Violence and Abuse towards General Practice Staff by Patients and the Public: A Scoping Review

Abstract Background General practice is the gatekeeper to secondary care in many countries. This unique role may expose general practice staff to violence and abuse by patients and the public, yet violence and abuse in secondary care receives more attention than that in general practice. Existing reviews on primary care do not distinguish the perpetrators of violence. A scoping review on violence and abuse by patients and the public towards general practice staff was conducted. Aim: to analyse the evidence on: 1. The extent, characteristics and impact of violence and abuse by patients or the public towards general practice staff. 2. Practices in violence and abuse prevention and support in general practice at individual and organisational levels. Design and Setting This scoping review followed the updated Joanna Briggs Institute guidelines and the PRISMA ScR guidelines. Method Six bibliographic databases, Google and Google Scholar were systematically searched. De-duplicated citations (N=19,519) were independently screened by two reviewers. Data were extracted with a bespoke extraction form. Results Fifty studies from 24 countries were included. Past-year rates for violence and abuse by patients and the public towards general practice staff ranged from 13.8% to 90.3% while career-long estimates were 18.3% to 91%. Long waiting times and unmet patient demands were the most common reasons. It impacted staff mental health and turnover intention and service capacity. No evaluated prevention or support interventions were reported. Conclusion Violence and abuse towards general practice staff is widespread, impacting both individuals and service delivery. However, interventions are under researched.