A spate of attacks in recent months has led to calls from health professionals for trust leaders and the Care Quality Commission to do more.

A major report on racism in the NHS by the British Medical Association (BMA), to be published this month, is expected to confirm ethnic minority staff facing “debilitating” levels of racism.

Now the Doctors’ Association UK, is warning of a rise in racist attacks “in accordance with what is happening nationally”.

Dr Yasotha Browne, diversity lead at the grassroots lobbying organisation, said: “The reasons will be multi-fold, but certainly in environments where racism is not taken seriously it will be very difficult for staff to feel that they will be supported when they have concerns or are a target.”

Last week, Dr Aman Amir spoke out about “heartbreaking” arson and racist graffiti attacks suffered by his practice in Knowsley, Merseyside.

The GP, who recently took over Roby Medical Centre, said “everything we’ve invested is undone” after a fire in the early hours of the morning caused extensive damage.

Just days before the arson attack, racist graffiti was sprayed on the front and side of the practice with the words “P***” and “paedo” scrawled on the white walls, Dr Amir said. “It’s very difficult because I’m the only person of colour in my organisation. Of course, I’ve grown up in the UK and unfortunately, I have at times faced racial stuff, but very rarely in my professional life,” he said.

Dr Browne, from Doctors’ Association UK, went further – telling ithat a white doctor in the same position would never have been treated the same way.

She said: “Dr Arora’s case has alarmed the profession. Many are conveying a feeling that this would not happen to a rich well connected – in other words ‘respected’ – white male doctor. Cases like this and disparities in treatment and fairness can be a damaging deterrent to those who may otherwise speak up or ally.”

Read the full article here

Healthcare workers have backed union calls for an inflation-proof pay rise for NHS staff, warning the health service is at “breaking point”.

Fourteen unions, representing 1.2 million health staff in England, have called on the Government to raise NHS pay and raised fears of a “growing exodus of exhausted staff”.

In a submission to the independent NHS pay review body, the unions urged action on pay to stem an “alarming” loss of medics. Inflation rose to 5.4 per cent last month, the highest for nearly 30 years, and as the cost of living crisis has deepened frontline workers have demanded a boost to pay.

Dr Yaso Browne, a Hampshire-based GP speaking on behalf of the Doctors’ Association UK (DAUK), told i: “People were encouraged to ‘protect the NHS’, but the people of the NHS need protecting from unfair freezes on their pay. 

“For years NHS staff have been offered wage increases below or barely meeting the cost of living, in real terms. They have gone and are still going above and beyond to keep the NHS running. Their pay needs to reflect the value the Government proclaimed it held for the NHS throughout the pandemic, and still claims it holds.

“Paying people a fair wage is a much-needed reality if we have any chance of retaining highly trained staff.”

Read the full article here

single swear word summed up the feeling in my GP group chat as they went on to alert me of the Government’s announcement on Sunday to deliver a third Covid-19 booster to all adults who want one by the end of the year.

My heart sank. I understood my colleagues’ dismay as I learned of the plan to ‘pause’ routine care to prioritise the boosters. We are all too aware of the current backlogs. Waiting lists have reached record highs as nearly six million people wait, while GPs see patients deteriorate, only to need increased care and more attention from the NHS. Meanwhile, hospitals continue to struggle with capacity.

We’re all worried there’s very little resilience within the system and GPs will still be asked to soldier on despite increasing pressures.

Throughout the pandemic GPs have been grossly undermined for managing this workload and maintaining safe working practices for both patients and staff. We’ve not fully recovered from this, and the distrust it has built makes the job much harder – for some untenable.

Colleagues routinely report ‘so much anger’ from the very people they are trying to help. It’s mis-directed and continues to be fuelled by our leaders under the guise of face-to-face appointments. I long for our politicians to admit how complex the issues are around our broken healthcare system. Instead, we see GPs flitting from being the scapegoats to the solution at the whim of a press release. The impact on morale is evident and GPs are, understandably, leaving in their droves.

So why are we not saying no to this disruption? The Omicron variant is much more contagious and it’s evading the vaccine and natural immunity – but less so with a third booster. Pfizer recently announced there will be four billion BNT162b2 vaccines produced – what we currently use – and this formula is not expected to change as they’re not able to adapt to new variants and scale up fast enough.

