Steven Alderson @StevenMAlderson Twitter profile

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Steven Alderson

@StevenMAlderson

10 months

Dr Lane graduated in 2002. He will have enjoyed £1K tuition fees, free hospital accommodation, & a starting salary of £26K (equivalent to £45K), when the average house price was £96K. It’s great he can ‘live on his pay’ - but a shame others won’t have the same opportunities.

Nigel Lane

@dr_nigel_lane

10 months

Some Consultants will strike tomorrow and Friday in the @NHSEngland . I will not. I am coming in to work a normal weekday shift both days. I have been a consultant for 9 years. I do no private work and can live on my pay which is over 3 times the average UK salary.

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Steven Alderson

@StevenMAlderson

4 months

In advance of a talk for @BeyondMedUK I’ve been doing some sums: think my move to Aus six years ago has meant I’ve earned £200K more, worked ~2000 hours less, & enjoyed a more flexible training programme, & significantly better quality of life. Leave the NHS. You deserve better

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Steven Alderson

@StevenMAlderson

11 months

The writing is already on the wall for UK anaesthetists. Massive expansion of the associate workforce in the NHSE Workforce Plan. And @RCoANews crows about, what, 70 extra ST4 places? STOP. TRAINING. YOUR. OWN. REPLACEMENTS. CC @doctorhelgi

Danny Wong (黄永年)

@dannyjnwong

11 months

If the argument is that the RCoA can only advocate but is unable to control the numbers of training posts, as that is under the control of HEE, then it cannot give assurances that the number of AAs being trained is also going to be constrained. This too is HEE's remit.

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Steven Alderson

@StevenMAlderson

11 months

@zackferguson Hungry Angry Late Tired

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Steven Alderson

@StevenMAlderson

2 months

1.) All five #RCPEGM motions must carry; 2.) The PA project must be paused immediately, given the subterfuge used to promote it; 3.) The RCP leadership must resign entirely 4.) New College elections must follow, with a total overhaul for voting rights for Members.

Partha S Kar 🇮🇳🇬🇧🏏🎥

@parthaskar

2 months

@ShaunLintern To add Shaun- none of this data was shared with their own Elected Councillors This is now more than a mess It’s now probity

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Steven Alderson

@StevenMAlderson

5 months

Good idea @wesstreeting ! Just need to match the Aussie salaries to recruit & retain next. That’s £210-315K a year, in my specialty…

Wes Streeting MP

@wesstreeting

5 months

This week I saw first-hand the difference that the @AustralianLabor government is making in Australia - with urgent care clinics that relieve pressure on GPs and A&E departments. @Keir_Starmer ’s @UKLabour government will adopt this approach with new Neighbourhood Health Centres.

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Steven Alderson

@StevenMAlderson

5 months

‘Some Dr Anons’ No. 90% of anaesthetists, voting at the RCoA EGM. 87% of surveyed BMA members. Concerns regarding the PA role, scope of practice, regulation, patient understanding, & impact on the wider MDT *are* the majority view.

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Steven Alderson

@StevenMAlderson

3 months

Wow. So you do 8 years of rigorous postgraduate training, pass the FRCA, finally CCT - just to prescribe someone else’s anaesthetic (& assume their medicolegal liability) via tickbox? #TheLeedsWay #NoWay

ExplosiveEnema

@ExplosiveEnema2

3 months

@Dr__Chloe @19MW98 @DrHuw I came across this in my travels Hopefully it gives you an idea...

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Steven Alderson

@StevenMAlderson

4 months

It’s British GPs today. It’ll be British ED Consultants tomorrow. After that…?

platinumpizza™

@Xeon4f145d96s1

4 months

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Steven Alderson

@StevenMAlderson

4 months

Can we please confirm which council members have voted for this position, so that informed decisions can be made at the next council election?

Royal College of Anaesthetists

@RCoANews

4 months

Our position on the supervision of anaesthesia associates is 2:1 We don't support 3:1

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Steven Alderson

@StevenMAlderson

10 months

Since a few people have asked me, I don’t think this view is remotely controversial in Australia. This is the ANZCA position statement on roles in anaesthesia and perioperative care.

