Richard Marks - London Anaesthetist @LondonAnaesth Twitter profile

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Richard Marks - London Anaesthetist

@LondonAnaesth

4 months

@RishiSunak You have brought shame and disgrace on the country and the electorate will teach you a lesson you will never forget.

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Richard Marks - London Anaesthetist

@LondonAnaesth

1 month

@gmcuk Until relatively recently the doctors sitting on GMC council were elected, not government appointees. Perhaps your archivist could add that, to highlight the change in culture which that signifies.

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Richard Marks - London Anaesthetist

@LondonAnaesth

3 months

@Councillorsuzie Making the overground lines easier to navigate is not pointless virtue-signalling, nor is it mayoral PR. It is making public transport easier to use and more accessible to use, especially when the current overground map is so confusing.

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Richard Marks - London Anaesthetist

@LondonAnaesth

10 months

Anaesthetic Recruitment 2021. The one where they told people they had jobs, then told them they didn't. The one where they got the 'rank' and 'score' values muddled up on a spreadsheet. We found out how it happened.

The mistakes in Anaesthetics Recruitment in 2021 - where did it go wrong? ..

In Autumn 2021 applicants for Anaesthetic training posts were hit by a series of errors. These were so serious that a Significant Incident Review was convened to find out what went wrong. Now, after...

www.schoolofanaesthesia.co.uk

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Richard Marks - London Anaesthetist

@LondonAnaesth

1 year

@NHS_HealthEdEng Greatest achievement of HEE is that they look like an employment agency, they act like and employment agency but they don't adhere to the laws governing employment agencies.

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Richard Marks - London Anaesthetist

@LondonAnaesth

5 months

@NHSE_WTE If we really and truly wanted to take the crisis in medical manpower numbers we'd look at retention of the staff we currently have

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Richard Marks - London Anaesthetist

@LondonAnaesth

7 months

When I trained - in the 1970s - the overriding priority for both junior and senior surgeons was to be in Theatre. Because thats where the learning takes place. Both on surgical technique and surgical pathology. "...[PAs] role in theatre frees up time for other activity…

Norfolk and Norwich University Hospitals

@NNUH

7 months

@Claps7597393932 @Xeon4f145d96s1 Hello, please see the attached statement

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Richard Marks - London Anaesthetist

@LondonAnaesth

6 months

The GMC is a registered charity, and its charitable objects are 100% tied to registered medical practitioners. Yet for several years they have been spending money on activities for non-medical practitioners. Astonishing, really.

Anaesthetists United

@AnaesUnited

6 months

Does regulating physican and anaesthesia associates breach the @GMCUK charitable objectives? We are writing to them to seek clarification. Co-sign the letter here:

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Richard Marks - London Anaesthetist

@LondonAnaesth

7 months

Recruitment for doctors-in-training - impersonal, centralised, anonymous, miserable. Recruitments for Associates-in-training - parley with our mateys and see to it they land the job. Why the inconsistency @NHSE_WTE ?

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Richard Marks - London Anaesthetist

@LondonAnaesth

3 months

It could be Game Over for national recruitment, following the Department of Business and Trade decision that, in their view, ANRO must comply with Employment Agency legislation

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Richard Marks - London Anaesthetist

@LondonAnaesth

7 months

As a matter of fact, Physicians Associates are not actually doctors-in-training @FBMH_UoM

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Richard Marks - London Anaesthetist

@LondonAnaesth

7 months

"Doctor of the week" certificate awarded to Physician Associate by a Head of School Of Medicine, Associate Dean and Director of Training for @RCPEdin Not wishing to criticise the award recipient in any way, but does @RCPEdin accept a PA can receive 'doc of the week'?

Dawn Ashley

@dawnashley13

3 years

Eau doctor of the week, Hannah, our physician associate. Extremely competent, good independent decision making, dependable and very well respected @NTeesHpoolNHSFT @MADEinHEENE

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Richard Marks - London Anaesthetist

@LondonAnaesth

7 months

An amazing night for UK anaesthesia. Especially pleased that the motion I proposed on regional recruitment were supported, thank you to all the members that voted for it.

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Richard Marks - London Anaesthetist

@LondonAnaesth

2 months

@LordPhilofBrum The NHS has placed two groups of workers alongside one another with overlapping roles but very different backgrounds, and after 20 years it still hasn't defined their working patterns. Absolutely dreadful people-management by those at the top.

