🔴 NEW: IT blunder allowed PAs at Calderdale and Huddersfield to "illegally" prescribe drugs inc opiates and sedatives
PAs prescribed oxycodone, codeine, lorazepam, diazepam and midazolam, despite being "instructed they are not legally able to prescribe”
Last time I was in the office Jon offered to buy me a coffee cos he was going out. I’m a millennial so I asked for an oat flat white. Turned out that coffee shop didn’t have oat milk so he WENT AND BOUGHT OAT MILK and took it back to the coffee shop to make my drink. Honestly 🙏
I am overwhelmed by the wonderful things that have been said by so many online today.
Tha day comes when one has to move on - that day for me comes on December 31st. I had no idea of the appreciation of our work on Channel 4News - I am humbled by the comments from so very many.
🔴NEW: NHS England orders hospitals to stop using physician associates to cover doctors’ shifts after
@Telegraph
investigation reveals that the practice is widespread.
🔴NEW: Physician associates accused of‘illegally’ prescribing at dozens of NHS trusts and missing life-threatening diagnoses, dossier claims.
@TheDA_UK
’s survey of 600+ medics comes as
@TheBMA
says “still time” to stop “dangerous” PA regulation 🧵
EXCLUSIVE: Nigel Farage should face "highest penalty" for "serious breach" of MEP Code of Conduct according to leaked letter to EU President from Advisory Committee on Conduct of Members.
My piece on
@Channel4News
tonight with
@mattfrei
and
@AndyLeeC4
Ministers and NHS executives have repeatedly claimed that PAs and anaesthesia associates (AAs) are not being used to replace doctors.
But leaked documents seen by this newspaper found associates on doctors' rotas at 31 hospitals in England.
Today
@TheBMA
council chair Prof Philip Banfield has called on the Health Secretary to launch an “independent inquiry to uncover the full extent of what is essentially a patient safety scandal”.
“Only last month, NHS England’s national medical director, Prof Sir Stephen Powis,…
Whistleblowers claim that any substitution of doctors is a risk to patient safety, especially out of hours.
The roster for the Hospital of St Cross in Rugby reveals that today the “on-call cover anaesthetist” shift is being filled not by an anaesthetic doctor, but by an…
In response to our investigation, NHS England issued new guidance to all trusts this week which states that associates are “not substitutes” for medically trained professionals and should never be used as “replacements” on doctors' rotas.
The family of celebrated film and theatre make-up artist Christopher Tucker have urged that the coroner investigate his death amid concerns over his treatment by a physician associate.
A pioneer whose work inspired a new Oscar category, Christopher died aged 81 from urosepsis…
🧵The leaked document says:
- The UK does not have lab capacity to test all NHS staff & need to prioritise by clinical need
- Up to 80% of the UK population could be infected with
#COVID
ー19 in the next 12 months
- As many as 7.9 million people may require hospitalisation
As medics call on
@UKHouseofLords
to intervene on GMC regulation of PAs,
@Telegraph
reveals:
1️⃣ Doctors across UK claim patients’ put at risk by PAs who failed to respond appropriately to medical emergencies – alleging more than 70 instances of patient harm and ‘near misses’. 🧵
THREAD A
@Channel4News
exclusive from me and
@vsmacdonald
Leaked Public Health England document reveals why most frontline NHS staff won’t be tested for
#COVID
ー19 even if they have symptoms.
In response to our piece, PHE said: “currently no policy position has been agreed.”
@TheBMA
Despite only receiving two years’ training and being unable to prescribe, both PAs and AAs can be seen picking up similar shifts to medics, in some cases reviewing patients independently.
At 13 hospitals, doctors’ work appears interchangeable with those of associates, with the…
@TheBMA
Prof Banfield
@TheBMA
said that the evidence this newspaper has uncovered “appears to be the exact opposite”.
“Victoria Atkins has a duty to patients and a duty to medically qualified staff to establish how widespread this practice is and, more importantly, stop it,” he said.
@RCPhysicians
During the closed debate, college fellow
@djnicholl
reported a conversation with a doctor who had been told by a hospital manager that: “We don’t need to answer to anyone about using PAs on doctors’ on-call rota. We don’t need to answer to you.”
🔴 NEW:
@TheDA_UK
’s dossier alleges PAs used doctors’ log-ins without their consent to ‘illegally’ prescribe drugs.
