To leave the NHS

[Jennywren100]

Just that really. Worked in the NHS nearly 20 years. I'm a senior doctor in a front line speciality and I just don't think I can go on. There is no option to move into private practice (there is no private practice in my speciality in the UK), but feel sad at the thought of chucking in nearly a quarter of a century of training (if you include medical school) and experience.

The list of reasons for leaving is varied and long and I know many colleagues feel similarly to me but either have better coping mechanisms than me, care less, or for various reasons leaving simply isn't an option. And I know my department is actually better than many.

I already work part time and took extended leave over the summer to see if a break would help. It hasn’t. My colleagues love me and value me - they regularly tell me, so it’s not about feeling undervalued in my team. It’s about being completely overwhelmed in a failing system......and the public having not one scoobie of an idea that their beloved NHS is about to implode as they daily pour through the doors with an ever increasing list of demands and sense of entitlement and an ever decreasing sense of responsibility for themselves.

I feel like I will have wasted most of my life if I leave but I spend my day being super nice to patients and relatives and come home and am grumpy and miserable to DH and DC - the people who mean most to me in the world. Its all wrong. I have absolutely no idea what I would do if I left. There must be other MNers who feel like this?

I’m an AHP OP, and have just applied for a post outside of the NHS. It’s really getting to me now - for women with kids it’s hard to work flexibly as service needs always come first.
As an institution I love it, but I agree with every word you’ve said.
You sound like a very good doctor who’d be a loss to the NHS, but until they start treating the staff with some dignity and respect this will happen more and more.
Put yourself and your family first.

I work in the NHS. I’m not a doctor though. However, am also looking to leave. My ‘speciality’ is treated appallingly by management. Like something scraped off the bottom of their shoes!
We get it from both sides - from doctors and patients! We really are piggy in the middle!
The NHS is top heavy with over paid pen pushing management who haven’t got the foggiest and care only about audits and budgets. They are instrumental in the demise!
Money wasted is ridiculous. Patients are also so entitled and unrealistic.
Personally, can’t wait until I find something else!! Good luck to you!

I can see all your reasons and when I'm with my dd when she's inpatient I can see lots of what you report. It scares me and I wouldn't leave my dd in hospital because I believe I need to be there to advocate for her (and check for mistakes due to staff overload). Not a criticism of staff, just saying that to me it's obvious people are being asked to do more than is safely possible.

My dd has a rare, complex condition. Complex medical needs at home but with no nursing support. Dh and I have been doing all her care now for 10 years and we're fortunate that she is really well and has few admissions. She had surgery for a new central line earlier this year.

I don't know how to put this well, but just want you to know that people like me know that our child's life depends on doctors and nurses staying in the NHS and so we fundamentally appreciate what you do. We see it and I always thank people personally when we can. We've had the same consultant for 10 years.

Around my caring responsibilities, I do as much as I can to highlight the problems and change things (write to MP, sit on a parent group for input into research, am currently contributing to patient's perspective chapter of textbook, have spoken at paediatric surgical conference etc).

Obviously, I want doctors and nurses and other health professionals to stay in the NHS because as a family we are vulnerable and know that it keeps our dd alive. However, I completely understand that your individual life and choices need to come first. I want to communicate how people in my position really value the staff in the NHS, but also to say that if there's any way you can communicate your thoughts and reasons etc to make any impact before/during/after you leave (if you do) then please do. I realise that changing this is beyond one person, but if you can do anything towards making a change I think it would help, even if just in a small way.

I used to work in early phase drug testing (before I was made redundant) and clinical research could be somewhere you might want to work. There are always qualified doctors who assess adverse events in pharmacovigilance departments & the work can be flexible.

OP, the NHS has saved my life twice. It has treated my badly injured son. It has helped my wife through pregnancy and childbirth.

You aren't being unreasonable to leave it. You've already given so much. Your career hasn't been wasted. You've helped what is probably thousands of people. If you are feeling burnt out, it is time to put yourself first for a bit now.

