Nel retweeted
The plan to allow physician assistants to see undifferentiated patients is irresponsible and poorly evidenced.
bmj.com/content/395/bmj-2026… @TheBMA @bmj_latest
Nel retweeted
Another new job ad for a physician assistant .
GP practices continue to ignore @lengreview recommendations and @rcgp guidance .
PA and GP appts seem to have equal status . How many more patients will be harmed ?
Nel retweeted
@PatientsAssoc public are greatest stakeholder in decisions affecting standards of healthcare for all of us.
You are (repeatedly) failing in your charitable objectives by not inviting wider patient input to matters of national concern.
Patients need a voice on Leng reforms 1/
Nel retweeted
Who are the 84 stakeholders ? Will a list of them be published ?
As far as I’m aware only
@rcgp
@RCPhysicians
Have published a way for their members to have a say .
What about the other organisations /Royal colleges ?
How can we engage if we don’t know who they are?
Nel retweeted
All very tame & 'look the other way' vs previous @CommonsHealth sessions.
Travesty that, increasingly so, no-one in government can be held to account. When everyone's watching their own back & future prospects, any body or committee can be captured, let alone individuals.
Nel retweeted
@PauletteHamilto
The government is replacing resident Drs and consultants with non-Drs. I’m surprised that you didn’t ask any questions about Dr substitution with ACPs, PAs , SCPs . The plan is to increase them to reduce the need to employ actual Drs .
Nel retweeted
This!
Absolute disgrace @PatientsAssoc
How do patients & public contribute to consultation on Leng Review recommendations?
You whole purpose ought to be to gather & represent public view on ALL healthcare matters, not keep stum when mates at DHSC instruct. 🤬
Nel retweeted
Why haven’t you informed the public about the physician assistant clinical protocols ? How can patients have their say? Aren’t you a stakeholder ?
Nel retweeted
@PatientsAssoc @SarahTilsed why haven’t you informed patients about the physician assistant clinical protocols out for consultation? You’re one of the stakeholders. How do patients get to have their say ?
@parthaskar
What matters most to you when it comes to health and social care for people living with more than one long-term condition?
This survey asks you to prioritise the research questions that matter most: buff.ly/RhRQipw
Nel retweeted
How many Drs responding to provide feedback on the proposed PA protocol were timed out whilst trying to complete the form set up by @RCPhysicians ? You will be fully aware of this issue @Mumtaz_Patel_1. Less than 10 minutes to complete responses is ludicrous. How many failed???
The deadline for submissions to the RCP on the Leng 'protocols' was 10 mins ago.
Here is what I wrote in response:
/
@parthaskar @djnicholl @medicalmodelbri @DrAsifQasim
Nel retweeted
Not a whimper from @NavinaEvans or @Prof_StevePowis about patient deaths, illegal irradiation of patients, or the illegal supply of Class A drugs by PAs
Instead they promoted conspiracy theories
Funny that this is what the @CMO_England accused us of
"Leaders"?
Remembering the time when @Prof_StevePowis and @NavinaEvans were caught coordinating twitter posts relating to false allegations in @thetimes of ‘abuse ‘ and acid attacks against PAs by Drs.
Did Drs ever get an apology for this disgusting behaviour by @NHSEngland ?
Nel retweeted
Our valuable Drs being driven out, scandalous. @DHSCgovuk @NHSEngland are waving them off, they're making way for further underqualified, unregulated PAs/ACPs/AAs to step in their shoes. If only the public new! @guardian @Independent @TheCanaryUK @ByDonkeys @38degrees @We_OwnIt
My nephew’s been unemployed since finishing F2 Aug 26. He would love to become an anaesthetist. He is moving to New Zealand next month to work in A&E since he can’t get a job beyond locuming or progress his career in the UK. It’s bonkers we’re exporting doctors🤯 @YvetteCooperMP
Nel retweeted
The deadline for submissions to the RCP on the Leng 'protocols' was 10 mins ago.
