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COVID-19: Abuse from patients soars amid longer waiting times

Pharmacy professionals said abuse was chiefly due to patients having to wait longer to be seen
Pharmacy professionals said abuse was chiefly due to patients having to wait longer to be seen

Waiting longer for medicines has been the most common trigger for abuse from patients during the COVID-19 pandemic, a C+D survey of pharmacy professionals has found.

A third (33%) of the 545 survey respondents who answered the question said the increased abuse was mainly down to patients having to wait longer to be seen by a member of staff in the pharmacy, while a quarter (26%) said the primary reason was a longer wait for prescriptions.

Other reasons cited by pharmacy teams included patients becoming angry because the pharmacy was out of hand sanitiser, face masks or painkillers (7%), patients not agreeing with social distancing measures that had been implemented (8%) and self-isolating patients being upset that their medicines could not be delivered free of charge (6%).

One fifth (20%) of respondents said there were other reasons for abuse from patients during the pandemic, with many commenting that all the reasons mentioned above had factored in abuse directed at them by patients.

The C+D survey ran between April 1 and May 10 and asked pharmacy professionals a series of questions about the impact of the COVID-19 pandemic on their teams and their business.

“Appalling” findings

The survey found that almost two thirds (64%) of 859 respondents had seen an increase in abuse towards their teams as a direct result of COVID-19.

When asked about the different forms of abuse, more than three quarters (79%) of the 692 respondents who answered this question said they had experienced verbal abuse.

This was followed by written abuse (13%) and physical abuse (8%). Two survey respondents said they had experienced sexual abuse from patients.

Mark Lyonette, chief executive of the National Pharmacy Association (NPA) said the findings were “appalling” and “appear to be related to the tensions caused by coronavirus”.

“Most patients and customers treat staff with courtesy, but this behaviour by a minority of people is totally unacceptable. The NPA and other bodies have been in discussions with senior police representatives about this matter and we have put out communications to the general public on the need to treat pharmacy staff with respect,” he added.

“Banging on shutters”

The C+D survey, to which a total of 1,018 community pharmacy professionals from across the UK responded, also asked staff to share examples of the abuse they have experienced during the pandemic.

One respondent said they had seen: “[patients] banging on shutters when we were having a lunch break, continuously shouting on the phone, insisting on home deliveries because the government announced it, [giving] abuse because their prescriptions hadn’t arrived or were not ready for them when they walked in”.

Another commented that they were “pushed out of the way by a man as I stood in his way while handing medication to another patient. When I pulled him up on it, he swore at me”.

Several respondents said some of the actions of GP surgeries, such as moving to closed-door working and prescribing in greater quantities, had exacerbated patient frustration.

One pharmacy professional said patients are “angry that they can’t easily make changes to their medication as GPs are working from behind closed doors”. Another said closed-door working had left patients were “scared and confused” about how to order and manage their medicines.

A different respondent commented: “Surgeries largely close their doors [and] give three months’ of post-dated prescriptions to a depleted team of staff to organise and prepare at very short notice. [They] tell patients we have prescriptions that we have not received yet. Patient expectation [is then] that we have their prescription”. This, they added, “leads to frustration” when the prescription is not ready for collection at the time the patient expected it to be.

Other survey respondents said racial abuse had been a problem, as had written abuse in the form of comments on social media sites such as Facebook.

Alongside the examples of abuse, pharmacy team members also commented on the positive treatment they had received from patients. One respondent said most patients had been “brilliant”, while another said they had seen “a huge increase in positive comments and thanks from people who have taken the trouble to write in expressing their gratitude.”

“Violence has to stop”

Commenting on the survey findings, Pharmacists’ Defence Association (PDA) director Paul Day said: “Sadly the pandemic has brought into focus an issue that we have campaigned on for a long time. Violence at work is ‘any incident in which a person is abused, threatened or assaulted in circumstances related to their work’ and it has to stop. There are no justifiable reasons for violence, only excuses.”

He added that the PDA has secured support for its campaign to end violence in pharmacies from police forces, community safety partnerships, politicians and employers from across the UK.

