In a debate on GP wellbeing at this year’s LMCs conference for England, doctors shared personal accounts of attacks on staff - with colleagues reporting being trapped in surgeries after hours with angry patients outside, bricks being thrown through surgery windows and staff receiving death threats.
The debate came a day after BMA GP committee chair Dr Farah Jameel warned that ‘abuse, aggression and everyday acts of incivility’ in general practice were ‘rising exponentially’, as she urged the government to throw its support behind the profession.
An overwhelming 95% of GPs taking part in the debate agreed that abuse of primary care staff ‘directly affects patient care and puts patient safety at risk’ - with 90% 'completely agreeing’. 92% of delegates agreed that BMA representatives should prioritise doctors’ safety and wellbeing during NHS England and government negotiations.
GP wellbeing
One GP described her NHS career as an ‘abusive relationship’, sharing that she had been forced to step back from a salaried role to protect her wellbeing. Others said they had regularly seen colleagues crying and working through illness to keep on top of demand.
Polling published in August by the BMA found that half of GPs had experienced verbal abuse over the previous month, while an MDU poll found that four in five family doctors said abuse from patients has worsened during the pandemic.
Central Lancashire GP Dr Andrew Littler described to delegates some of the instances that had occured at his practice. He said: ‘Much has been said and done already, however, it's not just shouting and aggressive behaviour, but also threatening behaviour and violence.
‘In my own experience, a red building brick was thrown through my surgery window. Luckily, no staff were injured...We have colleagues with death threats, simply advised to lock their windows at night. It's not enough, and more needs to be done. Zero tolerance should mean that: zero.’
Media attacks
Nottinghamshire GP Dr Carter Singh argued negative media campaigns had exacerbated abuse against general practice teams, and had in turn also demoralised the general pratice workforce despite their monumental efforts during the pandemic.
He said: ‘We've never worked harder in our profession and faced so much persecution - and I think that the media narratives and the political rhetoric are directly fuelling the public and patients' unrealistic expectations. My request to conference, to the GPC, our negotiators, and our representatives would be to please try to have a very strong media presence where we kick back against this denigration of our profession.’
Offficial statistics show that in October GPs delivered over 30m routine appointments, with 64% conducted face-to-face - reflecting the intensity of current general practice workload.
Bedfordshire GP Dr Christiane Harris said intense demand for services was driving GPs to unsafe hours even when they had reduced the sessions they work. ‘I work as hard now as I did when I was doing nine sessions, working 13- to 14-hour days, with at least two hours slotted in on other days - and, at the weekend I still have to do extra work to manage workload,’ she said.
Toxic work culture
‘Three weeks ago, I added so many extra patients to my afternoon surgery I couldn't see where it would end. I was having difficulties making decisions, while I've been watching my ill colleagues struggling to work because they worry about their workload being heaped on [others].
‘Years of adopting macho behaviours has led us to create the idea that we are somehow superhuman - demands have become greater and patients' expectations are increasingly unrealistic.'
Gateshead and South Tyneside LMC representative Dr Paul Evans told delegates that a colleague had resorted to dealing with the pressures of work by crying in a lay-by on the way home from work each night.
‘If we have created a system that does this to dedicated, caring professionals - and the best they can hope for is a few minutes to decompress by crying on their own in a lay-by, it means that we have created a system that is utterly toxic. the public needs to understand that if this continues they will not have a health service fit to deliver care to them,’ he said.
Workforce numbers
This week, MPs launched an inquiry into the NHS workforce crisis, which will consider whether doctor training can be shortened to address low staff numbers. But doctors' leaders have long warned that retention of experienced doctors in primary care is being neglected despite efforts to bring more doctors into GP training.
London GP Dr Gemma Eyres - who qualified as a GP within the last five years, said she had switched to locum work after the pressures of salaried work became too much. She said: ‘My relationship with the NHS as a doctor, and particularly as a GP, is sometimes an abusive relationship. I love it, I love it dearly, but it is often detrimental to my physical and mental health.’
‘The only way I can negotiate with it at the moment is to disengage with it and put in some real boundaries, which means I’m locuming. I strive to be a salaried doctor, and to be a partner in the future. But at the moment, with the way that things are, I cannot engage with that. Me and my peers are the future of GP, so we need to be thinking about how we can create a supportive environment.’
The debate comes two months after a Manchester man was charged with assault after an attack at a GP surgery in the city that left one GP with a reported fractured skull and other staff with 'deep lacerations.
MPs warned in June that NHS workforce planning is 'at best opaque and at worst responsible for unacceptable pressure' on staff across the health service - warning that 'chronic excessive workload' is driving a surge in burnout.
The BMA estimates that the workforce crisis in general practice has left each GP in today's NHS caring for 300 more patients on average than in 2015.
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source https://earn8online.com/index.php/389878/utterly-toxic-gps-speak-out-over-abuse-and-physical-attacks-on-practice-teams/
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