The latest report from the Intensive Care National Audit and Research Centre shows that just over half of Covid ICU admissions in the last two months were in those who were double vaccinated. Omicron is only thought to have spread within our population in the last few weeks, so this may not simply be attributed to a new variant. Simply put, this booster programme is our best chance of more of us remaining well and out of hospitals.

Mitigations beyond vaccines may be even more important with a rapidly growing anti-vax movement. Mitigations beyond vaccines may be even more important with a rapidly growing anti-vax movement, which has surged by millions and this could have ramifications to all of our vaccine programmes. The success of vaccines depends on herd immunity.

There are whispers that Test and Trace will continue until 2025 – a good hint life with coronavirus is here to stay. It’s time to embrace this as our normal for our own sanity. The Doctors’ Association UK supports normalised mask wearing with their #MaskUp campaign and perhaps splurge on the best perfume infused alcohol gel.

GPs will, I’m sure, again heroically deliver on this booster programme but the cost has to be levelled with long-term resilience building. More people will be in dire need of care as soon as this pause reverts to play and the GPs that are left to pick up the pieces may not be able to sustain this without expecting much better working environments. This includes professional respect, a stronger focus on other safeguards against the virus and future pandemics.

We need to embrace mitigations that don’t simply build on the shoulders of a very worn workforce that have simply been trying to do their best through the pandemic.

Perhaps it’s time we come round to the idea of what responsibility we can take and ask for more non-vaccine future proofing, in the hope that we can get on with our lives.

Dr Yasotha Browne is a GP and Diversity Lead with the Doctors’ Association UK

Read the piece in Mail Plus here

“Be kind. Don’t blame”

Yasotha Browne, GP lead at the Doctors Association UK, says, “Keeping each other accountable is a tricky task and there are many variables. Assuming you are colleagues of equal footing, with a trusting relationship, and you noticed a minor error, it’s important that you can approach them without blame.

“It’s therefore essential to have a no blame culture in place before you need to have a conversation about error. This means cultivating a culture where everyone understands that errors should be reported to help identify stresses in the system and the working environment, not as a mechanism for apportioning blame. A good way to do this is by being forthcoming about your own mistakes.

“We know that more mistakes happen when people are tired and stressed and, with already high rates of burnout among doctors, I would fully expect us to be seeing an increase in incident reports over the next five years.

“When approaching any discussion about an error, therefore, I would consider the context of that person’s working environment, the access they have to education and training, and, if privy to the situation, what is going on at home. Remember that marginalised groups, such as black and minority ethnic doctors, may be more fearful of being reprimanded.

“Finally, be kind. Don’t be judgmental about the error as a way of promoting your own practice. I have observed this in many colleagues—stress and competitive environments can make us default to the worst of what we are.

“Morale among doctors is low and we need to do our best to build each other up. This includes a compassionate and safe attitude to discussing and managing error.”

The move is the latest significant step into NHS provision from a company that has seen the number of patients registered with its GP at Hand service expand from less than 5,000 just over two years ago to more than 70,000 now. The GP at Hand service, which operates under a franchising arrangement with what was once a small west London GP practice, looks set to continue its rapid growth after being granted permission to expand its patient list in Birmingham and with a further expansion to Manchester expected this year.

The service has been accused of ‘cherry picking’ – which it denies – because more than 85% of patients registered with it are aged between 20 and 39 years old, and leaders have strongly criticised the government’s decision to allow its rapid expansion over concerns that the move is undermining existing GP services.

The Doctors’ Association UK GP lead Dr Yaso Browne said the Wolverhampton plans could destabilise existing general practice. She warned that NHS hospitals were already under unprecedented pressure, and said it was ‘extremely worrying’ to see changes that could threaten the GP gatekeeper role when the need for primary care to manage demand was greater than ever.

Excerpt from GP Online

Read Dr Yaso Browne’s full interview with GP Online

What are the implications for the GP-patient relationship?

This threatens traditional general practice where GPs see a range of age groups and complaints. Fitter and younger patients will likely prefer the convenience offered by online platforms such as Babylon. Those with chronic diseases or who are frail and elderly are actively excluded from registering with Babylon.

What are the implications for practices in the area that are not owned by the Trust?

