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Staff at UK GP surgeries facing abuse and ‘tsunami of demand’
- emergency summit reveals deep crisis with serious impact on mental heath of doctors, dentists and staff


(Primary care in England is ‘in meltdown’, says the chief executive of the Salford Primary Care Together partnership.)


NHS staff at GP surgeries are facing unprecedented abuse and aggression from patients, while stressed doctors are increasingly suffering from mental illness, because of an appointments system “in meltdown”, family doctors’ leaders have revealed.


The scale of the deep crisis in GP surgeries was revealed in an emergency summit of more than 60 NHS doctors, dentists and administrative staff in Salford, which the Guardian attended, triggered by a recent rise in verbal abuse.


“Patients are short-tempered and not happy waiting for anything … They want letters. The latest one was a request to speak to a GP because he needs a letter to confirm anxieties that cause him a problem in long queues – because he wants to take his son to [Southport amusement park] Pleasureland and does not want to queue.” Jan Crowshaw, GP manager


It comes after a recent poll by the body representing GP surgery staff across the UK found that 75% of them face abuse every day, including assaults, threats, racism and sexism.


Jan Crowshaw, a GP practice administrator in Salford for 27 years, said: “In all my time I have worked for the NHS, we have never ever encountered the level of vitriol that has been levelled at us in the past few weeks. We have all noticed not only huge increases in patient demand, but also massive increases in complaints.


“Perhaps most distressing of all is a real surge in the number of patients who feel it is appropriate to shout at, swear at and insult not just our non-clinical staff but clinical staff as well. We have one member of staff reduced to tears every single day.”


NHS figures released this month show that GP practices in England delivered almost 5m more appointments in March 2021 than the month before, and nearly 3m more than in March 2019.


“We are aware of one instance of a dentist committing suicide during the pandemic because of financial losses and job losses and I’m sure there are many more suffering with depression and stress-related illnesses.” Hamza Anwar, dentist


But surgeries are still struggling to meet the increasing demand for appointments and GPs have faced fierce media criticism for carrying out phone consultations because of Covid restrictions. NHS England has now told all GPs that they must offer face-to-face consultations.


The Institute of General Practice Management (IGPM), which represents staff across the UK, carried out the poll. It has launched a campaign video on YouTube calling for a zero tolerance approach called “If I die, it will be your fault” – after one of the most common abusive statements directed at staff.


Kay Keane, a practice manager in Stockport, told GP Online: “A man attended our practice with six knives because he didn’t get the treatment he wanted. He smashed up the waiting room and threatened staff members. It was terrifying and unacceptable.”

斯托克波特的一名诊所经理凯·基恩告诉GP Online网:“一名男子带着6把刀来我们诊所,因为他没有得到他想要的治疗。他砸碎了等候室,并威胁工作人员。这种行为是可怕和不可接受的。”

“Digital medicine is seen as lazy and actually it’s harder. Fifty per cent of a face-to-face consultation is [watching the patient] walk across the room. You are trying to see that down the telephone line. And it’s really, really hard. And I don’t think people understand that.” Lance Gardner, chief executive of Salford Primary Care Together


Lance Gardner, the chief executive of Salford Primary Care Together, who organised last week’s Zoom call of worried NHS staff from local practices, said surgery staff are having serious mental health problems as a result of the intense pressures on them.


“Primary care is in meltdown. It has never been like this. I am terrified that I am going to get a phone call that somebody in primary care has taken their own life. GPs are having to seek medical advice and counselling. People are mentally falling over. They have been hit by a tsunami of demand,” Gardner said.

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The Salford summit also heard how patients’ attitudes towards GPs were not the same as they were in the past.


“We were already busy to start with. It’s not like we started off with a great deal of capacity to fill … Patients are on long waiting lists and conditions slowly get worse as time goes on and we have to manage that. They keep contacting the practice to find what is happening [with their treatment or operations]. That causes a significant amount of absorption of time.” Dr Nick Browne, GP


“The patient perception of us has changed,” Dr Nick Browne, a Salford GP, said. “Somebody mentioned to me that they feel as though patients are coming to us with much more minor problems at a much earlier stage. Their expectations of our response is much greater.”


