The Blog

Accident and Emergency in Need of Resuscitation

I am a junior doctor. I love the siege-induced mentality of a busy department. I love the pressure of promptly assessing and treating patients in a life or death situation. I love the sheer variety of illness and characters I meet in a single day at work. And I have even learned to love the regular inebriated Saturday night crowd who verbally abuse me. You see, I am an A&E trainee. And according to all concerned, I'm about as rare as a hen's tooth.

You can therefore imagine my utter bewilderment when after initially reading the DDRB report, and latterly reading the firm contract offer, it was quite apparent no effort had been made to retain my services, let alone recruit new versions of me. But what about the flexible pay premia, or the new 'dangermoney'? Well, that works out to be thirty pounds extra a week, only available to senior trainees and does nothing to address the real underlying issues behind the recruitment and retention crisis of A&E doctors.

Sadly, I have the unenviable and universally accepted accolade of the most gruelling rota known to doctors. Also, given the ever increasing demand and ever decreasing supply of my services, I have the most intense day to day job. Burnout is a real issue and a struggle with the current work life balance. Nothing has been done to protect me from this. I'm not asking for special treatment, I'm asking for proper safeguards in order to protect my own health.

The elephant in the room for all UK A&E doctors is the call of the southern hemisphere. Right now it is a deafening concert. Already in 2015, we have lost 620 A&E doctors to our Australasian counterparts. They have joined what is estimated to be close to a third of our workforce that has already sought sunnier shores. Better working conditions, better hours (thus a better work life balance) and the fact it is accompanied by better salary makes it an awfully attractive prospect.

Until we examine and address the underlying causes of this self-fulfilling crisis (something that goes well beyond the remit of a new contract), I am afraid we will never improve the service and continue to stock other healthcare systems. This predicament is not something new; attendances have been soaring year on year without increasing resources or capacity. To think we can paper over the cracks with a poorly constructed financial package is quite frankly insulting. I am not alone in this view, with a damning letter penned by over 400 A&E consultants detailing as such. It just shows what little regard and understanding there is to my speciality.

However, with the Conservative government's single-minded focus for a seven-day NHS and the new, unprecedented cohesive unity of the doctor workforce, surely we can capitalise on the two and create a constructive outcome? Perhaps I am showing my political naivety, but I really do consider this to be the perfect time for directing positive change. From the current mire can come something special and permanent, but we need empathetic communication to affect it. This is a once in a generation time. I am just worried we will squander it.