Another ex-paramedic here. 15 years and I should have left 3 years before I actually did. In the end I was subject to an internal complaint from a work colleague who I later found out was applying for a promotion position she thought I was going for too. She complained about another of her "competition" also. It was the final straw that made me leave and I am so grateful to her vileness as it ultimately improved my life now I am out of the NHS (I work for the MOD now).

The vilification we suffer from the media - often in the guise of "supporting" the NHS is horrific and for my profession one particularly bad case that tarnished the career of a young Ambulance Technician who did absolutely nothing wrong - resulted in a lot of political point scoring from MPs and also Amb Svc management which resulted in a loss of terms and conditions for us. We lost the right to get protected meal breaks and time barriers for breaks meaning that we could be made to work for a full (12hr) shift without a break "if the needs of the service demand it" which in reality is every day. Before we would be taken off shift after 6 hours for a 20 min break if we had not achieved a break. Now there is no such protection and the onus is on the individual to request a "fatigue" break if you feel the need for it but have to have a meeting with a manager afterward to justify your reasoning for it. That was the beginning of the end really. I had regularly worked 13-14 hour shifts (we never get finished on time), often working 7+ hours before getting 1 20 min break for the entire shift.

It was never the patients or the types of jobs we attended that caused my depression - it was the relentless bullying and mismanagement of myself and the others who worked closely around me that made it impossible for me to continue.

I have never looked back. I don't miss it. I would encourage anyone to leave if they are unhappy. Better to leave too early than a day too late - it took me a year to recover my health and my DH (who also left AS management due to stress/anxiety/depression) has not ever fully recovered his mental health in the 3 years since he was medically retired.

I am in a similar situation. I love my job and the time with patients is what keeps me going. He rest (cuts, budgets, management, pathways, paperwork, bureocracy) stresses me to the point of considering a career change on a daily basis. But I don’t know what else I am good at.

I’m feeling a bit stressed just reading your description of the problems you face every day!

I don’t think there’s anything more vital than your wellbeing, and being in a workplace that’s not functioning at all well can affect that irreparably.

It sounds like the aspect of having the patients as a factor is making the decision harder for you, you want to help them but doing that is made so difficult and stressful that you want to leave.

Someone gave me a great perspective on a situation I need to leave but don’t want to because the project hasn’t quite come to frutition yet, they said look at what you have done for it already not what hasn’t been done yet. You’ve made a significant contribution already so you’re not wasting your qualifications etc.

I don’t know much about options available as a doctor outside of NHS etc, but from what some PP have said there are a few and maybe you should look into what those are before deciding what you do from here.

So sorry to hear this OP

It’s good to see that MN at least have an awareness of how we abuse the system (or waste it)

I think it’s a shame but your MH is clearly suffering . Take a break and regroup

Please
Come
Back eventually ! Maybe

I know it will go against the grain, OP, but it's time to put your own health and wellbeing before that of patients. You're clearly a very committed doctor, working in probably the most stressful field in medicine, and you will have helped tens (if not hundreds) of thousands of patients and their families over the years.

It's time to put yourself first.

I think you should email Matt Hancock with your reasons though, so he knows what a knife edge the NHS is on.

I am an NHS dentist and I second everything you have said about the system being close to collapse.
I wish that I could leave daily.
I struggle to earn a living and earn far far less than what ppl could possibly imagine.
This is the case for most of my colleagues BTW.
I also struggle with daily stories in the press about dentists botching up this, that and the other and subsequently being sued as many of the mistakes that I read about in these stories are easily done and could happen to any dentist.
Patients are definitely getting more and more entitled whereas the funding and renumeration is sinking.
I honestly don't know how much longer I can carry on in this system tbh

JennyWren and Polly - I’m also quite junior. I’ve taken a little sabbatical but I highly doubt I am going back. Probably won’t even do my exam in January. OH is doing a CT year as a locum in quite a complex surgical specialty (well, they’re all complex) but because it’s being counted as a CT year there’s not much flexibility. Every block of cross cover means staying at the hospital, every long day on call is probably extended by six hours due to poor staffing, he was left to run a medical ward alone during his FY2 year quite frequently.

