When Covid-19 first hit the UK last year, reports of both verbal and physical abuse towards NHS staff began to emerge. Doctors, nurses and other healthcare workers were spat at and labelled “disease spreaders”, among other forms of abuse, amid coronavirus fears.

A year down the line, reports confirm that the barrage of abuse has not subsided. The pandemic put the NHS under the most extreme pressure seen in recent history and now, staff are physically and emotionally exhausted with many suffering from burnout and fatigue.

With the success of the vaccine programme, the risk of hospitalisation from Covid-19 has significantly lowered and the NHS is now attempting to recover from the pandemic. However, due to the backlog of patients with unmet healthcare needs, waiting times will be long and tensions will run high for the foreseeable future.

If this abuse continues, we must question the fate of our NHS, as the BMA warn many healthcare professionals could retire early or move into alternative employment.

Abuse of staff in primary care

Healthcare professionals in both primary and secondary care have reported abuse, for differing reasons. In primary care, there is a perception that GPs are not offering enough face-to-face appointments. This has resulted in frustration from many patients, some of whom turn to anger and abusive behaviour.

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A survey of 571 practice managers conducted by the Institute of General Practice Management (IGPM) has now revealed the scale of the problem. The survey found that three-quarters (75%) of practice staff received abusive comments from patients on a daily basis, many of whom received verbal threats such as “If I die, it will be your fault” and “I pay your wages so give me what I want”. Furthermore, the survey found that 83% of staff reported having to remove a patient following multiple incidents, while 63% had been forced to called the police due to abusive behaviour.

As a result of the survey’s findings, the IGPM have launched a campaign video in which practice staff recount incidences of abuse they have been subject to during the pandemic. One staff member said: “Three of our team had their tyres slashed by a patient after we couldn’t give him an appointment. He phoned at 5pm and was offered an appointment the following day as we were fully booked.” Another explained how a patient turned up at the surgery and threatened staff with a hammer because he couldn’t get an appointment which suited him.

Robyn Clark, practice manager at Kingswood Health Centre, Bristol, and the co-founder of the IGPM said: “The aim of our campaign is to highlight the good work practices are doing, and make a plea to the public to be patient with our staff, instead of attacking them. GP staff have worked throughout the pandemic and have done their absolute best to support patients. We’re calling for the abuse to end now.”

Abuse of staff in secondary care

Unfortunately, abuse of staff is not just limited to primary care. In secondary care, Covid restrictions have meant that family members are not allowed to visit or stay with patients, even if they are very unwell. As a result of this, people often get frustrated and angry and take it out on the staff. Long waiting times in A&E and for specialist referrals have also triggered emotional outbursts from both patients and relatives.

According to a survey of RCM members last November, seven out of 10 midwives have suffered abuse from women and their partners due to Covid restrictions. These figures are further compounded by an MPS survey (taken last September and October) of 1,251 doctors. The survey found that 375 (30%) had been verbally abused by patients or relatives while at work during the pandemic. Another 63 (5%) had experienced physical abuse, and 88 (7%) had experienced abuse outside the workplace, such as when using an NHS queue at a supermarket.

These figures are shocking; however, they are likely to be just the tip of the iceberg as many incidents go unreported. According to the NHS Staff Survey 2020, almost half of NHS staff surveyed had not reported an incident of harassment, bullying, or abuse in the past year, with one nurse saying that filling in a form is a waste of time.

The abuse that many staff suffer on a daily basis is clearly taking its toll emotionally. According to the latest BMA tracker survey, more than half of doctors say their health and wellbeing is worse now than during the first wave of Covid, with 41% of doctors suffering from depression, anxiety or another mental health condition that has worsened during the pandemic

The survey also found that 26% of doctors are more likely to take a career break or seek early retirement in the next 12 months as a result of the pandemic, while almost a fifth (18%) of doctors are considering leaving the NHS altogether.

What is being done to tackle this abuse?

Doctors, nurses and other healthcare professionals have spent the last year on the frontline risking their lives to help others. And while initially this was met with gratitude, appreciation and a “clap for carers”, it has now turned into a torrent of abuse, anger and frustration.

If we are to protect the wellbeing of NHS staff and ensure there is a future for our NHS, employers must step-up to protect their employees. The NHS People Plan aims to do just this, with the promise to improve the experience of working in the NHS for everyone.

As part of the project, £1.1 million of funding has been allocated to piloting body cameras. However, more needs to be done and prevention methods must be put in place. Nurses want bodies such as the RCN to campaign against the abuse of NHS staff, which will help the public to understand the effects that abuse has on healthcare professionals.

Ultimately, physical and verbal abuse not only affects staff wellbeing, but also their ability to think clearly and make good decisions about a person’s care. In this way, staff abuse can impinge on patient safety and even endanger lives. Action must be taken; there must be proper support in place for staff and consequences for patients who are abusive. Unless some drastic change happens quickly, the security of our NHS could be at risk.