The campaign calls for a number of changes, including a zero-tolerance policy on violence towards pharmacy staff and regulatory standards that place “more robust requirements” on pharmacy employers to ensure their teams are safe.

“We reiterate our call to all pharmacy organisations to support the campaign so…the sector can be free of violence,” Mr Day said.

Other findings from the C+D survey include how pharmacy teams have coped with the pressures of the pandemic, and the impact of COVID-19 related medicines shortages.

Have you experienced abuse from patients since the start of the pandemic?

CAPT FX, Locum pharmacist

Patients have always been abusive well before the Coronavirus situation. The abuse which has never been discussed anywhere is that of Pharmacists by the shop and dispensing staff, especially Locum Pharmacists. The quality of training for pharmacy support staff over the years has been so poor that they are able to cope with the ever-changing landscape of Community Pharmacy.

It is not surprising that the quality of service including the pace has been so frustratingly slow that the patients have every right to be angry. In certain instances you have staff inflaming situations because they have never had or been equipped with communication skills to deal with challenging behaviour. Whilst we have every right to be protected from abusive behaviour, as a Profession and Commercial enterprises we have to equip our staff adequately to deal with patients of varying levels of distress or agitation.

I noted especially during this crisis, any abusive from patients was transmitted if not multiplied onto the Pharmacist. It is a worrying development where Pharmacists are abused by staff who know very well that Professional restraint means that they can not answer back. What makes it worse is that Corporate structures of multiples never support the Pharmacist because they say you are the Professional. It is like a mafia-style culture where as professionals, that aspect of our welfare is never considered. We suffer because there is no statutory or regulatory obligation for employers to provide staff, whose qualifications are commensurate with a profession that deals with human life.

This is what dilutes this argument that we are abused all the time without cause or reason. We have serious issues that need resolving instead of complaining blindly without introspection. The same can be said about how we went all the way to Parliament to complain about workplace pressure, without mentioning the same fact that employers are not investing in staff quality and numbers. My local Member of parliament was so disappointed. We are becoming known for our baseless mourning. Yes, I agree at times patients are abusive but every member of the Pharmacy team has to be trained and equipped to deal with Challenging behaviour. 

It's pointless for the Pharmacist to do CPD hours in communication skills just for purposes of dousing fires started by a staff member tactlessly telling a patient " you are doing my head in".   

Mark Boland, Pharmaceutical Adviser

'Yes, I agree at times patients are abusive but every member of the Pharmacy team has to be trained and equipped to deal with Challenging behaviour'

There is no training required, just the presence of a pharmacist with a backbone. 'Challenging' is a weasel word used by corporate management to bully low paid workers into accepting abusive behaviour from scum.

Abuse my staff on the phone, you will be banned and the phone will be put down. Abuse my staff in the shop, you will be banned and ordered off the premises. If any of the cowards who hide behind the scenes has a problem with this, they can come down to my branch and I will politely explain to them, face to face, how it is going to be. Twenty years of service, yet to have anybody make that journey. 

Sarah Smythe, Information Technology

Fantastic approach Mark and the use of the word "weasel" was spot on. Should be more like you . I was , until I walked out on "weasel incorporated" ( Boots) 

Ex Pharmacist, Community pharmacist

Pharmacy; it'll never get better. The end goal is complete online interface. Brick and mortar will be a small sector with very poor funding structures. All independent groups will downsize. The big companies will be okay with their hands in the right pockets. What a p*ss poor waste of potential this profession is becoming.

Industry Pharmacist, Head/Senior Manager

The big pharmacy companies will be ok?

Amazon has just entered the chat.

Soon-To-Be Ex-Pharmacist, Superintendent Pharmacist

Pharmacy is toast. The writing has been on the wall for several years and the wall is about to fall on us. The pharmacist role is becoming redundant with the relentless march of EPS, robotic dispensing, remote supervision, removal of services and the increased role of ACTs. Once it is decided (and that isn't far away) that supervision by a qualified pharmacist is no longer required, we are GONE.

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