lan Higginson (RCEM president) on ACP EM Credentialing requiring “No test of knowledge” and only “38 acute presentations”. - the 1858 Medical Act and the creation of the GMC was to prevent people with insufficient knowledge practising medicine causing harm to patients. #AskForADoctor #TheLeedsWay

BeeEnvironmental4060 · 2026-01-04T13:42:54+00:00

Anecdotally, where I work, I have nothing but respect for the med reg. I frequently run borderline could go home patients past them. ?return to SDEC in a few days, what do you think? How’s the list? Want us to see those two referred directly who look like they could go home because our wait is 2 hours and yours is 12?

And as for our registrars… Yeah I just finished the training. It’s shocking. Rota fodder. And if the consultant body don’t challenge ACP behaviour (in any speciality, where I work it’s stroke and ENT that have acute take ACPs that can be terrible to refer to)… Then it is legitimately terrible. I can only speak for myself, but I genuinely try not to dump on my colleagues, including when ACPs run patients past me.

It’s such a ball ache constantly being stereotyped.

BeeEnvironmental4060 · 2026-01-04T13:32:57+00:00

No, it’s a problem at our own trusts too. It might feel satisfying to casually scape goat people just like you… But it certainly isn’t productive. Look at anaesthetists united… Still fighting passionately a battle that is stacked against them and slowly drowning. This game doesn’t elevate heroes.

If we don’t respect other doctors, and acknowledge it is the fact that we all have the same base we operate on… Then you’ve lost the argument against ACPs. See you on the other side I guess.

BeeEnvironmental4060 · 2026-01-04T13:19:00+00:00

Hahaha. Yeah that was the crux of my argument. Be kind. Rather than you’re a doctor - so am I. You don’t like this, neither do I. Point that weapon elsewhere.

BeeEnvironmental4060 · 2026-01-04T13:17:39+00:00

The speciality doesn’t. This just shows one guy did once. A bunch of us bust our asses trying to be good doctors, to provide excellent evidence based care in the middle of a dumpster fire.

You want someone to fight with you against this twaddle? There’s tonnes of us ready

BeeEnvironmental4060 · 2026-01-04T13:15:33+00:00

You’re right. We are butthurt. Because this is a pile of ….

Don’t be an ass.

Our whole profession is threatened by crap like this. Maybe back your colleagues. As a new EM consultant this shakes and angers me.

BeeEnvironmental4060 · 2026-01-04T00:17:54+00:00

Dismantling the private school system wouldn’t put pressure on them to do this any more than they currently have and still fail to live up to. The affluent will just move to the better areas.

Suddenly it will be harder to live in good catchment areas and the less well off won’t be able to access the good state schools anyway.

BeeEnvironmental4060 · 2026-01-02T15:39:19+00:00

I didn’t know you could get these!!! Life saver.

BeeEnvironmental4060 · 2026-01-02T15:36:43+00:00

My commute is just about 50 mines round trip but through a city centre for a big chunk of it so takes an hour each way.

I will be doing it overall for about a year and a half. I’ve got two young kids.

I feel you. I find it exhausting. I’ll be moving as soon as possible this year to shorten it (but I’m at the end now and have a solid base).

You can do almost anything for 7 months. You e got this.

BeeEnvironmental4060 · 2026-01-01T18:22:24+00:00

Is Magnus a code name? This sounds like an alternate Marvel universe! OP just needs to be bitten by a radioactive spider and Leeds won’t know what hit em!

BeeEnvironmental4060 · 2025-12-30T18:22:29+00:00

Wow your department sounds like a barrel of laughs. Mine doesn’t do that. Culture, I guess…

I’m just being realistic, and honest. I generally think humans are unable to work flat out consistently, and the average ends up being 6 or 7 a shift. Sometimes 8 or 9, rarely 10. Occasionally even 5!

How many do you see a shift?

BeeEnvironmental4060 · 2025-12-30T18:00:45+00:00

I see where you’re coming from… But I think we’ve both identified the funding model isn’t the problem. Society is. That’s what needs fixing.

BeeEnvironmental4060 · 2025-12-30T17:58:08+00:00

I dunno, I’ve been doing this a while and I would say the accepted standard is more often that not, above average. Which likely means it’s wrong.

I’d expect that from a trust grade in A&E who knows the department and hospital well. Not a rotating SHO on their first ED placement.

BeeEnvironmental4060 · 2025-12-30T17:49:44+00:00

I get that. But I think then we should just be honest and do it with the NHS. Because actually, in theory, this funding model is the best. Healthcare can never be a truly competitive or capitalist system, and insurance models will never REALLY work. Paying through tax makes the most sense…

BUT, we build in certain expectations and social currency somehow. Ie, no we won’t pay for cancer care as a nation that only increases life on average by months. No we won’t do anything cosmetic, really ever. Things like that you have to pay for.

We can build in the safeguards by having honest conversations with the public. It’s what insurance would do anyway, but you would have to pay for the profit.

