Experience and impacts of violence and abuse by patients and the public towards general practice staff: a qualitative study.

Abstract (English)

BACKGROUND: General practice (family medicine) experiences more violence and abuse by patients and the public than in general hospital settings. Qualitative accounts on how violence and abuse are experienced and perceived remain limited in both breadth and depth. AIM: To explore direct and indirect experiences of violence and abuse that general practice staff have encountered from patients and the public, and the perceived impact on staff wellbeing and their practice. DESIGN AND SETTING: This qualitative study was the second part of a mixed-methods project, following an online nationwide survey of England. Participants were invited to an interview at the end of the survey. METHOD: 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. RESULTS: 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. CONCLUSION: Violence and abuse by patients and the public include a wide range of behaviours. It has profound and, in some instances, longstanding impacts on staff, including a persistent sense of being unsafe and disruption to their personal or social lives. It also affects clinical services through staff turnover and reduced service capacity.