Senior doctors have warned that practice staff and general practitioners are resigning after an unprecedented and growing wave of patient abuse that followed weeks of public pressure on face-to-face appointments .
Practice directors, receptionists and doctors spoke of daily confrontations with patients over issues such as appointments, vaccinations and blood tests.
Some have said patients have responded to media campaigns in recent weeks, leading Boris Johnson and Health Secretary Sajid Javid to pledge to increase in-person appointments.
Many practices maintain Covid-19 protocols to prevent the spread of the virus, including the use of face masks; some patients refused to wear them and became abusive when asked to do so.
The number of permanent general practitioners has declined steadily over the past five years – down 1,904 since 2016, or around 7% – to the point that in March of this year there were only 26,805 left.
The prime minister said on September 22 that the remaining GPs would have to provide an additional 50 million appointments, saying it was “only reasonable” for people to be treated in person.
Figures released last week by NHS Digital showed general practitioners made around 25.5 million appointments in August, including 1.5 million Covid vaccinations, up from 23.8 million in August 2019. Consultations at distance remain higher than before the pandemic, with 42% of consultations carried out by telephone or video link.
Professor Martin Marshall, President of the Royal College of GPs, said: “The criticisms that have been leveled at GPs and our teams in parts of the media and by some politicians in recent weeks have been among the worst in memory. It’s incredibly demoralizing and unfair when you’re working hard, trying to do your best for patients in the safest way possible, being told constantly that you’re not doing enough.
“This has a dangerous impact on the mental health and well-being of GPs and our teams, but also on our relationship with our patients, with numerous reports that practice staff are being abused by of frustrated patients.
“Our main fear is that this unfair review, on top of the existing pressures, will be the last straw for many general practitioners and other members of the practice team, forcing them to leave the profession early.”
He called on the government to show its support for general practitioners and administrative staff and to urgently respect its commitment before the pandemic to recruit 6,000 general practitioners and 26,000 staff members.
Javid was challenged on Radio 4 Today program on Saturday on his support for press campaigns after Dr Rachel Warrington, a GP partner in Bristol, said he had not supported GPs and had “no understanding” of what was going on in surgeries.
The health secretary said he wanted to work in partnership with general practitioners and reduce their administrative workload, but did not accept that some face-to-face appointments were unnecessary.
Javid admitted that face-to-face dates at pre-pandemic levels were not currently available. “At the moment we are in discussion with the leaders of the GP… and they have raised, I think, some great ideas and points on what more can be done.”
Angelika Slon, who runs a practice in south London, said she saw a large number of staff absences as a direct result of patient abuse and the rapidly increasing workload .
“There are a lot of lovely patients,” she said. “But the amount of rudeness has skyrocketed. We are understaffed – I recruited two new receptionists over the summer. One left after a few days and the other after a week and a half because they couldn’t cope with the pressure. Existing staff are also leaving, she said.
At the start of the pandemic, patients were supportive, Slon said, but as immunization levels increased and restrictions relaxed, some patients reacted badly when told the practice continued to maintain. NHS infection control measures, including the wearing of masks.
Other problems included the recent shortage of blood test vials and the late delivery of flu shots. In the worst-case scenario, practices write to abusive patients warning them that they can be removed from their list. “It was very rare,” Slon said. “Maybe something that happens three times a year. This year, I wrote more than ever. In the past two weeks, I’ve sent two.
Anila Jethwa, who worked as a receptionist in North West London for 19 years, said: “It happens every day. I’m 60 next year. I will look at my pension and if I can just survive it I will retire. If I can’t, I will continue to work but I will not work at the reception.
Receptionists often bear the brunt of bad behavior, but GPs are also affected.
General practitioners who have contacted the Observer anonymously talked about the strain on their mental health. One said he was working on his notice period. “I loved being a general practitioner,” he said. “But I’m so exhausted. I feel useless, marked for life.
A salaried general practitioner qualified in 2019 said: “Every day I leave work feeling broken and completely devastated. I’m not really there for my family. The worst part is that the patients are so aggressive and hostile that I am on the verge of tears, feeling that my attempts to help people and do my job are totally unappreciated. “
Dr Richard Fieldhouse, president of the National Association of Sessional General Practitioners, said there was evidence that general practitioners were stepping back from permanent roles altogether. “We are getting double the number of starting to use our system,” Fieldhouse said. “We have around 6,000 members, so around 30% alternates across the country. It’s so demoralizing right now.
The Department of Health and Social Affairs said a record number of people were training to become general practitioners, with up to 4,000 new entrants this year.
“This government has zero tolerance for abuse or violence against NHS staff,” an NHS spokesperson said. “Everyone has the right to work without fear of being assaulted or mistreated in a safe and secure environment.
“We are taking action to protect staff through the NHS Violence Reduction Program and will support the NHS, the police and the Crown Prosecution Service in bringing offenders to justice.”