Freelance journo covering NHS in the southeast & ambulances for HSJ. Not fond of authority whoever's in power. DMs open Alison.Moore@hsj.co.uk
Oxford, Oxfordshire
- Tweets 68,116
- Following 786
- Followers 6,092
- Likes 25,725
Sorry but no. Someone who is ill enough to require inpatient admission in a mental health hospital is not at the right place to discuss getting a job. And I suspect a lot of doctors will not co-operate with this.
229
856
5,300
205,142
What? Waiting times reduced from a year to 7 weeks by employing an administrator.
86
250
2,443
1,392,404
It’s becoming obvious that everyone has been sold a pup with physician’s associate roles. Docs thought they were getting a helper, someone to remove some of the burden of admin and chasing for junior docs and who could also do some routine tasks (but under supervision and 1/n
39
631
2,040
605,795
Exclusive: Matt hancock did not declare association with firm owned by his family which got on a framework to deliver servies to the NHS hsj.co.uk/finance-and-effici…
57
677
1,230
How do i take personal responsibility for my risk of catching Covid on a crowded train with no social distancing and other people choosing not to wear facemasks?
136
220
1,259
I thought I would find #Breathtaking upsetting. Instead it has just brought back my anger, mainly at Boris Johnson and Matt Hancock. Johnson was the worst possible leader for this sort of crisis.
26
157
1,070
24,597
The insanity of junior docs' working conditions continues to amaze me. What other professional groups are told they can't take holiday during substantial parts of their rota without doing swaps with colleagues - which they have to arrange? Or find it impossible to take two 1/n
34
205
1,077
106,354
Confessions of a junior doctor in the Times magazine this morning seems spot on: compulsory wellbeing sessions where they are told to reframe being "stressed" as being "challenged." Sessions which run through any possible lunchbreak. And no chairs.
50
190
998
I really find the "Karen" theme misogynistic and ageist - as if any woman over 30 is not entitled to an opinion or rights.
38
37
817
23,197
Tannoy at Paddington: "Inspector Sands to the country end of platform 1, please." That has to be a code for something, surely?
107
25
678
172,832
I can't think of any other employer which expects people to work all hours - often finishing after dark - and then charges them £50-60 a month to park their cars on its premises. NHS is sometimes bizarre.
32
90
644
71,855
BBC needs to make it clear that the additional pay juniors get is 1. for working up to 48hrs a week - which they have no choice over. 2. working weekends/nights - again they have no choice. Why does the BBC keep making errors over this?
43
193
614
96,332
supervision has a very high level of risk. I don’t have any answers to these issues but they need to be discussed and resolved before expansion of the role takes place 6/6
14
60
571
42,446
the expanded role many PAs crave (not to mention the starting pay differential which is, frankly, ludicrous). It also gives the gov an opportunity not to invest in more training places for docs which will mean future consultant posts will be harder to fill. In this 3/n
2
67
529
48,052
I actually get quite annoyed when I see things like this in NHS board papers: it is not always possible for next-of-kins to drop everything and care for a newly discharged person (even if they want to & feel capable of it). Think children, jobs, other caring responsibilities.
81
85
587
55,928
I wonder if trusts think about the loss of good will, impact on morale and staff retention when they post notices like this? Plus the inevitable FoI asking whether board meeitngs have coffee supplied....
54
98
574
62,355
direction). Meanwhile, some PAs thought they were getting a fast track to a fully hands-on role, nearly equivalent to a doctor. Realistically, those with a PA MSc are never likely to be happy with an admin/routine role but docs are unlikely to accept the near-equivalence of 2/n
3
64
491
49,672
BBC need to make it clear what these “extras” in docs’ pay are - not nice little bonuses but payments for working weekends, nights and a working week which is often 48 hours. Sorry to harp on but I feel it is a misrepresentation of the real position.
Patients at risk during doctor strike - NHS bosses bbc.in/3MjLfa4
11
77
479
115,989
I feel this overestimates deers' understanding of UK law.
