Dr Matt Kneale
@drmk.link
Doctors' Association UK ⚕️
Emergency Medicine 💊
Passionate about truth, equity and fairness
Slowly leaning into law and tech
@drmattuk on X / the cesspit ☠️
Emergency Medicine 💊
Passionate about truth, equity and fairness
Slowly leaning into law and tech
@drmattuk on X / the cesspit ☠️
Great to be at the FFLM Conference today. I’ll be speaking later on the move from discovery to accountability around the role of physician associates—looking forward to the discussion.
#FFLMConf25 @fflm.bsky.social @thedauk.bsky.social
#FFLMConf25 @fflm.bsky.social @thedauk.bsky.social
May 10, 2025 at 9:47 AM
Great to be at the FFLM Conference today. I’ll be speaking later on the move from discovery to accountability around the role of physician associates—looking forward to the discussion.
#FFLMConf25 @fflm.bsky.social @thedauk.bsky.social
#FFLMConf25 @fflm.bsky.social @thedauk.bsky.social
I always knew ChatGPT would show its value someday.
March 27, 2025 at 2:09 PM
I always knew ChatGPT would show its value someday.
1/ If Trump is kompromat and China is allied with Russia, the PLA may see 2025–26 as the best window to invade Taiwan. Trump’s Congress backs him, and he seems unwilling to spend American dollars defending former allies like Ukraine.
February 25, 2025 at 3:36 PM
1/ If Trump is kompromat and China is allied with Russia, the PLA may see 2025–26 as the best window to invade Taiwan. Trump’s Congress backs him, and he seems unwilling to spend American dollars defending former allies like Ukraine.
I'm not sure I have it in me to unpack the 'research' behind these referenced leaflets. Does this really clarify the limitations of PAs for patients? Beyond stating they can't prescribe antibiotics or request X-rays, what are the risks left unaddressed?
December 5, 2024 at 11:39 PM
I'm not sure I have it in me to unpack the 'research' behind these referenced leaflets. Does this really clarify the limitations of PAs for patients? Beyond stating they can't prescribe antibiotics or request X-rays, what are the risks left unaddressed?
Apologies if I lost some of you in journal club earlier—back to Lord Scriven. It seems he misunderstands the scope of practice. An SoP isn’t about 'individual competence'; it defines the safe, professional limits for a role.
December 5, 2024 at 11:39 PM
Apologies if I lost some of you in journal club earlier—back to Lord Scriven. It seems he misunderstands the scope of practice. An SoP isn’t about 'individual competence'; it defines the safe, professional limits for a role.
There were other issues, but let's move to the Emergency Department paper. At first glance, it's glowing: 7-day reattendance rates are similar, and patients had positive perceptions of PAs—though with limited awareness of their role.
December 5, 2024 at 11:39 PM
There were other issues, but let's move to the Emergency Department paper. At first glance, it's glowing: 7-day reattendance rates are similar, and patients had positive perceptions of PAs—though with limited awareness of their role.
For example, a low re-consultation rate does not confirm that diagnoses were accurate or treatment effective. It wouldn't identify things like, oh I don't know, missed cancers - off the top of my head.
December 5, 2024 at 11:39 PM
For example, a low re-consultation rate does not confirm that diagnoses were accurate or treatment effective. It wouldn't identify things like, oh I don't know, missed cancers - off the top of my head.
The Drennan GP study was small, observational, and lacked randomisation. Notably, no doctors were on the study team. PAs predominantly saw younger patients with fewer chronic or acute issues, raising questions about its applicability to broader practice.
December 5, 2024 at 11:39 PM
The Drennan GP study was small, observational, and lacked randomisation. Notably, no doctors were on the study team. PAs predominantly saw younger patients with fewer chronic or acute issues, raising questions about its applicability to broader practice.
This is misleading—there were fewer than 200 PAs in 2014, with the LTWP aiming to expand their numbers to 10,000 from just 5,000. The rapid rollout post-Junior Doctor strikes in 2016 is unprecedented. I'll leave you to guess why that might be.