Steven Alderson

@StevenMAlderson

11 months

The writing is already on the wall for UK anaesthetists. Massive expansion of the associate workforce in the NHSE Workforce Plan. And @RCoANews crows about, what, 70 extra ST4 places? STOP. TRAINING. YOUR. OWN. REPLACEMENTS. CC @doctorhelgi

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Steven Alderson

@StevenMAlderson

10 months

If there is no light at the end of the tunnel of NHS training, then that training isn’t a tunnel - it’s a dingy, miserable, hole. NHS consultant careers have to be attractive - and that specifically includes the salary. Otherwise why bother with the rest of it?

Barney Scholefield 🌈 💙

@BarneyUoB

10 months

I’m a paediatric intensive care consultant. I did not strike yesterday although fully support my colleagues. Instead I did my last ever night shift after 22 years in #NHS Sorry 🇬🇧 I’m leaving for 🇨🇦 next week. For me (and my children - the next gen) it was just too late 😔

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Steven Alderson

@StevenMAlderson

1 month

There’s a clear pathway for those of us with English Literature degrees to care for patients. It’s called Graduate Entry Medicine (via night school, and science A-levels, in my case).

platinumpizza™

@Xeon4f145d96s1

1 month

“Degrees in homoeopathy, computer science, English literature and human resources are being accepted as entry qualifications” - this is why it is extremely disingenuous to include the “3 years of preceding study” to the PA course as relevant in any way.

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Steven Alderson

@StevenMAlderson

7 months

It takes a special kind of stupid to admit in writing that your anaesthetic department is only ‘currently’ following guidelines for the provision of safe anaesthesia, *while under scrutiny*. And to admit too that future RCoA guidelines may just be ignored, if inconvenient? 🤦🏻‍♂️

Dr Done

@Dr_Done_

7 months

Now, I get lots of DMs But this has to be in the TOP 5 WORST❗️ ‘Unhappy vocal minority’ - how dare you raise concerns? ‘We need to be careful, but only while we’re under the microscope’ Storm analogy again when in fact a tsunami is coming 🫠 @SheffieldHosp @MajorKirsten1 ?

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Steven Alderson

@StevenMAlderson

6 months

@drcolinm You’re out of touch on this one, Prof. Trainees are afraid of the GMC. They are afraid of HEE & the LETBs. And with good reason - the former is responsible for innumerable suicides; the latter for serial careers ruined. Anonymous SoMe feedback is the future. Leaders can act…

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Steven Alderson

@StevenMAlderson

10 months

The Changing Face of Medicine *in the UK*. The Aussie College’s have firmly come out against PAs, AAs, etc. Such new roles in the NHS are due to serial failures in workforce planning, & a desperate desire to deliver some sort of healthcare, as quickly & cheaply as possible.

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Steven Alderson

@StevenMAlderson

10 months

As pointed out, Dr Lane likely didn’t pay *any* tuition fees (imagine that!) - they were introduced only in 1997, with a bursary covering the last two years of MBChB. Good for him. Just a shame he won’t support his colleagues in fighting for T&C remotely comparable to his own.

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Steven Alderson

@StevenMAlderson

11 months

The Associate workforce (whether AA, PA, SCP) & scope creep ( #TAVIgate ) is the next Full Pay Restoration. Except by the time MedTwitter accepts it’s a problem, & allows open debate, it’ll be too late. It’s time for the College’s to make a stand - or their members to force one.

Steven Alderson

@StevenMAlderson

11 months

The writing is already on the wall for UK anaesthetists. Massive expansion of the associate workforce in the NHSE Workforce Plan. And @RCoANews crows about, what, 70 extra ST4 places? STOP. TRAINING. YOUR. OWN. REPLACEMENTS. CC @doctorhelgi

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Steven Alderson

@StevenMAlderson

10 months

Starting F1. Starting F3.

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Steven Alderson

@StevenMAlderson

2 months

For any FRCPs undecided as to how to vote at #RCPEGM , this *must* swing your vote. Yours, a voiceless MRCP.

