreeting is "improving" the lives of doctors, the application window to go less than full time (80% = average 40 hrs/week, rather than 48 - which for all other NHS staff would be considered full time) has been increased from 3 months to 21 weeks.

@UtdActive @linds5560

Absolute scenes you love to see on the weekend.

@AlternativeMUFC Big Ben leapfrogging a defender is genuinely one of the best things I’ve seen this season

@AlternativeMUFC The assist…

WHAT. A. GOAL.

This year @wesstreeting imposed a new GP contract Provided an extra £1.50 to uncap the number of calls or requests per day & stand by the phone or computer And if the job isn’t completed within 24hours the GP will be sanctioned Job specifications below - can’t see a problem🤷🏻‍♂️

I’ve literally never been “looked after” as a resident doctor. Compared to other NHS employees we are treated and paid like dirt, called “juvenile delinquents” by the health secretary. Weird to see Wes being polite towards us, is he alright?

@ajp354 @TheBMA Unfortunately you seem to be unaware that war is a generic exclusion clause in travel insurance, so they will be covering the costs themselves. This policy simply provides short term support, I’m sure you’d agree being stuck in a warzone meets the definition of “emergency”.

@TheBMA Or, better still, use the insurance that they would have purchased and claim for lost wages back so the taxpayer doesn’t foot the bill.

We are aware of a number of doctors who have had their return travel to the UK disrupted by the ongoing conflict in the Middle East. Our view is any affected doctor should receive paid special leave if they are delayed in returning to work due to the conflict. Members who have been affected or are being denied paid special leave by their employer should get in touch with us - bma.org.uk/about-us/conta…

@dinosaurs4juice @TheBMA Hi Vic, Unfortunately you seem to be unaware that war is a generic exclusion clause in travel insurance, so they will be covering the costs themselves. This policy provides short term support, I’m sure you’d agree being stuck in a warzone meets the definition of “emergency”.

@TheBMA If this was the majority of taxpayers in the UK they would be expected to cover the costs themselves or use travel insurance. Disappointing really that taxpayers will foot the bill here. No wonder the NHS is broken

In light of Sir Jim's colonised quotes, I'd like to bring attention to the words of Eric Cantona...

@AlternativeMUFC Could be worse, could be spurs.

Poor performance and that was certainly a point gained rather than two dropped, considering how it played out. It is what it is & big Michael is still unbeaten. Please don't get carried away with any dramatics, it's fucking exhausting. Roll on the next one.

@Azeem_Majeed Our research shows that while consultation volume is at an all-time high, the complexity and intensity of those appointments have also increased. Creating more GP posts is best path to restoring patient access and ensuring the future of primary care in England's NHS.