Dr Rachel Clarke Profile picture
Palliative care doctor 👩🏻‍⚕️ Author DEAR LIFE, BREATHTAKING 📚 Rep: @AitkenAlexander 📝 @hospiceukraine 🇺🇦 THE STORY OF A HEART out 3.9.24 UK, 10.9 US 🫀
Dame Chris🌟🇺🇦😷 #RejoinEU #FBPE #GTTO🔶️ Profile picture DLlewellyn Profile picture Globalbizdynamics Profile picture Ruth Cuthbert #FBPE #Rejoiner #GetBrexitGone Profile picture 💬 Profile picture 35 subscribed
Jun 15 11 tweets 3 min read
I’m simply horrified to see @NHSEngland now literally breaking the law in how it misrepresents physician associates & other allied health professional - who are NOT doctors - to the public.

These posters are from the Bradford District & Craven Health & Care Partnership. 1/n
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I downloaded the posters from their website, here:

“Physician” is a title that’s protected in law - to protect you, the public, from the dangers of fake doctors masquerading as the real thing. 2/nbdcpartnership.co.uk/download/96/gp…
Jun 11 5 tweets 2 min read
Well, I’ve read the @Conservatives manifesto on health so you don’t have to.

Aside from the expected unfunded nonsense on those 40 fictitious new hospitals, cutting managers & using AI to ‘free up’ doctors & nurses etc, here’s a stand out out example of its vacuousness. 🧵 Image What even is this verbiage? A ‘plan’ to prevent cancer from occurring, but also to give patients the best possible care? When over 235,000 cancer patients have had their treatment delayed in the last 3 years?

Come on, @Conservatives, this is offensive. Image
Jun 9 9 tweets 2 min read
BREAKING/

This is a scandalous moment in UK medicine.

Over 80 Fellows of @RCPhysicians have just declared their lack of confidence in the College.

Why?

Because they believe its stance on physician associates (PAs) is recklessly failing patients.

Pls read - this matters. 🧵 Image The Fellows - over a quarter of whom are professors - are appalled by @RCPhysicians' role in in enabling the government's project of replacing doctors with cheaper & less well-trained doctor substitutes (PAs) in an extraordinary array of medical jobs across the NHS.
May 29 13 tweets 3 min read
The GMC have tweeted this in response to widespread alarm from doctors at a video showing an 'AA' (anaesthetic associate) openly bragging about using "local governance" to get away with less supervision by doctors.

I find the GMC's position deeply concerning.

Here's why. 🧵 The video in question was recorded at a GMC conference in 2022.

AAs, like PAs (physician associates), are not doctors.

They have neither a medical degree nor anything like the depth & breadth of doctors’ training, yet are being used increasingly as doctor substitutes.
May 13 4 tweets 2 min read
Astonished to see @timspector doubling down on his reckless comments re: boosting 'cancer immunity' by stopping using SPF year round.

The study on which he bases his claim is in mice, not humans - & one of the study's own authors has publicly disputed Spector's conclusions. 1/3 Image As a doctor, how can he possibly imply we should use less sunscreen in order to reduce cancer risk?

Vit D deficiency from lack of sunshine can be addressed by diet.

But fatal skin cancers, as I know all too well in palliative medicine, cannot. 2/3 Image
Mar 30 15 tweets 5 min read
🧵 Whatever your views on assisted dying, one thing I’d hoped we’d all agree on is that the topic is ethically fraught & complex.

Not so Matthew Parris.

For him, it’s simple. Old & frail people *should* be killed - to save society the cost of looking after them. 1/n Image In no sense am I twisting Parris’s words.

Here he rehearses an argument often used by opponents of AD to fight legal change - that with time, it will lead to people feeling pressured to end their lives prematurely (for it would be socially irresponsible of them not to). 2/n Image
Mar 21 15 tweets 3 min read
Dear 🇬🇧,

The current state of UK medicine - a brief 🧵

Exactly 1 week ago, I felt I had no choice but to resign from giving a keynote speech at this year's @RCPhysicians annual conference.