12
49
484
22,282
situation, it seems daft to consult on development of the PA workforce as the core role of the job is still disputed and, unless resolved, will be a running sore between the gov and docs for years to come. None of this helps patients and patient safety as well as access 4/n
1
50
438
45,406
Junior docs could give 14-days notice of action and join them? It would be the nuclear option.
🚨BREAKING: @theRCN members in England have voted to REJECT the NHS pay deal.
➡️54% voted to reject the offer, while 46% voted to accept.
RCN have announced that a 48-hour strike without derogations will take place from 8pm on 30 April to 8pm on 2 May.
19
46
450
101,203
No please....don't bring up bloody Nightingale hospitals again. How many times do people have to explain that it's not the beds, it's the staff. #HouseofCommons
5
54
408
I may be being uncharitable today but when I see appeals for volunteers to assist at mass covid testing sites in deprived areas, I just question why these can't be paid jobs given how much has been frittered away on management consultancies and the likes of Serco.
13
56
412
Just had it pointed out to me that the resident doctors' pay rise means that - for the first time - a doctor with 3 years of experience and 5/6 years of medical school will be paid more than a newly-qualified PA.
13
81
414
21,100
should be at the heart of any new roles in the NHS - a hurdle I don’t think some of the current job descriptions of PA roles or the reality of what they are doing addresses. In particular, I think PAs seeing undifferentiated patients in general practice without very close 5/n
3
45
394
43,655
There is likely to be a war of words between junior docs and the government in the run up to the strikes - and it may focus around what juniors are actually paid. The gov is likely to quote total pay and may conflate what different grades are paid - yesterday the BBC was 1/n
10
106
386
119,020
despite giving many months' notice. Think the answer to that one was - again - that they needed to sort out a swap. Juniors have little agency over their own lives yet are told they must somehow improve productivity. No wonder many are heading for Oz - wouldn't you? 3/3
10
39
390
12,669
This could become a very damaging dispute for a key trust. While it has to save money, the rates proposed are so low it is hard to see many docs accepting them: an F1 with a student loan would take home under £10 an hour for doing a shift on top of 48hrs normal working week.
Doctors to refuse overtime in major dispute with hospital trust ift.tt/Idhn9HQ
23
80
404
73,022
Will the minimum service guarantee for the number of docs on duty apply all the time? Like those nights when juniors are left in charge of hundreds of patients because there are gaps in their rota. Patient safety can be compromised by other things than strikes.
12
82
333
32,667
BBC giving false reassurance to patients. PAs don’t have to have a science degree/NHS work and currently they don’t have to be GMC registered. bbc.com/news/articles/c70r7d…
19
142
367
12,455
I'm shocked by how restricted some junior docs' leave is. Divided into blocks for each rotation (which can be just 4 months), can't carry forward if unused and can only be taken when on "normal" weeks (any when on nights/long days requires finding someone to swap with). 1/2
37
48
337
A month ago tomorrow I asked NHSE's press office how many graduating doctors had been left with an unallocated F1 position. I've heard it could be up to 1000 and some could only be told where they are going in July - less than a month before they are due to start work 1/2
9
94
304
212,612
Perhaps the most pressing IT need in the NHS - being able to get into computers quickly. How much of the NHS's "lost productivity" is due to this?
28
55
346
26,358
Your daily reminder that NHSE expects some first year doctors to hear where they are placed as late as 4 July (or even tba) and be ready to start work in this unknown destination w/c 22 July. Still no explanation from NHSE of how this has been allowed to happen. 1.n
16
122
297
144,123
I'm wondering at what point we need to start changing the message: "get yourself to hospital if you can" "it's better to carefully lift someone off the floor than wait hours for an ambulance" or - as Lucy Easthope says - "help isn't coming" buff.ly/49lZgxs
48
82
322
28,463
If anyone thinks things are going to quieten down now...the BBC has just stood me down from talking about junior doctors' strikes tomorrow morning because of the Huw Edwards story.
26
70
286
92,400
Junior docs need permits because they frequently rotate between hospitals - making it difficult to use public transport or live nearby. So why does a trust deny them permits?
