Staff at UK GP surgeries facing abuse and ‘tsunami of demand’
- emergency summit reveals deep crisis with serious impact on mental heath of doctors, dentists and staff

英国全科医生诊所员工面临虐待和“需求海啸”
——紧急峰会揭示了严重影响了医生、牙医和工作人员心理健康的深刻危机


(Primary care in England is ‘in meltdown’, says the chief executive of the Salford Primary Care Together partnership.)

(索尔福德初级保健合作组织的首席执行官说,英格兰的初级保健体系正在“崩溃”。)
新闻:

NHS staff at GP surgeries are facing unprecedented abuse and aggression from patients, while stressed doctors are increasingly suffering from mental illness, because of an appointments system “in meltdown”, family doctors’ leaders have revealed.

家庭医生的领导们透露,全科医生诊所的英国国家医疗体系(NHS)工作人员正面临着来自病人的前所未有的虐待和攻击,而由于预约制度“崩溃”,压力很大的医生正遭受越来越多的精神疾病。

The scale of the deep crisis in GP surgeries was revealed in an emergency summit of more than 60 NHS doctors, dentists and administrative staff in Salford, which the Guardian attended, triggered by a recent rise in verbal abuse.

英国《卫报》参加了在索尔福德举行的由60多名NHS医生、牙医和行政人员组成的紧急峰会,会议揭示了由最近不断增多的言语虐待引起的全科医生手术严重危机的规模。

“Patients are short-tempered and not happy waiting for anything … They want letters. The latest one was a request to speak to a GP because he needs a letter to confirm anxieties that cause him a problem in long queues – because he wants to take his son to [Southport amusement park] Pleasureland and does not want to queue.” Jan Crowshaw, GP manager

“病人的脾气很坏,等待什么都不开心……他们想要证明信。最近的一次是他想找全科医生谈谈,因为他想要带儿子去(南安普顿的游乐园)游乐场,不想排队,所以他需要写封信来证实自己的焦虑。”——简·克劳肖,全科医生主任

It comes after a recent poll by the body representing GP surgery staff across the UK found that 75% of them face abuse every day, including assaults, threats, racism and sexism.

此前,代表英国全科医生的机构最近进行的一项调查发现,75%的全科医生每天都面临虐待,包括袭击、威胁、种族主义和性别歧视。

Jan Crowshaw, a GP practice administrator in Salford for 27 years, said: “In all my time I have worked for the NHS, we have never ever encountered the level of vitriol that has been levelled at us in the past few weeks. We have all noticed not only huge increases in patient demand, but also massive increases in complaints.

简·克劳肖在索尔福德当了27年的全科医生,他说:“在我为NHS工作的所有时间里,我们从未遇到过像过去几周这样的尖言刻薄。我们都注意到,不仅病人需求大幅增加,而且投诉也大幅增加了。

“Perhaps most distressing of all is a real surge in the number of patients who feel it is appropriate to shout at, swear at and insult not just our non-clinical staff but clinical staff as well. We have one member of staff reduced to tears every single day.”

“也许最令人痛心的是,越来越多的患者认为,不仅对非临床工作人员,而且对临床工作人员,都有必要大喊、咒骂和侮辱。我们每天都有一名员工被骂哭。”

NHS figures released this month show that GP practices in England delivered almost 5m more appointments in March 2021 than the month before, and nearly 3m more than in March 2019.

NHS本月发布的数据显示,2021年3月,英国全科医生诊所的预约数量比前一个月多了近500万,比2019年3月多了近300万。
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“We are aware of one instance of a dentist committing suicide during the pandemic because of financial losses and job losses and I’m sure there are many more suffering with depression and stress-related illnesses.” Hamza Anwar, dentist

“我们注意到有一个牙医在大流行期间因为经济损失和失业而自杀的案例,我相信还有更多的人患有抑郁症和压力相关的疾病。”——哈姆萨·瓦尔,牙医

But surgeries are still struggling to meet the increasing demand for appointments and GPs have faced fierce media criticism for carrying out phone consultations because of Covid restrictions. NHS England has now told all GPs that they must offer face-to-face consultations.