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Richard Marks - London Anaesthetist

@LondonAnaesth

7 months

@Dr_Done_ @SheffieldHosp @MajorKirsten1 Everyone better behave, they're watching us; but once they heat is off its back to business as usual, me hearty lads, says Captain Pirate on his 'plucky little sailing ship'. Back to unsupervised practice? Where are the CQC when you really want them? @CQCpressoffice

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Richard Marks - London Anaesthetist

@LondonAnaesth

8 months

@PeteDeveson @lifeoftazza Delegate Exit

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Richard Marks - London Anaesthetist

@LondonAnaesth

8 months

Lancaster University part-time diploma to become a qualified Anaesthesia Associates. (PGDip AaPOS). Cost per year £6,500 funded by the NHS. Why is the NHS funding this? What's going on?

Anaesthesia and Peri-Operative Sciences PgDip - Lancaster University

Find out more about studying Anaesthesia and Peri-Operative Sciences PgDip at Lancaster University

www.lancaster.ac.uk

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Richard Marks - London Anaesthetist

@LondonAnaesth

3 months

The difference between a doctor and a technician is that the doctor looks at the whole patient not just the submucosa.

Dr Matt Kneale

@drmattuk

3 months

Family of film make-up artist call for inquest after treatment by physician associate which led to death. @JanetEastham @TheDA_UK @TheBMA

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Richard Marks - London Anaesthetist

@LondonAnaesth

5 months

@ShaunLintern Would you say that creating an entire cohort of healthcare workers without first defining their role, and creating ambiguity as to whether they are autonomous practitioners or fully-supervised assistants was reckless?

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Richard Marks - London Anaesthetist

@LondonAnaesth

4 months

@Assoc_Anaes Association of Anaesthetists ... "believes that AAs should be supervised on a 1:1 basis..... guidance should take account of those who are not content to supervise AAs". Is this the beginning of the end? Surely with 1:1 supervision they cannot be economically viable.

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Richard Marks - London Anaesthetist

@LondonAnaesth

3 months

@mark_toshner Placing two groups of workers side by side with radically different backgrounds and unclear demarcation of roles is something that only a particularly rotten employer would do. NHS senior management should hang their heads in shame.

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Richard Marks - London Anaesthetist

@LondonAnaesth

2 months

This thread nicely summarises the wrong that has been done to our trainees by the introduction of Associates. Undermining them, undercutting them and giving them a professional identity crisis. What sort of an employer would do this to its valued staff?

Rosie C 💙

@gaswomancometh

2 months

My perspective on AAs; a 🧵 I was an ANP before medical school and am now a specialty doctor in anaesthetics. I work with 2 qualified AAs who are excellent, I am often asked for my opinion given my background, so here it is a long thread including my own story.

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Richard Marks - London Anaesthetist

@LondonAnaesth

7 months

@BMA_JuniorDocs @TheBMA Excellent statement from BMA juniors. Could the BMA Consultants and SAS doctors also issue their support for this initiative.

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Richard Marks - London Anaesthetist

@LondonAnaesth

11 months

@DrMattThomas1 Rotational training is a historical relic from a time when there was free doctors accommodation. Now itsju st part of a depersonalised and harsh recruitment system, with very little clinical/educational benefit (except in a few subspecialties), and is a major source of stress.

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Richard Marks - London Anaesthetist

@LondonAnaesth

6 months

The role of PAs and AAs needed to be defined before they started recruiting applicants who were led to believe the job was "like a doctor but without going to medical school". The current expansion, before regulation and scope planning, is badly judged.

Gemma Lewis

@gem1509

6 months

There's a place in the NHS for the PA role but not at the expense of fully trained, specialist medics. Bringing PAs to join the NHS now is like trying to train firefighters in the middle of a Californian wildfire.

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Richard Marks - London Anaesthetist

@LondonAnaesth

7 months

Failure to define what PAs should be doing is central to our current dilemma. The recent @RCSnews statement said they must be 'implemented appropriately' then failed to define what that means. More clarity needed asap. #MedTwitter

RCS England statement on Physician Associates and the extended surgical care team — Royal College...

We are aware of the concerns expressed by our colleagues regarding the current and planned expansion of non-medically qualified roles, which will inevitably affect the surgical team. We share...

www.rcseng.ac.uk

Dr Done

@Dr_Done_

7 months

Physician’s Assistants should to the following jobs, and the following jobs only: - Discharge letters - Cannulas - Bloods/NGs/Catheters - Create patient lists - Scribe on ward rounds That would really assist the physicians.

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Richard Marks - London Anaesthetist

@LondonAnaesth

3 months

What is especially concerning in this paper is the reference to Trusts paying higher salaries to Associates than NHS Health Careers suggests. @PeriopMedUCL are mentioned as an example Where is this money coming from? Is the magic money tree being used…

Anaesthetists United

@AnaesUnited

3 months

The current working model for Anaesthesia Associates is not financially viable. To make economic sense either the level of supervision by Doctors needs to be reduced, likely to compromise patient safety, or the AA programme itself should be terminated.

