Aggression towards GP receptionists is a ‘frequent and routine’ occurrence in general practice say researchers who called for urgent measures to mitigate the harm to staff.
Analysis of 20 studies across five countries, 11 done in the UK, concluded the level of aggression is a ‘serious workplace safety concern’ and more evidence is needed on how best to prevent and manage it.
As well as impact on the wellbeing of individual staff members it also has wider implications for retention and sickness absence, the researchers concluded in the research in Family Practice.
All the studies looked at found that hostility and verbal abuse are commonplace but also ‘relatively unavoidable’.
This can include patients shouting, screaming, swearing, using racist and sexist insults and name calling.
While physical aggression was less commonly reported, it could be severe including being hit, shaken, stalked and threatened.
A Pulse investigation into rising levels of abuse directed at practice staff found a 16% rise in crimes involving violence at GP surgeries since 2019.
Receptionists in the studies looked at most often attributed the triggers for patients’ aggression and hostility to frustrations with booking appointments and admin systems but also errors, delayed access to doctors and prescription refusal.
Staff usually try to placate patients to avoid the situation from escalating, but at the cost of their own wellbeing and workplace productivity. They said patient aggression was the most difficult part of their role.
In the long-term, direct and indirect exposure to repeated patient aggression was reported in the studies looked at to lead to burnout and fatigue.
Things that worked to curb the problem were flexible appointment books systems, early availability of appointments, and consistent patient management practices. The Australian researchers said.
And receptionists felt better able to manage patient aggression if they had received relevant training, had confidence in their de-escalation skills, and if they could refer to formal policy and rely on back-up from other colleagues.
But in the research looked at there was little in the way of coordinated support for general practice reception staff on the receiving end of patient aggression, with only a small proportion given professional counselling.
Reception staff are essentially having to deal with the aftermath of systems not functioning properly without having the status or autonomy to change them.
‘Receptionists are the recipients of unremitting verbal abuse and hostility from patients and adapt their behaviour and demeanour to placate and please patients to avoid escalation of patient frustrations,’ the researchers said.
‘It is clear that receptionists in general practice deserve evidence-based measures to improve their working conditions and wellbeing, which will no doubt also have flow-on benefits for the community and entire healthcare sector.’
RCGP chair Professor Kamila Hawthorne said: ‘It is deeply concerning and entirely unacceptable for receptionists or anyone working in general practice, to be at the receiving end of abuse of any kind when they are trying their best to do their job of caring for patients in increasingly difficult circumstances.
‘We share our patients’ frustrations when they have difficulty accessing our services, and the vast majority appreciate that GPs and our teams are doing the best we can under intense workload and workforce pressures. The reality is that having to work in these circumstances, with the additional worry that you may face abuse, sometimes on a daily basis, will have a significant impact on the mental health, wellbeing and morale of the individuals themselves and the wider practice team.
‘GPs and their team members should not be having to go to work with the expectation of facing verbal or physical abuse. We must address the underlying problem and tackle the intense workload and workforce pressures facing general practice, which appear to be leading to abuse towards GP teams becoming increasingly common.’