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Violent incidents in general practice double in five years

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Workplace violence Police recorded over 1,000 violent incidents in GP's surgeries last year

The number of incidents of violence in general practice has doubled in the last five years, with doctors blaming staff shortages and fake news about their being unwilling to see patients during the pandemic. According to an investigation by the British Medical Journal police forces recorded 1,068 violent incidents between 2021 and 2022, up from 586 between 2017 and 2018.

The Royal College of General Practitioners (RCGP) described the treatment of GPs and their staff as ‘unacceptable’ and the increased violence as ‘particularly distressing’, warning that it might lead to staff exiting primary care. ‘Increased levels of abuse, as shown in this report, will be having a significant impact on the mental health, wellbeing and morale of individual doctors and practice staff,’ said Professor Martin Marshall, RCGP chair.

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‘This, alongside the intense pressures GPs and our teams are working under, and sustained media and political scrutiny of our new ways of working since the pandemic are undoubtedly contributing to some people evaluating whether they’re able to continue working in general practice.’

GPs also told of receiving abuse on social media, by trolls referencing media stories of GPs refusing to see patients during the pandemic. But Professor Marshall sees the real issue in staff shortages, and called upon the Government to make good on promises to recruit more staff.

‘Our workforce is not big enough to manage the increasing health needs of our patients. This was the case before the pandemic, and has only been exacerbated by the crisis,’ says Professor Marshall. ‘The Government made a manifesto pledge of an additional 6,000 GPs by 2024 – plus 26,000 additional practice staff - and we urgently need these numbers to be delivered so that we can safely deliver the care and services that our patients need, now and in the future.’

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Abuse and violence directed towards healthcare staff is unacceptable on every level. Professor Marshall's comments regarding the negative impact on our primary care workforce are without doubt true. This will result in staff leaving (or reducing their hours) and exacerbate the existing recruitment and retention challenges.

Issues of abuse and violence have long been associated with A&E practice, traditionally here the contributing factors have been related to alcohol/drugs. The triggers for the increase in unpleasant behaviour directed at primary care teams appears to be related to 'built up' frustrations in accessing face to face care, delays in NHS111 clinician call backs, increasing delays in accessing timely diagnostics, and an estimated 6 million patients (many in chronic pain) on ever expanding waiting lists. It is acknowledged that many of these 'same day/urgent' primary care patients get displaced to emergency departments and urgent care services, where the system is already at breaking point (or broken), and the circle of patient frustration/anger continues.

In my view the perpetrators of abuse and violence directed to health staff must be prosecuted, not least to set an example. The wider contributory issues relating to NHS capacity/resilience in both primary care and acute settings requires a major overhaul. I suspect that the traditional model of primary care is over, and finding (and funding) a reasonable alternative will not be easy .

Mike Paynter
Consultant Nurse
Somerset
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