Phil Smith

Back for a time limited period only.

As I have said many a time? The healthcare system in this country is awash with Dunning-Kruger Yet- it isn't the fault of the individual alone. It's also because many a GP leader have encouraged colleagues to think such. As has @rcgp with their past policies and their former Presidents etc And here we are. If that's how you feel GPs are trained- why indeed is there a surprise when many feel 'we can do their job'? For the record? Here is how you get to be a newly qualified GP. And me-as a Consultant for 18 years would be less trained than a newly qualified GP - to be a GP. Yet? The belief in the tweet is simply- stunning @Parody_RCGP @VictoriaTzB @DrSelvarajah @doctor_katie @CoastingGP @padsbigsis Link: bmj.com/careers/articl…

EXCLUSIVE 🚨 George Cottrell opened account with secretive overseas payments company just days before it was used to channel “unexplained” £500,000 to Reform Cottrell became client via his entity in Montenegro — immediately before payment NCA can’t trace thetimes.com/uk/politics/ar…

I hope @RCPhysicians members and fellows see this. Louella is fighting for, and representing, physicians. Not the RCP itself, or the RCP vice president for education and training... Imagine if she had got that role and you had someone as effective as her in position #VoteBetter

🚨 Some unplanned IBD admissions may be avoidable - and the causes extend beyond disease severity. In a mixed-methods study involving 80 survey respondents and 13 clinician interviews, avoidable admissions were associated with missed opportunities for earlier intervention, delays in specialist care, difficulties navigating services and system constraints that prevented timely action. The findings highlight the need for rapid-access flare pathways, clearer patient education, better-integrated care and investment in specialist staffing, appointments and infusion capacity. How should IBD services be redesigned to intervene earlier? With thanks to Rachel Louise Hawkins and co-authors for this important contribution to the IBD literature. @wannabehawkeye @fcsampson @AwareIbd @IbdSheff @PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman #IBD #CrohnsDisease #UlcerativeColitis #Gastroenterology #HealthcareImprovement #HealthInequalities

@parthaskar @RCPhysicians @TheKingsFund @lengreview @DrLKVaughan @DrAsifQasim @respirologist @ShivaniM_KC @TIME_research @TheSnoozeDoctor @DrSelvarajah @Rezaidi @DrHuw @doctor_oxford Good to see this Partha. A big injustice that those who pushed for vexatiously should be ashamed of. Keep fighting the good fight and you never know - fellow again, maybe El-presidente in the future? That would set the cat amongst the pigeons!

*NEWS* There is something freudian about this. 12 months in the “sin-bin” As adjudged by @RCPhysicians panel - as a form of punishment for exposing ‘chicanery’ around PAs - as subsequently shown in @TheKingsFund investigation Vindicated by @lengreview and now High Court- see below. 12 months- Ghosted from RCP meetings, ignorance of documents written during time on Council etc etc. Many asked me to walk away. “Why bother” Yet? I never have- from anything And am back now. With zero regrets for work done to stop expansion of PAs without regulation- encouraged by the RCP. 12 months is nothing in a journey to protect the public. And bar a few dinner parties? Little lost. As I said? This arc isn’t complete yet. Amidst all the grief- I still have time. It’s good to be back- my lack of respect is never for the RCP But individuals who have lowered the bar over the years. It’s been a while- hello RCP Much love. Partha Kar FRCP @djnicholl @mmamas1973 @valhumphreys51

@DrLKVaughan Glad they are changing things but what an utterly ridiculous state of affairs - this is who is in charge of crucial NHS decisions, and this is how they run things. And yet, we are cast as troublemakers - the trouble these "leaders" create is 10 fold!

Well well. Just heard back from NHSE. Seems like they are swamped with complaints. And are rethinking things. Twitter and email works!

Congratulations to Dr Penelope Edwards (St Mark's Hospital, London) on winning the BMJ Gut Best Laboratory Science Abstract award. 📸 Pictured at the recent British Society of Gastroenterology Annual Meeting in Liverpool with Gut Editors-in-Chief (left to right): Professor William Grady, Professor Thomas Rösch and Professor Matias A. Avila. 🏆 Award-winning abstract: Evidence of Systemic Immune Activation in Peripheral Blood in Patients with Lynch Syndrome. This research provides new insights into the immune response associated with Lynch syndrome, the most common inherited cause of colorectal cancer. By identifying evidence of systemic immune activation in patients' peripheral blood, the study advances our understanding of how the immune system responds in individuals with Lynch syndrome. These findings could contribute to the development of improved biomarkers for cancer risk assessment, surveillance and, ultimately, strategies for earlier detection and prevention. Read the abstract here: bit.ly/4wPfeL7 Congratulations to Dr Edwards and the research team on this well-deserved recognition for outstanding laboratory science with the potential to improve the understanding and management of Lynch syndrome. #BSGLive2026 #GutJournal #LynchSyndrome #ColorectalCancer #CancerResearch #LaboratoryScience #Gastroenterology @BritSocGastro @FrontGastro_BMJ @BMJOpen_Gastro

