Freelance journalist covering the health service - southeast & ambulance for HSJ. Not fond of authority whoever's in power. DMs open Alison.Moore
@hsj
.co.uk
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
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?
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.
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.
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.
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?
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
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
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
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.
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
🚨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.
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
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.
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
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
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
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.
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
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.
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?
Car park at my hospital has decided to put the barrier down to non permit holders
Junior doctors can’t get permits
When asking the attendants where I CAN park for my WORK:
“No idea. Try your chances on a double yellow maybe”
Ideal working conditions
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
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?
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.
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
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.
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?
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.
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?
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.
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?
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
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
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.
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.
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.
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.
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.
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)
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.
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.
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.
Unbelievable that there is not much political noise about this - and very little from
@wesstreeting
or Labour. No exaggeration to say these problems are killing people.
An app that can help patients find the shortest A&E queue & help relieve pressure on A&E staff. Good for patients, good for clinicians. Another step forward in the NHS tech revolution
DHSC making the case that NHS staff get a lot of other benefits as well as pay - but is fair to include these as part of their "total reward"? Journos occasionally get free lunches (or at least biscuits) but we would not be happy if it was used to argue against a pay rise!
£99! For a jab that has been produced in hundreds of millions, if not billions, and presumably has enormous economies of scale. And the groups eligible for free jabs are being cut back.....not even health and social care workers this time round. 1/2
"Covid-19 jabs will be sold on the high street for £99 from next week, as Boots becomes the first major pharmacy to launch a private vaccination service."
The Telegraph revelations are bad for Matt Hancock and those around him - and particularly Simon Case - but I’ve not read anything which makes me think lockdown was fundamentally the wrong decision.
These graphs are *terrifying*👇
It all feels a bit like the MMC/MTAS debacle all over again
So important that we open up sufficient training numbers to fill workforce shortfalls *and* ensure those not in formal training get mirrored T&Cs
Just had it confirmed that my FoI request for performance of a clinical contract against KPIs requires a panel to determine it because of potential commercial interests issues. If that's the case, I think accountability in the NHS can pack its bags and go home.
Unexpected transparency from trust phone switchboard.
"Can I speak to the chief executive's PA please?" "You can but I have never known her pick up the phone."
Can't we just move Christmas to Easter? Celebrate then when elderly and vulnerable have been vaccinated and hopefully pubs and restaurants are open. Have a quiet Dec and try to get numbers down....
Junior docs had a rough pandemic: redeployed with training interrupted, often not able to progress in their chosen field, working extra hours & some living apart from families so as not to put them at risk. It seems churlish not to have offered them something in the pay round.
So how many other trusts have declared a critical incident without telling the public/local GPs like Lincolnshire? DMs open and anonymity guaranteed, as always.
Just been sent another advert for a Deputy Chief Nurse open to those without registration qualifications of experience as a nurse.
I would not recommend working in an organisation that did not value professional knowledge (of any professional group)
Its a red flag 🚩🚩🚩🚩
junior docs’ work mean they can’t do normal things other people can such as take on a regular commitment in the evening or weekend or take holiday when they want (eg can’t take time off if on nights). Their working week is normally the equivalent of 6 days.
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.
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
I'm not surprised that many juniors choose to locum or take a year off after their foundation years - they will have struggled to get even a two week holiday during this time. Lots of leave taken in 2/3 day slots - not much of a break 2/2
So to be crystal clear. While literally hundreds of my colleagues up and down the country have been unable to secure anaesthetic jobs or progress in their career, the RCoA took £1.8 MILLION to expand associate replacements.
This is very sad and a harsh reminder of what the last two yrs have done to many NHS staff. We are only just beginning to understand the impact of long covid and working through a pandemic on frontline staff but
@mancunianmedic
won't be the only casualty.
So, when everyone's fuel bills go up by £800 a year in October, what are the NHS's plans to retain staff who will be desperate to earn every extra pound they can?
If PAs are doing invasive procedures such as vein harvesting and the patient has not consented to their involvement, it is surely assault? And should something go wrong, the trust would struggle to find a defence to any claim…..
Safety fears as non-medical staff / PAs learn neurosurgery ‘on the job’ from medical secretary via a two year's PA masters to amputating limbs- with no medical training and no surgical training
What is happening to medicine in the uK? The last time…
The AstraZeneca vaccine/blood clots issue in Europe is one of the worst examples of the application of the precautionary principle I can recall. Pretty clear there's no evidence of an increased risk of blood clots yet people will have to wait longer for a life-saving vaccination.
The NHS pay deal - now certain to be accepted by the staff council - embeds a real terms pay cut of about 6% from 2023-24. The lump sum brings pay roughly into line with inflation but only for 2022-23. The starting point for 2023-24 is 6% lower.
I am hearing (reputable source) that at least one national media is monitoring NHS staff's social media accounts to try to find examples of failures to socially distance/abide by rules. Do be sensible in how you behave and what you post.
I genuinely feel sorry for most PAs in the current furore over their role. I think some are being misled about how rigorous their training is. But those who produced this seem to believe they are trained to an equivalent level as GPs: they aren’t.
The stories of sexual assault are horrifying - but so is the burden of travelling to different hospitals to get experience. Do docs feel the different experience they get is enough to justify travel time and tiredness/impact on relationships?
Think she is wrong on this. So many NHS staff say they waste time logging on that it must impact on patient care through dimished productivity. Just because a policy comes from Matt Hancock does not make it wrong.
Matt some of the biggest complaints from NHS staff are lack of beds, crisis hit A&E departments, not enough doctors and nurses, waiting lists too long, operations cancelled. Whilst taking ages logging on might be a concern let us concentrate on main priorities for the NHS 👍
#NHS
It needs to be shouted from the rooftops that the Brazilian who sadly died "on the Oxford covid drug trial" received the placebo not the vaccine. Was too low in the BBC story and many people will just read the headline.
Not many CEOs would speak out like this. Perhaps more should because the NHS is heading for a long and damaging period of strikes which ultimately will harm relations with a key group of staff.
Longest strike in NHS history begins today. Another c2,000 ppl added to our waiting list, at a cost of £1m-plus.
Our junior doctors are deeply unhappy with pay. They’re our future medical leaders. We have no NHS without them.
If Scotland can get to the table why can’t we?
This is MP
@PhilipDaviesUK
. Much like the rest of the Tory party, he hates doctors. However, it seems he hates them even more than his other crony friends. The tweet below is a reply he sent to a doctor who sent him the BMA letter asking him to support the strikes.
Don’t get excited about today’s new hospitals money until you know 1. Are these new projects or ones with funding already announced? 2. Is this new money? 3. What will happen to the rest of NHS capital spend? 4. Timescale. 5. How funding will work. Expect smoke & mirrors
BREAKING: amb response times for October are out and are, frankly, horrific. Cat 2 calls - which should be responded to within 18 mins - are at nearly 54m. This is emphatically a position which is causing patient harm.