The British Medical Association, the UK’s largest doctors’ unx, wrote last week to the health secretary, Matt Hancock, to request an urgent meeting about the GP crisis. The fear in many surgeries is that patients needing urgent care will be missed because appointments are snapped up so quickly.


“A patient turned up at the surgery and threatened staff with a hammer because he couldn’t get an appointment that suited him.” NHS staff member, in the Institute of General Practice Management campaign video


The BMA’s GP committee chair, Dr Richard Vautrey, said it was very concerning to hear of the rising levels of abuse and aggression being experienced. “There can never be an excuse for this kind of behaviour,” he said. “Unfortunately, GPs and practice staff are very often at the receiving end of this frustration, when really it has originated as a result of many issues outside the control of the practice, such as lack of resourcing, chronic understaffing and years of underinvestment by the government.”

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Prof Martin Marshall, chair of the Royal College of General Practitioners council, said the supply of doctors was not enough to meet demand: “This was already the case before the pandemic, and we are now at crisis point. We are hearing from our receptionists and practice staff that they are bearing the brunt of this frustration, and even anger, and this is having a serious impact on their wellbeing and morale.”

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“The job of being a GP is largely undoable at present and these pressures are keenly felt by our teams,” he added.


Crowshaw said staff were “drowning under the workload”. “We don’t want to miss the cancer or suicidals. [But] our access has become first come, first served, with those that shout the loudest at the head of the queue.”


“The mental health and wellbeing of [pharmacy] staff is at an all-time low and staff are also facing abuse from the public.” Luvjit Kandula, director of pharmacy transformation, Greater Manchester


Some fear the situation will get worse as patients on long waiting lists for operations turn to their GP for extra care. Increasingly surgeries are just shutting down and “handing in their keys” because they cannot cope.


“I was talking to our lawyer and she said six GPs in the last week in April rang her law firm to hand their keys in,” Gardner said. “They hadn’t had six GPs s hand their keys in the previous six years, never mind in five days.”


My nearest GP practice only accepts new registrations on Wednesdays between 12 noon and 1 pm. They only accept 25 new registrations per week. You have to go to the surgery with the form already filled in - no they don't have blank forms, you have to print it yourself.
The surgery tells people not to queue up and wait, but by 11am there's almost always a queue of at least 20 people, and it only gets longer. The excess folk in the queue hope that those in front of them have mistakes on their forms, for which they'll be sent away to try again next week. Unfortunately, even if you're, say, 10th in the queue, there's no guarantee of success, because people often bring 3, 4, or 5 forms with them, to register their entire family. If you're unlucky and don't manage to get registered, don't panic! The helpful receptionists will direct you to other local practices, who only accept a smaller number of new patients one day a week.


Do you live in the Soviet unx, circa 1960? That bloody sounds like it. My god.


I used to complain about my town's GP office having a 3 to 6 week wait for appointments, but after hearing other people's stories I believe we are practically spoiled - since we can at least book online appointments and sometimes catch cancelled appointments.
Speaking of public services going downhill, I actually live abroad and 10 years ago I renewed my passport. Easy form, postage application, fee in local currency and my passport was posted to me within 3 weeks.
I just finished renewing my passport again in the same country. Only in-person applications at the centre halfway across the country, “We recommend you stay another business day in case of interview" and they're only open from 9am to 11am Mondays, Wednesdays and Fridays, so another business day means a 3 day stay.
The logistics were well over three times as expensive as the passport itself, which was already £140. 4 hours each way by train, hotel, then another train and hotel journey to pick up the passport.
Including lost income from days off, renewing a passport cost me about £800. Because funding has been cut so severely that all passport services in this country were shut down, replaced by agents who forward applications to the UK, of which there are only four in the country.
Edit: to make it worse, they never changed any policies due to Covid. Still in-person only. A friend finished his application before Covid, then was told to travel to the capital city to pick up his passport... while both the capital city and his own city were in lockdown.