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Richard Marks - London Anaesthetist

@LondonAnaesth

4 months

The lack of clarity on what Associates can and cannot do is astonishing. How have we allowed this to happen?

Anaesthetists United

@AnaesUnited

4 months

Did you know that on Thursday the govt is to legislate for Regulation of Anaesthesia Associates without even defining what they can and cannot do? Did you know that they're using a parliamentary wheeze to avoid any awkward questions? Does your MP know?

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Richard Marks - London Anaesthetist

@LondonAnaesth

1 year

@LeylsTurk The cardiologist probably thought he was cracking a very witty joke and would have been totally unaware of the impact of his comment. Seniors and people in positions of authority need to recognise how seriously their juniors take throwaway criticisms like this.

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Richard Marks - London Anaesthetist

@LondonAnaesth

6 months

An extraordinary general meeting of the Royal College of Anaesthetists (RCoA) held on 17 October looks like the start of a revolution in UK medicine. Or, more precisely, a counter-revolution. And while we're all waiting for regulation to start, is the CQC hiding in a fridge?

Phil Whitaker

@pwhitakerwriter

6 months

My piece in ⁦ @NewStatesman ⁩ on the mounting medical counter-revolution against the alarming scope-creep of unregulated PAs and AAs in the NHS

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Richard Marks - London Anaesthetist

@LondonAnaesth

9 months

@mmamas1973 @steven_hassel @Jamesbr42538384 Makes it much harder to train doctors if PAs assess the 'easy' acute cases in A&E and only call the Reg if they're difficult. Medicine is all about pattern recognition; you need to examine a lot of patients before you can recognise the outliers.

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Richard Marks - London Anaesthetist

@LondonAnaesth

11 months

@Dr_Done_ Its not just that PAs are nice people (as are most doctors). They have the crushing advantage that they are permanent and not endlessly rotating. So they establish professional and inter-personal relationships much more easily. Short-term rotational training is very damaging.

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Richard Marks - London Anaesthetist

@LondonAnaesth

7 months

I'm not sure the general public really understands what the lack of a defined 'scope of practice' really means. It means that somebody who is not a doctor can do whatever their employing Trust ask them to do. Voila. All manpower shortages solved.

David Little

@DrDLittle

7 months

Open letter to @RCRadiologists regarding the proposed GMC regulation of AAs and PAs. Co-signed by an astonishing 617 members and Fellows in <24hrs! This overwhelming call for action simply cannot be ignored. @halliday_kath @DrStephenHarden @tomroques @OliverReichardt

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Richard Marks - London Anaesthetist

@LondonAnaesth

8 months

Maybe its not about the money (as you say, they aren't cheap). Its not the quick workforce fix either. Maybe the motive for expanding them is retention. They're underqualified to go to Australia or Canada. And insufficiently trained to quit the NHS and work privately.

JP Lomas

@jplomas

8 months

Both topical and interesting from the analytical mind of Prof JJ Pandit at @RCoANews updates — economic proposition of AA vs SAS… do the NHS workforce plan numbers hold up?

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Richard Marks - London Anaesthetist

@LondonAnaesth

8 months

Of all the allegations and claims made in this article, here's the one that worries me the most. They acknowledge their statement contradicts the views of the College, but they're saying it anyway. How do you deal with people like that?

Janet Eastham

@JanetEastham

8 months

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

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Richard Marks - London Anaesthetist

@LondonAnaesth

6 months

Adding staff who are not doctors .... to the GMC register brings into question the competence and qualification of the whole medical profession. Is this not, in the most broad and abstract terms, bringing the profession into disrepute?

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Richard Marks - London Anaesthetist

@LondonAnaesth

9 months

A Court ruled 8 years ago that, by changing a surgeon at the last moment, the patient's consent became invalid. Court ruled that patients have a right to make an informed choice, based on who would be operating on them. Act quickly, @NHSEngland - current consent forms need to…

Anaesthetists United

@AnaesUnited

9 months

@gmcuk advise that the names and roles of the key people who will be involved in their care are shared with patients. Consent for anaesthesia must be modified with this advice in mind.

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Richard Marks - London Anaesthetist

@LondonAnaesth

2 months

@parthaskar @bmj_latest @RCPhysicians @trishgreenhalgh @mmamas1973 @DrLKVaughan @UKGastroDr @RowanHarwood @doctor_oxford @RoshanaMN @MRCPandFRCPs @AntonEmmanuel2 @OrthopodReg The RCoA has called for a pause in recruitment of AAs - here's their formal statement. Surely if the anaesthetists can do it then the physicians can too.

