GP surgery staff given training to deal with abuse as reception staff 'leave in droves'

Some staff have reported being abused in the street, while receptionists “are walking out in droves”, a health boss has revealed.

A campaign has now been launched to tackle the abuse. Health services are also working to improve access to appointments, Staffordshire County Council’s Health and Care Overview and Scrutiny Committee was told on Monday.

Lynn Millar, director of primary care and medicines optimisation for the area’s six Clinical Commissioning Groups (CCGs), said: “We’ve got a YouTube video that’s quite strong around the kind of abuse that practices are receiving and the impact on them. The campaign is about being patient and zero tolerance around abuse.

“We’ve put on resilience training for staff about how to deal with difficult people and there’s been really high uptake rates on that. We’re seeing a whole spectrum of abuse that staff are having to deal with

“Increasingly in general practice we’ve seen daily acts of verbal aggression but we’ve also seen some quite nasty physical aggression against our practice staff. It’s having a huge impact on our frontline staff, particularly our most junior members – our receptionists.

“We’ve had a number of physical attacks – there was one at the weekend where a patient jumped over the reception and started to attack staff physically. We’ve had patients fighting in reception as well.

“The abuse is pretty widespread across all of our practices. It’s happening everywhere at the moment, which is really disappointing.

“Staff have said they’re afraid, they get abused in the street and we just can’t tolerate that.”

But Councillor Philip Atkins said: “I’m concerned about access to GP surgeries still. The training for receptionists doesn’t really get to the nub of the problem.

“People are frustrated. If they are going to have a go at the receptionist, and you are training receptionists how to do anger management, that doesn’t get to the bottom of the original problem, which is people’s frustration that they haven’t been able to access a GP.

“I go past the one next to me and there’s a queue of 70-plus-year-olds waiting to collect their prescriptions in the pouring rain. That is not right. You’ve had 20 months to do something about it and nothing’s happened.”

Ms Millar responded: “General practice sees around 400,000 patient appointments a month. It’s huge, it’s eye-watering and what is more so is the number of telephone calls. That’s where it has been falling down.

“We’ve got a fixed workforce in primary care but we’ve got a huge peak in activity. I would say practices are doing over and above what they have ever done before in terms of the volumes of work going through practices.

“What still is a huge problem for us is the volume of calls. We are seeing another 100,000 calls a week in our practices. We’ve bought additional phonelines, we’ve got new ways of using Teams, additional cloud-based telephony, things like that.

“But we’ve only got so many people in the workforce to answer the phones and that’s our real problem. People are waiting a long time on the phone and that’s something we do acknowledge. We’re working with practices around different solutions we can put in place.

“In terms of the abuse I do recognise that people are frustrated, but that’s having a knock-on effect on our receptionist staff. They are walking out in droves, so we have got an added problem now.

“We’ve got even less staff than we did 12-18 months ago and people don’t want to come and work in a doctors’ surgery because of the levels of abuse, which I will say is daily.

“I take your point – we do need to do more. We will be meeting with all 146 of our practices, we do that every single year. We also have a target approach for the bottom 20% and we work with them very much on a one to one basis.”

Lichfield District Councillor David Leytham said: “I have the misfortune to be a patient at a practice which seems to have locked itself away. They’ve got eight GPs – you cannot make an appointment with a doctor. You can only see either a healthcare assistant or a nurse.

“I’ve even got the nurses now saying ‘will you do something about this please’. There are major issues with this surgery. Eight GPs – where are they? What are they doing?

“Primarily people lose their cool when they are ignored or frustrated, therefore receive lower quality of service than they expect. That’s why they get very angry and resort to violence.”

Ms Millar said: “I don’t think violence and aggression are ever acceptable and that’s the message we need to get out, that we need people to be patient and any violence or aggression is not tolerated. We have had some quite serious incidents you wouldn’t believe and we don’t see people in supermarkets getting this level of treatment.

“We know the majority of our practices in Staffordshire and Stoke on Trent are good or outstanding – I think we’re at 96% now. But we do know some practices that have poor access.

“They were poor before the pandemic and they are poor now and we know who they are. It’s a low number but it tarnishes the rest of primary care, so we’re working with those practices who provide low face to face appointments, not a lot of appointments generally and at the wrong time.

“We saw a huge dip during the pandemic in terms of face to face appointments. Face to face appointments during the pandemic at its height were around 20%, with the majority of capacity delivered remotely.

“Since then we have seen a gradual increase in face to face appointments. Staffordshire and Stoke on Trent were the most improved system in the whole country in terms of the increase in face to face appointments – we had a 6.2% increase in our appointments between August and September (rising from 55.2 per cent to 61.4 per cent).

“The vast majority of appointments are with a GP. I think 70 per cent are GP appointments. About 62 per cent or our appointments are delivered on a face to face basis and that’s starting to feel like quite a good balance for people.”