Violence in primary care: a growing problem?

Gulati et al (2021) cite evidence that between 2013 and 2014, there were 68 683 assaults reported against NHS staff in England, of which 25% involved primary care staff. In 2017, the Royal College of Nursing undertook a survey of its membership, reporting that ‘28% of all nursing respondents working in the NHS stated they had experienced physical abuse in the previous 12 months'; and in primary and community care 68.1% and 15.9% of respondents experienced verbal abuse and physical abuse, respectively (Royal College of Nursing, 2018).

Professor Gautam Gulati is a consultant forensic psychiatrist and Adjunct Associate Clinical Professor at the University of Limerick. ‘The following violent scenario,’ Prof Gulati told Practice Nursing, ‘occurred in primary care: a GP registrar at a busy inner-city practice saw Mr A – a young man with a history of substance misuse – recently released from prison. Mr A sought a prescription of diazepam, but the registrar explained that he saw no justifiable clinical indication and advised alternative treatments. Mr A became angry, seized a chair, and threatened to throw it at the registrar, who raised the alarm and was joined by an experienced practice nurse. Together, they used de-escalation strategies and eventually, Mr A was escorted from the practice. Nobody was injured but several practice staff were visibly shaken. An incident debrief revealed that Mr A had a history of violence against healthcare professionals and whilst this was flagged on his records, the computerised record system was not functioning that day due to a cyber-attack.’