December 5, 2024 at 11:39 PM
This is misleading—there were fewer than 200 PAs in 2014, with the LTWP aiming to expand their numbers to 10,000 from just 5,000. The rapid rollout post-Junior Doctor strikes in 2016 is unprecedented. I'll leave you to guess why that might be.
What does 'mid-level' mean? What is the 'medical model'? How can PAs replace doctors on rotas and safely diagnose without the same training?
These buzzwords obscure the real question: Do PAs truly understand and fulfil the responsibilities of a doctor?
These buzzwords obscure the real question: Do PAs truly understand and fulfil the responsibilities of a doctor?
December 5, 2024 at 11:39 PM
What does 'mid-level' mean? What is the 'medical model'? How can PAs replace doctors on rotas and safely diagnose without the same training?
These buzzwords obscure the real question: Do PAs truly understand and fulfil the responsibilities of a doctor?
These buzzwords obscure the real question: Do PAs truly understand and fulfil the responsibilities of a doctor?
With most healthcare interventions, you establish risk before rollout - and certainly before extending the rollout after concerns have been raised. Imagine if Boeing simply went and accelerated the building of Boeing 737 MAX planes in 2019 after concerns were raised.
December 5, 2024 at 11:39 PM
With most healthcare interventions, you establish risk before rollout - and certainly before extending the rollout after concerns have been raised. Imagine if Boeing simply went and accelerated the building of Boeing 737 MAX planes in 2019 after concerns were raised.
I'm glad he agrees supervision has been inadequate.
December 5, 2024 at 11:39 PM
I'm glad he agrees supervision has been inadequate.
This claim against the BMA is defamatory.
He also failed to address the false claims of acid attacks by doctors against PAs in hospital car parks. Was it professional of UMAPs to spread this misinformation? What about their CEO referring doctors to the police and regulator?
He also failed to address the false claims of acid attacks by doctors against PAs in hospital car parks. Was it professional of UMAPs to spread this misinformation? What about their CEO referring doctors to the police and regulator?
December 5, 2024 at 11:39 PM
This claim against the BMA is defamatory.
He also failed to address the false claims of acid attacks by doctors against PAs in hospital car parks. Was it professional of UMAPs to spread this misinformation? What about their CEO referring doctors to the police and regulator?
He also failed to address the false claims of acid attacks by doctors against PAs in hospital car parks. Was it professional of UMAPs to spread this misinformation? What about their CEO referring doctors to the police and regulator?
Fear of speaking up is real in the NHS, especially for rotating trainees in departments with permanent staff like PAs/AAs. This silence can affect patient safety and training. Does Lord Scriven fully recognise this dynamic?
December 5, 2024 at 11:39 PM
Fear of speaking up is real in the NHS, especially for rotating trainees in departments with permanent staff like PAs/AAs. This silence can affect patient safety and training. Does Lord Scriven fully recognise this dynamic?
If we'd waited, this review might never have happened. Early advocacy on PA and AA roles—despite 'limited evidence'—brought us here. Speaking out early drives change, not waiting for perfect data.
December 5, 2024 at 11:39 PM
If we'd waited, this review might never have happened. Early advocacy on PA and AA roles—despite 'limited evidence'—brought us here. Speaking out early drives change, not waiting for perfect data.
Thank you @baronesskeeley.bsky.social & @nataliegreenpeer.bsky.social for bringing medical profession + public's concerns to this debate.
December 5, 2024 at 7:17 PM
Thank you @baronesskeeley.bsky.social & @nataliegreenpeer.bsky.social for bringing medical profession + public's concerns to this debate.
Greater Manchester Cancer Alliance has piloted physician associates in roles that include "independent" cancer clinics in urology, lung and acute oncology.
This is criminal.
It will need to form part of the review announced yesterday into MAPs.
This is criminal.
It will need to form part of the review announced yesterday into MAPs.
November 21, 2024 at 9:10 AM
Greater Manchester Cancer Alliance has piloted physician associates in roles that include "independent" cancer clinics in urology, lung and acute oncology.
This is criminal.