GPs largely receive funding by numbers of patients registered. The Babylon model which exists in London and Birmingham, attracts fitter patients with a quoted 0.1% of those registered having chronic disease. Therefore practices not part of the network will have patients with higher needs. The way general practice is currently funded this would mean that despite the additional work generated by patients with more complex health needs the practices would not be sufficiently reimbursed doing this work. This may lead to financial ruin and GP practices closing unless the government changes how practices are funded.

Could we see the start of a two-tier system as patients look to join practices that are part of the setup?

Yes. We will continue to see private companies exploit the current GP funding scheme and profit by cherrypicking patients, putting traditional general practice, which is there to provide holistic care from birth to old age, at risk. The Doctor’s Association UK strongly believes that this is unethical. Does this then put pressure on practices to join the Trust/be taken over in order not to miss out? Yes if they are invited to join. Practices not already part of the scheme may find that the Trust will not see profitability in absorbing practices who have a higher proportion of patients with chronic diseases. Or we could see Trusts take over primary care services and introduce more corporate structures with less clinical autonomy including salaried GPs and the end to the very cost effective GP partnership model.

Does this represent a threat to the future of traditional general practice?

Yes. There is no need for the NHS to shamefully give room for private companies, such as Babylon, to profit from absorbing fitter patients, at the expense of both general practice and our vulnerable patients. This has the consequence of destabilising the crucial gate keeper role of GPs, which secondary care relies on to keep demand and wait times as low as possible. Our NHS key performance indicators are already some of the worst on record; it is hugely worrying that we are potentially threatening this further long term. Matt Hancock has endorsed Babylon as freeing up GP resources for those most at need but this would require a complete overhaul of how GP practices are currently funded to be true. If the NHS app which NHSx are developing was able to provide a similar digital platform this would give enough choice for patients to have online consultations as well as other options like telephone consultations, home visits and face to face consultations managed under one practice providing more joined up care and likely less risk adverse practice such as proper antibiotic stewardship. This set up risks cost effective and gold standard practice of care and could spell the end of general practice as we know it.

The trust admitted, however, that there is ‘proportionate risk’ for patients coming to harm. The email, signed by the trust’s medical director, Dr Allister Grant, said that GPs and community services were ‘well-equipped’ to cope.

GP leaders have said GPs could be left with sicker patients, who are beyond their scope of practice. A spokeperson for Royal Cornwall Hospitals NHS Trust said ‘nobody will be discharged if they still need care that can only be provided in hospital’ but for many it is ‘far better’ to be managed in the community or at home.

The email sent by the tust said: ‘One of the mitigations was to look at the level of risk that clinicians are taking when discharging patients from Treliske Hospital [now known as Royal Cornwall Hospital] either to home or to community services, recognising that this may be earlier than some clinicians would like and may cause a level of concern. ‘It was agreed however that this would be a proportionate risk that we as a health community were prepared to take.’

It later added: ‘We discussed the fact that the community services, voluntary services and primary care are well equipped to manage some of these earlier discharges.’

Yaso Browne, GP lead for the Doctors Association UK, said early discharges was a risk to GPs as well as patients. She said: ‘If premature discharges are indeed occurring, this is not just a threat to the safety of the individual patient but also to already stretched community services. ‘It may mean that GPs will have to prioritise managing these sicker patients potentially involving work beyond their scope over patients they routinely manage and have been trained to see.’

Dr Browne also told Pulse: ‘This desperate plan puts both patients and clinicians at risk – and is a clear symptom of our NHS in crisis.’

Read the full article in Pulse by Anviksha Patel:

http://www.pulsetoday.co.uk/news/nhs-hospital-trust-says-gps-will-manage-patients-it-has-told-doctors-to-discharge-early/20039983.article

The Red Cross in 2017 said the NHS was in humanitarian crisis. And that was following 2 people dying on a trolley waiting to be seen.

Dr Yaso Browne, DAUK Lead Editor

Interviewed alongside other healthcare staff Dr Yaso Browne speaks about the reality of working in today’s NHS. She explores the impact skeleton staffing on waiting times and patient safety, as well as discussing the impact of under-resourcing on doctors and healthcare professionals.

63% of doctors say they are burnout at work, and unfortunately 430 healthcare professionals have committed suicide in the UK.

Dr Yaso Browne, GP and DAUK Lead Editor