Jan Hansel

@VirtueOfNothing

2 months

I will just leave this table here to do the talking. The @RCPhysicians leadership has attempted to mislead its Fellows at the #RCPEGM . 🔗

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Steven Alderson

@StevenMAlderson

2 months

For the entirety of my UK medical training, there was a pervasive sentiment that Medical Royal College’s don’t care about, or listen to, their trainees. It turns out it’s even worse than that. They actively lie & misrepresent the views of their Members when it suits…

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Steven Alderson

@StevenMAlderson

1 year

The @gmcuk are just descending into Kafka-esque farce at this point. I’m surprised they even tell those accused *what* they are accused of. They have lost all face validity following a string of dubious decisions (typically against IMGs). @TheBMA should declare no confidence…

Demetris Ioannides

@DoctorDemetris

1 year

@Xeon4f145d96s1 @gmcuk @BAPIOUK @parthaskar They then used this against her as evidence of lack of insight, saying it was "unrealistic" for her to claim that she never slips up. I have no words for this type of process, but it's certainly not fair or just. 2/2

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Steven Alderson

@StevenMAlderson

4 months

The reality is that the Conservative British Government simply *don’t want* to pay doctors what they are worth. They never will. Vote with your feet. Strike. Then leave.

LBC

@LBC

4 months

'We haven't got enough money to spend £2 billion a year paying doctors, but we can find £8 billion a year to cut a tax that's only paid by the richest 4%.' @BenKentish points out the flaw in the government's claim that the UK 'can't afford' a pay rise for junior doctors.

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Steven Alderson

@StevenMAlderson

11 months

I’m a Member of @RCPLondon & a Fellow of @RCoANews - after years of training. Both Colleges need to unambiguously make a stand for quality in the provision of safe healthcare - medicine should be practiced by qualified physicians; anaesthesia delivered by qualified anaesthetists

David Oliver

@mancunianmedic

11 months

"We will shorten, narrow and cheapen training, dump responsibility and cost onto employers and ignore what expert clinicians outside government roles are telling us is required"

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Steven Alderson

@StevenMAlderson

4 months

@ClareGerada @dobbyjog @Dr_BellaR You’ve also got a bit of a COI, given your role with the Hurley Group & their direct employment of PAs. Presumably better for the Group’s bottomline than medically qualified staff, given the ARRS arrangement?

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Steven Alderson

@StevenMAlderson

5 months

@TheSalariedPA I mean, they had medical students working clinically during the pandemic.

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Steven Alderson

@StevenMAlderson

2 months

We should collectively nominate the team behind @AnaesUnited . They have delivered a ‘major project for the College’, worthy of a medal IMHO - refocusing the RCoA on the aims of its’ founding Charter.

Royal College of Anaesthetists

@RCoANews

2 months

Is there someone you think should have a College award? Has a trainer given you outstanding support? Has an SAS colleague or a consultant inspired you? We are looking for nominations from all grades of anaesthetists. Nominations to awards @rcoa .ac.uk

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Steven Alderson

@StevenMAlderson

8 months

The charter of RCoA is clear. The RCoA must promote the highest standards of anaesthesia - not dilute them with progressively lesser trained & experienced staff substituting for anaesthetists on the cheap. If the College leaders won’t uphold their own Charter, they should resign

Anna Batchelor

@AnnaBatchelor

8 months

Consultants are highly paid (well were and should be again) highly trained and can use those skills across several patients. I support the @RCoANews @RCoAPresident

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Steven Alderson

@StevenMAlderson

10 months

British doctors: why are my Terms & Conditions so bad? British doctors & Medical Royal Colleges: you don’t actually need any of my training, qualifications, or experience to do my job.

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Steven Alderson

@StevenMAlderson

9 months

Once again, AI is the answer! 🤦🏻‍♂️ Or maybe just listen to properly trained, experienced, consultants?

Jeremy Vine

@theJeremyVine

9 months

I think AI will have to be used from now on. AI would have caught this — and execs would have to properly document their reasons for overruling it

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Steven Alderson

@StevenMAlderson

10 months

@VirtueOfNothing I mean, I’d expect a medical student to do a better job of assessing a patient than this.

