What I think I'm essentially arguing for her is the right to be told as a patient if your care is deviating from some sort of norm, as at the moment employers can do what they like, draw up a local SOP or scope, and tick the box that says 'appropriately qualified professional'

I suggest that you strongly reconsider the choice of words. The problem is not communication but a system that allows unqualified people to see children & the undifferentiated. To stop this happening again, we need interim application of the BMA scope & RCGP recommendations.

Another extremely distressing case of medically unqualified "physician's assistant" harming a patient in general practice, this time a little girl. 1. Mother had no idea PA wasn't a doctor - examination without consent is assault 2. PAs are not supposed to see children 3. Inappropriate prescribing of an adult vaginal pessary not only harmed the child, but led to a subsequent safeguarding referral for the mother, who was suspected of *sexual abuse* until it became apparent what happened. 4. The GP "remotely supervising" this PA authorised an inappropriate prescription, and a pharmacist dispensed it. Both mother and child are understandably negativelly affected by this incident, which should never have happened because Leng Review and various medical bodies have urged the goverment to put a stop to PAs working in general practice, or seeing children, or seeing undifferentiated patients, since they are not medically qualified. The harms of this outrageous breach of medical ethics and patient safety continue to mount, while the government is mindlessly ploughing on with unsafe doctor substitution plans. How is it possible that the medical profession has said NO a million times already, to an unsafe practice in their own field, there have been deaths and egregious harms, and nobody in positions of influence is stopping? "Supervision" of non-doctors who are allowed to do doctors' jobs, by doctors, is still unsafe. Nobody should be allowed to practice medicine without requisite medical qualifications, full stop. Non-doctors don't know what they don't know, so doctors remotely supervising them won't know either, unless they have seen the patient themselves. Doctors can only reasonably take responsibility for remote decisions on the basis of other medically qualified colleagues' information, because we share the training, ethics, responsibility and cognitive process. Even then, it's still best to see the patient yourself, but this isn't always possible due to sheer volume of work. Only doctors can do *medical work* in teams. Add non-doctors into those teams, and the medical safetynetting of asessement and decision making is gone.

All medical examination without consent is assault. The mother says she believed the PA was a GP, which suggests the PA never clearly identified themselves as a non-doctor, which would imo invalidate any consent mother has given for her child to be examined.

This would not have occurred if our scope of practice had been followed. Or the Leng Review. PAs must not see undifferentiated patients. They do not have the requisite knowledge to make it safe. @jamesmurray_ldn please follow RCGP recs and remove PAs from general practice.

Patients tell their story all too often @LaylaMoran but they may not wish to share ALL info with ALL providers ALL the time – do all the staff in your local pharmacy have to see the notes on consequences of prostate surgery?  Or the full details of traumatic experiences?

Would pts have a say in who sees what on their records? There’s historical info on pts GP records which they may not want all staff to see Ex-past relationship breakdown/ STI/drugs etc Especially given inappropriate access by hospital staff in high profile cases

Lovely introduction in your own words explaining how much work you have done to embed the PA role into primary and secondary care over the last number of years I don't want to be accused of misrepresenting you or your "Showcase" of best PA practices Onto the list 👀 6/

pharmacists are great. no question. but the idea that 'minor illness' can always be separated from major or what will be ongoing needs are not true. Additionally, 'minor illness' is often the way that people get to know their GP; builds relationships, and creates trust;

I am an old nurse and completely agree with you. What this type are doing is also undermining the important role we have as nurses! I would suggest calling them Matrons like the old days. They are not Consultants.

What do you think the legal situation is for patients who did not know their surgeon was not medically qualified (and therefore not actually a surgeon) and experienced complications? Is it as bad as it sounds, or would the trust simply say we deemed them to be qualified?

1. In NHS Forth Valley Scotland there surgical care practitioners (non medically qualified individuals that have no formal surgical training / have not passed surgical fellowship exams) undertaking advanced breast surgery autonomously, with "remote"consultant supervision. That this is happening in a first world healthcare system is both dangerous and incredulous. ➡️The post involves working autonomously in an outpatient setting to review, diagnose and implement a comprehensive treatment plan, including gaining informed consent for surgery and listing patients for surgical intervention. ➡️The post involves autonomously working in an operating theatre environment – both in procedure rooms and main theatres – to perform surgical procedures independently and to lead the theatre team to deliver safe surgical care for the patient. ➡️ Assume responsibility for individuals within a clinical setting /caseload under remote Consultant supervision. Here is the job advert: apply.jobs.scot.nhs.uk/Job/J… (i have saved content in case it mysteriously goes down)

Q: Why must the RDs rotate? A: To gain sufficient experience and knowledge to become mere SHOs, of course. Q: So nobody who doesn't do that can do what SHOs, let alone registrars do right? A:... Q: Right?! A: No sorry that would make staffing difficult and we can't have that.

Doctors, sign the petition today! The medical reform needs a serious rethink. We’re calling for: - separate registers for PAs and reduction of blurred lines - title protection for doctors - no increase in the GMC powers of appeal - new powers for PSA to demand info when needed

The GMC reforms that are on the table won’t fix what’s broken. Doctors are being let down by a system that lacks fairness, patients are feeling the impact too. We need to see real change. Sign the petition👉 petition.parliament.uk/petit…

She is ultimately responsible . This is why the supervising consultant should be listed on the GMC register alongside their PA .

It’s outrageous that I work with nurses who manage CRRT and ECMO for the region’s most critically unwell babies and children, being paid band 5. It seems highly skilled bedside nurses are not valued in AfC, anywhere near as much as ‘leaders’ or ‘specialists’.

We wonder why there’s a nursing crisis in my specialty, when these exceptionally competent, very high trained nurses can earn more money working nicer hours, in an office, for significantly less responsibility and much less moral injury. We must value our nurses financially.

WE DID NOT CONSENT for NHS England to share our private health data to private companies which include Palantir - a company involved in mass surveillance & genocide! This should terrify & ENRAGE us all. This is OUR personal data!!

For me, this paper exposes the rotten core of the workforce substitution project. Millions of pounds and hours of manpower have been wasted writing nice frameworks and sitting on national committees for employers to IGNORE THEM. Because there is NO regulation. 9/