It will need to form part of the review announced yesterday into MAPs.
This is criminal.
It will need to form part of the review announced yesterday into MAPs.
After the BMA called on the government not to use taxpayers' money to support the GMC in its defence, senior GMC and DHSC officials discussed their strategy.
This email suggests the government WILL fund the GMC's legal defence ("pickup the costs of new professions")
This email suggests the government WILL fund the GMC's legal defence ("pickup the costs of new professions")
November 21, 2024 at 8:33 AM
After the BMA called on the government not to use taxpayers' money to support the GMC in its defence, senior GMC and DHSC officials discussed their strategy.
This email suggests the government WILL fund the GMC's legal defence ("pickup the costs of new professions")
This email suggests the government WILL fund the GMC's legal defence ("pickup the costs of new professions")
via @Mike88881221 on X
NEW: Emails show that the GMC lobbied the government to fund its legal defence against bereaved parents & @anaesunited.bsky.social.
The legal action challenges the GMC's failure to distinguish between doctors & physician associates or set a 'scope of practice' for PAs.
NEW: Emails show that the GMC lobbied the government to fund its legal defence against bereaved parents & @anaesunited.bsky.social.
The legal action challenges the GMC's failure to distinguish between doctors & physician associates or set a 'scope of practice' for PAs.
November 21, 2024 at 8:33 AM
via @Mike88881221 on X
NEW: Emails show that the GMC lobbied the government to fund its legal defence against bereaved parents & @anaesunited.bsky.social.
The legal action challenges the GMC's failure to distinguish between doctors & physician associates or set a 'scope of practice' for PAs.
NEW: Emails show that the GMC lobbied the government to fund its legal defence against bereaved parents & @anaesunited.bsky.social.
The legal action challenges the GMC's failure to distinguish between doctors & physician associates or set a 'scope of practice' for PAs.
A concerning decision has been made to cut general medicine placements in Year 2 from 12 weeks to just 9, citing students found it “too difficult” (Revalidation Report, p. 6).
November 18, 2024 at 2:00 PM
A concerning decision has been made to cut general medicine placements in Year 2 from 12 weeks to just 9, citing students found it “too difficult” (Revalidation Report, p. 6).
These are wonderful.
Nikon D70 was my first camera back in the mid 2000s. What a time! You're right, it's now going for £40. I might go back!
Nikon D70 was my first camera back in the mid 2000s. What a time! You're right, it's now going for £40. I might go back!
November 15, 2024 at 11:01 PM
These are wonderful.
Nikon D70 was my first camera back in the mid 2000s. What a time! You're right, it's now going for £40. I might go back!
Nikon D70 was my first camera back in the mid 2000s. What a time! You're right, it's now going for £40. I might go back!
1/ A recent acquired Root Cause Analysis (RCA) sheds light on further critical safety issues surrounding Physician Associates (PAs) in the NHS.
November 17, 2024 at 10:47 PM
1/ A recent acquired Root Cause Analysis (RCA) sheds light on further critical safety issues surrounding Physician Associates (PAs) in the NHS.
Why is Doctors Vote claiming credit for the UHB trust's rate reversal, when this outcome was actually negotiated by IROs and the LNC—not by Doctors Vote? This looks like an attempt to take undue credit. Wouldn't be the first time.
November 17, 2024 at 10:47 PM
Why is Doctors Vote claiming credit for the UHB trust's rate reversal, when this outcome was actually negotiated by IROs and the LNC—not by Doctors Vote? This looks like an attempt to take undue credit. Wouldn't be the first time.
Just remember—if you’re a doctor concerned that people are dying, you're labelled as abusive and need to #BeKind If you’re a PA who doesn’t like being asked to treat others with respect, you’re allowed to say shut up, make threats, and throw around accusations of sexism and more
November 17, 2024 at 10:46 PM
Just remember—if you’re a doctor concerned that people are dying, you're labelled as abusive and need to #BeKind If you’re a PA who doesn’t like being asked to treat others with respect, you’re allowed to say shut up, make threats, and throw around accusations of sexism and more