“Frustration with the system was why I went off in the end,” said Conor Calby, 26, a paramedic and Unison rep in southwest England, who was recently off work for a month with burnout. “I felt like I couldn’t do my job and was letting patients down. After a difficult few years it was challenging.” While he usually manages to keep a distinct divide between work and home life, burnout eroded that line. He also lost his sleep pattern and appetite. The final straw came when what should have been a 15-minute call resulted in three hours on the phone trying to persuade the services that were supposed to help a suicidal patient to come out. “I was on a knife edge. That was due to the system being broken. That’s the trigger.” When he first started in the ambulance service six years ago Calby saw it as a career for life. Now, the job has changed dramatically. With scheduled 12-hour shifts often ending up closer to 16 hours, he is too tired for socialising. And he usually sees just two or three patients per shift rather than the 12 he used to, spending much of his time waiting in a queue of ambulances outside hospitals. Doctors and nurses are struggling under the strain too. After her third time with burnout - the last resulting in her taking six months off work – Amy Attwater, an A&E doctor, considered leaving the profession altogether. Attwater, 36, said in the Covid crisis, during which a colleague killed himself, she started having suicidal thoughts and doubting her own abilities. She twice reported that she was being bullied but said no action was taken. “The only thing I was left with was to take time off work. I ended up having therapy, seeing a psychiatrist and being on two antidepressants,” said Attwater, the Midlands-based committee member for Doctors’ Association UK. The conditions now, because of the NHS crisis, are “even worse than it was during the pandemic”, she said. There is not time to take a moment after a life-or-death incident with a patient, resulting in secondary trauma, and some big hospitals have a “toxic culture”. The attitude of consultants is “right, on to the next,” she said. “By the time you come home you’re just shellshocked. The amount of times that I’ve come home and just cried and cried and cried.” Facebook groups are filled with advice on how to leave the NHS, while many of her colleagues are leaving to work in Australia or New Zealand. Last year, Attwater decided to reduce her A&E hours to part-time, and take on part-time roles in teaching and as an NHS 111 doctor, to give her more flexibility to protect her mental health. “The standard of care isn’t good enough and we, as doctors, feel like it’s our failure. But it’s a system failure,” she said. London-based Vicky, 34, is a fourth generation nurse. But lately, for the first time in her 11-year career, she has started thinking about other jobs. “You have to think, can I live like this?” she said. “I’ve never seen things as bad as they are now, and I have never felt as stressed and demoralised and taken advantage of as I do now.” Sickness in her workplace is “incredibly high”, she said, with more than half suffering conditions such as anxiety and depression. “People have just pushed and pushed and pushed, and there’s only so much that you can give. We’re all trying our absolute best and we’re at crisis point.” Nurses, she said, need better pay, greater numbers and better long-term training. A West Midlands paramedic, who cannot be named, has been off work for several months with burnout and is unsure whether she will ever go back to the job she used to love because the working conditions have made it “soul destroying”. The single mother said the job is nothing like the one she started eight years ago, responding to emergencies. Now she spends as long as 13 hours “babysitting” GP patients in queues outside hospitals. She has lost two stone in weight from stress, hardly ever gets breaks and routinely finishes several hours late, making her feel like a “failure as a mother”. And when she reaches patients, she is often at the receiving end of anger. “It’s soul destroying. I start in the morning, go to a house, they say ‘we’ve been waiting for 14 hours, where have you been?’”