@drmattuk
said practice “not only breaches legal and ethical standards but also endangers patient safety” 🧵
@UKHouseofLords
@Telegraph
@TheDA_UK
3️⃣ Surveyed doctors at 24 trusts in England claim to have witnessed PAs prescribing drugs and requesting ionising radiation – both would be illegal
4️⃣ At a third of trusts, they report seeing PAs introduce themselves as ‘doctor’ or not correct those who wrongly identify them🧵
Today
@TheBMA
launches PA and AA 'scope of practice' document. Family of Emily Chesterton, who died aged 30, after being misdiagnosed by a PA, in attendance. Chair Prof Banfield: “we had hoped that this was an isolated case. Sadly, when we've asked doctors, it is not.”
@DrPhilBanfield
At Dudley Group a junior doctor alleged PA missed “obvious heart attack” on ECG, having “just signed it as if it was normal”. They also “furious” at PA using their GMC credentials to prescribe: “When I confronted him he said, ‘Well, you're going to sign it for me anyways’.” 🧵
Medics also say having PAs on the doctors’ rota is inefficient.
At the ambulatory assessment unit in Oxford’s John Radcliffe Hospital, associates work shifts that had previously been assigned to doctors.
A senior medic familiar with the department said: “It generates more work…
Millionaire Brexit backer Arron Banks eagerly pursued a multibillion-pound gold deal brought to him by a Russian oligarch with links to the Kremlin just months before the EU referendum, Channel 4 News can reveal.
#TheBanksFiles
@UKHouseofLords
@Telegraph
2️⃣ At over half of England’s hospital trusts,
@TheDA_UK
’s survey respondents claim doctors being replaced by PAs on the rota, despite only completing a two-year postgraduate course. DHSC say their
role “is to support doctors, not replace them”. 🧵
The leaks show that 10 hospitals used PAs and AAs to fill gaps in the medic roster caused by sickness.
Nine used them as on-call senior house officers (SHOs) – junior doctors with at least one year’s experience – and two even gave them emergency “bleeps” to respond to…
King’s College Hospital in south London is the biggest tertiary liver transplant centre in the country – and its rota shows a PA working in place of an SHO doctor.
A staff member familiar with the service said: “The PA is definitely counted towards the minimum staffing of two…
NEW: CMO orders any patients with Danish travel history with ?Covid-19 to be managed in "strict isolation" and transfered to "a specialised infectious diseases centre" on testing positive. I'm getting "Wuhan novel coronavirus" deja vu with this
#mink
-variant Covid-19...
The revelations come as the
@RCPhysicians
continues voting on five measures that would curtail the scope and delay expansion of PAs proposed at a closed extraordinary general meeting on March 13.
@TheDA_UK
@TheBMA
@AndrewDLansley
@jfoster2019
@Fox_Claire
The medic, who also alleges they had to physically intervene to stop a PA writing a script, said: “we are talking about the sickest of the sickest children… major cardiac surgeries, multi-organ transplants.”
Trust confirmed PAs on Dr rota but investigating prescription claim🧵
⏳ On Mon Commons approved draft legislation to enable the GMC to regulate PAs. But
@TheDA_UK
and
@TheBMA
are calling for a last-minute intervention from the Lords. They want the order amended so PAs are regulated by the HCPC instead. 🧵
If all motions pass, Dr Nicholl told The Telegraph it would “call into question the sustainability of NHS England’s Long Term Workforce Plan” – under which associate numbers will increase almost fourfold to 12,000 by 2036/37.
🔴 Scrutiny of the PA role has intensified since last July when a coroner attributed the death of Emily Chesterton, 30, to the failings of the physician associate she consulted, but this is the first indication of the potential scale of the problem.🧵
At the Queen Elizabeth Hospital in Woolwich, London, The Telegraph found a PA working both on a non-doctor rota and taking a locum shift as a junior medic, which the trust described as rare and a last resort “to ensure patient safety”.
From August 2023 onwards, it is clear that a line in the rota for the acute medical unit at St George’s Hospital previously ring-fenced for “twilight” SHO doctors has been replaced with one for PAs. The trust insisted that PAs “do not replace our junior doctors”.