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Richard Marks - London Anaesthetist

@LondonAnaesth

20 days

@gmcuk And yet a court upheld a GMC decision not to take FtP action against the architects of MTAS, because their action in running a flawed recruitment system was deemed too far removed from their job as doctors. The lines seem very grey.

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Richard Marks - London Anaesthetist

@LondonAnaesth

9 months

Anaesthetic National Recruitment Office under investigation by Department of Business and Trade over workers rights.

ANRO under investigation by Dept of Business and Trade over workers rights ..

The Enforcement and Sanctions office at the Department of Business and Trade has agreed to investigate whether ANRO – the Anaesthetic National Recruitment Office – is complying with regulation 27 of...

www.schoolofanaesthesia.co.uk

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Richard Marks - London Anaesthetist

@LondonAnaesth

2 months

@bbchealth Nowhere in that statement does it say the @AoMRC back the rise in numbers of PAs. It says they need to restricted and supervised. Was there a separate statement saying that medical leaders back the rise? Or is that bit made up?

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Richard Marks - London Anaesthetist

@LondonAnaesth

5 months

@VictoriaAtkins Would be helpful if you clarified whether, in your opinion, PAs and AAs should always be acting directly under the supervision of a doctor, on a case-by-case basis; or whether they are permitted to act autonomously and unsupervised.

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Richard Marks - London Anaesthetist

@LondonAnaesth

7 months

Hello, my name is [Forename Surname] and I am one of the physician associates working in [specialty]. Physician associates are commonly referred to as PAs. I work alongside the doctors, but I am not a doctor.

Physician associates told they must not call themselves doctors

Staff without medical training who fill gaps in the NHS workforce must tell patients they are “not a doctor” when introducing themselves, under new guidance.The

www.thetimes.co.uk

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Richard Marks - London Anaesthetist

@LondonAnaesth

8 months

Lancaster Uni have pulled the video. For those that missed the original, it seemed to be 2 hours of AAs talking openly about how they 'bend the rules' and have extended their scope. Seems like someone somewhere has woken up to the implications of what they're saying.

Oba Babs-Osibodu

@ObaBabsOsibodu

8 months

"I think they assume you're the anaesthetist... I don't say I'm an anaesthesia associate." Patients are being deliberately misled. If this is considered acceptable, so much so that @LancasterUni even published it online, just imagine what is done and said behind closed doors.

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Richard Marks - London Anaesthetist

@LondonAnaesth

6 months

Separate registers for doctors and associates is a clear requirement of the Draft Order, and distinguishing AAs from PAs additionally specified. GMC have spent over £5m on this so far, you think they'd've read the spec first.

Christopher Clarke

@chrisgdclarke

7 months

@DrDLittle Talking to GMC workers it’s intentional. We need to be clear about the problems this will cause and the undermining of medicine.

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Richard Marks - London Anaesthetist

@LondonAnaesth

3 months

Royal College of Anaesthetists continues to deliver on EGM Motions; with a letter sent today to clinical directors in anaesthesia calling for a pause in recruitment of new AAs and a pause in development of AA enhanced roles.

Royal College of Anaesthetists

@RCoANews

3 months

Following our Board of Trustees’ meeting last week, we have written to the Clinical Leaders in Anaesthesia Network regarding EGM resolutions 1 and 2. We have published the letter on our website:

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Richard Marks - London Anaesthetist

@LondonAnaesth

3 months

@JimBethell Its the same in anaesthetics. Most interactions are incredibly straightforward, except for the ones where it isn't. Which, if I may say, is slightly less than helpful.

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Richard Marks - London Anaesthetist

@LondonAnaesth

6 months

@AnaesUnited That NHSE letter to the @TheBMA reads to me like:- We created the job of Associates before we worked out their job description or their regulation. Now we want to create 12,000 more of them and everyone is getting all upset. And its all your fault 😭😭😭😭

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Richard Marks - London Anaesthetist

@LondonAnaesth

7 months

This is precisely the problem with Physicians Assistants; because the concept of an everlasting FY1 completely ignores human nature. Most of us, in our working lives, hanker after promotion and additional challenges. So Assistants want to grow into Associates.

Jim Crawfurd 💙 🇺🇦

@jim_crawfurd

7 months

@Jo_McGinn @iDrSunny And yes, I think one of the biggest problems with the whole PA concept was the idea that anyone would want to be an “eternal FY1”, which is how the idea was sold to doctors.