The behaviour of the College leadership left me no choice. 1/n

The @RCPhysicians had been forced by its Fellows to hold an Extraordinary General Meeting - the third ever held in its >500 year history.

Fellows were appalled at the College's key role in driving through the government's plans to replace doctors with cheaper substitutes. 2/n
Mar 20 16 tweets 5 min read
Dear UK public,

Yesterday, hot on the heels of widespread concern among doctors at the govt’s project of replacing NHS doctors with doctor substitutes, @gmcuk released a blog about its future intentions.

It left doctors like me reeling.

Here's why 🧵

gmcuk.wordpress.com/2024/03/12/dev…
Image @gmcuk First, a reminder of what the GMC is.

Founded 166 years ago, the GMC protects the public by maintaining a register of drs in the UK, controlling entry to the register & suspending or erasing members if necessary.

It sets standards for all UK doctors.

Weighty, vital stuff. 2/n Image
Mar 18 17 tweets 4 min read
Dear 🇬🇧,

Please read - this NHS scandal potentially affects you all.

🧵 Having studied the data, just released, from the @RCPhysicians members' survey on PAs, I couldn't be more disgusted by the lack of probity, honesty & fairness of those who lead my Royal College. 1/n Image Last week, @RCPhysicians leaders were forced, against their will, by members & fellows to hold an extraordinary general meeting: only the 3rd in the Royal College's >500 year history. 2/n
Mar 9 11 tweets 3 min read
🧵 Doctors are depressingly used to being smeared by govt ministers.

But likening us to intimidatory "drug dealers" is a new low from @JimBethell.

He's trying to delegitimise our genuine patient safety concerns about @DHSCgovuk's roll out of PAs as doctor substitutes. 1/n The crux of the issue is this.

The government (reasonably enough) looked at ways of reducing the NHS staff bill.

Physicians assistants - less qualified & cheaper than doctors - would assist doctors in admin/straightforward tasks, freeing them up for more complex work. 2/n
Feb 18 5 tweets 2 min read
"Staff members were buying rain ponchos from Amazon because they offered better protection than what we had."

Please read this devastating interview with Dr Nathalie Macdermott, who caught Covid after being denied PPE by her hospital. 1/3
thesun.co.uk/tv/26011843/br… Nathalie, a former runner, is so severely disabled by Long Covid, she has to use a mobility scooter.

Like so many NHS staff, she was treated like cannon fodder - even as the government told the public (dishonestly) there were no problems with PPE supplies.

It's scandalous. 2/3
Feb 17 9 tweets 2 min read
🧵 Underlying the govt's decision to replace doctors with doctor substitutes in a huge variety of roles (including, incredibly, putting PAs on senior registrar on-call rotas), is something deeply concerning that we need to address.

Namely, the devaluing of a medical degree. A 5 year medical degree (4 years, at a push, if you are a grad entry student), is a gold standard, a benchmark, an assurance to the public that the NHS doctor treating you has an vast breadth & depth of knowledge & expertise - right from day one of their clinical practice.
Feb 12 10 tweets 4 min read
Tomorrow evening - thanks to the generosity of @BAFTA & @ITV - over 100 members of NHS staff will arrive at BAFTA for the UK premier of BREATHTAKING.

3 years in the making, I can hardly believe we've reached this point. Feeling so nervous!

Being on set was extraordinary /🧵 Image We built a three storey hospital from scratch inside an old, disused higher education college in Belfast!

Every detail needed to be utterly, authentically NHS.

The scuffs, the stains, the scrapes, the shabbiness - nothing would be sanitised nor sensationalised at all.
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Jan 18 19 tweets 5 min read
🧵/ The government doesn’t want you to know it, but it is currently conducting a massive, un-evidenced, cost-cutting experiment in the NHS, replacing doctors with so-called physician associates. 1/n

theguardian.com/society/2024/j…
Image PAs were originally termed physician assistants. They were introduced here - or so we thought - to support doctors with simpler tasks, in order to free them up to use their expertise to perform more complex ones.