但外科手术仍难以满足日益增长的预约需求,由于新冠肺炎限制,全科医生进行电话咨询的做法受到了媒体的猛烈批评。NHS现在告诉所有的全科医生,他们必须提供面对面的咨询。

The Institute of General Practice Management (IGPM), which represents staff across the UK, carried out the poll. It has launched a campaign video on YouTube calling for a zero tolerance approach called “If I die, it will be your fault” – after one of the most common abusive statements directed at staff.

代表全英员工的全科医疗管理协会开展了这项调查。该组织在YouTube上发布了一段宣传视频,呼吁采取零容忍的方式,名为“如果我死了,那就是你的错”——这是针对员工最常见的辱骂之一。

Kay Keane, a practice manager in Stockport, told GP Online: “A man attended our practice with six knives because he didn’t get the treatment he wanted. He smashed up the waiting room and threatened staff members. It was terrifying and unacceptable.”

斯托克波特的一名诊所经理凯·基恩告诉GP Online网:“一名男子带着6把刀来我们诊所,因为他没有得到他想要的治疗。他砸碎了等候室,并威胁工作人员。这种行为是可怕和不可接受的。”

“Digital medicine is seen as lazy and actually it’s harder. Fifty per cent of a face-to-face consultation is [watching the patient] walk across the room. You are trying to see that down the telephone line. And it’s really, really hard. And I don’t think people understand that.” Lance Gardner, chief executive of Salford Primary Care Together

“数字医学被认为是懒惰的,实际上更难。面对面的咨询有50%是(看着病人)在房间里走两步。现在你试图通过电话线看到这一点。这真的非常非常难。我认为人们并不理解这一点。”——兰斯·加德纳,索尔福德初级保健中心的首席执行官

Lance Gardner, the chief executive of Salford Primary Care Together, who organised last week’s Zoom call of worried NHS staff from local practices, said surgery staff are having serious mental health problems as a result of the intense pressures on them.

索尔福德初级保健中心的首席执行官兰斯·加德纳表示,外科医生承受着巨大的压力,正面临着严重的心理健康问题。上周,他组织了Zoom电话会议,让当地诊所忧心忡忡的NHS工作人员参加。

“Primary care is in meltdown. It has never been like this. I am terrified that I am going to get a phone call that somebody in primary care has taken their own life. GPs are having to seek medical advice and counselling. People are mentally falling over. They have been hit by a tsunami of demand,” Gardner said.

“初级保健正在崩溃。从来没有这样过。我很害怕我会接到一个电话说某个初级护理的医务人员自杀了。全科医生必须寻求医疗建议和咨询。人们在精神上崩溃了。他们受到了需求海啸的冲击,”加德纳说。

The Salford summit also heard how patients’ attitudes towards GPs were not the same as they were in the past.

索尔福德峰会还听说,患者对全科医生的态度与过去不一样了。

“We were already busy to start with. It’s not like we started off with a great deal of capacity to fill … Patients are on long waiting lists and conditions slowly get worse as time goes on and we have to manage that. They keep contacting the practice to find what is happening [with their treatment or operations]. That causes a significant amount of absorption of time.” Dr Nick Browne, GP

“我们一开始就很忙。这并不是说我们一开始就有很大的能力去填补…病人在长长的等待名单上,随着时间的推移,病情慢慢恶化,我们必须处理好这一点。他们不断与诊所联系,以了解(他们的治疗或手术)发生了什么。这会导致大量的时间消耗。”——尼克·布朗医生,全科医生

“The patient perception of us has changed,” Dr Nick Browne, a Salford GP, said. “Somebody mentioned to me that they feel as though patients are coming to us with much more minor problems at a much earlier stage. Their expectations of our response is much greater.”

“病人对我们的看法已经改变了,”索尔福德全科医生尼克·布朗说。“有人对我说,他们感觉好像病人来找我们时,只是觉得自己有一些早期阶段的小问题。他们对我们的反应期望更高。”

The British Medical Association, the UK’s largest doctors’ unx, wrote last week to the health secretary, Matt Hancock, to request an urgent meeting about the GP crisis. The fear in many surgeries is that patients needing urgent care will be missed because appointments are snapped up so quickly.