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Richard Marks - London Anaesthetist

@LondonAnaesth

6 months

The 7-digit GMC registration number for PAs needs to be reconsidered.

The Royal College of Radiologists

@RCRadiologists

6 months

Following Faculty Board on 2 November, we have released the following statement regarding physician associates:

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Richard Marks - London Anaesthetist

@LondonAnaesth

2 months

@wesstreeting The blurring of the distinction between PAs and doctors dates back to when Labour first introduced them to the workplace.

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Richard Marks - London Anaesthetist

@LondonAnaesth

8 months

@JackTeh96 Is this for real? Moonlighting by setting up a for-profit non-medical business is the way to progress your career as a doctor? Has someone lost the plot?

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Richard Marks - London Anaesthetist

@LondonAnaesth

4 months

@mancunianmedic @pointlesslettrs Aside from the salary, the letter describes the job of a junior doctor as 'a rewarding life of service to be enjoyed'. The 'life of service' phrase is an interesting choice of words and perhaps describes the culture and perceptions of work-life balance in 1958.

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Richard Marks - London Anaesthetist

@LondonAnaesth

3 months

Surely regulation of Associates should define in some way what it means to be an Associate. If the GMC cannot do this then they should formally delegate that to some body that can, and not just leave it to market forces and the whim of the rota writer.

Anaesthetists United

@AnaesUnited

3 months

We call on the @gmcuk to clarify unambiguously that scope of practice, levels of supervision and training should be set by the Royal Colleges/Faculties, and not by the employers. To protect the public, and to protect the Associates themselves, this needs to be crystal clear

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Richard Marks - London Anaesthetist

@LondonAnaesth

7 months

The doctors that other doctors call in a crisis. World Anaesthesia Day #WAD2023 is a way to remind people of who we are, what we do, and what a vital contribution we make. And the sax player is fantastic.

Anaesthetists United

@AnaesUnited

7 months

For World Anaesthesia Day on Monday 16th let us be proud of what we are and what we do. And at our Team Brief in the morning let us all sing, dance and cheer to our collective anthem - The Gasman's Shanty. Hoorah! The Gasman's Come. #WAD2023

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Richard Marks - London Anaesthetist

@LondonAnaesth

7 months

Possibly the one thing more headline-grabbing than an unregulated non-medical associate administering an anaesthetic is an unregulated non-medical associate carrying out brain surgery.

Safety fears as non-medical staff learn neurosurgery ‘on the job’

Physician associates (PAs) without medical training are learning “neurosurgery on the job” as royal medical colleges call “extraordinary” meetings over the use of the unregulated profession.

uk.style.yahoo.com

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Richard Marks - London Anaesthetist

@LondonAnaesth

3 months

@drcolinm And "practitioner in medicine" is different too.

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Richard Marks - London Anaesthetist

@LondonAnaesth

7 months

My Opinion piece in the BMJ on the growth of anaesthesia associates, why I have awoken from my indifference, and what I hope will be achieved at the RCoA EGM next Tuesday.

Why anaesthetists are calling for an extraordinary meeting on anaesthesia associates

Richard Marks explains why a group of anaesthetists is calling for a wider debate on increasing the number of anaesthesia associates In the past I never really gave much thought to anaesthesia...

www.bmj.com

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Richard Marks - London Anaesthetist

@LondonAnaesth

4 months

@AnalysisDrawer The RCoA, who are actively pursuing a pause in AAs, have interpreted it to mean a pause in all further recruitment of new, student AAs.

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Richard Marks - London Anaesthetist

@LondonAnaesth

20 days

How much of this has arisen because of the change to random scoring? When there was a 'reserve list' in the past then this was for the weaker candidates only who were left to await their turn. Now there are strong candidates who for no reason have been left on the bench to sweat…

BMA Students

@BMAstudents

21 days

Hundreds of UK final year medical students have been told by their foundation schools that they could only get three weeks notice of what hospital and city they will start working in.....🧵

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Richard Marks - London Anaesthetist

@LondonAnaesth

7 months

Recruitment of junior doctors. Coaching an international sports team - 6 points Hold a national managerial role for a year - 6 points Family settled in the area - Nil points

Alison Moore

@AliJaneMoore

8 months

Are we really selecting doctors by whether they have competed nationally in a sport, play a musical instrument to a high standard or have set up a business on the side? Is there a risk of indirect discrimination in this?

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Richard Marks - London Anaesthetist

@LondonAnaesth

5 months

The Royal College of Anaesthetists call for a pause in the expansion of Associates is starting to have an impact. Why are other Colleges so slow to pass the necessary resolutions?