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Steven Alderson

@StevenMAlderson

4 months

Patients need to be clear as to who is responsible for their care, & who is assessing them - particularly in an undifferentiated acute or emergency setting. How is this anything other than deliberately intended to obfuscate? @RCEMpresident @DrLindaDykes

Disillusioned doctor

@Disillu89254799

4 months

A "Consultant Practitioner" in EM @NHSGlos A vague, non-title which puts patient safety at risk by not making clear that they are not a doctor. Utter madness. #patientsafety #scopecreep @Dr_Done_ @Xeon4f145d96s1 @DrEilidhMaria

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Steven Alderson

@StevenMAlderson

11 months

@doctorhelgi @RoshanaMN @Dr_Done_ @totalguff Sure, but let’s be honest - if the College flat out said ‘we do not support this model of anaesthesia provision in the UK, & suggest that our Fellows should not support it either’, then it would be dead in the water. We see listening events - but where is the learning?

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Steven Alderson

@StevenMAlderson

2 months

This is atrocious. @RCPhysicians have clearly misrepresented the views of their Members to their Fellows, with the clear aim of influencing voting at the EGM. This must be a resignation matter for the RCP leadership.

Jan Hansel

@VirtueOfNothing

2 months

I will just leave this table here to do the talking. The @RCPhysicians leadership has attempted to mislead its Fellows at the #RCPEGM . 🔗

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Steven Alderson

@StevenMAlderson

10 months

No great surprise that training numbers continue to be cut in specialties which support the introduction of Associate workforces, at a College level. This is the next FPR - but by the time #MedTwitter deems it acceptable to voice concerns, it’ll be too late.

Nathan Titterton

@ntitterton

10 months

This is rlly disheartening. Posts may have 100% fill rate but there were also less available (at least in England) than in 2022 Anaes CT1: 435 down to 425 Emergency CT1: 321 down to 315 IMT1: 1375 down to 1360 GP: 3650 down to 3433

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Steven Alderson

@StevenMAlderson

10 months

In the setting of a terminally cash-strapped, under-staffed, declining NHS, there is a broader patient safety story to be told ( @ShaunLintern ). It’s one of inappropriate, often unregulated, & deliberately obfuscatory role substitution. …

Dr Done

@Dr_Done_

10 months

Is this true? If so, it is criminal. ☠️

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Steven Alderson

@StevenMAlderson

4 months

@DrNeilStone It will be progress when the NHS recognises that 48 hours a week is *more than* full time, & trainees wanting to work a *standard* working week (or 80% LTFT) are merely asking for the same as every other healthcare worker

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Steven Alderson

@StevenMAlderson

11 months

@_Jim_Lewis @RCoANews @doctorhelgi I’m not sure that having non-medically trained anaesthetists giving anaesthetics is good for patient safety, to be honest. I can quite understand why staff might aspire to it, & struggling NHS bodies promote it. And I’ve nothing against any HCP trying their best…

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Steven Alderson

@StevenMAlderson

9 months

@VirtueOfNothing @ukmat82 @cannula_service @RCoANews I sat on the original PA working group at HEE, in 2013. Intention was genuine physician assistants, liberating core trainees to focus on training. Look how that turned out. The NHS will always choose the cheaper, quicker, option - quality be damned.

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Steven Alderson

@StevenMAlderson

5 months

The UK medical profession & wider NHS has totally lost the plot.

Mamas A. Mamas

@mmamas1973

5 months

This is an absolute crazy situation on two counts- that PAs with no medical training are advising doctors as the "on call paediatrician " 😳 and that if doctors follow this advice they are legally responsible. I think if faced with such a situation doctors should ask to speak…

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Steven Alderson

@StevenMAlderson

1 month

Hope you’ve seen this @ShaunLintern . The majority of surveyed anaesthetists don’t feel that Anaesthetic Associates provide safe, or high quality care. How can NHSE continue with their expansion?

Royal College of Anaesthetists

@RCoANews

1 month

We have published the findings of our survey of members’ perceptions & experiences of anaesthesia associates. The survey responses have been reported by Research By Design, who conducted the survey on our behalf. The report is available on our website:

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Steven Alderson

@StevenMAlderson

4 months

@TheSalariedPA In fairness, the RCoA EGM, BMA survey, & pending RCP EGM, suggests that very few doctors - aside from those with financial interests in the matter - support the current approach to PAs in the workforce. RCPE have it right - it’s time to return to physician assistants.

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Steven Alderson

@StevenMAlderson

10 months

Oh my, the last line is something else…

Fawz

@FawzNK

10 months

Targeted Instagram ads hurting me while I’m just trying to mindlessly scroll.

