Violence and Abuse towards General Practice Staff

Background

The recent British Medical Association (2022) survey reveals that General Practitioners are more likely to experience direct verbal abuse from patients and the public than hospital doctors. Equally alarming was that 67% of GPs reported witnessing abuse by patients towards their colleagues and 96% of those who had witnessed it said it was towards reception staff. Two-thirds of GPs said that their experience of abuse, threatening behaviour or violence had become worse after the COVID lockdown. Research in other healthcare settings indicates that such experiences affect staff physical and mental health and increase levels of stress, anxiety, PTSD and burnout. These issues can lead to sickness absence and reduced job satisfaction. Intention to leave the job / profession is one of the commonly reported outcomes of experiencing workplace violence and abuse. This is detrimental to an already depleted, burnt out and hard to recruit workforce. Indeed, on 1st March 2022, the House of Commons Select Committee on Health and Social Care heard expert evidence on workforce retention, recruitment and training. An area highlighted was how the current service model leads to frustration in patients. It was pointed out that the current situation in general practice affects medical students’ motivation to join the workforce.

Aim

To explore staff experience of violence and abuse by patients and the public in general practice, the organisational contributory factors, the impacts on staff wellbeing and practice, and prevention.

Methods

A scoping review, and a qualitative study with staff in East Midlands

We will conduct a scoping review following the Joanna Briggs Institute framework and report using the PRISMA extension for scoping reviews.

For the qualitative study, we will conduct 20 to 30 interviews with staff who have directly or indirectly experienced violence or abuse by patients. We will invite participants to interviews through a brief online survey. We will use maximum variation sampling to include both clinical and non-clinical staff across the region. We will also aim to get representation from different genders for clinical and non-clinical staff.

A PPI adviser and a practice manager collaborator will be part of the project management team to advise on the research and dissemination throughout the project.

Analyses

The information gathered from the online survey will be summarised as the population and participant background. We will apply framework analysis to the qualitative data informed by an occupational health psychology model

Research Impact

The findings will inform the development of an intervention to mitigate the effects of experiencing violence and abuse on staff and a study to test the intervention. They will also inform the development of guidelines for preventing and managing such occurrences and a consensus study as part of the guideline development.