Many rotas seen by The Telegraph do not clearly distinguish between doctors and PAs, for example, by putting any credentials in illegible superscript, or omitting them entirely.
In response, NHS England has ordered all hospitals “to ensure that the full name and job title of…
EXC: ‘Anaesthesia associates’ recorded claiming NHS trusts let them ‘bend the rules' to carry out complex procedures normally reserved for doctors & give anaesthesia “unsupervised”.
@RCoANews
"do not support" assistants “enhanced” roles
@AnaesUnited
“There are times when the PA covers the long day-twilight on-call shifts, meaning that they are the sole staff member covering that sub-team out of hours. There is also no senior on site during those hours, meaning that the PA must ask members of other teams to prescribe for…
BMA chair
@DrPhilBanfield
: "Regulating doctors and non-doctors together is potentially dangerous, as it increases the risk of patients mistakenly believing PA care equals doctor expertise. It does not.” One Dr alleged PAs misdiagnosed patient’s metastatic cancer as muscle ache🧵
@TheDA_UK
@TheBMA
@AndrewDLansley
@jfoster2019
@Fox_Claire
DAUK’s
@drmarttuk
: “despite being introduced to alleviate the burden on doctors, the survey reveals that PAs have done the opposite.” At Birmingham Children’s Hospital a doctor said they felt “very unsafe” when 1 of just 4 medics covering wards at night was replaced by a PA. 🧵
In nearly all circumstances, it is a serious criminal offence for anyone other than a doctor, dentist, pharmacist or vet to supply controlled drugs under the Misuse of Drugs Act 1971. The Telegraph understands that the trust has not referred any of the PAs involved in this…
@TheDA_UK
@TheBMA
📣 Peers incl.
@AndrewDLansley
have voiced concern at The Tel’s findings, with two intending to raise them in Parliament.
@jfoster2019
said dossier was evidence PAs “should not be licensed with the GMC” while
@Fox_Claire
said change “much bigger than [ministers] are letting on”🧵
Ana Diamond, a 24 year old London student, was psychologically tortured for EIGHT MONTHS in the same Iranian prison where Nazanin Zaghari-Ratcliffe is STILL held
#FreeNazanin
@IAmAnaDiamond
tells
@Channel4News
’s
@LindseyHilsum
why she’s speaking up now
@DrPhilBanfield
Dr claimed PAs in GP repeatedly missed the cancer, despite blood results “tantamount” to a cancer diagnosis. “The patient could have been saved eight months of pain; their life could have been prolonged” DHSC: “while these incidents are rare, any harm caused is unacceptable”🧵
In 10 hospitals,
@TheTelegraph
found that PAs counted towards the minimum safe number of medics on shift.
NHS trusts have a legal duty to provide enough suitably qualified staff to meet patients’ needs, but there is no set formula to calculate the required doctor-patient ratio.
EXCL: Anorexia patients may be given palliative care not eating disorder treatment, leaked NHS guidance reveals.
@carolinenokes
says guidance not endorsed by
@rcpsychEDFac
is “horrifying”.
@AgnesAyton
calls for “alarming” document to be repealed.
While at Salford Royal in Pendleton, an associate covered shifts in trauma and orthopaedics when the SHO caught Covid.
The hospital said this was “unplanned help”.
@drmattuk
@TheDA_UK
@gmcuk
Solicitor Sean Caulfield
@hodgejonesallen
explained that: “If a PA has innocently carried out acts of supplying controlled drugs, which they were not authorised to do, it might not be in the public interest to prosecute them.
“However, if anyone, PA or otherwise, intended to…
@DrPhilBanfield
DHSC said “patient safety is paramount” & will be ‘boosted’ by regulation & GMC will “operate strict fitness-to-practice procedures & set education & training standards.” They & NHS said PAs should be supervised & work within scope of practice, which excludes prescribing.
An NHS England spokesman said their new guidance is in addition to the NHS’s expectation that PAs and AAs should work “under the supervision of a doctor and within the scope of their practice”.
Trusts told this newspaper that their associates have a named consultant supervisor…
But the letter NHS officials Prof Powis and Dr Evans sent to all trusts this week states: “It is important to emphasise that PAs are not substitutes for doctors; rather, they are specifically trained to work collaboratively with doctors and others as supplementary members of a…
Addressing The Telegraph’s findings, a health department spokesman explained there is an expectation for local services to adhere to national policy.
