u/Canyon7096

Educational supervision sounds manageable when it is described as a few meetings a year. The actual work can include portfolio review, forms, difficult conversations, ARCP preparation and sorting problems between scheduled meetings. For consultants supervising several trainees, how much SPA is actually attached to it? At what point does the number of trainees make proper supervision unrealistic within the time given?

A 10 PA job can look fairly ordinary until the sessions are spread across two or three hospitals. Travel, parking, moving equipment or notes, and trying to join meetings from the wrong site can eat a surprising amount of the week. How is travel between sites recognised where people work? Is it properly built into the job plan, or does the timetable assume you can move between places without losing any time? DGH and tertiary comparisons would be useful here.

One complaint can mean reviewing notes, meetings, statements, governance discussion and a response that takes far longer than the original clinical contact. Is that workload recognised anywhere in people's job plans, particularly in specialties dealing with a high volume of complaints or incidents? When one lands in an already full week, what actually gets moved?

Supervision is often treated as a quick sign off. In practice it can mean reviewing decisions, being available for escalation, checking documentation and taking over the awkward cases when the limits of someone else's role are reached. For consultants supervising PAs/AAs/ACPs or other non medical roles, what time is actually recognised for this? Has anyone had supervision written into the job plan as a defined activity rather than something expected around normal clinical work?

Two consultant on call rotas can carry the same headline supplement and be completely different jobs. One may mean occasional phone advice. Another means repeated overnight calls, coming in, sorting gaps and then trying to function normally the next day. How do people judge whether an on call commitment is reasonable before taking a post? Which specialties have the biggest mismatch between the supplement and the actual disruption?

Two consultants can be doing very similar clinical work and still end up with quite different job plans. Same type of clinic, similar patient numbers, but different admin allowance, SPA or recognition for other work. How much visibility do people actually have of colleagues' job plans? Do departments ever review like for like activity together, or is everything negotiated one consultant at a time? Does transparency make job planning fairer, or just create another argument?

During job planning, assuming you don't have a role like CD or college tutor etc, how do you justify your SPA time?

As a gastro reg, I have a daily combo of chia seeds, flaxseed and psyllium husk for the fibre (to prevent bowel cancer) plus try to hit a weekly 30 plant points (for gut microbiome diversity)! 💩

AI scribes are being presented as an obvious answer to clinical admin. The difficulty is that current NHS guidance emphasises transparency, while indemnity advice appears more cautious about consent. The clinician still has to check the record and remains responsible if something important is missing or wrong.

For consultants already using these tools, has documentation time genuinely fallen once consent, checking, corrections and sensitive consultations are included?

Who approved the system locally, who owns an error, and is there a clear departmental policy for when it should be switched off?

Maybe I am being too cynical, but this feels like another productivity saving where the benefit is counted centrally and the risk stays with the clinician.

Healthwatch survey, more than 2,700 people found that 81% wanted clinicians to tell them when an AI scribe was being used and seek explicit consent. Comfort was much lower for mental health, sexual health and domestic abuse consultations. healthwatch

For those doing PP or locum via limited company. How much does your accountant charge and are you satisfied with their services? From my experience some accountants charge a fixed yearly fee while others charge a percentage of yearly revenue and want to know what is considered a reasonable amount

Has anyone been in a department where a nurse is the departments clinical lead. I came across a colleague who was in one and the leadership was in a mess. Management felt it's best they "control" the department via a nurse clinical lead.