Former A&E consultant Dr Brian Fisher speaks out about RVH pressures
The safety of the A&E provision within hospitals in the Belfast Health Trust is under the spotlight as the BBC reveals that emergency consultants have written to senior management about their concerns.
The BBC also understands that the clinical director of Belfast's Royal Victoria Hospital (RVH), Dr Russell McLaughlin, has stepped aside due to his unease over the issue.
However, it is not the first time that an emergency consultant at the RHV has taken such drastic action.
Speaking publicly for the first time about his decision to take early retirement, Dr Brian Fisher, said his role at the hospital just left him feeling "burnt out."
"I was drained. I was burnt out, I'd lost the drive and it affected my home life, my family life because there was so much of my personality being used up in trying to deal with the patients on the shop floor," he said.
"Also, in trying to deal with the difficulties that the department put in my way, from the perspective of trying to provide a good standard of care under very, very difficult circumstances."
In an interview with the BBC, Dr Fisher who retired last year at the early age of 56, said he had no other option. And he said that he feared for his colleagues whom he had left behind.
"It was a very stressful environment," he recalled.
"There were times that there were so many patients waiting to be seen that the system was straining - you had grave concerns that one more catastrophe and the entire place would have fallen apart."
Dr Fisher added: "The sick ones would be seen but the ones who were less sick would have to wait unnecessary periods of time. It was close to breaking point at times."
Referring to his colleagues, Dr Fisher who no longer practices, said: "They will be feeling the same pressures I did.
"I mean, it's going to be hard on them, they are younger and they have more years ahead of them. They're also having to deal with the added pressures of the City hospital's A&E closing.
"I mean, it's very likely that they may get burnt out as well. It's such a shame because we are in the job because we want to help sick people."
Belfast City Hospital's A&E unit closed temporarily on 1 November last year due to a shortage of senior staff.
Dr Fisher has claimed the closure should have been better planned.
"Such a big move without planning for the beds, for extra lab support for radiology, all those things that are part of the job. We need seven day working for more departments than just those in the ED.
"Lots of people saw the move coming many years ago but there was no forward planning. No political will and too many thinking of their little empires," the former consultant added.
When asked about the response from senior management, Dr Fisher said the perception was that "the message isn't getting through".
"Time and time again communication is passed up the chain of command but when I was there it didn't change dramatically - the letters were sent off about the potential dangers, but things just stayed the same," he added.
In a statement on Monday, Belfast Health Trust said it was working to secure additional resources for the winter period when increased demands will be placed on its services.
The statement added: "We are confident with all the improvements in place for patient care that we can provide the reassurance that the winter ahead will be well managed with the dedication and engagement of all the staff in the Belfast Trust."