“We have been clear that the role of associates is to work with doctors, not to replace them, and we expect healthcare…
Conservative peer Baroness
@jfoster2019
said the “practice of PAs illegally prescribing” uncovered by The Telegraph adds to concerns already raised about the risk that PAs pose to patient safety. 🧵
@drmattuk
@TheDA_UK
@gmcuk
@hodgejonesallen
@natalieben
The
@TheBMA
wants the draft legislation to be amended so that the Health and Care Professions Council have oversight of PAs instead of the GMC, claiming licensing doctors and non-doctors together “increases the risk of patients mistakenly believing PA care equals doctor…
Expectation: Hancock's "protective ring" around care homes
Reality: 23 residents dead from ?
#Covid_19
in the care home where Mona Da Gama's (
@liveinlondon99
) mum lives.
Promised tests STILL not arrived.
On
@Channel4News
Mona tells Hancock: Send tests NOW, before any more die.
@drmattuk
@TheDA_UK
@gmcuk
@hodgejonesallen
At the debate next Monday, Green Party peer
@natalieben
, who filed the 'fatal' motion, said she will be “begging the Government to go back to the drawing board to find a different way forward that has the support of medical professionals, communities and patients”. 🧵
HERE:
@Channel4News
exclusive from me and
@vsmacdonald
Leaked Public Health England document reveals why frontline NHS staff may not be tested for
#COVID
ー19 even if they have symptoms
@drmattuk
@TheDA_UK
On Monday, peers will debate a 'fatal' motion that could derail government plans to bring PAs under
@gmcuk
. Allowing them to be regulated by the GMC could lead to PAs later being given the authority to prescribe drugs.🧵
The Tel has previously published allegations from doctors at 24 trusts who alleged that PAs had illegally prescribed drugs and ordered scans with ionising radiation (data from
@drmattuk
@TheDA_UK
). But this is the first time an NHS trust has admitted to inadvertently giving…
I’ll share more details from tomorrow. For now I’ll add that Baroness
@SalBrinton
intends to raise the “extremely worrying” details of Christopher’s case at the HoL debate on Monday saying they “provide yet more evidence why the government’s proposals risk undermining patient…
3⃣ The Trust’s patient safety incident investigation found the PA was not responsible for any errors, & that even if a urology doctor had been available, it was "unlikely" his treatment would have changed
Eight senior doctors who examined the PSII told
@Telegraph
they disagreed
FOI response revealed that from July 2023 to January, PAs accidentally given access to the prescribing system, making 22 drug prescriptions. Trust insisted no patients were harmed & “a hard control has now been implemented to prevent any further PA prescribing incidents”. 🧵
@drmattuk
@TheDA_UK
@gmcuk
@hodgejonesallen
@natalieben
@TheBMA
Baroness
@SalBrinton
, the former Lib Dem health spokesman, who also opposes GMC regulation of PAs, said the “very worrying” incident raised serious governance questions: “There are very senior clinical managers in the hospital trust who should have been all over this.” 🧵
4⃣ Four urology specialists said they would have rescheduled Mr Tucker’s procedure due to his high risk of “life-threatening” sepsis
FWIW a further five urologists I consulted came to the same conclusion.
One directed me to this article:
@UKHouseofLords
@SalBrinton
📢CALL OUT to patients, doctors and all NHS staff: to keep this investigation into patient safety at the top of the news agenda, I need your help.
📧 Anyone reading this post can direct message me on ‘X’ or send me an email on Janet.Eastham
@telegraph
.co.uk🧵
9⃣Having previously declared him fit for discharge, on Dec 12, the day of his cystoscopy appointment, staff noted Mr Tucker’s rapid, shallow breathing and “worsening” bloods.
The last entry on his notes before the procedure recorded elevated infection markers. His “bloods trend”…
🧵In response Public Health England told us: ”We won’t comment on the contents of a leaked document. This document is subject to ongoing discussion on proposals being developed with the Department of Health and Social Care and currently no policy position has been agreed.”
Calderdale and Huddersfield NHS Trust would not confirm whether any PAs who prescribed these medications without legal authorisation had lost their jobs as a result.
A spokesman said they “fully understand the prescribing rights for different parts of our workforce” and…
Brave whistleblowers. A trail of data. A secret system for dealing with allegations of child abuse.
