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Practices should have zero tolerance for abuse of staff

It was refreshing this week to hear a politician standing up in parliament and proposing a bill pertinent to healthcare workers, one that I am going to make the assumption would receive universal support from us all.

Chris Bryant, the Labour MP, was given time to discuss a private members bill that is in itself a great start. He argues that sanctions for those physically assaulting NHS staff are too lenient and need to be strengthened and thereafter enforced. He feels that too often the perpetrators of these assaults get no more than a slap on the wrist. The figures are shocking:

There were 59,794 attacks on NHS staff in 2011-12. The figure increased to 70,555 by 2015-16. Yet the number of criminal sanctions for those assaults has actually fallen in that time, from 1,380 to 1,250. That is a lot of people who are not seeing justice.

Who could argue that NHS staff, who come to work every day to help others, should not have stronger protection in law against physical assault? Not me.

However, I wonder if the bill should be widened to include verbal assault and not just physical? Whilst a physical attack is of course traumatising, dangerous and damaging, the effect of verbal attacks can be equally damaging, if in a different way.

As GPs we see far too much verbal abuse and on a daily basis. Aimed at all practice members, I have too often witnessed patients screaming abuse at receptionists and issuing threats of retribution ‘should their child deteriorate’ or ‘their relative not get their statin script immediately’, or if ‘they don’t get an immediate appointment’. I have seen nurses experiencing foul abuse for not issuing malaria tablets on an NHS script!

Then alongside this I hear on an almost daily basis from GP groups of verbal attacks from patients and/or relatives which leave many a colleague shaking, scared and almost unable to carry on and see the remaining patients in their session.

It really isn’t acceptable for any worker, NHS or not, to experience abuse, physical or verbal, in the line of duty. But it seems the sands are changing and patients are feeling more able to behave like this and doctors often seem reluctant to take action when it does happen.

Clearly this is a broad generalisation and much of it is down to patient education. I work in two practices where the patients almost never act in this way because they know that it won’t be tolerated. In another practice, however, it is a daily occurrence and likely a combination of the patient demographic and practice response. I recently had a screen message for my next patient stating ‘patient threw chair at receptionist last time here’! If it were my practice this patient would have been off the list immediately, not having a screen warning added to the notes. We definitely promote what we permit.

To this end, my message is three-fold. I applaud Chris Bryant’s bill and hope that it gets through its second reading and makes it into law. Thereafter I look forward to seeing it wielded by the courts and perhaps the message will seep through to the public that they cannot abuse NHS staff for any reason, in any setting.

I also appeal to all GP partners to take a stand and implement a no tolerance policy on any form of abuse. We are on a slippery slope and its time to grab the sides and climb back up.

Dr Renee Hoenderkamp is a portfolio and media GP in London



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