Congratulations to Professor Peter Irving (Guy's and St Thomas' NHS Foundation Trust) on winning the "BMJ Frontline Gastroenterology Best Patient Benefit in Gastroenterology Abstract award" 📸 Pictured at the recent British Society of Gastroenterology @BritSocGastro Annual Meeting in Liverpool, Professor Peter Irving receives the award from Dr Philip Smith, Editor-in-Chief of Frontline Gastroenterology. 🏆 Award-winning abstract: Randomised controlled trial of withdrawal of thiopurines when switching from intravenous to subcutaneous infliximab: Results of the MINIMISE study. The MINIMISE study addressed an important question in inflammatory bowel disease (IBD) care: can patients safely stop thiopurines when switching from intravenous to subcutaneous infliximab? In this multicentre randomised controlled trial, patients in stable remission who discontinued thiopurines after switching to subcutaneous infliximab had outcomes that were non-inferior to those who continued combination therapy. There was no increase in clinically significant anti-drug antibodies or disease activity over 24 weeks, supporting the possibility of simplifying treatment while avoiding the long-term risks associated with thiopurines. These findings have the potential to reduce medication burden and improve the long-term safety of care for many people living with IBD. Abstract available via bit.ly/4gDeIel Congratulations to Professor Irving and the entire MINIMISE study team on this well-deserved recognition for research with the potential to improve patient care. #BSGLive2026 #Gastroenterology #IBD #Research #PatientBenefit #InflammatoryBowelDisease #ClinicalResearch @Gut_BMJ @BMJOpen_Gastro @PhilSmithIsBack

Lucy, as much as I admire you, your faith here in NHS 'process' is touchingly naive. For 2 reasons. Firstly, for any process (even the most reasonable one) to be kicked off, some kind of threshold has to be reached. Complaints are a good example here. Most pts/rels 1/

Worth a read of this thread from @DrLKVaughan Amends and clarifications on its way from @NHSEngland shortly There are about 4-5 “Medical Directors” nowadays across @NHSEngland @DHSCgovuk Have they read this? I doubt it. Then again- clinical leadership isn’t much of a thing nowadays.

For the endoscopists amongst you... How would you describe this jejunal lesion? What's the diagnosis? Check it out here ▶️ ▶️ ▶️ bit.ly/4pnrrnz @PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman #ClinicalCase #CaseOfTheWeek #MedicalEducation #MedEd #FOAMed #Gastroenterology #GITwitter #ClinicalPearls #DiagnosticChallenge #CaseDiscussion

Beyond dumb Knowing what happened to patients I saw, referred on or was asked to give advice on, is one of the most rewarding aspects of my job I love finding out what happened - did my treatment advice work? Is there learning? What could I have done differently? What was the diagnosis? You can't actually be a doctor without following up on patients you saw.

This is a knee jerk reaction to staff accessing the notes of high profile media stories inappropriately Which TBC is sackable But there are many reasons for Drs to legitimately access notes & this highlights executive misunderstanding & a desire to be seen to be doing something

NHS plans to ban doctors from accessing the records to follow up on patients they have assessed just shows that the upper levels of NHS management understand zero about medical training and education. Reviewing the notes of patients I saw and what happened to them is how my

💭 What can the NHS learn from healthcare systems abroad, without losing the values that make it unique? After almost 4 years practising gastroenterology in the Gulf, Professor @Laith_Rubaiy reflects on faster implementation, digital integration, reduced bureaucracy and the potential for “reverse innovation”. Which international healthcare lesson should the NHS adopt first? Read this thought provoking letter here 👇 👇 👇 doi-org.iclibezp1.cc.ic.ac.uk/10.1136/flgast… @PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman #NHS #Gastroenterology #HealthcareInnovation #DigitalHealth #AIinHealthcare #GlobalHealth #MedEd

Important thread by @DrLKVaughan. This guidance by @NHSEngland was set up, presumably, to help tackle the type of unethical voyeuristic snooping behaviour seen from some NHS workers with Southport pts, celebrity pts etc. What has been produced is a farce. Slow clap @NHSEngland

All of this ignores the fact that the patient record is ALSO effectively doctors' work product. And that our work as doctors is far more than direct patient care. This is almost completely unworkable. Utterly typical of the NHS to take a problem and overkill the solution.

Doctors will still be able to access records cos GMC- mandated reflective practice, but only for 6 months. Licensing is YEARLY. The revalidation cycle is FIVE years. 5/

There are a whole series of other work-related activities that require access to patient records that are now prohibited or limited. 4/