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Steven Alderson

@StevenMAlderson

3 months

You shouldn’t need an IT system alone to prevent illegal prescribing by practitioners. Where is the probity? Where is the professionalism? @FPARCP

Janet Eastham

@JanetEastham

3 months

🔴 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”

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Steven Alderson

@StevenMAlderson

1 month

@DrNeilStone Depends on the pharmacist, and the drugs. Most know nothing about common anaesthetic drugs, for example.

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Steven Alderson

@StevenMAlderson

11 months

@mmamas1973 Finally, someone senior gets it - and isn’t ashamed to say it. The UK has chosen a path of ever-eroding standards, & medical workforce musical chairs. Seemingly anyone can do anything, providing they get paid a pittance for doing it.

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Steven Alderson

@StevenMAlderson

10 months

@gaslad At least the NHS is now being open that it’s a defacto charity running on donated staff time & money

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Steven Alderson

@StevenMAlderson

11 months

Again, if an entire specialty is to be reshaped, it must be with the assent of College members & fellows, after open discussion & debate. Not a decision made opaquely, by a few Council members - who, precedent suggests, often stand to personally benefit from it.

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Steven Alderson

@StevenMAlderson

5 months

@interview_coma I’m glad you’re pleased, Stuart, as this sort of corner cutting, cut price, healthcare is exactly where the NHS is heading. It’s going to be doctors for the best, Associates trained over two years for the rest.

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Steven Alderson

@StevenMAlderson

9 months

These are serious, credible, anaesthetic colleagues - & this is a serious, credible, opportunity to change the direction of RCoA. If you are a Member or Fellow of the College, please lend @AnaesUnited your support.

Anaesthetists United

@AnaesUnited

9 months

Introducing two of our core members: @LondonAnaesth and @dannyjnwong . Our senior members have been instrumental in formulating our motions for an EGM, liaising with the @RCoANews along the way.

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Steven Alderson

@StevenMAlderson

9 months

What a helpful intervention from NHSE. What next? NHSE reminds trusts not to appoint serial killers, in wake of Letby conviction. The centre knows it has to do *something* but has no idea what…

Health Service Journal

@HSJnews

9 months

NHSE reminds trusts not to appoint unfit directors, in wake of Letby conviction

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Steven Alderson

@StevenMAlderson

4 months

As with Full Pay Restoration before it, the various anon accounts posting about this issue on SoMe - dismissed by many as an angry minority - have been speaking truth to power. They clearly reflect the concerns of the majority of RCoA, BMA, & now ASiT members. Time to listen.

ASiT

@ASiTofficial

4 months

📢 New #ASiT Report on Physician Associate Impact on Surgical Training and Patient Care 🏥👩‍⚕️ 🔍 Largest ever ASiT survey: 1,978 doctors across all surgical specialties in the UK. 🤝 Focus: Physician Associates (PAs) impact on surgical training and patient care 📈 73.8% worked…

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Steven Alderson

@StevenMAlderson

4 months

Is there nothing in British medical training which HEE haven’t messed up?

Ollie Burton

@ollieburtonmed

4 months

For our medical seniors who aren't aware, this exam is genuinely what is used to select for entrance to SHO level NTN in most specialties now, because a certain subset of our seniors signed off on it, presumably because it was cheaper than doing something else.

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Steven Alderson

@StevenMAlderson

11 months

@drlaurajane @Google I got threatened with a Datex for making myself a cup of tea on nights as a new F1. In Aus our hospital arranged a food truck festival to thank staff post-COVID; had free BBQs on site for the International Day of the Nurse; and puts free ice creams in the fridges in summer.

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Steven Alderson

@StevenMAlderson

4 months

Too many shitty departments & hospitals accustomed to an endless supply of junior doctors, who they need make no effort to recruit, retain, or train. If NHS hospitals had to recruit doctors like they do PAs, then we might actually see them being valued & paid what they’re worth.

@medicalmodelwithabriochebun

@medicalmodelbri

4 months

Excessive Rotational training needs to end for junior doctors. I’m sick of seeing ‘ we’re better because we don’t rotate ‘ coming from unregulated PAs .