26
35
280
71,498
weeks off consecutively even with swaps? Or get rotaed to work on a day when they are required to do mandatory training at another location and are met with blank stares when they question this? Heard today of another junior rotaed to work on the night of their wedding 2/n
4
32
275
24,497
How can trusts defend clinical negligence claims if major procedures are carried out by people without a medical degree, surgical training and, currently, professional regulation? Would anyone really have given informed consent to this? NHS Resolution must surely stop this.
Is the public aware that the person removing their gall bladder may have no medical degree, no medical training, no surgical membership exams - none of that?
Did anyone consent to this?
What an absolute travesty of informed patient care, as PAs now replace trained surgeons 🤷♀️
13
126
256
34,209
To follow on from this, I'm told there is a cohort who will find out what hospital they will be working in on 4 July. Their induction may start w/c 22 July leaving them 18 days to find a home. They will have applied as early as Oct. The NHS can surely do better than this.
A month ago tomorrow I asked NHSE's press office how many graduating doctors had been left with an unallocated F1 position. I've heard it could be up to 1000 and some could only be told where they are going in July - less than a month before they are due to start work 1/2
12
73
257
54,165
Just remind me how many years training resident docs have to go through before they run a clinic by themselves.
Independent PA-led surgery clinics at @AlderHey?!
More worrying details are emerging about the unsafe use of Physician Associates by @AlderHey
- Only three months on the job training before "flying solo"
- Replacing registrars and consultants
- Listing patients for surgery
8
71
244
17,097
Junior doctors rotate on predictable dates to known patterns of work so why does the NHS continually fail to pay them correctly? Getting less than expected in Aug's pay packet is a common gripe but does not seem unsolvable - so why does it continue?
18
27
246
46,238
Trust did not respond to questions around consent. I assume there is a strong audit trail showing how this was planned and risk assessed, and patients consented, before the operations went ahead? Should be FoIable.
10
58
231
30,085
Daughter in Africa has just spotted a Yorkshire Ambulance Service vehicle! Someone took a wrong turning?
16
36
251
What's the point of the NHS demanding new DBS checks each time an employee moves to a different trust however recently the one one was done? Costly and can delay recruitment.
38
20
234
55,903
I think Mr Meddings rather misjudges NHS staff if he thinks they would have acted differently if they knew who he was.
I’m the NHS chairman. My wife still had to wait all night in A&E
thetimes.co.uk/article/35ebe…
33
40
230
67,506
I simply don’t understand why so many NHS staff don’t get flu jabs.
Four in five staff in Oxford University Hospitals Trust not protected against flu ift.tt/EpY97Bm
28
17
238
53,557
These are very worrying misrepresentations of the level of experience and expertise PAs are likely to have. Who signed them off?
I’m simply horrified to see @NHSEngland now literally breaking the law in how it misrepresents physician associates & other allied health professional - who are NOT doctors - to the public.
These posters are from the Bradford District & Craven Health & Care Partnership. 1/n
7
58
209
13,266
The biggest barrier to doing more elective work is probably staffing. What are NHS managers meant to do - knit their own orthopaedic surgeons?
26
45
189
Job description for an apprentice PA working in general practice. All you need is a 2:1 or higher in a science-based degree.
70
73
214
318,372
And another. If @wesstreeting really wants to address some of the non-pay issues for resident docs, here's where to start: don't let the NHS make it impossible to be a parent and a doctor. (Remember these docs have little control over where they work and the shifts they have)
10
68
237
35,695
A reminder of why resident docs need parking permits. Not much chance of public transport at 2am on Boxing Day.
Christmas Eve: 12:00-22:00
Christmas Day: 16:00-02:00
Boxing Day: 16:00-02:00
New Year’s Eve: 22:00-08:15
New Year’s Day: 22:00-08:15
I really struck out on luck for my emergency medicine rotation over the festive period 😂 no family time for me I guess.
3
52
231
22,681
NHS staff are going to have a rough time persuading patients and hospital visitors they need to continue to wear masks/have LFT tests/observe PPE protocols when the message from gov is corona is no longer an issue and no protective measures are needed.
