• Site map
• Contact us
• About us
• How to join
• Feedback

Violence at work : the experience of UK doctors

• Violence is a problem in the workplace for almost half of respondents and this is consistent for both GPs and hospital doctors. Differences do exist according to specialty of hospital doctor, with those working in A&E and psychiatry more likely to report violence as a problem in their workplace.
• More than a third of respondents have experienced some form of violence in the workplace in the last year. This is the case for both hospital doctors and GPs. Amongst hospital doctors, those working in A&E, psychiatry and obstetrics & gynaecology are more likely to report experience of patient violence.
• For the majority of respondents, the violence experienced was from patients or patients’ families/relatives. Around half of respondents knew the perpetrator before the incident took place. GPs are more likely to know the perpetrator or their family prior to the incident, compared with hospital doctors.
• Almost all those respondents who report experience of violence had been the victim of some form of verbal abuse in the past year, a third had experienced threats and a fifth physical assaults. The incidence of verbal abuse is by far the most frequent, with a quarter of respondents experiencing this form of abuse more than 5 times in the last year.
• The majority of violent incidents took place in the doctors’ office or hospital ward. Amongst GPs, the majority of incidents took place in their office or waiting room, whilst for hospital doctors, the most frequently cited location was the hospital ward.
• The most frequently stated reason for violence is that the perpetrator has health related/personal problems, followed by dissatisfaction with service provided, a history of violence/abuse or intoxication with drugs/alcohol.
• In a third of violence cases, no action was taken following the incident. A third of incidents were reported and in other cases the perpetrator had been removed from their patient list or the police had been called.
• Some form of support was received by less than two-thirds of respondents following a violent incident and more than half stated that the incident had not affected their work. More than a third of respondents had considered withholding treatment from a patient due to the threat of violence.
• The majority of respondents have not received any training on how to deal with violence from patients, although a third of doctors are worried about potential violence from patients. More than half of respondents have taken precautions against potential violence
• The majority of respondents reported that they had witnessed violence from patients directed at others in their workplace in the last year. This was largely directed at nursing staff and receptionist/administrators and was in the form of verbal abuse or threats.
• A third of respondents were of the opinion that, as doctors, it was not possible to adopt a zero tolerance to violence. Reasons given for this opinion include the difficulties involved in both implementing and enforcing such a policy, the obligation of doctors to treat all patients, no matter what their condition, and the inherent problems of an over-stretched and under-funded healthcare system.

• Measures to reduce violence need to be based on sound risk assessment and risk management underpinned by effective strategies and locally developed policies. A standard definition of violence must also be adopted to avoid confusion and misinterpretation.
• Under-reporting of violent incidents is a widespread problem amongst health professionals, particularly doctors. Recording of violent incidents should be encouraged and formal protocols should exist for documentation of violent episodes. Trusts and practices should provide a ‘no blame’ environment, where staff do not feel guilty if they are the subject of violence and also know how to deal with it when it does occur. Reporting of incidents must be followed with appropriate action if the system is to be effective. De-briefing or counselling facilities should be offered, where appropriate.
• Tackling violence against doctors and other healthcare staff requires partnership working between local police, the relevant agencies and the media. Raising awareness of patients’ responsibilities and accepted behaviour will also contribute to a reduction in violence against doctors.
• A central priority should be the provision of training for doctors on the management of potentially violent situations. Training should be in place for all health care staff and should cover such issues as methods of restraint, communication, managing aggression and personal safety.
  • Feedback
  • Equal opportunities
  • Privacy policy
  • Terms and conditions
  • Accessibility
  • Help

  © British Medical Association 2008