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Steven Alderson

@StevenMAlderson

9 months

@DrRaviJ You’re doing outstanding work Dr Ravi. You’ve seen a killer convicted. But don’t stop there. The whole rotten system needs to be challenged. Please, keep going.

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Steven Alderson

@StevenMAlderson

1 year

Oh what a surprise, it’s RETENTION again. Cough @wesstreeting cough

Sky News

@SkyNews

1 year

The problem isn’t that we’re not training enough GPs: trainee numbers have surged in recent years. Yet there’s been no increase in young GPs joining the NHS. Most GP training takes only three years, so something is going on

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Steven Alderson

@StevenMAlderson

11 months

@DrLKVaughan In fairness Louella, I’ve worked in Adelaide for the last six years - in anaesthetics, ICM, PHEM; across public & private; & retrieved from almost every hospital in the State. It is significantly better than anywhere I’ve worked in the UK.

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Steven Alderson

@StevenMAlderson

10 months

@mancunianmedic @ShaunLintern Almost as if DH/NHSE want a workforce of non-internationally mobile Associates, rather than experienced, fully qualified, doctors. To a degree - if you aren’t interested in clinical quality - that’s fine, but why the College’s meekly facilitate it I will never understand.

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Steven Alderson

@StevenMAlderson

11 months

@RoshanaMN @doctorhelgi @Dr_Done_ @totalguff One problem is that RCoA has apparently decided on a policy & actions without consultation with it’s Members and Fellows, & which is diametrically opposed to their interests in many instances. Quiet private chats aren’t appropriate when an entire specialty is being reshaped…

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Steven Alderson

@StevenMAlderson

10 months

Enormously unsurprising that most of the steering committee of #FutureDr are GPs. Not one craft specialty represented. Perhaps ‘Google’ (!) can replace a GP - I wouldn’t know - but it can’t replace anaesthetists, intensivists, or retrieval physicians (never mind surgeons!).

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Steven Alderson

@StevenMAlderson

8 months

Wow this brings back memories. I haven’t had to apologise regularly to patients since I moved to Aus, six years ago. For the most part, I’ve worked in services which deliver very high quality, timely, well-equipped & staffed care. It’s essentially resource unlimited healthcare.

Philip Banfield 💙

@DrPhilBanfield

8 months

Like many many doctors, I apologise almost everyday I work on the wards for something we’ve not been able to do, the time patients have had to wait or the lack of staff. Yet everyday there are also examples of fantastic care given by fabulous teams often against the odds. #WeCare

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Steven Alderson

@StevenMAlderson

4 months

@RCoANews Why do you support any erosion of the standards the College was founded to maintain?

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Steven Alderson

@StevenMAlderson

6 months

@drcolinm …on it or not (much as they’ve failed to act on feedback raised through the existing avenues you promote) but at least this way their inaction & dismissiveness will be plain for all to see. That’s transparency.

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Steven Alderson

@StevenMAlderson

4 months

@TheSalariedPA *trying their hardest to ensure that physician assistants practice with appropriate scope, governance, oversight, & with full patient comprehension of the role

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Steven Alderson

@StevenMAlderson

4 months

@cruncherwax Once you accept that the NHS & most patients have no interest in quality, it’s easier to imagine. Look at how PAs are handling undifferentiated risk in GP-land.

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Steven Alderson

@StevenMAlderson

4 months

@galanthophile @BeyondMedUK Well, then they need to vote for a government who will fund better, and be prepared to pay for better

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Steven Alderson

@StevenMAlderson

9 months

@Parody_RCGP How can you ‘work independently’ *and* ‘be supervised by a senior doctor’? It’s one or the other.

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Steven Alderson

@StevenMAlderson

5 months

@ukmat82 Ah, every other HCP branch seems to have appropriated ‘consultant’ Matt. AAs and PAs will be no different. Just give it time.

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Steven Alderson

@StevenMAlderson

9 months

@ShaunLintern There’s a broader patient safety story here re. endless role-substitution, & deliberate institutional opaqueness about who is caring for patients (particularly when patients believe they’ve seen a doc but haven’t). Frances highlighted RNs being replaced by HCAs as problematic…

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Steven Alderson

@StevenMAlderson

11 months

@Xeon4f145d96s1 For comparison, interns (PGY1) get paid £41K in South Australia.

