@anaesthetic_spr @Anisocyte It’s like an inter -college competition to out stupid each other …….the RCP are putting up a good fight😂😂
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Dr Andy Breakell
2.6K posts
Dr Andy Breakell
@TheBreakster
WLGC 1873 ⛳️🌹 - MSK Orthopaedic 🦴 Trauma and Sports Doc - 🚑 Pitch - Side Doc ⚽️🏉Chester FC Doc ⚽️- RSM council 🏛️ ALS doc❤️ - Med Legal Trauma Expert⚖️
Liverpool, England Katılım Nisan 2021
126 Takip Edilen591 Takipçiler
@Anisocyte They want to tick the diversity box and appear humble.
They were like: “We are the first college allowing a nurse to chair the Royal College of Physicians.”
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The CEO of the Royal College of Nursing should be a medical doctor, not a nurse.
Discuss.
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@valhumphreys51 @Burnt2020 @medicalmodelbri @LittlePersonDoc @anaesthetic_spr @lascapigliata8 It immediately raises the issue of dishonesty …….so if they are dishonest about who they are and their status ……..is their statement about the clinical events dishonest 🤷🏻♂️
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@Burnt2020 @medicalmodelbri @LittlePersonDoc @sunshine222blue @anaesthetic_spr @lascapigliata8 Just come across this and thought I’d point out that it’s largely agreed by lawyers who specialise in med law that failure to disclose to a pt what type of med professional is treating them raises significant issues around IC and could, if harm occurred, amount to clin neg
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“Dr Clinical Lead for Physical Health Consultant Practitioner Senior Clinical Leadership NIHR”
Basically a NURSE.
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@sunshine222blue @anaesthetic_spr @lascapigliata8 Yes you are deliberately misleading the public as the PhD is a research qualification ( doctorate) - you may have researched dog food nutrition!!….before litigation I always look for dishonesty …..council love ❤️ dishonesty😎👍
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@jim_crawfurd @HelenFlavell1 @Molly2323232323 @medicalmodelbri At least you are honest Jim……which is refreshing 😎👍
Bear in mind that NO other profession would allow any short cut tiering system to short cut a route to clinical practice …..paramedics / nurses/ physios / pharmacy …..you always need the base degree🤓
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@TheBreakster @HelenFlavell1 @Molly2323232323 @medicalmodelbri Ok, I would expect RCEM to say “that’s crazy”. Fair cop.
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Oh wow
Jim Crawfurd 💙 🇺🇦@jim_crawfurd
@Burnt2020 @medicalmodelbri @skynetbuffering @rcgp @uclh Nurse practitioners have been doing this in EM for 40+ years, and there are “nurse led clinics” in many hospital specialties, not to mention primary care. I think RCEM is unusual in seeking to define and standardise this, but should probably be commended for that, not vilified.
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@Molly2323232323 @jim_crawfurd @HelenFlavell1 @medicalmodelbri NHsE may not care about RCEM tiers or any tears 😭 shed by members if they promote the next step from ACP ‘reg’ level to consultant…..the next step up is managerial / co- ordinator
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@jim_crawfurd @TheBreakster @HelenFlavell1 @medicalmodelbri So it would be crazy for RCEM to say that an ACP is equivalent to an EM consultant doctor?
But it's not crazy for RCEM to say that an ACP is equivalent to an EM registrar doctor?
Why is that?
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@HelenFlavell1 @jim_crawfurd @Molly2323232323 @medicalmodelbri ….so Jim…..if NHSE say that after 12 months in an ED post an ACP can apply for an ED consultant post would you support RCEM in developing credentialing for that step up …..or would that be a step too far👀
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@jim_crawfurd @Molly2323232323 @TheBreakster @medicalmodelbri But only an estimated 10-15% of EM ACPs are credentialed. The NHSE does not differentiate base profession for the ACP pathway.
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@Megsenmumdr @jim_crawfurd @medicalmodelbri @Oxfordite @hlnewey @Molly2323232323 @DrLKVaughan Litigation claims for A&E / EM are through the roof and rising - wrong diagnosis 40% cases / wrong treatment 25%…..I think it’s 1st or 2nd in the league table at NHS Resolution …..and prediction is for higher volumes ⬆️
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@jim_crawfurd @medicalmodelbri @TheBreakster @Oxfordite @hlnewey @Molly2323232323 @DrLKVaughan A non medically qualified ANP decides its flu without any investigations to r/o appendicitis, without any documented medical review (apparently a review by someone who trust doesn’t know of 🤷🏻♀️ & no records of) , even then we get told “but a Dr could make mistake”. 2/n
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@medicalmodelbri @jim_crawfurd @Molly2323232323 @hlnewey @DrLKVaughan And what’s also interesting is not ONE other professional body has copied this lunacy to date 😂😂
So I can’t top up my medical degree training at the College of Physiotherapy with credentialing …..I have to sit the full degree…….ditto College of Paramedics…..➡️full degree 😎
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@medicalmodelbri @jim_crawfurd @Molly2323232323 @hlnewey @DrLKVaughan As I said previously - RCEM have taken it upon themselves to set up a ‘medical school’ - not affiliated to any University - to teach Emergency Medicine to anyone who fits the entry criteria at any given point……and hand out certificates of competence/ education😬
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@Oxfordite @jim_crawfurd @hlnewey @medicalmodelbri @Molly2323232323 @DrLKVaughan I think Jim this was the PA argument early on wasn’t it ??…….’everyone makes mistakes- so don’t pick on us - we can harm people just as well as doctors can’😬😬…..the question is risk/ liability…..is the orthopaedic/ MsK / exams / CPD robust ….or not 🤷🏻♂️
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@jim_crawfurd @TheBreakster @hlnewey @medicalmodelbri @Molly2323232323 @DrLKVaughan Err..