Sounds sensible, and it is... 2/n
Dec 10, 2023 10 tweets 3 min read
Many thanks, @wesstreeting.

Have to say I really didn't have "stop exploiting those patients you see dying in corridors in horrifically overwhelmed A&Es" on this year's Christmas list.

Please consider reading this short thread in response to your Sunday Times interview. 1/n Image First up, where we agree. Yes, of course the NHS needs to innovate. Better & more creative use of tech, logistics & patient-centred approaches are vitally needed.

And some of the ideas you outline in your interview, below, are fascinating. 2/

thetimes.co.uk/article/wes-st…
Dec 3, 2023 13 tweets 4 min read
🧵1/ This week, as @borisjohnson fights for his political legacy, he will be watched by 1000s of people whose loved ones fought Covid for their last breath - and lost.

Johnson's strategy will be to apologise, yet insist he got “the big calls right”.

But did he?

Facts matter: Image 2/ Both Prof Neil Ferguson & Prof Graham Medley, who sat on SAGE, have already told the Inquiry that by Feb 2020 they worried the NHS would be overwhelmed by Covid.

Yet Johnson missed the first 5 Cobra emergency Covid meetings & didn't chair his first meeting until 2 Mar.
Nov 5, 2023 8 tweets 2 min read
1/ Amid the melodrama & catfighting of this week’s Covid Inquiry, a key mistruth has been largely overlooked.

When former NHSE boss Simon Stevens revealed Matt Hancock’s desire to play god with patient’s lives, he implied that rationing did not occur.

That is simply not true. Image 2/ One of the most agonising aspects of the pandemic for NHS staff was witnessing - & being forced to participate in - the horrific consequences for patients of the NHS being overwhelmed to such an extent we simply could not provide normal standards of care.
Nov 1, 2023 10 tweets 2 min read
1/ The sheer depths of Downing Street’s wretched incompetence, arrogance, narcissism & macho posturing revealed this week shock precisely no-one who worked in the NHS during Covid.

Let me remind you (as I did at the time) what those early hellish days of Covid were like for us. 2/ We faced a deadly virus with no vaccines & no treatments.

We watched Covid killing doctors & nurses in China & Italy.

We stepped up - of course - to try and help if we could, only too glad to use our training in a national crisis.
Jun 25, 2023 7 tweets 3 min read
On Tuesday, @MattHancock will appear before the
UK National Covid Inquiry.

Amid him eating kangaroo genitals, being bathed in cockroaches, dad dancing on TikTok etc, it’s easy to forget the sober detail of his pandemic record.

But NHS staff can’t forget.

And this is why. 🧵 @MattHancock In March 2020, PPE shortages on Hancock’s watch were so dire that nurses even resorted to using bin bags to try & protect themselves – not that this prevented them from catching Covid at work.
independent.co.uk/news/health/co…
Jun 18, 2023 7 tweets 2 min read
🧵 A note on complex grief and that partygate video:

Complex or complicated grief is characterised as being in an ongoing, heightened state of mourning that prevents you from healing.

A crippling sense of loss or other severe & unpleasant emotions endure & prevent recovery. A person’s ability to function normally can be severely impaired, and for many months or years.

You may feel numb, angry, bitter, unable to focus on anything but the death of your loved one. You may suffer from hopelessness, depression or feel that life is not worth living.
May 8, 2023 5 tweets 1 min read
I am so bone tired & disgusted to be working in an NHS that’s been flogged half to death by successive Conservative governments that cannot & will not permit a national health service to flourish.

Why do I have to see patients take their last breaths on trolleys in corridors? Why do I have to see a man of 80 collapse in tears because his hip pain is so severe he would rather be dead than endure it?

Why can’t I get him the hip replacement that would transform his life?

Why are people going blind because hospital ophthalmology is at breaking point?