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Practice hit with breach notice after only GP goes off sick with burnout

A GP principal has been hit with a breach of contract notice after going off sick from burnout, having had to manage a 4,500 patient list for two years on his own due to problems recruiting a partner.

Dr Shahzad Arif, of Church View Surgery in Doncaster, has been on long-term sick leave with stress since 7 April, leaving the practice with no permanent GP despite attempts to recruit since 2013.

Dr Arif told Pulse that he had taken time off having consulted his own GP, and decided that it would be in the best interests of the patients.

However, when he was unable to arrange locum cover on his first day off sick – the Tuesday following the Easter bank holiday weekend – patients that were unable to be treated by the practice’s advanced nurse practitioner or healthcare assistants had to attend A&E, resulting in NHS England issuing a breach notice.

But Dr Arif’s LMC leader said that, in a one-GP practice, there was no way he could have developed a contingency plan, and the direction to go to A&E was the safest option in the circumstances.

NHS England told Pulse it has now offered Dr Arif support, and was working closely with the practice and Doncaster LMC to develop a long-term improvement strategy.

However, Dr Arif told Pulse he was left ‘frustrated’ that support wasn’t available until he had to go on sick leave, and it was only through the LMC and his practice team’s efforts that he felt able to return.

He said: ‘I think it was perhaps something waiting to happen, there was a slight trigger that day because the practice had been unusually busy and I decided I need a break, I couldn’t go on working.

‘And since I went off sick, things started moving a bit quicker as a result. We’ve been supported a lot by Doncaster LMC – especially [LMC medical secretary Dr Dean Eggitt] who actually came in and did locum sessions to stop the practice from getting another breach notice from NHS England.’

Dr Eggitt said that longer-term plans to make the service sustainable were also being looked at, with the practice seeking quotes from local private GP providers who could provide regular salaried GPs and a long-term recruitment strategy.

He told Pulse: ‘In theory the practice needs to have a contingency plan, but in reality what can the contingency be if there are no doctors? The contingency has to be to go to A&E, which is what they did.

‘Sympathy has got to go to [Dr Arif], managing his practice for two years with 4,500 patients and breathing at the same time is a feat in itself. Never mind recruiting on top of this.’

Karen Curran, head of co-commissioning, NHS England North (Yorkshire & the Humber), said: ‘Our responsibility is to ensure that patients continue to have access to primary care services at the practice, through the contract that exists between NHS England and Dr Arif. Sufficient GP cover has now been secured up to and beyond the date Dr Arif is expected to return to clinical practice.

‘NHS England is doing what it can to support the practice during this difficult time and will continue to work with the staff there, the LMC and the CCG to ensure patients registered with the practice have access to primary medical care services when they need it.’

Doncaster has been particularly badly hit by recruitment problems, with one practice having little success in finding a GP despite offering a £20,000 ‘golden handshake’.

Pulse has been campaigning for NHS England to introduce high-quality occupational health support services nationally to help GPs with workplace stress as part of its Battling Burnout campaign.

Readers' comments (67)

  • Why do other surgeries in this Surgery's neighbourhood not have the same recruitment crisis. How come none of the other surgeries have similar issues.

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  • They will.

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  • If he's not providing the service then he is in breach.Close the practice and disperse the list.

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  • The people who use Shahzad Arif's practice should have been told what was going on. He must be an exceptional person to have carried on so long and Almost always in these cases the doctor receives overwhelming support and compassion from the community. Unlike the disgusting inhumane treatment received from NHS England. Perhaps they might consider attending the Conference on Compassion being run by Chester University in October - speakers include Clare Gerada, Karen Armstrong, and other 'leading thinkers'. K A heads an organisation which seems very like like a cult ,to promote 'compassion'. (There are actually 12 steps to compassion described!) It obviously needs funding so £150 one day or £250 two days. Some of the attenders and supporters are from health services. Is this going to take off alongside mindfulness. mindful cognitive therapy, resilience training , Balint groups , reflective thinking groups......when do those who dream up these things - and problematically then start persuading others that they need them, ever get any real work in the surgery done?! Which is where more compassion than can ever be measured , and probably should not be, (comodification of compassion - unbelievably crass) -actually takes place! Stay well Shahzad Arif.

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  • Bob Hodges

    If only 'resilience training' could enable GPs to run personal lists of over 4000 patients without getting burnt out eh??

    That means they could halve the number of GPs.

    All the best to Shahzad Arif who sounds like a bit of a champion for having coped so well for so long.

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  • I wonder how many clinical sessions this GP was doing before going off sick. For a patient list of 4000 he should be going 16 clinical sessions (each lasting 3hrs) to provide the needed access to his patients.

    No wonder GP partners are very hard working.

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  • Let's see what happens in Dumfries and Galloway .

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  • Why it is imperative to be able to close lists for patient and doctor safety. GPC please note

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  • Well done Shahzad Arif however there are plenty of locum agencies out there and you could /should have set up links with them back in 2013 or your practice manager should have done. I suspect you are trying to run this practice on your own without such help. Well now you have seen it does not work. A good practice manager should/could take a lot of admin burden from you and allow you to do what you have been trained to and do best. Can you not link for admin support with another local surgery? I know that any option will mean money out of your pocket but better to be alive and a few pennies short than any other option.

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  • And so starts the chain reaction.....

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