Global Study Reveals Violence in GP Surgeries Linked to Long Waiting Times and Drug Refusals

Published: 23 September ‘2025. The English Chronicle Desk

A comprehensive global study has revealed that violence and abuse directed at staff in general practice (GP) clinics is a widespread and alarming phenomenon, with long waiting times and the refusal to prescribe requested medications emerging as the most common triggers. The research highlights the profound risks faced by healthcare workers worldwide, underlining the urgent need for policy interventions and improved protection measures for frontline medical personnel.

The study, conducted by Shihning Chou, an associate professor of forensic psychology at the University of Nottingham, represents the first large-scale effort to assess aggression against GP staff on a global scale. Chou’s analysis drew upon fifty prior studies conducted across twenty-four countries, including the United Kingdom, China, Australia, Germany, Ireland, Kuwait, and Barbados. Her findings paint a stark picture: up to nine out of ten GP surgery staff members report having experienced either verbal or physical assaults at some point in their careers. In many regions, an equivalent proportion reported experiencing such incidents within the preceding twelve months alone.

The consequences of such aggression are far-reaching. Staff subjected to threats and abuse often suffer from heightened stress levels, anxiety, and lasting psychological effects, with many considering leaving the profession altogether. The research emphasized that younger and less experienced employees, particularly female staff and receptionists, are disproportionately affected, highlighting the vulnerability of frontline administrative personnel in GP practices.

According to Chou’s study, the most frequent catalyst for aggressive behaviour among patients is prolonged waiting times. Between 31% and 73% of GP staff surveyed in earlier studies identified delays in receiving care as the primary trigger for violence or verbal abuse. Closely following this, unmet patient demands, such as refusals to prescribe medications or dissatisfaction with the perceived quality of treatment, were also cited as significant contributors.

Professor Kamila Hawthorne, chair of the Royal College of General Practitioners, expressed deep concern over the findings. “That incidences of abuse against GPs and our teams are so widespread – and as this research demonstrates, not confined to the UK – is extremely distressing,” she said. “It is entirely unacceptable for anyone working in general practice to face abuse while simply trying to provide essential care.” Hawthorne added that some incidents are so severe that GPs are forced to involve the police or remove patients from their practice lists to ensure the safety of staff and other patients.

News outlets such as Pulse, a website dedicated to general practice professionals, have chronicled several disturbing examples of assaults. Among them were incidents involving a man wielding a baseball bat and another carrying knives, both targeting GP surgery personnel. Other reported attacks include verbal abuse, threats, and instances of intimidation, reflecting the dangerous environment that many frontline staff confront on a daily basis.

The research further explored how certain systemic and institutional factors may indirectly contribute to the prevalence of aggression. Some studies noted that inadequate staff training in professionalism, interpersonal skills, and conflict management, as well as staff attitudes, may exacerbate tensions and increase the likelihood of confrontations. While such factors do not justify violence in any form, they underscore the need for continuous professional development and better support mechanisms for healthcare workers.

Dr. Julius Parker, deputy chair of the British Medical Association’s GPs committee, echoed these concerns, stating: “General practice is the front door to healthcare in the UK and across the world. GPs are on the frontline, dealing with people in pain, anxious, and often frustrated with wider healthcare systems. But frustration or distress can never justify violence against healthcare professionals.” Parker stressed that systemic reforms should focus on reducing stressors that contribute to patient aggression, while simultaneously safeguarding staff welfare.

Real-world examples illustrate the human impact of these findings. In one case, a Manchester GP practice faced repeated verbal abuse from frustrated patients, with some incidents escalating to physical altercations. In London, one resident lived with a boarded-up bedroom window for years in social housing, paralleling the broader issue of unmet needs triggering frustration and aggression. While these incidents occurred outside the GP context, they illustrate a pattern of distress-driven confrontations that can manifest violently when patients feel ignored or underserved.

In Scotland, Dr. Osama Farooq, a GP based in Fife, reported experiencing both physical and racial abuse after leaving his surgery following a twelve-hour shift. The sustained harassment compelled Dr. Farooq to leave the area entirely, highlighting the profound personal and professional toll that patient aggression can impose. Similarly, Pulse has documented cases of staff being spat upon or assaulted by patients refusing to comply with medical guidance, further emphasizing the widespread nature of the issue.

The study’s findings also align with data from last year’s MDDUS research, which reported that 84% of GPs had experienced verbal abuse, while 24% suffered physical attacks within a twelve-month period. One particularly concerning case involved a patient with Covid-19 deliberately coughing on a receptionist after being denied a prescription. Such incidents illustrate the urgent need for both preventive strategies and robust legal protections for healthcare personnel.

Experts argue that violence against healthcare workers is not solely a UK problem but a global challenge. The international scope of Chou’s research, encompassing countries across Europe, Asia, Oceania, and the Caribbean, indicates that systemic pressures, high patient demand, and unmet expectations contribute to a common pattern of aggression. In every country studied, staff reported feeling stressed, undervalued, and unsafe, emphasizing the universal nature of the problem.

Recommendations emerging from the research highlight the importance of timely patient communication, structured appointment systems, and clear guidelines for prescribing practices. Additionally, regular staff training in conflict resolution and de-escalation techniques is crucial to mitigating potential risks. Organizational culture also plays a key role: fostering an environment of support and respect can help staff feel empowered to address difficult situations and seek assistance when confronted with aggressive behaviour.

The implications of the research extend beyond healthcare facilities. Violence against GP staff undermines public trust, diminishes workforce morale, and risks long-term retention of qualified professionals. As the global demand for healthcare continues to rise, the safety and well-being of frontline staff must remain a priority, requiring coordinated action from policymakers, healthcare organizations, and local authorities.

Professor Chou concluded that violence in GP surgeries is a complex, multifaceted issue. While individual acts of aggression may appear isolated, the global patterns reveal systemic vulnerabilities and persistent pressures on both patients and healthcare workers. Addressing these challenges will require comprehensive interventions, including better resource allocation, patient education, and protective policies to ensure that those providing care are not placed at risk.

As nations grapple with increasing demand on healthcare services, the research serves as a wake-up call for governments and healthcare bodies to implement effective measures. Only through concerted efforts can GP staff continue to provide essential care without fear of abuse, ensuring that the doctor-patient relationship remains rooted in trust, professionalism, and safety.