Experience and impacts of violence and abuse by patients towards general practice staff.

Abstract

General practice (family medicine) experiences more violence and abuse by patients and the public than general hospital settings. Qualitative accounts on how violence and abuse are experienced and perceived remain limited in both breadth and depth. To explore 1. direct and indirect experiences of violence and abuse that general practice staff have encountered from patients and the public, and 2. its perceived impacts on staff well-being and their practice. This qualitative study was the second part of a mixed methods project, following an online nationwide survey. Participants were invited to an interview at the end of the survey. Data were collected via semi-structured interviews conducted between August and December 2023. Quantitative survey responses were extracted to describe the characteristics of participants, their experience of violence and abuse and feelings of safety and support at work. Interviews were transcribed and thematically analysed following the framework approach. Twenty-three general practice staff members participated, including 17 women and six men. Fifteen participants were in non-clinical roles and eight were clinicians. Six themes were identified: violence and abuse through direct interactions, violence and abuse beyond direct interactions, increased risk, individual impacts, occupational impacts, and impacts on care and services. Violence and abuse by patients and the public includes a wide range of behaviours. It has profound, and in some instances longstanding, impacts on staff, including constantly feeling unsafe and affected personal or social life, but also on clinical services, including staff turnover, and reduced service capacity.