Subscribe to the
#CallBethel
podcast to follow the
@Telegraph
investigations team on our year-long hunt into the Jehovah's Witness organisation.
🎧➡️
Leaked PHE “Easter 6 Investigation” circulated to ministers that exposed “rampant”
#Covid_19
in study care homes despite “stringent infection control practices”.
🦠~40% residents Covid+ (half asymptomatic)
🦠~20% staff Covid+ (1 in 5 symptomatic)
DHSC said GMC regulation of associates had “cross-party support and will boost patient safety” and that the council “will operate strict fitness-to-practice procedures and set education and training standards.”
They added that the role of PAs is “to support doctors, not replace…
6⃣ Tomorrow peers will decide on
@natalieben
's motion that could derail Govt's plan for GMC regulation of PAs
@SalBrinton
intends to raise “extremely worrying” details of Christopher's case in debate as “yet more evidence why Govt's proposals risk undermining patient safety”
7⃣ There are concerns about the objectivity of the Trust's internal investigation, given the name of the physician associate on the 'review team' matches the initials of the PA who gave medical notes to the probe.
It is understood that the PA who co-authored the review, and has…
MON: Concerns from 600+ medics continue to raise concern in
@UKHouseofLords
. Former Lib Dem health spox Baroness
@SalBrinton
said promoting PAs “sounded like a sensible proposal” a couple of years ago, but “what has panned out is just absolutely not what we understood then”. 🧵
🔟 Last month, Dr Janet Lippett, the trust’s CMO, told BBC Radio 4 that senior doctors “are always available for [PAs] to discuss cases” – and a hospital spokesman reiterated this “stringent supervision”.
But
@drmattuk
co-chair of
@TheDA_UK
, who debated Dr Lippett on the…
2⃣Christopher died aged 81 from urosepsis at Royal Berkshire Hospital, less than 48 hours after a PA performed a cystoscopy despite signs of infection
The PA afterwards failed to document the need for antibiotics or to request them from the ward doctor
Marion: “As a teacher, retired teacher now, I've worked alongside many fantastic teachers and teachers’ assistants — they are not known as pedagogues’ associates, for obvious reasons.
“Keep it simple —say what they are.”
Tune in tomorrow evening to see
@C4Dispatches
expose the Britain's university spending scandal feat. the 100000s of receipts I've waded through over the past 5 months 🤓
#dispatches
#USSstrike
8⃣ Christopher’s niece, Catherine Tucker, a professor at Massachusetts Institute of Technology, said it contained a “shocking amount of prevarication, extraneous information, a lack of transparency, a lack of plain language – and then the thing that really killed him was missed…
Hello! I’m looking to speak to people with disabilities and chronic health conditions - who live in supported living - about access to healthcare during the pandemic.
If you have experience of this, please do message me on here or email Janet.Eastham
@itn
.co.uk
#journorequest
Also GMC: The attached table, correct as at 17 December 2020, shows the number of licensed doctors falling into each conviction category and also the overall number of unlicensed doctors identified by a search (this includes doctors who are registered but not licensed and also…
Today, an independent tribunal of the Medical Practitioners Tribunal Service has suspended Dr Sarah Benn’s registration for a period of five months.
Dr Benn was referred to a tribunal because in 2022, she breached several court orders, which amounted to contempt of court, and as…
1/9 On
#Channel4News
@alextomo
tells us the
#frontlinestories
of key workers who feel invisible
The refuse collecters, shelf-stackers and bus drivers who keep the UK ticking over in lockdown
One cleaner told us: "Every day I am going to work, risking my life, for £9.41 an hour"
Supervision in GP is critical, says
@HelenRSalisbury
: “the main problem is about unknown unknowns. If we allow [PAs] to only come to us when they think there is a problem, sadly, mistakes are going to happen.”
Whether or not sex work is empowering is irrelevant. What definitely isn’t empowering is having benefits sanctioned, having no access to housing or drug and alcohol services, being fined or arrested for just trying to get money to feed your kids.
Michael
@profmsharpe
, I’d like to ask you a bit more about this. Extreme suffering sharpens one’s sense of what is important in life; and I think what we have seen is that many
#MEcfs
patients feel the most important thing, for survival, is scientific progress.