Shaun Lintern

@ShaunLintern

5 months

The RCOA calls for a pause on recruitment of new student anaesthesia associates while it investigates safety concerns:

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Richard Marks - London Anaesthetist

@LondonAnaesth

7 months

All the talk of 'regulation' misses the point. This is all about de-regulation and liassez-faire. Its about how the checks and balances that have governed training and practice in healthcare have been conveniently bypassed and evaded. Open your eyes.

Anaesthetists United

@AnaesUnited

7 months

Reforming medical training and employment is cumbersome, restricted, and full of vested interests. This government wants to sidestep the rules and cut corners by making up 'different professions. Or as they call it, "New ways of working".

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Richard Marks - London Anaesthetist

@LondonAnaesth

8 months

@RCSnews RCS statement on PAs all hinges on the phrase "implemented appropriately" but doesn't give any definition, guiding principles or worked examples of what is or is not appropriate.

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Richard Marks - London Anaesthetist

@LondonAnaesth

7 months

For we doctors, scope of practice narrows after completing training and becoming a consultant. I no longer do neuro, cardiac or obstetrics even though I trained in all 3. Why is it the other way around for Associates? Why are we saying that after they have trained their scope of…

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Richard Marks - London Anaesthetist

@LondonAnaesth

11 months

@zackferguson Anaesthetists Intensivists Surgeons Others

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Richard Marks - London Anaesthetist

@LondonAnaesth

8 months

@parthaskar Its in Good Medical Practice 2024 edition very explicitly. Time to see the end of "Hi I'm one of the anaesthetic team".

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Richard Marks - London Anaesthetist

@LondonAnaesth

3 months

"We will discuss with the General Medical Council how they plan to reflect surgical specialty scope of practice in their intended regulation of physician associates". Because at the moment the regulators aren't regulating.

Anaesthetists United

@AnaesUnited

3 months

Congratulations to @RCSnews for their new statement on PAs which highlights the concerns over proposed MAP clinical leadership roles that overlap those that should be reserved for doctors, and emphasises the importance of defining scope of practice

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Richard Marks - London Anaesthetist

@LondonAnaesth

11 months

@ELHT_NHS @Doctors_Vote @ELHT_CEO As the GMC puts it:- You must treat your colleagues fairly and with respect. You must not bully or harass them or unfairly discriminate against them. Was this form assessed before it was introduced?

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Richard Marks - London Anaesthetist

@LondonAnaesth

7 months

So now we're asking applicants to ST4 to demonstrate they've got previous exposure to anaesthesia including taster days, and the role of a core trainee. #anro

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Richard Marks - London Anaesthetist

@LondonAnaesth

1 year

Checklists in theatre have become focussed on the filling out of a form, often electronically, rather than on sharing information between team members. There must be lots of people that genuinely believe that "if it isn't documented it wasn't done".

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Richard Marks - London Anaesthetist

@LondonAnaesth

7 months

@DocKayK @Xeon4f145d96s1 @dannyjnwong @AnaesUnited @gaslad @VirtueOfNothing There's a petition going around about this, and its interesting to see who has signed it already.

423 people signed and won this petition

Southampton doctors ask for your support against the undemocratic expansion of AAs at UHS

www.change.org

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Richard Marks - London Anaesthetist

@LondonAnaesth

7 months

Very astute comment on how young doctors (perhaps not in anaesthetics, but in many specialties) have had their roles redefined in the last 20 years Surgical trainees of all grades, for example, should be in theatre except under rare circumstances. Etcetera.

DJ33

@DJ3370178658

7 months

@LorickFox I believe the roles are different in the USA and in the UK. In the UK, young doctors have been relegated to ward monkey status whilst the patient stuff is done by higher paid, less trained PA’s who wave a piece of paper in front of a doctor to sign to take legal responsibility.

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Richard Marks - London Anaesthetist

@LondonAnaesth

4 months

@Assoc_Anaes And can we knock on the head, for once and for all, the oft-repeated myth that AAs can somehow 'improve turnover' by having the next patient ready before the previous case has ended. Because we cannot currently do that with senior trainees or two consultants.

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Richard Marks - London Anaesthetist

@LondonAnaesth

2 months

I've also been blocked by this @bbchealth journalist after asking about the story she wrote about physician assistants. Maybe she doesn't realise people can have more than one account on Twitter.

Ginny Bowbrick

@GinnyAB

2 months

Dear @BBCNews I politely asked your journalist @OReillyGem to read the @RCSnews statement regarding PAs following our last Council meeting. I was polite. I referred her to a website. And she blocked me. Is this how you work now? No debate? #shameful

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Richard Marks - London Anaesthetist

@LondonAnaesth

8 months

The upcoming EGM of the RCoA is largely focused on Anaesthesia Associates - but there are two Motions around recruitment of anaesthetic trainees. Give them some thought, they make a difference.