A few weeks ago in Paeds we had specialties in another hospital nearby arguing the toss over which one would accept a child whose airway we spend seven hours maintaining. He had quite a rare condition, so I can see why there was deliberation. Eventually they accepted him, we had to get a special transport team from another trust, and they then said the acceptance was on the proviso that he was anaesthetised. We went through all that, he was sent, and then they changed their minds about the intervention that was promised to his mother.

I did one rotation where every post take lasted 14 hours because there were so many outliers. Everywhere. All across the hospital. I’m talking gastro alongside gynae. It was horrendous. I felt like I was living in a sea of long days on call, with a normal day’s pay. The BMA’s response on that one is pending.

I honestly wish I’d never switched careers. I feel much happier at home working, but generally dreading telling my family who are all proud of me, but don’t accept how horrible it is. My friends who know have said I’m looking healthier, I have more time for everyone, my garden no longer looks like it belongs to nobody. I think I’d much rather be 10 years down the line knowing I did what would make me happier overall, not wondering whether it was all worth it to fulfil a dream I began bitterly regretting quite quickly.

As a final note, I know a fair few people who have jumped ship. Not a single one regrets (or at least they say they don’t)

I know it will go against the grain, OP, but it's time to put your own health and wellbeing before that of patients

Pretty much every poster has said that or words to that effect.

Could you go work for somewhere like NHS Digital as a subject matter expert? Keeps you within the NHS and paying your pension but not having to do the actual practicing.

I know there's plenty of others that do it and they're always a great source of knowledge on products and services being developed for the NHS as a whole.

@Jennywren100

Thank you for highlighting this issue here. I'm not a doctor but work closely with doctors (many of whom have become ill through work-related stress).

I see first-hand, every day, the pressure doctors are working under. I hear their stories (that they're too distracted about what happened at work, what they might have missed, calling back into the department to check on something well after their shift has ended - all of which stop them concentrating on what their kids are saying to them/their kids' homework) and that they have the feeling of dread heading to work each day (or night).

That they are often verbally abused by patients (& their families) for situations entirely out of their control.

That (non-clinical) management continue to pile on work despite doctors' collective views will be unsafe for patients to take on any more.

We are currently looking at the alarmingly high rate of physician suicide - the fact that doctors are 4 times more likely to take their own lives is horrifying. Although I have no stats to back it up right now, I have no doubt that the pressure of the job and the unreasonable demands placed on them my a system close to breaking point, not to mention complaints - many of which are unfounded (not all, of course) contribute significantly to this.

The public needs to know what is going on behind the scenes!

I hope you figure it out. I always feel so sad when I hear a doctor talking of leaving... but I completely understand why.

Hello OP, I am also a fairly senior doctor. I recognise your description of working in ED. About 3 years ago I had very similar thoughts and feeling about by job which were linked to burnout depression and anxiety. I Occupational Health were able to organise help for me. Interestingly now that I am mentally well I am able to cooe far better and really enjoy my job again - despite the same frustrations. I could not work in ED though with the challenges you face - it is brutal and relentless.
It sounds like you need to change specialty or perhaps move into research/teaching . I did a careers anchors things with the coach that our professional support unit paid for me to see. It did make me realise what was important to me. At the very least get some proper help as your current views may be clouded by anxiety/depression.

It seems like we do the same job, down to the detail you shared about battles to get people out of the department or lost bloods. I’m not proud of walking over to pathology a couple of weeks ago and bursting into tears because they had lost samples that I had spent hours phoning back and forth about. Admittedly I was 36 weeks pregnant but that was the straw that broke the camels back that day. I hadn’t cried at work since FY1.

I took some time out a few years back, set up a business and did a spot of locum. I’m back in now full time (although on mat leave) and glad to be back. It’s hard work, it’s a killer, I do sometimes really regret emergency medicine because it is a battle to do anything.

DH and I are constantly being contacted by head hunters to go to Australia which we are sorely tempted to take up. DH goes through weeks where he wants out and then others where he loves it.