Here is what I wrote in response:
/
@parthaskar @djnicholl @medicalmodelbri @DrAsifQasim
Nel retweeted
Coz leaving it up to the individual depts and consultants ( local scope) is how Pts get killed.
It’s how @NHSEmployers have posted 43 jobs for PAs to work as Dr substitutes since @YvetteCooperMP was appointed.
It’s why Owen Dickinson & the Welsh LP PA haven’t been struck off
Nel retweeted
Whatever be the abuse taken, whatever be the personal impact, however much attempts made to ignore (Been fascinating to see behaviour of local Deanery under @NHSE_WTE recently)?
Once a stand was taken in 2023?
That consistency does not shift.
Patient safety sits paramount.
Signed - and part of group -which has sent this now to @RCPhysicians
The RCP must:
1. Reject the draft national clinical protocol for physician assistants outright.
2. Take leadership by developing its Interim guidance for physician associates working in the medical specialities into formal national guidance.
It is a matter for physicians what elements of clinical practice we consider can be safely delegated.
Up to @Mumtaz_Patel_1 @OGMustafa @HilaryWMedic @RunningMadProf and Council next.
You all were part of the senior leadership who lost an EGM once.
It's not a bad thing to heed history.
@djnicholl @mmamas1973 @PhilSmithIsBack
Dear @bmj_latest & @pulsetoday so far
57 signatures in our open letter to @RCPhysicians
40 current FRCPs, 12 current members and five recently resigned – four fellows & one MRCP.
This will be submitted to RCP on Monday
#physicianassistant
dauk.org/rcp-letter/
Nel retweeted
Whatever we can actually do, we can afford
We have UK doctors who want to train
We have the capacity for significant expansion in specialist training posts
And yet this @andyburnham Govt continues to make the purely political choice not to do so
UK can never be short of £s!👇🏻
The Bond Market Bluff vincegomez.com/articles/the-…
Nel retweeted
Just to showcase how far down the rabbit hole some of the Royal Colleges (in this case @RCoANews), along with @NHSE_WTE @NHSEngland @gmcuk et al have all gone- on the hubris of idealogy.
Myth 1:
There isn't enough doctors to do the job.
Fact:
In the context of anaethesia?
The competition ratio for Anaesthetics CT1 in the NHS is 10.54:1 for the 2026 Round 1 recruitment cycle (5,766 applications for 547 posts)
AFTER removing those pesky foreigners aka IMGs (as far as I am aware)
Myth 2:
There isn't enough money to hire doctors
Fact:
Look at recent job advert for a Physicians Assistant (Anaesthesia)
Salary & Pay Scale: NHS Agenda for Change Band 7 (£55,524 - £62,652 per annum)
Above doesn't factor in cost of supervision via a Senior Consultant
Riddle me this.
What is the feasible reason to have these roles when you have trained doctors (NOT foreigners)- done at cost to tax payer to do the role?
It makes no clinical, financial or policy sense.
Yet?
Here we are.
Pontificating why NHS is non-productive or has safety issues - wherever you look.
I repeat to all.
Do NOT do to others you wouldn't want to do to your loved ones.
@RoyLilley @JanetEastham @lengreview @KamranAbbasi @DrNatBroughton @YvetteCooperMP
THIS is the question.
Let me take it one step further.
Your most loved one is due to have surgery.
You have a choice as to who 'puts them to sleep for the procedure'- and then 'wakes them up'.
1. It's either a trained Anaesthetist aka a Doctor
2. Or a Physician Assistant in Anaesthesia aka Not a Doctor
The answer to me is obvious.
Not in bazillion years should it be number 2.
If you @NHSEngland @NHSE_WTE actually believe in 'Informed Choice'?
Inform them properly- not dupe them with made up titles.
What a two tier system we have descended to.
I repeat- do NOT do to others what you won't do to your loved ones.
Nel retweeted
Thank goodness for senior consultants like @parthaskar standing up for patient safety. As a living donor and peer advocate, I know "available" means nothing when an unconscious patient crashes. We need a proper, fully qualified doctor directly doing the job, not shortcuts. 🛑🩺