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Steven Alderson

@StevenMAlderson

11 months

@Brozapine @MHA_92_ @RCoANews @doctorhelgi It’s the next pay restoration, TBH. I was dismissed as a ‘disgruntled former trainee’ five years ago for pointing out NHS T&C were shocking. It’ll take MedTwitter another five years before it can acknowledge Associates are a bad idea.

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Steven Alderson

@StevenMAlderson

7 months

@Aidan_Baron Surely 1.) first principle working, based on solid basic science; and 2.) knowledge of the rarer diseases, as well as the more common stuff, is exactly the point of medical school? I use the former daily as an anaesthetic registrar; the latter frequently as an ICM SR.

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Steven Alderson

@StevenMAlderson

11 months

@RoshanaMN @doctorhelgi @Dr_Done_ @totalguff We need real transparency around this - who has agreed at RCoA to back Anaesthetic Associates; what are their COIs; what lobbying or Government influence has taken place (including £, to fund the Faculty); what risk assessments have been competed (re training/care).

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Steven Alderson

@StevenMAlderson

5 months

@interview_coma What are the checks and balances you think exist? Neither PAs nor AAs (in my field) have regulated scope of practice, nor an accountable regulator. The answerable body for setting standards (the RCoA) has advised all departments to cease new hires, but they continue…

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Steven Alderson

@StevenMAlderson

6 months

@parthaskar Hardly ‘amazing’, Partha. The year 15 consultant headline salary is pretty close to that of an Aussie senior registrar… Still about half what you’d earn here as a consultant.

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Steven Alderson

@StevenMAlderson

8 months

@Xeon4f145d96s1 @Resuspiece Independent when there’s a good outcome, dependent and supervised when there’s a poor outcome, right?

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Steven Alderson

@StevenMAlderson

10 months

@ntitterton And in all those specialties, there are growing numbers of Associate practitioners, supported by the relevant College. What. A. Surprise.

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Steven Alderson

@StevenMAlderson

10 months

@drmattuk @Dr_Done_ And get paid £70K for 37 hours a week

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Steven Alderson

@StevenMAlderson

11 months

@doctorhelgi @RoshanaMN @Dr_Done_ @totalguff So far, many of the ‘listening events’ over the last few years come across as ‘I’m sorry you feel that way’ non-apologies for various issues with training/recruitment/curricula reform/associate workforce. The key question is ‘what will the College now do differently’?

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Steven Alderson

@StevenMAlderson

7 months

The Medical Royal Colleges, & their Presidents & Councils, should be ashamed of themselves. Their fundamental role is to maintain quality & set standards - not to become complicit in their erosion. We may as well revert to the barber surgeons…

AMA President

@amapresident

7 months

"A physician associate in neurosurgery told the Physician Associate Podcast that he had “zero training in neurosurgery or neurology” during his course...‌he now “scrubs in and operates on things like subdural haematomas” Truly unbelievable🤯🤯🤯 @TheBMA

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Steven Alderson

@StevenMAlderson

11 months

@doctorhelgi @RoshanaMN @Dr_Done_ @totalguff Call me naive, but I think for such a fundamental change in how the specialty is delivered - and we can both see how this is going to go - it should be openly discussed and voted on by Members/Fellows

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Steven Alderson

@StevenMAlderson

7 months

@VirtueOfNothing Once a mass of AAs are in post, Government can erode their favourable T&C too. Perhaps by 26% or so. This is the special ‘introductory rate’, to get people to sign up 😀

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Steven Alderson

@StevenMAlderson

11 months

The ceaseless push for cheaper, less qualified, associate workforces will be the end of both specialties as we currently comprehend them. The Colleges were founded to uphold standards - so uphold them.

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Steven Alderson

@StevenMAlderson

11 months

No one expects politicians or accountants to understand why you need a decade of training to care for complex medical inpatients; or to deliver safe anaesthesia - but we expect the Colleges to, and to make this case at the highest levels.

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Steven Alderson

@StevenMAlderson

11 months

If nothing else, the Colleges cannot be complicit in undermining the very standards they set, & have examined against, since they were founded. It’s time to end the associate-ification of British medicine.