13
47
204
No, the NHS is not a job creation scheme. But it is the sole employer of foundation year doctors in particular. If you want people to shell out £100K in fees and living costs to get a medical degree, they need to feel there is a job at the end.
"I’m not running a job creation scheme; I’m running a National Health Service."
Ah, so he knows the NHS isn’t a careers fair… yet here we are, swapping real doctors for PAs, ACPs, and co.
Hope patients enjoy a round of medical roulette.
#AskForADoctor
mirror.co.uk/news/uk-news/we…
22
185
673
28,618
Daughter's comment (she currently has virus of unknown origin): "So Prince Charles can get tested and I literally work in A&E and I can't. FFS."
6
62
198
Parents fear spread of ‘associate’ doctors at NHS will end in more tragedies
thetimes.co.uk/article/1f4f5…
27
59
185
169,105
So Nigel Farage thinks docs have got it wrong on smoking. About as evidence-based as the rest of what he says.
3
152
186
Shocked to find that junior docs applying for specialist training get points fot doing lots of courses but are only funded by their trusts to do one. Disadvantages those struggling financially/with family commitments?
16
22
184
A 6% rise in the minimum wage (as suggested today) would bring it above the current Agenda for Change rate for band 2 workers such as some healthcare assistants. Remind me again, how much we value those working in health and social care?
14
31
193
20,640
The patient had a tension pneumothorax outside the operating theatre and went into cardiac arrest. The surgeon used a penknife to release it and the patient survived. Not clear where the nearest scalpel was and if the surgeon should have waited for one to be located.
11
15
190
103,204
Recovering covid-19 patients at Medway FT are being sent home with food packages to ensure they don't have to worry about shopping fot essentials for a while. All funded by community donations.
1
26
188
I think to get a MH admission nowadays you are pretty damn ill. There may be some people who are ready to leave but can't - often due to housing/packages of care ouside hospital not being in place. I think jobs are probably further down the line for many....
1
6
184
5,270
It seems to me something has fundamentally shifted in the "market" for doctors over the last few months. F2s left without training places, but few clinical fellow jobs and even fewer locums meaning an F3 year is no longer viable for many. Not sure I fully understand what 1/3
8
36
178
53,967
Good to see the Charity Commission stepping in after Marie Stopes paid its chief exec £434K. Wonder how many other charities dependent on NHS-funded work pay their chief execs more than any NHS organisation does? Perhaps I should do a story on this?
19
57
174
An NHS trust - not one of mine - is holding a board meeting tomorrow. The public have to submit questions which must relate to the agenda by 9am the day before. But the agenda and papers have not been published on its website....so no one can ask questions.
9
61
166
35,754
How can some NHS hospitals increase staff car parking fees by RPI each year when unions get criticised for using RPI rather than CPI in their pay demands?
7
31
165
12,695
Ruminating on how bizarre it is that train services are so dependent on overtime. But is it not also ridiculous that the NHS can't run unless junior docs work a 48 hour week? And the whole system is designed around this? I know the justification used to be that they needed 1/2
10
14
159
105,641
I've chased every few days since then but have still to get any numbers out of them. I'm having to resort to FoI to get the information. Meanwhile a lot of young doctors are wondering where they are going to be living for the next 2 yrs, what it means for relationships etc. 2/2
2
22
167
10,513
The way we treat the doctors of the future is beyond belief. These "placeholders" will start their first jobs in 7-8 weeks and still don't know where they will be based. That could be anywhere from Derby to Boston - so they can't sort accommodation until they know more.
4
65
163
16,369
Hearing that one trust is asking junior docs who are preparing to strike for proof of union membership. That's well out of order.
12
25
163
76,199
A 2 year pay freeze for public sector workers - floated in leaked gov docs today - is not going to go down well. It would affect many of the people being clapped for on Thursday nights.
24
68
164
350 new med school places in 2025-26: the bulk of the expansion of med students will come much later and some of these numbers are tiny. However, could someone in NHSE please note it means you need 350 more FY1 places in 2030. 1/2 hsj.co.uk/workforce/south-ea…
8
33
164
17,554
First Guardian of Safe Working fine at Sussex Partnership - for some poor junior who ended up working a 24 hour shift.
