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“Tie a yellow ribbon”
  1. Stephan Hard
  1. General Practitioner, Laidlow Surgery, Greater Rising, UK

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One hundred and eighteeeee!! Amazing. I’ve just managed to break my New Year's resolutions in one fell swoop. The bottle of wine is empty, so is the box of doughnuts, and I’m still on the couch.

It's nonsense trying to make lifestyle changes in January. The days are short and cold, the paperwork pile is still here from last year, and the waiting room is stuffed with miserable people who like me have once again failed to maintain their resolutions and are heaving with problems they've only themselves to blame for.

OK, let's shine a light on this otherwise gloomy picture. Revalidation is coming closer, as is the next round of Government-engineered money-saving changes to the way we work. The primary care trust is stripped down to bare bones so for once has a good reason for not returning my calls. To put it bluntly, before too long I’m going to get shafted either because if I look after my patients properly I won't have time to jump through all the hoops, or if I try to get through these hoops I’ll cock-up something with my patients. Expressions like ‘rock and a hard place’ spring to mind.

For years we've spouted ‘prevention is better than cure’. Lose weight to avoid diabetes, use a condom to avoid STIs, and erase your text messages if you don't want to get slapped. Now it is time to follow our own sage advice. And I’m not talking about ‘no more doughnuts’.

When I think of what causes me the most stress, surprisingly it's not patients. It's mindless initiatives, and directives created by people who have never actually experienced the NHS' frontline. These are the people who spent months and thousands of pounds creating an obesity strategy whose message is ‘eat less’! I can't wait to see the strategy message for reducing unwanted pregnancies and STIs – ‘f**k less’?! Just as I master the Choose and Book system, I now find I have to use the Patient Referral Service instead, and that ultrasound scans go to a different provider, unless of course it's Thursday in which case they go to the usual place. Just as I master ticking off multiple blood test requests with two keystrokes, I’m told we are now using a new template. Just as I think things couldn't get more ridiculous, I’m told that I have to attend mandatory training in ‘lifting on the ward’. I don't work on a ward and haven't done for over 10 years! It's bad enough that I have to spend my precious personal time answering stupid online multiple choice questions about data protection – forgive me, but I don't give a monkey's about which year the Data Protection Act was enacted. The people doing this should be the idiots who leave laptops on trains and buses.

Stress management Step 1 – identify causes of stress. Step 2 – avoid these. Step 3 – if you can't avoid the causes of stress find ways of relaxing so you're in a better frame of mind to address the stress-causing situation. OK, Step 1 – done. Step 2 – more challenging, but I must achieve it otherwise I’ll be shoved into Step 3 – wine, doughnuts, couch – which works but was something I was trying to give up. So the key is achieving Step 2, which will become my ‘new’ New Year's resolution. It's something I should have done years ago, but like most life changes, and successful resolutions, there needs to be a point where the benefits do actually outweigh the considerable risks. I’m at the line and am going to step over it. The final push coming from yet another day spending more time battling with the NHS IT system than with patients, and spending less and less time with my family. So after many, many years of committed service, and considerable mental debate, the time has come. I’m leaving the NHS. I’ve done my time and I’m coming home, stopping off at the haberdasher's on the way to get a length of yellow ribbon, and the supermarket to get something to celebrate with.

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  • Competing interests None.

  • Provence and peer review Commissioned, internally peer reviewed.

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