GP surgeries should be safe havens, where patients feel respected, listened to, and cared for.  However, instances of abuse within GP surgeries can shatter this trust, leaving patients feeling vulnerable and afraid - I know as I have experienced it firsthand from several Doctors within the same surgery.

These are people I thought I could trust and would never behave like that.

It is imperative that we address this issue head-on to ensure that GP surgeries throughout the UK remain places of healing and comfort.

Reports and studies indicate that abuse within healthcare settings, including GP surgeries, is an increasing problem.  This not only affects the mental well-being of patients but also impacts their likelihood of seeking further medical assistance, potentially exacerbating health issues.

Abuse usually falls in to two main categories:

• Professional Misconduct and Boundary Violations
• Clinical Gaslighting and Red Flags

To break it down further, abuse can manifest in many forms: 

• verbal disrespect/abuse/vertical abuse;
• making you feel 'small' or 'worthless';
• belittling;
• emotional/psychological;
• refusing to apologise;
• gaslighting;
• medical gaslighting (where a patient’s genuine physical or psychological symptoms are dismissed, mocked, or improperly blamed on external factors or outright denied);
• exploitation;
• invalidation;
• degradation;
• isolation techniques;
• breaches of privacy;
• dishonesty;
• oppression;
• withholding information;
• withholding test results (which you are entitled to, unless discretion is needed); 
• intimidation;
• stone-walling;
• MR interference;
• coercive control;
• issuing ultimatums;
• being shunned;
• silent treatment;
• physical attacks;
• unprofessional conduct;
• mis-use of Local Medical Committees (LMC)/MDU bodies to hide behind when complaints arise or escalate; to evade accountability - should you, as a patient, find yourself in this situation upon receipt of any documentation from a GP surgery mentioning LMC/MDU in wording, you must obtain IMMEDIATE legal counsel;
• 'deliberate and malicious' contamination of care - this is very insiduous in nature;
• discrimination;
• homophobia/racism/ageism;
• scare tactics; possibly even deploying 'abuse by proxy' both within and outside a surgery to inflict further harm, 'doubling down', increasing isolation, frustration and inflicting harm widespread, across the PCN so a patient in a sense is 'blacklisted' rather than the actual perpretator(s) face accountability;
• neglect of duty and failure to provide appropriate medical care;
• denying a Local Resolution Meeting where the responsible parties should apologise (LRM);
• Using other members of staff - maybe others to inflict abuse against a patient - deploying various insiduous means (abuse by proxy);
• not working alongside secondary care for dubious reasons, at detriment to a patient;
• adopting 'hard-line', insensitive approaches to patients' medical needs/conditions such as dismissing and refusing pain relief for complex, painful, chronic conditions; making you suffer unnecessarily and subsequently then exacerbating the issues physically by non treatment (including inducing social and psychological consequences) as a result - this falls under remit of 'medical neglect' or in extreme cases, like severe under treatment at end of life or in palliative care - a form of 'legal abuse' or 'reckless negligence'.  There is a difference of course between legitimate clinical reasons to withhold and medical neglect;
• not treating physical symptoms;
• trying to say 'it's all in your head', which is extremely harmful 
• airing personal, controversial views on online platforms, visible to a patient/wider; at detriment to a patient

The above is not an exhaustive list...

A very serious further matter is 'Accountability Gaps', which is an insidious further form of abuse (not only unfair to a patient on the already receiving of abuse but to other patients and the overall reputation of the profession): this is when subsequent leadership of said Doctor(s) under several complaints, is elected in 'the dark', or on 'the quiet', despite unresolved or persistent complaints; maybe on PCNs or LMCs or within surgeries themselves - subsequent discoveries of this; create severe friction; further hurt and demonstrate how organisations/bodies 'protect' internal members rather than addressing public/patient concerns and putting things right.  

With around 41,000 GPs practicing in approximately 7,000 surgeries in the UK, it is crucial to establish a robust system for reporting abuse, ensuring accountability and transparency.  This is needed as those who abuse find all manner of ways in 'concealing and covering' their tracks.

We propose the following actionable steps:

1. Establish a dedicated, anonymous reporting system for patients who have experienced abuse, ensuring protection and confidentiality;
2. Implement mandatory training for all GP surgery staff on recognizing, preventing, and addressing abuse within their organisation; to look for signs of it amongst staff - Practice Managers need to uphold their duties; keep a log of all complaints against GPs (including partners within their own surgery) by patients/members of staff and escalate higher - that is part of their role. 

Practice Managers should be a first point of contact. 

Be aware of 'Internal Workarounds' - this is crucial for staff who notice (but who may not not be aware of reports of abusive behavior made) and maybe might see informal workarounds (such as frequent chaperoning of specific Doctors or the organisation avoiding placing vulnerable patients around them for instance) - something isn't right here - you must pay attention to this, log it and report your concerns and log any incident.  

You must report it - do not fear retaliations; report it outside of your surgery if needs be.  It is a moral obligation.

Informal walkarounds may be needed to address a problematic physician, and typically should focus on these tactics and strategy:

Direct Observation

• Scheduling "random", unnanounced walkarounds during the doctor's active shift/working day (benefits intercepts behavior firsthand without relying solely on anonymous reporting).

Real-Time Staff Check-ins

• Pulling nurses, residents, and administrative staff aside for brief, casual conversations (benefits - evaluates psychological safety and uncovers under-reported vertical abuse).

De-escalation Presence

• Having a senior clinician physically present on the floor (benefits - diffuses active tension and signals to the disruptive Doctor that their environment is being monitored).

3. Develop a comprehensive review process to investigate reports of abuse swiftly and fairly, with consequences for instances of misconduct.

I stress consequences because despite reports made, at times, those in power within organisations, can turn a blind eye or even manipulate reports of abuse; gaslight complainants; twist things owing to varying factors and conflicts of interests.

In Doctors' surgeries, there should be leaflets/flyers distributed/placed on walls so a patient can know who to report to, if not directly to the surgery for fear of consequences.  Healthwatch; GMC; CQC; ICB; advocacy services being some of the relevant bodies to report to.   The ICB is crucial here as you may not feel you can report to the surgery directly - you do have a choice however under legislation: file complaint with either your surgery or the ICB.  You cannot do both.

Placing leaflets/flyers about abuse in general or on noticeboards; and agencies specialising in abuse should be made public in waiting rooms - knowing where to turn.  It also serves as a reminder and deterrant to staff to behave.  Maybe you need someone to talk to first to give you the courage to report formally - these outside organisations are skilled at recognising abuse and can make you see clearly your situation.  Check online for sources.

Surgeries have zero tolerance policies up against abuse towards staff, but where are the policies protecting patients?  It works both ways.

'Vertical abuse, describes abusive or bullying behavior between people at different levels of a hierarchical power structure' - this can easily occur within a GP surgery'.  But it is unacceptable.

By signing this petition, you are joining us in urging healthcare authorities and the NHS to prioritize patient safety and dignity in GP surgeries. Ensuring a respectful and supportive environment for patients is essential for their health and trust in the healthcare system. 

Please sign and share this petition to drive change and make GP surgeries safe for everyone.