21
23
165
111,810
I know the "Clap for Heroes" movement is well-intentioned but I have not seen one tweet from an NHS staff member welcoming its return and plenty saying they really don't want it. I think its time has passed.
14
17
147
Apart from those in the military, I can think of no other sector where some staff are routinely told they need to uproot their lives - and those of family and children - and move somewhere else (or face a long commute after 12 hours days).
The more i think about post graduate medical training, the more absurd I think national recruitment is.
I'm thirty years old with a Dr partner, a family & friends & I want to buy a home & you're telling me I have to apply to "The UK" and take what I'm given.
14
18
147
39,709
Lots to bash UHSussex about legitimately but this BBC story did not deserve to be on its website front page. I read it yesterday and assumed this happened mid-operation in an operating theatre. It didn’t.
‘Key inaccuracies’ in BBC story about ‘penknife surgeon’, says trust ift.tt/jpqNwfO
9
23
157
41,461
NHS England talking of a tidal wave of flu hitting the NHS. Just a reminder that 50-64 year olds werre offered free flu vaccinations a couple of years back and this has now been dropped.
24
54
161
36,093
With so few effective treatments available to most people, not to mention the lack of support more generally, I'm not sure how vital early diagnosis of dementia is.
Early diagnosis of dementia is vital and quick blood tests have the potential to catch this condition sooner in thousands of patients.
That's why we are investing in world-leading trials to ensure any new treatment can be rolled out safely and rapidly.
thetimes.co.uk/article/thous…
15
12
153
43,350
Every time I read about the “value” of NHS data I think this is our data - it belongs to the patient and it should be their decision about how it is used.
8
27
146
9,327
How can GMC regulation of PAs go ahead before this reports?
Health secretary launches independent review into safety of physician associates buff.ly/40Qp1Ux #PAs #physicianassociates #NHSworkforce #patientsafety
6
44
160
9,417
Do I get the impression everyone is just a little .... underwhelmed by the 10-year health plan?
16
9
167
9,913
Gov is obviously pushing this figure. I don't think it is true for F1s (average well below £40K?) but worth remembering that they get these extra payments because they are working nights and weekends with an impact on time with family/friends/hobbies etc.
15
10
149
35,697
Hard to see where this dispute goes now. The juniors have a mandate until the end of Feb and not much sign of their support wavering. The ball is very much in the government's court now, whether they like it or not.
Junior doctors and consultants announce first ever joint strike dates ift.tt/E4xYfOl
7
23
136
50,211
This is a very telling graphic. People working in other sectors have also seen a drop in the real value of their pay but by nothing like as much. (Amb staff figs are affected by a rebanding of paramedics, I think)
7
73
138
16,978
When I see senior docs still praising trainees who come in on rest days and stay late to get extra experience (usually just watching an op) as showing "commitment" and being likely to "excel" I wonder which century they think it is.
4
5
141
17,737
The pay discrepancy between resident doctors and physician assistants really rankles and is part of the reason they are willing to strike.
6
69
162
9,259
How awful to refer to your own colleagues - who have no choice about rotational training - as "of no value" to the dept. Perhaps a period of reflection on how they are deployed and developed is called for.
You won’t be surprised to hear that the consultant surgeon who referred to FY1s holding “no value” when running a department, works at St. George’s.
The bastion of interdisciplinary work between PAs and doctors.
8
28
141
29,612
The insinuation that resident doctors work part-time to take advantage of locum shifts is ridiculous. Also no mention of impact on career progression/longer in training.
Quarter of junior doctors work part-time. thetimes.com/article/8fa5108…
18
30
161
62,112
There's a lesson in this thread: when a doctor says they wrote the (influential) paper on this condition and you are not medically qualified, it's time to stop arguing.
I’d be interested in knowing what it is in the 2yr PA curriculum which has made them silver bullet diagnosticians from day 1 after qualifying. Like what do they include that even MBBS 4+5 is missing. All I’ve seen from his matrix is less breadth and depth and less time learning…
2
20
150
10,317