I hope abolishing NHSE fixes some of these perverse incentives for trusts to seek alternative income streams.

More than anything I'm frustrated by poor leaders like Dr Navina Evans who must have been aware & yet can't listen to doctors & work to improve things.

8/8

The sad thing is, they're not even trying to hide it. Most screenshots from my FOI request but a lot of info is freely available online:

global.hee.nhs.uk/supporting-g...

www.hee.nhs.uk/sites/defaul...

education.uhb.nhs.uk/clinical-edu...

7/8

They can apply to any speciality. There's no workforce planning or ringfencing for specialities/regions most in need.

I've no doubt these doctors are suitably qualified.

But amidst ongoing NHS crises, how can we provide training for up to 300 Saudi drs & yet not our own?

6/8

It seems the agreement is expected to be renewed in 2030 when it expires.

This is so backwards.

UK drs are emigrating unable to get training & yet trusts are being paid by foreign govts to train their drs here.

Why can't we put money into training the drs we already have?

5/8

Where was the consultation with doctors, royal colleges, BMA about this? Feasibility to deliver training & impact assessment?

It's infuriating HEE, DHSC, GMC all approved this.

On a backdrop of ⬆️ competition ratios & ⬇️ training satisfaction during the same period.

5/8

What little comfort it may provide, it doesn't seem to take away from the pool of UK training nos.

I'm sure these doctors are highly capable & they do need to meet the same benchmarking standards.

But UK drs are expected to go through the CV & application rat race. Why?

4/8

NHSE said they didn't give or receive any money, but confirmed that Saudi govt pay UHB directly. (I have separate FOIs still pending about this).

Why UHB? The "prestigious" trust often in the news for toxic leadership has historical working relationship with Saudi DoH.

3/8

During covid in 2020+ as UK doctors faced redeployment, exam cancellations & delays, recruitment mishaps, moral injury, @england.nhs.uk, HEE, UHB were busy helping support a growing no of Saudi doctors enter UK training.

2/8

11/11 The paper is available here www.bmj.com/content/388/... and an accompanying editorial by Kieran Walshe is here www.bmj.com/content/388/... As he notes, “The prospects for extending their role … now seem remote”

5/11 ⚠️ Notably, we found no evidence that physician associates add value in primary care or that anaesthetic associates contribute positively in anaesthetics. If you add cost of supervision, which the studies don’t, it’s very unlikely they are cost-effective

4/11 🏥 Our findings suggested that the evidence was limited and preliminary. There were important concerns about the competence of PAs in managing complex patients and prescribing (which happens, even if illegal)

Also please ignore the vignetting, I'm using a DX lens on a film camera and Nikon's annoying changes mean it cuts off 35mm film.