Job wise - medical writing, pharmacy, med photographer and aid worker are some of the jobs my former colleagues have gone on to do. Everyone else buggered off to Australia a few years ago.

I'm not sure about the NHS ( I work in education) but money isn't the problem its there, but the salaries those at the top end attract. I am a TA working with SEND students fully qualified with a degree in learning support and am paid roughly the same as cleaners & kitchen staff. The SLT are on salaries I could only dream off. The NHS like the education system will only work if everyone is paid correctly for the job they do. One dept in our school hasn't even got a printer as they can't afford to do the printing and it's only the start of term!!!

Awww. Thank you for all your lovely comments. I have considered taking a break. The problem is that medicine moves on so fast. It’s took me a very long time to feel that I was back up to speed after mat leave. I kind of know if I took a proper break I’d never go back. Thank you for suggestion of other things to do- I’ll check them out. I’d just like lots of MNers who don’t work for the NHS to read this also just to try and get the msg across about how bad it is........
I’m just going to fix my smile now as I walk into work

I'm 49, from watching the news all those years (and childhood experience) it seems we have always had a shortage of staff in the NHS. This is through governments of all colours. Why don't we just train more? Train enough that we can lose some to emigration or other careers. Why have we never trained enough? Make training free on condition you work for the NHS for a set number of years, if you don't then you have to pay back the training costs.

Would more staff make the biggest difference to your working conditions op?

I don't work for the NHS btw and have limited experience receiving care, luckily me and my family are healthy.

Another NHS dentist here, working in a very niche area of secondary care and employed by a hospital. I could have written most of these posts myself. I work part time and act as a safety net for people who cannot access general practice. GDPs like @user1471556443 are having to practice defensively to protect themselves and some patients are caught between our service (whose criteria they don’t fit) and general practice (where they could be treated but practitioners daren’t take the risk).

I cannot remember the last time I had a lunch break. We are our own admin team. The pressure for targets is relentless. The only thing that keeps me there is the fact that I know I can provide decent care for vulnerable patients. I want out though, and I can’t see me lasting much longer.

Too much immigration and nowhere near enough resources to cope.

The demands on doctors, nurses etc will keep rising until the whole thing collapses.

Then again, most MNers have no problem with 250-500k a year NET immigration year after year after year, so they reap what they sow.

Same goes for people on here moaning about the lack of affordable housing coupled with stagnant wages driving down living standards.

..and I'd pay them not to do nursing......the most under paid, overworked, undervalued glass-ceilinged job in the public sector". They are total heroes and I really have no idea how they do it.

That makes me want to cry. I’m a nurse, I’ve always been told ‘this is just how it is’.
We can’t look after people if we don’t have the staff or resources to do so.

Op, I admire your honesty. I don’t know how you do it and find it sad that in a caring professional we all want out.

From your first post I guessed you worked in A and E. My DH and I both have chronic health conditions and need the NHS.

It amazes me how the staff in A and E give such good care in such stressful working conditions. There is always someone who is shouty and abusive (and they usually have the most minor injury in the waiting room). Most patients really do appreciate you.

If you do quit, you will be missed but that won't take away from all the years you spent in the NHS and all the people you helped.

You survived much longer than me. I lasted 10 years in the NHS, including working as a maternity support worker and then training as a midwife. It was the best and worst decision I ever made. My mental health was completely erroded, I was signed off 3 times in 3 years, needed medication and therapy, and only then did I leave. I loved LOVED my job, caring for women and families was such a passion, but I couldn't continue to do it at the expense of my sanity, my relationships and my wellbeing.

Bullying, belittling, blame culture, lack of support, lack of resources, poor management - need I go on?

Leave. I am so much freer and happier. I work in the charity sector and honestly just wish I'd done it sooner.

Loads of love and luck to you OP xxxxxx

@bluerinsesurrey Please don't derail this thread with your xenophobic nonsense - the NHS is being chronically under resourced to make privitisation possible, and immigration is the current Government's easy way to make you believe that the problem isn't with them.