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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.


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