Over a third of doctors have suffered verbal or physical abuse from patients or their relatives during these past months of the Covid-19 pandemic, according to a recent survey of GPs by the medical indemnity organisation, Medical Protection.

The reported abuse includes graffiti, notes through the door, and has not been confined to surgery premises, with GPs receiving abuse whilst out in supermarkets and elsewhere.

The survey of 1,250 doctors over a month from mid-September to mid-October found that 35% of respondents had faced verbal or physical abuse, and 7% had experienced abuses whilst outside of work.

Much of the abuse relates to the mistaken belief that GP surgeries are closed and doctors are not seeing patients face-to-face. Graffiti on a doctors’ surgery in Bristol in late October implied the GPs didn’t care and a note through a GP surgery door in Suffolk implied that the GPs were not available.

At the start of the pandemic the message from the government of ‘Stay at Home, Save the NHS’ resulted in a huge drop in people seeking help from GP surgeries in other medical settings. GPs were given guidance to triage patients and Matt Hancock and NHS England pushed the widespread move to digital access – telephone and skype appointments.

GP surgeries responded accordingly and rapidly changed the way they worked, but at no time did they stop face-to-face appointments entirely or close.

The guidance and government messages led to a sharp downturn in GP visits, but the most recent data on GP consultations released by NHS Digital shows that the figures are back up again. Indeed, the figures are up substantially, with higher demand than at the same time in 2019. In September 2020 there were 1 million more GP appointments than September 2019, 1.5 million more same day appointments than in September 2019, and 56.6% of appointments were face-to-face.

So why the mistaken belief that GP surgeries are not doing face-to-face or are closed? Well much of the recent abuse targeted at GPs has been blamed on a letter sent by NHS England in September.

The letter to GPs was to remind GP practices of their duty to provide face-to-face appointments and warned that the failure to do so could constitute a breach of contract. A press release to national media on the subject sparked a deluge of negative coverage about a lack of GP access. The BMA demanded NHS England issue a correction and said that  “Any inference that in-person consultations were put on hold is an affront to the committed GPs who have continued to go to work throughout the pandemic. NHS England’s primary care medical director, Dr Nikita Kanani, has since apologised for the letter.

Comments in the MPS survey also noted that the guidance the GP surgeries are following for triage – NHS England guidance that all patients should be remotely triaged while the pandemic continues – is also a major source of complaint and a trigger for abuse.

The increase in abuse comes at a time when 2 in 5 doctors said their mental wellbeing is worse compared to the start of the pandemic.

The BMA GPs committee chair Richard Vautrey, wrote to NHS England & NHS Improvement executive director Ian Dodge at the end of October, calling for GPs to be given urgent support. Commenting on the latest consultation figures, he said: “Today’s figures show that GP practices are very much open for business.” However, GPs face a very difficult winter ahead, with demand up, new complex working arrangements and longer hours.

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