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Last Updated: Saturday, 1 January, 2005, 01:11 GMT
Danger on the NHS front line
By Pat Hagan

Receptionist
Receptionist must deal with frustrated patients
Barbara Owen loves her job as a GP receptionist. After more than 23 years in the post, it clearly has some kind of lasting appeal.

Yet her long service is peppered with tales of abuse by patients that range from the mildly irritating to the potentially life-threatening. One incident, in particular, stands out.

"We had one young man who threatened us with a knife once because he wanted a certificate signed by the GP.

There's no point interrupting someone who is ranting and raving at you.
Barbara Owen
"But he was not registered with the practice and had not even been seen by one of the doctors. He had just walked in off the street and became very angry when we refused.

"He pulled the knife from his pocket and held it to our faces."

While one of the surgery team talked calmly with the assailant, the practice manager dialled 999 and the police arrived within 15 minutes.

Although the man was arrested without hurting anyone, the incident left its mark on the staff at Laindon Health Centre in Basildon, Essex.

"We were all scared," recalls Barbara. "But you have to try and let them get it out of their system first. There's no point interrupting someone who is ranting and raving at you."

Threats frequent

Such extreme violence is rare. But research shows that verbal threats and abuse from angry patients are a daily occurrence for doctors' receptionists up and down the country.

Receptionists are more in the front line than doctors because they are the gatekeepers for primary care.
Dr Nat Wright
According to the results, published in the journal Family Practice, two-thirds of receptionists had been subjected to verbal abuse in the previous year.

Six out of 10 reported telephone abuse and 55% had experienced face-to-face outbursts.

Researchers from the NFA (No Fixed Abode) Health Centre for Homeless People in Leeds surveyed receptionists at 50 practices across the city.

Each one was quizzed on the level of abuse they suffered and whether it had gone up or down after the government launched its nationwide "zero tolerance" campaign against violence in the workplace in 2000.

The results revealed that the zero tolerance policy appeared to have no impact on the level of abuse and that practices located in deprived areas were more at risk.

The NHS Security Management Service launched a renewed attempt to get tough on verbal attacks on NHS staff last month, issuing advice to hospitals and primary care trusts on possible sanctions, including legal action.

But although groups such as the British Medical Association have been campaigning for years on the issue of violence against GPs, little research has been done on the problem facing receptionists.

"Verbal abuse is widespread but the threat of physical abuse is more common in practices in areas of higher deprivation," the researchers concluded.

"This study is the first to identify the incidence of abuse of primary care receptionists."

Receptionists vulnerable

Dr Nat Wright, who took part in the study, said it showed receptionists were even more at risk of from abusive patients than GPs.

He told the BBC News website: "The focus has always been on abuse of doctors. But receptionists are more in the front line than doctors because they are the gatekeepers for primary care.

"We felt this was a much-needed area of research."

Kelly Marland, aged 19, has been a receptionist for three years at Stamford House surgery in Ashton-under-Lyne in Lancashire.

Although she has experienced no physical threats, verbal assaults are, she says, "an occupational hazard".

"We are in the front line and it can be very frustrating. Most abusive patients calm down fairly quickly although there are some who walk out and bang the door behind them."

According to Barbara Owen, most patients can be placated with a little patience and understanding. But she admits receptionists don't always have the best reputation.

"Sometimes we get called the 'dragons behind the desk' but that's a bit unfair. A lot of people do not understand our jobs."




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