RCoA EGM on 17th October - the Recruitment Motions ..

On 17th October the Royal College of Anaesthetists is holding an Extraordinary General Meeting. The EGM was called for by Anaesthetists United, a group that I am closely involved with. Much of the...

www.schoolofanaesthesia.co.uk

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Richard Marks - London Anaesthetist

@LondonAnaesth

7 months

@DrDLittle The GMC refusal to decide who should be setting Scope of Practice (not themselves, but not anyone else either) defies logic. Regulators should not be advocating laissez-faire.

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Richard Marks - London Anaesthetist

@LondonAnaesth

6 months

@Dr_Done_ You should also encourage reporting of persons acting without the necessary qualifications and skills to the CQC since they have the responsibility for enforcing this. I've written a short blog post, with a link to the CQC reporting page at

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Richard Marks - London Anaesthetist

@LondonAnaesth

4 months

@AliJaneMoore The role of Associates was created, and large quantities of money were thrown at the project, before there was any agreement on what Associates would or would not be able to do. Normally I'd place cock-up ahead of conspiracy, but in this case I'm not so sure.

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Richard Marks - London Anaesthetist

@LondonAnaesth

7 months

Almost 90 per cent of the more than 4,300 RCOA members voted to pause the rollout of AAs, with very strong support on motions around supervision and communication with patients about the role

Health Service Journal

@HSJnews

7 months

The Ward Round: Not just another royal college row

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Richard Marks - London Anaesthetist

@LondonAnaesth

3 months

@ClareGerada @UKGastroDr @NHSEngland @RCPhysicians @parthaskar @DrLKVaughan PAs and AAs are being scrutinised at the moment because the constraints and scope of their practice is so poorly defined. No other group, including doctors, is so unbounded. Regulation, which was the opportunity to address that, has failed to grasp that nettle.

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Richard Marks - London Anaesthetist

@LondonAnaesth

2 months

The issues around Associates are getting more and more scrutiny as the general public becomes increasingly aware of them.

Doctors fear two-tier GP plan as rise of 'helpers' may put patients at risk

The alert follows the death in 2022 of Emily Chesterton, 30, of Salford, from a pulmonary embolism after being misdiagnosed twice by a PA at a London GP practice

www.mirror.co.uk

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Richard Marks - London Anaesthetist

@LondonAnaesth

21 days

@dannyjnwong Good luck Danny, and .very best wishes to you and your family. Hope the move goes well. Thanks for all you have done for the NHS and the wider medical community.

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Richard Marks - London Anaesthetist

@LondonAnaesth

2 months

@OReillyGem Is that the story that says medical leaders welcome the expansion in numbers of Associates on the back of the recent Academy statement? Can you clarify which of the leaders actually said they "welcomed" it.

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Richard Marks - London Anaesthetist

@LondonAnaesth

7 months

@oliverdevine @Dr_Done_ Describing having a PA as "...like having the best SHO you ever had, and keeping them long-term" overlooks the point that this SHO will expect to become a registrar.

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Richard Marks - London Anaesthetist

@LondonAnaesth

3 years

@RCoANews @RCoAPresident @strachanjamie @gasgal13 @chris__carey @sally_ghazali @Anaes_Trainees @AoMRCTrainees @AnaesthesiaScot @HEIW_NHS Makes you wonder why experience gained in an HEE-appointed post is automatically recognised for training while an identical post in the same hospital that isn't appointed by HEE is not. What does HEE actually contribute?

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Richard Marks - London Anaesthetist

@LondonAnaesth

8 months

@csubbe @JeanetteRCR @AoMRC And she then emphasises that although nurses could do some of these tasks they've got bigger things to do and tasks like this are precisely the role of PAs. By inference, this must be where the bar is set in other specialties.

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Richard Marks - London Anaesthetist

@LondonAnaesth

8 months

@csubbe Chris it appears @JeanetteRCR speaking on behalf of the @AoMRC has made this very clear. On the radio yesterday she confirmed that at present PAs should be doing venepuncture, putting up drips etc. Listen to her answer at 1:21 in the interview.

aomrc endoscopies not on the cheap.mp4

drive.google.com

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Richard Marks - London Anaesthetist

@LondonAnaesth

3 months

Employment Agency legislation provides strict rules about privacy and confidentiality, the issuing of job information and timetables. Contravention of the Act carries both a civil liability for damages and the risk of prosecution.

