We’ve all been there before: you feel under the weather, so you call your GP (general practitioner) surgery to book an appointment to speak to a doctor. Once you’ve listened to the infinitely looping hold music long enough that it’s permanently etched into your brain (and which you just know hasn’t changed since the ’90s), a staff member picks up.
Online re-enactments of the scenario that follows have become the latest comedic TikTok trend in the UK. According to these viral sketches, the GP receptionists that pick up are hostile, dismissive, and downright rude. They are inconvenienced by your call, they get a kick out of gatekeeping NHS appointments, and from what it seems, they just can’t be bothered to help. With hundreds of thousands of likes and comments in agreement, it appears the videos ring true for many viewers.
But is this exaggerated caricature really fair, given what we know about the NHS working conditions right now? These are the same workers living the headlines we can’t escape from: the lack of appointments, the dwindling staff numbers, the ever-increasing demand on health services, all of which – paired with severe government underfunding – is pushing the NHS even further into crisis. How do the workers carrying this pressure on their shoulders feel about this reputation, and is it indicative of a deeper problem?
« Fighting back tears whilst being shouted at is something I’ve gotten really good at. »
Lily*, who works as a receptionist at a practice in the north West of England, finds the videos hurtful. « I’d offer anyone the chance to spend a day in our shoes, to see what we deal with behind the scenes, » the 28-year old says. In her 12 years on the job, she can’t recall a single day where she hasn’t been verbally abused by patients, either on the phone (her team answers anywhere between 300 and 500 calls a day) or on the front desk. « Fighting back tears whilst being shouted at is something I’ve gotten really good at. »
« Kill yourself, » « I’ll be outside waiting for you. » and « the world would be a better place without you » are just a few of the worrying comments Lily repeatedly receives, on top of a constant stream of being patronised, sworn, and shouted at. She’s even witnessed a patient try to grab one of her colleagues by the throat. « It’s hard to go to work knowing what’s waiting for you, » she explains. Often sitting in the car park in floods of tears before her shifts, on multiple occasions she’s had to be signed off of work for stress and anxiety. « It’s horrible… Nobody should have to put up with this. »
Sadly, Lily’s experience is shared by a number of receptionist staff across the UK. A 2021 survey from the Institute of General Practice Management (IGPM) revealed that 75 percent of receptionist staff say they receive abuse on a daily basis, whether verbal, racist, or physical. 83 percent said they’ve had to contact the police to help deal with patients in the past.
75 percent of receptionist staff say they receive abuse on a daily basis, whether verbal, racist, or physical.
As the first voice or face patients encounter, receptionists (who are officially known as care navigators) are forced to face the brunt of their frustrations. While Robyn Clark, the director of the IGPM, understands that some patients may feel vulnerable when they’re ill, she also believes that their tolerance, and their ability to wait for appointments, has plummeted since the pandemic. « Quite often we find that the patient’s expectations don’t match up with what the issue is, » she explains. « A lot of the time, they expect an Amazon Prime-style healthcare service, which isn’t what the government has set us up for. »
In her eight year career, GP manager Caroline* has never had to send out as many letters warning patients against their behaviour as she has in recent years. « There seems to be such a huge wave of resentment towards reception teams, » she says. Labelling the videos as « a nasty way to take a pop at a group of people who can’t defend themselves, » she wants the general public to show compassion to care navigators, who are working under what she calls « a heap of unprecedented pressure. »
This pressure is also trickling down to surgery staff in other roles, like the nurses and GP registrars forced to squeeze in extra appointments to meet the demands of disruptive patients. According to Caroline, a nearby practice manager has had to be escorted to her car by police for fears over their safety, while Caroline herself has had to involve the police after being repeatedly harassed by a patient who has hounded her on social media and used other identities to taunt her. « I don’t want it to affect my whole life, but of course it worries me, » she sighs.
« It’s depressing to see this rhetoric online, because everyone I work with really cares. »
Maxine* started her receptionist role in Suffolk weeks before the pandemic began. « It’s depressing to see this rhetoric online, because everyone I work with really cares, » she tells Mashable. The 32 year old points out a common misconception highlighted in the videos: that receptionist staff aren’t qualified to ask patients about their symptoms. « A lot of people complain that we think we’re doctors, but to determine the most suitable type of care we have to ask these questions – it’s literally the purpose of our job, » she says, explaining that these protocols are put in place by GPs themselves and not care navigators on a power trip. « If you have a problem that doesn’t require a GP, of course we’re going to keep you away from them, » Caroline adds. « We’ll get you to see an on-site paramedic, advanced nurse practitioner, physiotherapist, or mental health nurse instead. »
Responding to suggestions that receptionists are lazy (and spend their time filing their nails and nattering about reality TV while the surgery phone rings), Maxine argues that receptionists are constantly working, from chasing hospital appointments to filing clinical correspondence and organising referrals, all while dealing with a torrent of abuse. « Some of the videos show receptionists as being almost defensive, » she says. « I’d say a lot of them probably are – they’re so used to having their guard up all the time. »
« We’re trying our hardest, but we can’t fix a broken system. »
Maxine, Caroline, and Lily also highlight that while the number of doctors and nurses leaving the NHS is well-known, not enough attention is paid to the receptionists who are also leaving and not being replaced. This problem is echoed across the UK: in January, a GP surgery in North Yorkshire was forced to close its doors indefinitely after struggling to hire receptionist staff due to the abuse they face in the role.
« You’re asking people to face constant abuse in exchange for little more than minimum wage, all while their job is being trashed in the media and online, » Maxine, who recently moved to a different role at her surgery partly to avoid abuse, argues. She admits that at one point, she purposefully hid her job title from people outside of work in fear of backlash.
It’s important to acknowledge that many people face complex challenges when trying to access vital healthcare. People with chronic illnesses and disabilities report having negative experiences when seeking medical care. Research shows that disabled and chronically ill patients often cite difficulty communicating with NHS staff.
With pressure on the NHS at breaking point, it’s clear the system is at breaking point. The receptionists we spoke to believe that more compassion is needed when it comes to interactions with NHS workers. « We’ve been built as a country to believe that when we’re ill, we can click our fingers and see a GP, but that time has passed, » Maxine says. She believes that patients have a responsibility to educate themselves about the number of other services that GP surgeries provide. « There needs to be more transparency in how a surgery actually works, » she continues. Lily agrees, and wants to remind patients that the care navigators on the other side of the phone have their own feelings, too: « We see and read everything you put out there, and it hurts. We’re trying our hardest, but we can’t fix a broken system. »
In 2021, the IPGM released a campaign video raising awareness of the abuse GP receptionists face, named after a phrase they’re all too used to hearing: « If I die, it will be your fault« . The organisation has also written to the health secretary urging for an improved campaign around public education of other GP services. In the meantime, Robyn wants the people creating and commenting on these videos to understand the impact of their words, especially as they may come back to bite. « If you think it’s hard to get on the phone now, it’s going to get even worse as more videos like this are made. Because when staff leave, who will want to replace them? »
*Names have been changed to protect identities.