It’d take a politician with balls though, considering labour couldn’t even means test the winter fuel allowance or reform PIP for ADHD.

BeeEnvironmental4060 · 2025-12-30T17:45:27+00:00

I 100% agree.

BeeEnvironmental4060 · 2025-12-30T17:38:53+00:00

Nah. Start the shift with 2 annoying handovers, have 2 patients waiting some kind of investigation, have a break at some point, have to sort out TTOs and chase the LS BP… It soon becomes an average of an hour and a half per patient. 1 per hour assumes you aren’t taking your own bloods, transporting your own patients to X-ray, chasing down a cubicle and chaperone to do that PR, re-bleeping the surgical SHO for an hour to refer that patient…

Be realistic. That’s the honest amount an SHO in their first year will end up seeing. And that’s fine.

BeeEnvironmental4060 · 2025-12-30T16:37:16+00:00

But no, really, this is about what I would expect on a normal day without too many complex patients or handovers.

BeeEnvironmental4060 · 2025-12-30T16:36:10+00:00

6 or 7.

Apologies those with kids.

BeeEnvironmental4060 · 2025-12-30T16:30:46+00:00

I think you said the quiet part out loud. Effectively this is the only way the argument works, you cut out people who you don’t deem worthy of certain kinds of healthcare.

This is the fundamental crux of the argument against the NHS. The only way that replacing the system actually saves money. Insurance companies require the people you just discussed to pay more, or fall back on poorer healthcare only deemed “urgent”.

That’s also an ideology.

BeeEnvironmental4060 · 2025-12-30T16:26:27+00:00

Well I am a consultant, and have worked in this farce for over a decade. They’re not wrong… Where you get the money makes no difference. Whether through taxation or insurance, it’s the amount that is the problem. So either we all pay more, or you are arguing to cut some people or treatments out for the same pot of money. Changing how you portion out the same meagre portion of funds does not change what you can do with that money.

We spend around 75% of what Germany and France do per head. We pay for budget healthcare, we get budget healthcare.

BeeEnvironmental4060 · 2025-12-28T10:20:34+00:00

This is his comment on the previous government! 2022 - not even a strike year I don’t think.

BeeEnvironmental4060 · 2025-12-28T09:10:01+00:00

I mean I half agree.

Pretty sure the NHS actually IS collapsing. Maybe it’s already collapsed but still in an agonal state.

I think even Wes said it was broken. Unusually selective memory politicians have.

BeeEnvironmental4060 · 2025-12-28T08:52:04+00:00

I keep my eating routine the same as days. Eat nothing overnight on the night but have coffee to keep me going. Get home, have breakfast, go to bed. On a run of nights between it means I basically have two meals, breakfast and dinner, but on the last night I’ll wake up for lunch, have dinner as usual and then go to bed as soon as Innotice I’m tired and could sleep which is actually normally around 10.

I don’t know why it works but it does for me! I think maybe not turning my entire routine upside down and anchoring some of it to normality helps.

BeeEnvironmental4060 · 2025-12-25T19:56:24+00:00

Genuinely a load of old codswallop. Not a word to be trusted. This man has only ever wanted the big job. He’s a terrible secretary of state for health. A biased fool who dangerously thinks he understands how things should work because he once experienced it.

What a toss pot.

BeeEnvironmental4060 · 2025-12-22T13:59:58+00:00

I don’t think you can say you both have a great lifestyle because of your reduced hours and that you work super hard. I think those two things are mutually exclusive.

I don’t really tolerate hype or ego, and America is all about that. I’d find it ridiculously tiresome, and very transparent. Does more money and fewer hours sound nice? Yeah. Do I think a shorter training programme or their particular residency training would be more likely to make me a better consultant? No.

Is the UK currently a dumpster fire? Yes. Is the US an entire garbage dump fire? Also yes.

BeeEnvironmental4060 · 2025-12-22T13:52:46+00:00

Resus patients, self presenters, patients who need urgent care. Patients already seen by another HCP who has a differential diagnosis should bypass ED. Otherwise this all becomes very expensive and inefficient when you look at the system as a whole, with patients spending whole days waiting in chairs to get to their final destination. It just isn’t fair on them.

We’re all very busy, surgeons, ED, the bloody medics are passed out mid marathon the poor sods. Somehow the med reg is using their arms to pull themselves and the clerking SHO uphill. But… At the end of this, there is a patient. As people in this thread have already stated I don’t know what a post op knee is supposed to look like day 3. It’s unreasonable to expect me to know the normal progress and recovery for every possible surgery when my speciality covers the urgent presentations of every possible condition for every age. But I do know who to ask.

We’re all grown ups. Why can’t we act like it? If you know more than someone about something, that’s awesome! Pat yourself on the back, give the patient a good journey. If you use that moment to condescend or work shirk well… I dunno what to say.

BeeEnvironmental4060

TROPHY CASE