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Richard Marks - London Anaesthetist

@LondonAnaesth

8 months

@jplomas @willtube4food @RCoANews AAs earn £51-57k for a 37.5 hour week (with a generous leave allowance of 33 days A/L, 8 days public hols plus study leave) according to a recent ad. When you at that alongside the bursaries for training, and subsidies for GMC/College/exams -- the financial arguments aren't that…

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Richard Marks - London Anaesthetist

@LondonAnaesth

2 months

Royal college of Physicians tearing itself apart as rift between senior leadership and the members grows wider.

Partha S Kar 🇮🇳🇬🇧🏏🎥

@parthaskar

2 months

Ok then I am breaking ranks As Councillor @RCPhysicians Open letter to council Time for senior leadership to consider their positions Silence is complicity And that? Isn’t me Enough. #RCPEGM

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Richard Marks - London Anaesthetist

@LondonAnaesth

4 months

@drjonchambers1 @mancunianmedic We've lost sight of what the role of a doctor is. The day-to-day routine of a junior doctor has completely changed during my lifetime, in many ways they have been marginalised, thus creating the vacuum that the alternative workforce is filling.

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Richard Marks - London Anaesthetist

@LondonAnaesth

2 months

PAs benefit the workforce because they don't have to work nights and weekends like the rest of it. Wait, say that one again....

Meg 👨‍👩‍👦‍👦💙👩🏻‍⚕️🇮🇳🏏🎥🇬🇧⚽️

@Megsenmumdr

2 months

@ExplosiveEnema2 @MichaelC7389 @Doc_IonaCollins @Roddy_Neilson @iDrSunny @Molly2323232323 @ABarotchi1 @medicalmodelbri @Xeon4f145d96s1 @IVfacts @AlisonGeorge10 @BMA_James_Steen @Microbedoc2 @DrLindaDykes @MStott88 All of us kept asking what do PA bring to MDT Apparently it’s “excellent work life balance” - for them 🤦🏽‍♀️ PS:- Reposted after deleting old one & zooming in further as I hadn’t noticed the name badge on.

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Richard Marks - London Anaesthetist

@LondonAnaesth

4 months

@davehartin And I've been musing that qualifications and titles confer some sort of externality, so that the public and employers know who is and is not competent to deliver particular sorts of treatment. Worth a thought.

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Richard Marks - London Anaesthetist

@LondonAnaesth

7 months

@UKGastroDr "... there are approximately 4000 PA’s...their role has been unclear to some" Thats an understatement, their role is unclear to many. How, in very general terms,do u see their current role. Making diagnoses? Taking blood and putting up drips? Performing operations?

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Richard Marks - London Anaesthetist

@LondonAnaesth

8 months

@Expo1222222 @AnaesUnited @AoMRC Seems like the scope creep is already with us - look at this advert Anaesthesia Associates were described as people to do the basic stuff in order to let doctors to the more advanced -- but hard to see whats left for the doctors if this is anything to go by.…

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Richard Marks - London Anaesthetist

@LondonAnaesth

2 months

There is a role for Associates. But RCP President confirms "... we recognise that there is still some ambiguity around their scope of practice and about their role for patients.". So there is a role. We just don't know what it is yet.

There is a role for physician associates in the NHS

The upcoming extraordinary general meeting at the Royal College of Physicians is an opportunity to contribute constructively to the debate around the future of physician associates We are in the...

www.bmj.com

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Richard Marks - London Anaesthetist

@LondonAnaesth

1 month

Most striking thing about this survey is that amongst those consultants working regularly with Anaesthesia Associates only 56% of them are confident in their abilities. That's a very concerning statistic.

Anaesthetists United

@AnaesUnited

1 month

The @RCoANews have published their extensive and carefully-designed independently-commissioned survey on AA's. Main findings - AAs negatively impact doctor training, and expansion is viewed negatively even by those working with them.

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Richard Marks - London Anaesthetist

@LondonAnaesth

1 year

@DavisVThomas @BenZaranko @TheIFS The introduction of slow and frustrating IT systems in the clinical arena has slowed everything down and now seems irreversible. As is the constant focus on minor detail at every point; perfection is the enemy of good.

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Richard Marks - London Anaesthetist

@LondonAnaesth

3 years

Are Anaesthetists the unsung hero of healthcare? Not any more. Now we have an anthem. Sing it loud and sing it proud. Hoorah! The Gasman's come.

The Gasman's Shanty [VIDEO]

There once was a man to be put to sleep So that the surgeon could cut deep His blood was thin, his chest was tight And the vultures circled lowHoorah! The Ga...

www.youtube.com

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