
Sign up to save your podcasts
Or
I describe in detail my experience of challenging the NHS for using nurses in roles typically performed by doctors, and the subsequent harassment and interactions with the GMC.
My story began after the birth of my daughter in 2002, because I did not want to see my daughter getting a thornprick while playing, and die like numerous kids with Community Associated Staphylococcus aureus. I have been managing hospitals since 1989. Observed problems in diagnosing and managing illnesses and infections in primary care, particularly noting nurses and some doctors labelling illnesses and abusing antibiotics without thorough clinical examination or correct treatment. Working as a locum GP,
I had the opportunity to read notes written by GPs and ask patients what the doctor advised and treated. The patients' answers were shocking. I checked and validated their answers because numerous doctors wrote that their chest was clear when they had not identified situs inversus, hirsutism, gynaecomastia, and even TB. I knew GPs were documenting information that was not true.
For more than 30 years, I worked as the registrar and later as a staff paediatrician in hospitals. It was here that I used to read notes and clinically examine, not to validate junior doctors but to identify faults so that I could rectify them early. This habit made me read notes meticulously, and as a doctor, I felt a deep ethical discomfort. I did not want to share this information and criticise members of my own profession, so I chose nurse-led practice.
In a nurse-led practice, nurses offered diagnosis and treatment without supervision. I identified numerous cases of wrong diagnosis, treatment, and advice given by nurses and doctors, resulting in delayed diagnosis, complications, pain and suffering for patients.
This was the first Pilot Nurse-led practice created in the NHS. Noting that nurses lacked the knowledge, training, and experience to make correct diagnoses and offer treatment. Allowing nurses to work as doctors (taking history, clinically examining, requesting investigations, referring to specialists, advising, and prescribing) was unethical. I believed that patients who access primary care were developing complications due to errors in diagnosis and treatment by frontline staff like junior doctors and nurse practitioners. I described nurses offering advice and treatment to patients they should not, becoming overconfident.
To address this, I developed a simple colour-coded symptoms list, "MAYA," to help receptionists and nurses differentiate minor from serious illnesses. I expected patients with red symptoms to be referred to a doctor, but nurses did not like this and said, "We are Independent Nurse Prescribers," and showed me the Nurses' Pharmacopia. The number of patients suffering complications, delays in diagnosis, and incorrect treatment escalated.
I raised concerns about nurses being allowed to work as doctors in Thames Doc -Out of Hours, offering advice to manage emergencies and prescribing drugs. I wrote to GMC and asked them to define the word "Doctor" because the nurses who were not qualified passed the PLAB to prove they were safe and were allowed to work like me.
Upon raising these concerns, the Chairman of Surrey Primary Care Trust (PCT) informed nurses that I had raised concerns, leading nurses to initiate complaints. Staff were instructed to monitor my consultations and behaviour.
The investigation process was prolonged, dragging on for almost two years, by presenting new, unsubstantiated claims. I went off sick because the stress was unbearable; I wrote to the GMC in November 2009 explaining the unsafe situation of returning to work in a nurse-led practice and stating that I am defending medical ethics. In this communication, I clarified the problem you were facing. You explained to a GMC Policy Officer that they don't guarantee protection from victimisation for raising concerns.
I describe in detail my experience of challenging the NHS for using nurses in roles typically performed by doctors, and the subsequent harassment and interactions with the GMC.
My story began after the birth of my daughter in 2002, because I did not want to see my daughter getting a thornprick while playing, and die like numerous kids with Community Associated Staphylococcus aureus. I have been managing hospitals since 1989. Observed problems in diagnosing and managing illnesses and infections in primary care, particularly noting nurses and some doctors labelling illnesses and abusing antibiotics without thorough clinical examination or correct treatment. Working as a locum GP,
I had the opportunity to read notes written by GPs and ask patients what the doctor advised and treated. The patients' answers were shocking. I checked and validated their answers because numerous doctors wrote that their chest was clear when they had not identified situs inversus, hirsutism, gynaecomastia, and even TB. I knew GPs were documenting information that was not true.
For more than 30 years, I worked as the registrar and later as a staff paediatrician in hospitals. It was here that I used to read notes and clinically examine, not to validate junior doctors but to identify faults so that I could rectify them early. This habit made me read notes meticulously, and as a doctor, I felt a deep ethical discomfort. I did not want to share this information and criticise members of my own profession, so I chose nurse-led practice.
In a nurse-led practice, nurses offered diagnosis and treatment without supervision. I identified numerous cases of wrong diagnosis, treatment, and advice given by nurses and doctors, resulting in delayed diagnosis, complications, pain and suffering for patients.
This was the first Pilot Nurse-led practice created in the NHS. Noting that nurses lacked the knowledge, training, and experience to make correct diagnoses and offer treatment. Allowing nurses to work as doctors (taking history, clinically examining, requesting investigations, referring to specialists, advising, and prescribing) was unethical. I believed that patients who access primary care were developing complications due to errors in diagnosis and treatment by frontline staff like junior doctors and nurse practitioners. I described nurses offering advice and treatment to patients they should not, becoming overconfident.
To address this, I developed a simple colour-coded symptoms list, "MAYA," to help receptionists and nurses differentiate minor from serious illnesses. I expected patients with red symptoms to be referred to a doctor, but nurses did not like this and said, "We are Independent Nurse Prescribers," and showed me the Nurses' Pharmacopia. The number of patients suffering complications, delays in diagnosis, and incorrect treatment escalated.
I raised concerns about nurses being allowed to work as doctors in Thames Doc -Out of Hours, offering advice to manage emergencies and prescribing drugs. I wrote to GMC and asked them to define the word "Doctor" because the nurses who were not qualified passed the PLAB to prove they were safe and were allowed to work like me.
Upon raising these concerns, the Chairman of Surrey Primary Care Trust (PCT) informed nurses that I had raised concerns, leading nurses to initiate complaints. Staff were instructed to monitor my consultations and behaviour.
The investigation process was prolonged, dragging on for almost two years, by presenting new, unsubstantiated claims. I went off sick because the stress was unbearable; I wrote to the GMC in November 2009 explaining the unsafe situation of returning to work in a nurse-led practice and stating that I am defending medical ethics. In this communication, I clarified the problem you were facing. You explained to a GMC Policy Officer that they don't guarantee protection from victimisation for raising concerns.