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Independents' Day

Two thirds of GPs experience abuse from patients as rates rise

Exclusive Rising numbers of GPs have experienced some form of verbal, written or physical abuse from patients in the past 12 months, an investigation has revealed.

The Primary Concerns report, from Pulse's publisher Cogora, surveyed almost 2,000 primary care workers, including 600 GPs, finding that (66%) have experienced abuse - a rise of seven percentage points from the year before.

Broken down by type of abuse, some 4% of GPs have experienced physical violence from patients in the past 12 months, compared to 2% the previous year.

But in the same time period, well over half (61%) of GPs reported having experienced verbal abuse - an increase from 55% the year before.

Around a quarter of GPs (24%) also received written abuse, up from 17% in 2015.

But compared to other primary care staff GPs remain less affected by abuse than nurses and practice managers.

Practice managers were the most likely to have experienced all forms of abuse and just 9% said they had not experienced any form of abuse by patients in the last 12 months, a decrease from 26% in 2015.

There was a particular spike in written abuse directed at practice managers, including messages online and on social media, which increased from 10% to 44%.

The one slight sign of improvement was in physical abuse of nurses, with only 7% of nurses reporting they had experienced physical abuse in 2016 - down from 10% in 2015.

Across all primary care workers, the numbers experiencing abuse were reported as:

  • Verbal - 64% (up from 54%)
  • Physical – 6% (unchanged)
  • Written – 24% (up from12%)

GP leaders said the findings were very ‘concerning’ and that NHS needed to be sure it ‘backed up’ staff who were faced with abuse of which there should be zero tolerance.

But, perhaps surprisingly, the researchers found that physical abuse had 'no effect on morale', although verbal abuse was rated higher and, again, most acutely felt by practice managers.

The leading contributor to low morale among primary care workers was cited as 'unrealistic demand from patients', followed by heavy workloads and 'unfair criticism from politicians'.

The report said: 'Physical abuse from patients was rated as having no effect on morale, whereas verbal abuse from patients seemingly had a greater impact. While this only had a moderate effect on GPs, it was rated more highly by practice managers - the professional group most likely to receive this form of abuse.'

One practice manager contacted in relation to the survey said they were subjected to abuse ‘on a weekly basis’.

They added: ‘I have no idea why they feel that this is appropriate behaviour. The message that keeps coming through is that they feel they are entitled to privileged treatment that they are not getting even though they have paid for it.’

GPC deputy chair Dr Richard Vautrey said: 'It is very concerning that any patient feels that they can act in this way when GPs and their staff are doing their best to help and care for them.’

‘The NHS must not only adopt a zero tolerance policy to abusive behaviour but must also back up practice staff when they are subjected to these type of incidents.’

He added: 'Whilst some GPs have been subjected to appalling levels of verbal and physical abuse they are aware that there remains a level of respect for them shown by patients which is not equally shown for their staff, in particular those on the front line such as reception staff and practice managers.’


Source: Cogora survey of 1,190 primary care workers including 600 GPs 

Readers' comments (29)

  • Spuds

    What is "verbal abuse". Disagreement with a patient? Unhappy, stroppy patient?

    It is part of our role to deal with that. I doubt we are "verbally abused" to that degree.

    Maybe we are all too blooming sensitive and inclined to be "victims". Maybe we should accept that in the public-facing occupations (especially when our patients may be stressed or mentally ill or just inadequate personalities), people will sometimes not just be pleasant and lovely to us and may lash out verbally. Maybe we should forgive them (even if they don't ask for that forgiveness).

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  • i have not agreed to being sworn at as part of my job
    Yes people are upset because of illness etc but we are trying to help. We are not a punchbag for people's abuse. We are not too sensitive and it is high time people start respecting their interactions with medical staff. Where is the forgiveness from patients when mistakes are made in an overworked and underfunded symptoms?

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  • Cobblers

    Would be interested to know if any research into size and sex of the doctor and abuse? I cannot recall any verbal abuse but then I am built similar to a second row rugby forward. Is this bullying pure and simple?

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  • Spuds 10:32 am maybe I am too sensitive because verbal abuse really does upset me. I'm lucky to have good patients who tend to be very engaging and I am able to talk down lots of irate people but verbal abuse is 100% unacceptable. Part of the reason we are losing good GP's is that they can't work in scenarios where they are spoken too like s@it. I knew really good medical students who quit medicine because of the verbal abuse or "banter" they got from consultants and what a loss that was. And I'm not talking about the patients who've just had bad news or have a miserable illness and aren't understandably sweetness and light, I mean just nasty people. It should not be condoned

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  • I can handle the threatening patient who we offlisted. The police were very supportive.
    Having to write a report in response to the subsequent NHS England complaint and reading their bumpf that accompanies this ('treat all complaints as learning exercises') is what is most offensive.

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  • i have practiced for 35 years as gp.i never had physical abuse or written abuse. two incidence of angry patients. one when i refused to give diconal in 1982 and one in 1994 when i refused sick note.

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  • haha Cobblers (locum GP) i'm female and only 5 foot 3 but an ex prop and I take no cr*p including from my subtances misuse patients and probationers. they know that and wouldn't dream of verbally abusing me as they would leave with a rocket up their backside!

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  • Wow Spuds, how terribly condescending of you. If only your bleeding heart empathy extended to your colleagues. Pathetic.

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  • Spuds - what a silly statement, I only hope that was for a reaction.

    Abuse should never be tolerated. But my memories of trying to get patients off listed often meant huge amounts of paperwork and justifications!

    The concerns is that NHSE/GMC increasingly working on an assumption of guilt and even appraisal ask for reflection which is meant to indicate GP learning.

    I too have seen this increasing abuse contribute to people leaving or retiring early.

    A real tragedy.

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  • If they were paying to see us we would suddenly see these numbers drop. Free at the point of use = not valued.

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