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Steven Alderson

@StevenMAlderson

10 months

…Doctors have been too concerned about perceptions of elitism; Departments too concerned about filling roster gaps (with anyone); & Medical Royal Colleges too concerned about loss of influence. In short, the profession has dropped the ball again. …

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Steven Alderson

@StevenMAlderson

7 months

The NHS is no-longer interested in providing high quality care; only (vaguely) accessible care, delivered by anyone willing to provide it, in a crumbling & failing system.

AMA President

@amapresident

7 months

"A physician associate in neurosurgery told the Physician Associate Podcast that he had “zero training in neurosurgery or neurology” during his course...‌he now “scrubs in and operates on things like subdural haematomas” Truly unbelievable🤯🤯🤯 @TheBMA

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Steven Alderson

@StevenMAlderson

10 months

A patient died recently, believing themselves to have twice seen their GP - it was a Physician Associate, who continues to practice in the absence of meaningful clinical overnight or regulation. The preponderance of ‘Advanced’ ‘Associate’ roles has met with little scrutiny…

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Steven Alderson

@StevenMAlderson

1 year

…& organise a boycott of their fees indefinitely, until their kangaroo courts are sorted out.

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Steven Alderson

@StevenMAlderson

11 months

@DrAseemMalhotra @piersmorgan The faux-grief is a little jarring alongside the self-congratulatory view count, & furious spamming of politicians & broadcasters. Expect your next message of condolence to link to your Patron & tour 🙄

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Steven Alderson

@StevenMAlderson

4 months

@TheSalariedPA Personally, no. Depends how you define ‘abuse’ - one prominent PA included ‘questioning the existence of the role’ within that term. I wouldn’t.

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Steven Alderson

@StevenMAlderson

9 months

Do labels on syringes next

derek guy

@dieworkwear

9 months

i dont work in medicine, but untucked looks better to me also, that shirt looks like it has a lower side pocket, which would be difficult to use if you tuck

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Steven Alderson

@StevenMAlderson

2 months

The @RCPhysicians is going to need a new, unifying, President by the end of the week - to oversee an urgent programme of work to repair its’ reputation, & the state of British medicine. I hope @mancunianmedic is clearing his diary.

Jan Hansel

@VirtueOfNothing

2 months

And it’s only Monday noon!

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Steven Alderson

@StevenMAlderson

10 months

This ridiculous profileration of unintelligible NHS job titles - counted at over 70,000 permutations this week! - makes a total mockery of #MedTwitters favourite #hellomynameis campaign. What does it matter if a patient knows your first name, but has no idea what your role is?

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Steven Alderson

@StevenMAlderson

11 months

@doctorhelgi @_Jim_Lewis @RCoANews I don’t know enough about Scandinavian healthcare to comment. In the NHS context, multiple previous care scandals have noted the issue of role substitution, & replacing better qualified staff with cheaper, less qualified alternatives - ie Francis on RNs being replaced by HCAs.

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Steven Alderson

@StevenMAlderson

9 months

The @RCoANews Charter is clear: RCoA must 'maintain the highest possible standards of professional competence in the practice of anaesthesia for the protection & benefit of the public'. The move to an Associate workforce is at direct odds with this & must be opposed @AnaesUnited

Anaesthetists United

@AnaesUnited

9 months

We are a group of anaesthetists, concerned about the planned expansion of Anaesthetic Associates. This will impact the quality of delivered anaesthesia, and the training of our future colleagues. Read our mission statement below ⬇️

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Steven Alderson

@StevenMAlderson

11 months

@doctorhelgi @FearneHill @RCoANews Well, it’s sometimes very difficult to see what difference that would make, Helgi. There needs to be clear blue sky between the College & a failing Government, which has driven the NHS into the ground.

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Steven Alderson

@StevenMAlderson

1 month

@UKGastroDr The removal of the word ‘physician’ is the key bit, since these individuals aren’t that. Sounds like the sort of thing RCP could one some sway with…

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Steven Alderson

@StevenMAlderson

9 months

@timricketts_ @Medic_Mermaid Why do you need scrubs to pontificate about sodium and write TTOs, Tim? A crinkled shirt from M&S, and non-iron trousers from Burtons are the only scrubs medics need.

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