GP: Why I have to quit job I love

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A GP who is leaving her practice at Portadown Health Centre due to unbearable pressures has outlined in an emotional letter the stark realities which forced her to quit the job she loves.

And she has warned that the impending crisis could affect all patients at the health centre.

Dr Shauna Heanen, who will leave Bannview Medical Practice in under three weeks, has given the Portadown Times permission to print the full letter, as it is the first time she has had the chance to speak directly to her patients.

The letter was presented at a special, recalled sitting of the Stormont Health Committee on Monday.

In it, Dr Heanen reveals how she found herself caring for 5,200 patients on her own in October, after her colleagues left. On the day that she had to admit she couldn’t cope any more, she had been overwhelmed by the workload.

Dr Heanen outlines her fears of what will happen at the practice when she leaves.

“At present my reception staff are starting to leave as they have been put on to redundancy notice.

“I have multiple patients on serious drugs who require monitoring who I cannot give follow-up appointments to as they fall after my resignation date. I have palliative care patients who are dying, patients who have cancer, patients with severe mental health problems and children on at risk registers who will not have a GP in less than three weeks,” she writes.

“The rest of the practices in the health centre are not far behind us at present and if each were to get 1,000 extra patients, they will one by one collapse.”

The full letter is below:

My name is Dr Shauna Heanen. I am a GP Partner in Bannview Medical Practice. I am writing this to urge the Health Committee to take urgent action to save General Practice. I am not a politically minded GP - I am a GP who used to love her job and I took great pride in what I did.

Like many GP practices throughout Northern Ireland our workload over the previous 2-3 years has been growing exponentially. This was due to a combination of factors - an aging population with multiple comorbidities, a high number of nursing home patients, migration into the area and unresourced work being moved from secondary care into primary care.

We recognised that the workload was not sustainable and tried to identify ways to cope. We advertised for a new salaried GP with no success and then we asked for list closure which was declined.

GP Partners in the practice were working 12 -14 hour days with no breaks - I often didn’t eat until 9pm at night . We were unable to get annual leave, study leave or even get locums to work winter pressure clinics.

The practice was staffed by two partners and two salaried GPs. The two partners were working 12-14 hour days and bringing work home just to try to keep on top of the workload. One of the salaried GPs went off on maternity leave in March 2016 and then a GP Partner left the practice in August 2016. This left me and one heavily pregnant salaried GP trying to provide a service for 5,200 patients. We barely scraped by.

I advertised for partners, salaried GPs and locums to no avail. When the other salaried GP left in October I was left with 5,200 patients by myself. On the day when I had to admit that I couldn’t cope anymore I had done 40-50 phonecalls to patients, two over full surgeries which kept growing in number as more patients phoned, three house calls, 200 acute scripts, 150 blood results, hospital letters and then a range of phonecalls to various allied health professionals.

I left work in tears that day - I hadn’t slept in 4–5 days, couldn’t remember the last time I could eat a proper meal and couldn’t concentrate.

I was off work for two weeks and gave my resignation to the board - this broke my heart. I love my practice, my staff and my patients but I couldn’t manage the workload and was so scared that I would make a mistake due to the severe pressure. I went back into work to see my practice manager after two weeks and the choas met me at the door - the post which was normally cleared daily was piled high, there were 400 acute scripts, a list of phonecalls that needed returned.

I returned to work the next week with the board supplementing our locum rate to attract locums to the practice. Dalrida are providing a telephone triage service. To date no solution has been found. I leave in just under three weeks.

My practice provides a vital lifeline to a population with many social and cultural needs. At present my reception staff are starting to leave as they have been put onto redundancy notice. I have multiple patients on serious drugs who require monitoring who I cannot give follow-up appointments to as they fall after my resignation date. I have palliative care patients who are dying, patients who have cancer, patients with severe mental health problems and children on at risk registers who will not have a GP in less than three weeks.

Neighbouring practices are starting to feel the pressure as our patients start to leave. The rest of the practices in the Health Centre are not far behind us at present and if each were to get 1,000 extra patients they will one by one collapse. That will be the start of the end of GP practice as we know it in Northern Ireland.

I am 38 years old - a youngish GP - I have been a partner for five years. I have been left as the “last man standing”. Now instead of enjoying my job I am simply firefighting. I am a dedicated and committed GP - I always wanted to be a GP and now I am being forced to leave.

Northern Ireland has a committed and resourceful GP population who are trying at present to prop up a collapsing service. We don’t have the luxury of years to fix this problem - we have weeks.

Regards,

Dr Shauna Heanen