Not enough GP’s - The U.K. Government has known for years that many were due to retire, yet kept training places too restricted - So now we don’t have enough GO’s for the country..
Brexit has caused more European doctors to leave, so cutting the numbers further.
All down to U.K. Government Policy..
You reap what you sow..
It’s left us with a big problem.
Even if the right actions were taken (they have not been), it would still take 10 years to fix properly.


I mean, I don't doubt staff receive lots of abuse from a very vocal minority but this article felt a bit patronising, especially the bit about people coming in with minor conditions. Like, yes, that's what a GP is for ideally? It's frustrating to read on NHS online that you should speak to your GP about a whole host of minor conditions, only to find that your practice won't even consider you for an appointment.


especially the bit about people coming in with minor conditions. Like, yes, that's what a GP is for ideally?
So rude of these patients to not have attended medical school.


Exactly. I went into my GP a couple of years back because I felt my chest being really tight for a couple of weeks. 5 mins later I left the doctors being told you it is caused by stress and not my heart being messed up.
Despite feeling like a bit of a tool, the doctor said it was good I came in regardless.
Instead of encouraging people to go to the doctors for a diagnosis in a 5 minute check, lets just let potential diseases become critical, let the patient suffer and cost the taxpayer tens of thousands for surgeries and care which could have otherwise been prevented.
Absolutely backwards.


Exactly I was having chest pain and getting very dazed whilst training for a competition a few years back, went to the GP turned out it was just my low blood pressure and some muscular strain. But said it was good I came in because I had the same symptoms as someone who could have been about to drop dead form heart failure.
The whole point of the GP is to clear this up


I had chest pain a couple of years ago that had been going on for a few days. No other symptoms that would suggest a heart attack but I wanted to see a doctor to get it cleared up.
When I finally got through to a receptionist, they straight told me to call 999.
So I thought fuck it and called for an ambulance, and when they arrived they were shocked to discover that I was in fine health, calmly opening the front door and walking around. They assumed that they were here for someone else and I was to show them to their patient.
When I said it was me that called for them as instructed by my local GP they were stunned. They ran all the tests on me and I was fine, it later turned out I had rib cartilage pain in the sternum that was easily treated.
If I’d seen a doctor at my local GP they would have instantly been able to see I wasn’t having a heart attack and would have saved the trouble of calling out an ambulance that could of gone to someone who actually needed it.


Probably cause dealing with most GPs is a consistently shit experience for most people. Even if you manage to get an appointment there's zero guarantee that whoever you get in the other end actually takes your problem seriously.


I don't condone abuse, but it should at least be acknowledged that the GPs are absolutely useless at the moment.


The NHS has been a national disgrace over the last 15 months so it's hardly a surprise.


Every time I've called the GP it's taken over an hour to get through.
Every time I've called the GP it's taken weeks for an appointment.
Every time I've been seen it's always "Make another appointment to come see me in a few months".
Every time I've had a major issue I've had to fight tooth and nail to have anything done about it.
Every time I've seen any professional I've had to rattle off the relevant medical history sometimes for multiple professionals in one visit.
Every time I've had to be referred to a specialist it's treated as a hassle that the GPs will graciously go through for me.
Every time I've needed bloods I've had to write letters asking why the relevant blood forms are not being dispensed.

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Every time I've spoken with the receptionists they have been nothing but polite and professional, but they're clearly heavily overworked.
Every time I've seen a GP they talk about random shite for 5 minutes each time. I appreciate that they appear to care about my life, but that's 5 minutes you could be spending with another patient. Or maybe it isn't, I'm not a Doctor.
Every time I've needed a letter it's taken over a month to be written and signed. Literally just for things like "This patient is being seen for X, please accomodate her"
Every time I've talked about this with anyone, it's always been "The NHS sucks" rather than "The NHS is in desperate need of funding"
Every time I've had an easy time of things like getting antibiotics or painkillers or blood tests, I feel guilty, as if I've cheated the system.
Every time I've used private services, these problems have been way less exagerated, which is awful because that's exactly what the Tories want. They want to privatise healthcare so that they can stick their fingers into the pie.