Violence and abuse towards GP practice staff ‘widespread’ internationally

Violence and abuse towards GP practice staff is ‘widespread’, according to a review of 50 studies into the issue globally.

The review, by academics from the University of Nottingham, assessed studies from 24 countries into abuse by the public or service users towards staff working in general practice or their equivalent.

It found that the proportion of participants experiencing violence and abuse in most UK surveys was over 60%.

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Past-year rates for violence and abuse towards staff across all analyses ranged from 13.8% to 90.3% and career-long estimates were from 18.3% to 91%.

The most common form was verbal abuse, with reports from staff having experience this over the previous year ranging from 42.1% to 89.8%, and 87% over respondents’ whole career.

Long waiting times were identified as the most common perceived cause for violence and abuse – with 30.8% to 73.0% of staff respondents attributing it to this – while ‘unmet patient demands’ including refusal to prescribe expected medications was also commonly identified.

‘Correlates’ at a staff level varied but 10 studies identified being female as a correlate, and younger or less experienced staff were also identified in some studies to be more likely to experience abuse.

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Meanwhile, substance abuse and mental health difficulties were commonly identified as correlating factors among perpetrators: between 11.7% and 91.0% of participants associated substance use with violence and abuse.

The review pointed out that suggestions to mitigate or combat abuse were ‘under researched’ overall and ‘no evaluated prevention or support interventions were reported.’

However, proposals identified in some studies included staff training on violence prevention, reducing caseloads and increasing consultation ‘to alleviate staff–patient tensions’.

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Police involvement was rarely suggested among the studies, according to the review, as ‘staff felt reluctant because of fear of reprisal, aversion to added paperwork, and the belief that publicising violence would encourage further incidents’.

A version of this article was first published by our sister title Pulse