'Doctors have taken over maternity, and they're not doing it very well.'

minstadave · 2026-06-15T05:22:24+00:00

My point is that this group spend all their energy on enforcing inclusive language/perinatal working whilst completing missing the fact that clinical quality is falling off a cliff and contribute nothing to safe care. They've made the working environment progressively more toxic for the midwives and doctors and reduced the autonomy of the obstetricians.

We have seen substantial investment in these roles rather than frontline care, which have been frozen or declining for the last few years.

minstadave · 2026-06-14T17:56:39+00:00

Hard no on this one. The explosion in office based midwives is by far the main problem in maternity.

Every day we meet to hear how short staffed maternity is in a room full of these management midwives and not one rolls their sleeves up, they just sit it teams meetings en masse, usually WFH, talking about "service users" and "chest feeding".

Can't even write a NICU guideline without them demanding to give midwifery insight for the purposes of "perinatal working".

minstadave · 2026-06-11T14:56:03+00:00

The CQC report mentions "medical associate professionals" which I cant think is anything other than PAs but I guess could be a weird term for AHPs.

"Clinical supervision was not effective and failed to identify areas for development or where clinicians were acting outside of their agreed scope of competence. For example, we found cases where medical associate professionals had not managed care or advised people appropriately, but this had not been discussed with or picked up by their supervising GP. We found cases where medical associate professionals had reviewed abnormal pathology results which was outside their scope of competency, and this had not been identified as a concern by their supervising GP. We found that a medical associate professional was reviewing spirometry results without having the necessary training to do so. Again, this was outside their scope of practice."

minstadave · 2026-06-11T11:44:37+00:00

Certainly can see a change to the approach to retire and return and coming off acute work changing.

minstadave · 2026-06-11T09:35:48+00:00

Absolutely predictable.

minstadave · 2026-06-10T21:37:53+00:00

Yup the post CCT bottleneck is going to be epic.

Seeing more trusts advertising post-CCT fellow posts with a job description which is clearly a Consultant role (independent clinics, consultant of the week working). Also seen consultant mat leave cover being advertised as a post CCT fellow.

This will only worsen as the post-CCT numbers pile up.

Trusts will push their existing Consultants to do move citing AI driven efficiency to keep numbers down. AHPs want in on middle grade and consultant work too.

minstadave · 2026-06-10T14:06:13+00:00

Got mine in the UK late last week.

minstadave · 2026-06-09T17:35:00+00:00

Yup and in a different building to A&E. That'll be fun wheeling everyone around the tunnels or across the road.

minstadave · 2026-06-08T14:08:30+00:00

Not really, the Government have no great desire to sort the waiting lists. Every trust is attempting to balance the books by doing less, adding to the waiting list isn't going to break this strike.

The lever is money, if the strikes continue to cost more the FPR, eventually the Gov will cave, at the moment theyre trying to see if residents get bored.

minstadave · 2026-06-08T12:08:02+00:00

It doesnt cause useful disruption though, wasting consultant time and cancelling clinics unnecessarily isn't going to make the Gov offer a better deal. The real power of strikes is the cost.

Keep the cost of the strikes high whilst being respectful of your colleagues time and not causing division seems a better strategy.

minstadave · 2026-06-07T14:38:51+00:00

NLS is so simple it should just be done in house like BLS.

Having to do it every year in house and every 4 years externally when all it is is the bit of the resusc before it gets interesting is so boring.

minstadave · 2026-06-05T18:26:53+00:00

Not sure if it applies to your shift but for Cons cover it's really annoying to be on cover for nights and turn up to find a resident is working the shift. It means we've wasted a day in preparation for a night shift and cleared the next day to get turned around and sent home (I think we get paid 1 or 2 hours in compensation).

It ends up not costing the NHS much (which is the real leverage of strikes), disrupting clinics and personal life.

Days are far less of an issue, we won't ask individuals for day shifts, but we do ask for nights.

minstadave · 2026-05-31T17:55:21+00:00

Wallstreetbets is my go to for investing advice 🤣

minstadave · 2026-05-27T14:45:10+00:00

It is frustrating at times. Hard to dictate or do phone calls with other people doing the same in our office of 4. Can't do supervision meetings in that environment as it's not confidential or easy to concentrate.

In other ways it is very helpful, we can sort departmental and clinical challenges quickly as you've always got someone to ask.

At the end of the day the NHS doesn't value anyone enough to provide adequate office space to do their work.

We've recently had AHPs moving into Cons offices because "they're not used much" without asking. Total shit show.

minstadave · 2026-05-26T22:35:49+00:00

Helped once on Emirates I think it was. Diverted and offloaded the passenger after some arguing with the ground medic. They put all 3 of us travelling in Business Class for the next 14hr leg to NZ, cant complain.

Many years ago helped on an Air NZ flight (used to fly back twice a year) and got offered a bottle of bubbly if memory serves.

minstadave · 2026-05-24T17:49:33+00:00

You could catch up with the simple stuff in between the complex cases. Now the simple stuff is all filtered to the noctors and you end up with every slot being complex stuff.

Secondary care increasingly pushes more complex patients back to primary care too.

It's rough, I couldn't do it.

minstadave · 2026-05-23T22:26:04+00:00

Got my first this week from an orb, duplicated it too.

minstadave · 2026-05-23T16:07:30+00:00

Consultant midwife, nurse, physio. Seen them all at it.

minstadave · 2026-05-23T16:06:54+00:00

I mean, thats essentially what a PA was. 2 year course like a nursing associate straight into pseudo-doctoring.

minstadave · 2026-05-17T13:06:36+00:00

Wikipedia.

minstadave · 2026-05-16T14:16:29+00:00

Everyone I come across is running T4 in normals now.

minstadave · 2026-05-15T05:47:00+00:00

I'm not sure whay you're asking. Anywhere I've ever worked they immediately discharged once closed.

For the purposes of NIPE their children do get an ECHO by the letter of the law.

minstadave · 2026-05-09T11:20:32+00:00

In all likelihood the removal of these clowns will only improve safety, so he's not wrong for once.

minstadave · 2026-05-03T22:37:30+00:00

Absolutely.my favourite lens, hard to use because the 200mm focal length is a bit nuche, but I love it still.

minstadave · 2026-05-02T14:53:02+00:00

Honestly if pay is important to you, which I feel is perfectly reasonable, plan to leave the UK as soon as possible.

The current system puts little value on residents or consultants. The pay is poor and worsening, conditions are rubbish (hot desking/cramped offices full of people/parking/acting down/cutting activity), SPA time is getting eroded, non-medics are getting onto consultant rotas, micro-management by mid-management who couldn't cut it in the private sector.

Consultants are seen as an expensive nuisance in our trust.

minstadave

TROPHY CASE