Taskification and substitution in the NHS - a hypothetical case of how splitting up pt care into "tasks" misses the diagnosis & costs more: A recently married 45 yr old Pt develops bloody diarrhoea over 4 weeks. "The protocol" says they need a blood test, stool MCS & FIT test 1/ Not seen by a Dr but tests requested, message sent via NHS app to patient. Bloods show raised WCC, very slightly low Hb and raised Plts. FIT test is positive. According to protocol a colonoscopy is needed as FIT positive. Message sent via NHS app. Not seen by Dr. 2/

@mouseter_chef It is difficult as I have failed. I have failed as things I said would happen have still happened and that brings no joy or satisfaction but sadness, and, yes, some anger.

To answer your question as best as I can I will firstly say it is complex and the system is set against 1/ @mouseter_chef you as an individual. I put myself forward for the relevant committees to truly represent my peers (and always did this) and did speak directly to the key decision makers but I will admit I often felt surrounded by a sea of apathy (from fellow committee members) 2/

Way back in 2015 when Twitter/X and social media was not as big a thing as it is now, back in 2015, there were lots of concerns how #PAs where being pushed forward by @RCPhysicians whilst junior doctor strikes were on the horizon 1/x Doctors were pretty apathetic then, Anons didn't exist but there was a growing disenchantment with how doctors were treated, paid, deprofessionalised etc. The learnt behaviour was to 'shut up and put up' with a very paternalistic approach from the medical leaders of the day 2/x