英国最大的医生工会英国医学协会上周致信卫生大臣马特·汉考克,要求就全科医生危机召开紧急会议。在许多手术中,人们担心的是需要紧急护理的病人会被错过,因为预约时间很快就被抢订一空了。

“A patient turned up at the surgery and threatened staff with a hammer because he couldn’t get an appointment that suited him.” NHS staff member, in the Institute of General Practice Management campaign video

“一个病人出现在手术现场,拿锤子威胁工作人员,因为他无法得到合适的预约。”——NHS工作人员,在全科医学管理研究所宣传视频中说道

The BMA’s GP committee chair, Dr Richard Vautrey, said it was very concerning to hear of the rising levels of abuse and aggression being experienced. “There can never be an excuse for this kind of behaviour,” he said. “Unfortunately, GPs and practice staff are very often at the receiving end of this frustration, when really it has originated as a result of many issues outside the control of the practice, such as lack of resourcing, chronic understaffing and years of underinvestment by the government.”

英国医学协会全科医生委员会主席理查德·沃特里博士表示,听到越来越多的虐待和侵犯行为,我们感到非常担忧。“这种行为永远没有借口,”他说。“不幸的是,全科医生和执业人员往往是这种挫折的受害者,而实际上,这是由许多超出执业控制范围的问题造成的,比如缺乏资源、长期人手不足和政府多年投资不足。”

Prof Martin Marshall, chair of the Royal College of General Practitioners council, said the supply of doctors was not enough to meet demand: “This was already the case before the pandemic, and we are now at crisis point. We are hearing from our receptionists and practice staff that they are bearing the brunt of this frustration, and even anger, and this is having a serious impact on their wellbeing and morale.”

英国皇家全科医生学院理事会主席马丁·马歇尔教授表示,医生的供应不足以满足需求:“大流行之前就已经出现了这种情况,我们现在正处于危机点。我们从前台和实习人员那里得知,他们遭受了挫折、甚至愤怒的冲击,这对他们的福祉和士气造成了严重影响。”

“The job of being a GP is largely undoable at present and these pressures are keenly felt by our teams,” he added.

他补充说:“目前,全科医生的工作基本上是做不了的,我们的团队深切感受到了这些压力。”

Crowshaw said staff were “drowning under the workload”. “We don’t want to miss the cancer or suicidals. [But] our access has become first come, first served, with those that shout the loudest at the head of the queue.”

克劳肖说,员工们“被工作量压垮了。我们不想错过癌症或自杀的人。(但)我们的准入已经变成了先到先得,以及那些排在队伍前面的喊得最大声的人。”
原创翻译:龙腾网 http://www.ltaaa.cn 转载请注明出处


“The mental health and wellbeing of [pharmacy] staff is at an all-time low and staff are also facing abuse from the public.” Luvjit Kandula, director of pharmacy transformation, Greater Manchester

“(药房)员工的心理健康和福祉处于历史最低水平,员工还面临着来自公众的虐待。”——鲁吉特·坎杜拉,大曼彻斯特区药房转型部主任

Some fear the situation will get worse as patients on long waiting lists for operations turn to their GP for extra care. Increasingly surgeries are just shutting down and “handing in their keys” because they cannot cope.

一些人担心情况会变得更糟,因为等待手术的病人会转向他们的全科医生寻求额外的照顾。越来越多的外科手术因为他们应付不来而关闭并“交出钥匙”。

“I was talking to our lawyer and she said six GPs in the last week in April rang her law firm to hand their keys in,” Gardner said. “They hadn’t had six GPs s hand their keys in the previous six years, never mind in five days.”

加德纳说:“我和我们的律师谈过,她说4月份的最后一周有6个全科医生打电话给她的律师事务所要求‘交出钥匙’。在过去的六年里,他们加起来都没有遇到过六个医生‘交钥匙’,更不用说短短五天之内了。”