Online consultations exposing GPs to more patient abuse, LMCs warn

Abusive patients are using online consultation tools to target GPs, with LMCs warning that demanding patients are emboldened by the Government’s access push.

Speaking at last week’s UK LMC conference, Dr Sarah Rowe, a Devon GP, revealed a patient had sent a ‘barrage’ of ‘abusive’ and ‘threatening’ messages via the practice’s Accurx online consultation tool. 

Dr Rowe was speaking in favour of a motion which was passed at the conference, focusing on expanded protections for GPs from abusive patients.

Dr Rowe said: ‘My practice recently had to call the police after a patient was initially very verbally abusive to a female colleague. Not content with that, they sent a barrage of Accurx messages verbally abusing that GP and threatening herself and her family.  

‘That patient was charged and given a community order to attend an anger management course, which we feel is appropriate. 

‘But it did make me reflect we have no mechanism to insist on that kind of behavioural change when the abuse is only low level and persistent, even though that’s what we deal with day in day out.’ 

Essex LMCs chief executive Dr Brian Balmer told Pulse he was aware of the issue. 

And he added: ‘Online consultation just widens the demand, that’s it’s biggest fault. The main problem is it’s telling everybody as they can have everything anytime. 

‘If the Government wants to have that service, that’s fine, but they better ask the truth. They’re basically advertising a service which cannot possibly do what it’s telling people it can do.

‘Patients are being driven by the press, being told that access is everything. 

‘Patients do not have a divine right to see the doctor that you want, regardless how you behave. That is not the case. No politician says this: “You have a right of access to decent services, but that means you’re going to behave properly”.’ 

The LMC conference motion said that ‘vexatious patients’ should be removed for abusive or threatening behaviour and not be allowed to re-register with another practice without ‘demonstratable evidence of behaviour change’. 

It also asked that the special allocations scheme for violent patients be expanded to include ‘persistently abusive’ patients, and to drop the requirement that patients can only access these schemes if the GP practice has made a police report. 

Proposing the motion, Dr Claire Barnsley from Wakefield LMC complained that ‘zero tolerance’ only ‘exists rhetorically but not operationally’. 

She shared an account of her practice manager who was ‘seven months pregnant’ and who had ‘received highly personal and distressing messages’ from a patient.

‘GPs and practice staff are at higher risk than the general population, yet this remains a hidden problem cloaked by professionalism, fear of escalation, shame and a lack of shared language to describe what is happening’, she said.

‘Abuse now commonly presents through persistent and vexatious complaints, high volume and abusive email contact, subject access requests used as a tool of pressure, repeated regulatory reporting and repeated attempts to re register after removal for abusive or threatening behaviour.’ 

Despite this, she said there was ‘no authoritative guidance’ for GPs, employers, or regulators, police thresholds were ‘high and inconsistently applied’, and NHS systems compel practices to continue engaging with patients ‘even after abusive or threatening behavior has caused harm’. 

Earlier this year, an ICB mistakenly advised patients who had appealed being on the special allocation scheme that they could return to their original GP practice. 

Pulse has contacted Accurx for comment.