But they didn't just abandon Drs They abandoned the PAs who they spent the past decade lying to. And now we have a cohort of graduates facing anxiety around job losses while College Leaders clink wine glasses in Grand Halls congratulating eachother for a job well done Cowards

I don’t want you putting any of my loved ones under anaesthesia Even with that additional information Because it’s dangerous and my choice. As a medic And a person. Throwing acronyms at me makes little difference - esp when I know what “instantly available” in the NHS means Hope that’s ok. You can’t force me or anyone else to see a non doctor when we don’t want to.

Expert healthcare costs money Colour me shocked

If a time based assessment is there to differentiate candidates, then the time part is important Either everyone should have the same time, or it's giving some people an unfair advantage Extend time for all, or don't for any

Just three years ago we had doctors on £29,384 per year by the way.

Charlie Massey told @LaylaMoran that Royal Colleges set scope for PAs because the @gmcuk don’t have the clinical expertise to do so . Why then, were no Royal Colleges represented on the anonymous Clinical Advisory Group ? @parthaskar @thomasdolphin @trentconsultant

Back in 2010, the minimum wage was £12,064 and the 'higher earner' band started at £43,875. You only paid 40% tax once you were earning 3.6x the minimum wage. There was clear incentive to progress, learn and aspire for more. As things stand, you now start paying 40% tax once you earn £50,270 which is just 1.83x the minimum wage. If it was the same multiple as 2010, the 'higher earning' band would be £98,841 and everyone below this amount would be paying 20%. Someone on £98,841 is effectively losing out on £9714.20 net per year if the bandings had simply moved in line with previous multiples relative to minimum wage. This is one of the reasons why the middle class is being eroded and why there's a cost of living crisis in the UK.

You can replace doctors on a rota; you cannot replace their clinical expertise. The true costs emerge in missed diagnoses, delayed treatment, and preventable mass harm. Patients pay the price. In two currencies: cost and lives.

I love the great rewriting of history that is taking place around PAs

Teaching on a course yesterday where a candidate reminded me of a time (10 years ago) when I saved a patient’s life by decompressing a tension pneumothorax via the scrotum. Find THAT in the guidelines or protocols for noctors.

I told you @BBCHughPym There is more to this than just ADHD 360 Check out her other company links at companies house CIOs all over the place find-and-update.company-info… @YvetteCooperMP @FT @Smyth_Chris

Jason Arday’s plagiarism attracted a total of 249 articles, which led to his death. Michael Gove’s own girlfriend was charged with possessing indecent images of children, yet the media remain silent. Gove wrote about Arday AFTER her charges. THIS IS FUCKING OUTRAGEOUS!

A draft clinical protocol for Physician Assistants has been shared with us for our feedback. We will be responding with our view that it does not provide sufficient safeguards for patients, and risks undermining residents’ training. 1/5

This whole episode has been quite stressful. But it does clarify that not one but TWO regulators do not think that the use of the term 'noctor' (not-a- doctor) meets the bar for a full investigation. It is NOT inherently derogatory of offensive. bmj.com/content/bmj/394/bmj-…

A senior doctor (GP) suspected this child had acute appendicitis..an easily treatable condition but one that every medical student understands can't be missed and can kill..he was appropriately referred but never saw another doctor...he's dead..this should be a never event!!

THIS KEEPS HAPPENING…..a child should never be discharged from hospital without seeing a doctor. NEVER👇

I'm being generous to many people here but the coming crisis (we have not seen anything yet!) with workforce substitution & lowering of healthcare standards has some roots way back in the sheer desperation of some clinicians (esp A&E) that hands on deck was all that was needed 1/

Nine year old Dylan Cope died from sepsis. His GP had suspected appendicitis and sent him to hospital. A paediatric nurse practitioner assessed him in A&E without reading the GP’s referral. His abdominal pain was attributed to flu and he was discharged without a documented examination by a doctor. The coroner concluded that his death could have been avoided. Dylan’s family have suffered an unimaginable loss. As a doctor working in general practice, what stands out to me is that his GP had recognised the possibility of appendicitis and referred him for further assessment. That concern needed to be heard and acted on. When we refer a patient with a suspected serious illness, we need to know that the concern prompting that referral will be properly assessed. A different diagnosis may emerge, but the referral’s findings must be considered before a patient is sent home. Dylan’s father told the inquest that he believed the practitioner assessing his son was a doctor. He also repeatedly raised concerns about appendicitis. Families deserve clarity about who is treating their child and to have their concerns heard. This case raises serious questions about how referrals are handled and when an examination by a doctor must take place. Employers must ensure that supervision arrangements translate into the assessment a patient actually needs. There is also a wider discussion about advanced practitioner roles. The BMA recognises their valuable contribution within healthcare teams. It calls for nationally agreed limits of practice and clear supervision requirements, with advanced practitioners supporting medical teams rather than replacing doctors on clinical rotas. Its position is that they should not independently diagnose or manage patients whose underlying condition has not yet been established. I support those safeguards. Clear responsibilities protect patients and support staff to practise safely. Dylan’s parents are asking for children referred to A&E by a GP with suspected serious illness to receive a documented, face to face examination by a senior doctor before discharge. That is a call we should take seriously. They should not have had to lose their son to ask for it. telegraph.co.uk/news/2026/10…

Dylan Cope’s parents, in their own words, recount the devastating loss of their son. No family should have to fight to learn who treated their child. No family should need to battle a healthcare system for basic competence. Stop the substitution, NOW: piped.video/G542cOwZHqM?is=m1Z1…

RT @Telegraph: Dylan Cope, nine, was discharged from hospital after being wrongly diagnosed with flu 🔗 telegraph.co.uk/news/2026/10… https://t.c…

Doctor substitution is being championed at the highest levels yet anyone with a grain of common sense or integrity knows it’s nonsense I wonder what platitudes @theRCN or @RCEMpresident would offer these parents given their involvement in enabling this scenario?