And that patient??
What of that patient?
A few years ago they'd have received a competent, efficient, diagnosis by a *doctor*..
Is this patient harmed or dead?
How to compensate for avoidable predictable failure by incompetents?
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@jim_crawfurd @hlnewey @medicalmodelbri @Molly2323232323 @DrLKVaughan I have no idea as it’s a litigation case - I have asked for evidence of training in Musculoskeletal medicine / orthopaedics / evidence of MsK CPD etc to back up my feeling that’s it’s close to zero!!
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@jim_crawfurd @hlnewey @medicalmodelbri @Molly2323232323 @DrLKVaughan As I said earlier Jim - I’m just dealing with a missed cauda equina from such a ‘trained discharge’ ……the clinical assessment was poor ….the diagnostic work up was poor…..not a cat in hells chance of spotting the disorder.
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@Molly2323232323 @jim_crawfurd @DrLKVaughan @medicalmodelbri Jim - when I ultrasound a rotator cuff tear and inject PrP into the tear….is that me acting as an advanced physio ….or just a basic doctor doing a job I have training in …..nothing advanced or special about it ……and a set of vital signs…..band 6 nurse job 🤷🏻♂️….I could go on
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@jim_crawfurd @DrLKVaughan @TheBreakster @medicalmodelbri How can a consultant doctor supervise 'advanced practice in the base profession'?
Because the base profession isn't medicine, is it?
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@Molly2323232323 @jim_crawfurd @DrLKVaughan @medicalmodelbri So essentially Jim ……RCEM are setting up a ‘school’ of emergency medicine -within the wider medical profession - with a variety of entry level professions ……with the aim of a universal graduate that is competent and safe……..is this a template for others e.g cardiology🤷🏻♂️
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@jim_crawfurd @DrLKVaughan @TheBreakster @medicalmodelbri For clarity, is is consultant doctors who provide supervision & oversight to tACPs?
If so, how is that possible when tACPs claim their role is 'advanced practice in the base profession'?
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@DrLKVaughan @jim_crawfurd @medicalmodelbri 2/2
When I ask if the same level of scrutiny applies to ACP shifts in A&E which are paid £5 less per hour……the answer is NO……just the ACP course sign off will do…….what sort of lunatic quality control system runs like this in health care🤷🏻♂️
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@jim_crawfurd @TheBreakster @medicalmodelbri I completely understand this as the initial motivation a good decade ago. The bad thing was happening anyway, so let's try to ensure there are standards etc.
But now we are left with the consequences.
Regardless of RCEM's intentions, it is now seen as legitimisation
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@DrLKVaughan @jim_crawfurd @medicalmodelbri 1/2
If you register with an agency to cover an A&E Reg shift or higher……you have to essentially plot your 20 year educational and experience journey with every exam you have sat/passed and all your life support courses /some cases your research etc……
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@jim_crawfurd @medicalmodelbri Nope
I’m arguing that anyone who practices medicine in ED as a specialty will need to sit the MRCEM…..there can’t be 2 pathways.
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@jim_crawfurd @medicalmodelbri Interesting article today in the Telegraph basically charting the value decline of the MSc in the UK…I would agree that production line ‘masters’ medical specialists when they have barely spend anytime in clinical work is a joke🤓
I would add that any ED exam = MRCEM for anyone
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Britain’s spiralling master’s degree crisis – and the jobless graduates who have no other option
A masters degree now has been massively devalued with very little added value in knowledge than a base degree…and it’s £20k for the privilege 😱 telegraph.co.uk/money/consumer…
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@jim_crawfurd @medicalmodelbri Jim - if it’s quality assurance :
How does the public recognise the base training of an Advanced Practitioner ?
If you attend A&E with back pain….it could be
1 A pharmacist
2 A paramedic
3 A nurse
4 A physio…that makes the assessment
I’m just dealing with a missed cauda E !
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@medicalmodelbri I’m not seeking to equate - clearly ACP is a significant evolution from that original “minor injury ENP” role.
The point I’m making is that individual trusts were already developing “majors nurse practitioners” long before RCEM came up with ACP credentialing.
1/2
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