The headlines have dominated front pages and social media feeds for years: the NHS is under tremendous strain, and so are the people working to keep it afloat.
The commentary around the stability of the NHS usually concerns the working conditions and pressure on clinical staff like doctors, surgeons and nurses, and rightfully so – they work tirelessly to keep the UK healthy, safe and ultimately, alive.
But sometimes, it feels like the media framing misses out on a key group of workers also beavering away to keep the cogs turning: clerical staff.
Those receptionists, secretaries, switchboard operators and medical records organisers – all of whom work to keep hospitals, GP surgeries and medical centres running as smoothly as they can.
After university, I worked as a receptionist in the audiology unit of a Surrey hospital for almost a year. Without a doubt, it was the most stressful job I’ve ever had (and I’m now a journalist, so that’s saying something).
There are so many misconceptions, myths and nasty stereotypes associated with these roles – meanwhile, abuse is rife.
A 2020 survey revealed that over a quarter of workers across the NHS have experienced harassment, bullying or abuse at work from patients, while a study a year later by the Institute of General Practice Management showed that 75% of GP receptionists say they receive abuse on a daily basis, ranging in verbal and racial abuse to physical altercations.
Even worse, 83% of those respondents said they had to call the police to diffuse these situations.
‘You’re the face of a broken system’
Mila* – who preferred not to share her real name – worked in a team of GP receptionists, or as she puts it “the UK’s most hated people”, for over a year between 2021 and 2022 in Wales.
Her responsibilities included answering phones, booking appointments, processing prescriptions and test results, and liaising with hospitals.
She says that in the role, stress came from all angles – especially patients.
“As a receptionist, you’re the face of a broken system, so you become a punching bag for frustrated patients,” she says.
“There’s pressure from patients to give them what they want, which is rarely possible... The phone lines opened at 8am and by 8:30am we only had emergency appointments left. There were also pressures to do things beyond our control like speed up test results or referrals, which just wasn’t possible.”
For Mila, abuse from patients was a normal part of her working life.
“A patient on the phone once said to me something along the lines of, ‘I know what time the surgery closes so I could wait outside and follow you to your car’, and another patient threw a pen at me over the desk and it just about missed my eye,” she says.
“It’s easy to hate on receptionists, and I’ll admit I’ve chuckled at a few memes having a go at GP receptionists for being unhelpful and grumpy… But we have mere seconds to emotionally recover from often being verbally abused over the phone before we have to answer the next one.”
Despite this abuse, Mila says she still feels for each and every patient she interacted with.
“I do empathise with every single patient I spoke to, even the ones who were abusive to me because I understand how frustrating it is,” she says.
“Being a GP receptionist was never my dream job, but I was going to do my best at it regardless because I love to help people, and I wanted to give these people appointments so badly but I couldn’t.”
Mila wishes they could’ve hired more people to help answer phones and support patients in getting appointments, but says “the money wasn’t there to do it”.
“It was the same for clinical staff – we only had a set number of doctors, nurses and practitioners, so only a certain number of patients could be seen,” she adds.
But figures released in 2023 by NHS Digital, and analysed by The Telegraph, found the number of GP receptionists is actually rising at three times the rate of family doctors.
Across England, for example, there are almost 40,000 receptionists working in doctors’ surgeries, which is nearly 10% more than the number of GPs.
‘It zapped my quality of life’
Violence and abuse toward NHS colleagues can have a devastating and lasting impact on staff health and wellbeing.
A 2022 NHS Staff Survey found 14.7% of NHS staff had experienced at least one incident of physical violence from patients, service users, relatives or other members of the public in the last 12 months.
And more than one in four (27.8% of) NHS staff had experienced at least one incident of harassment, bullying or abuse in the last 12 months from patients/service users, their relatives or other members of the public.
Across Wales (and the rest of the UK) there are policies in place for GPs and their teams when patients are violent and aggressive.
One such scheme, referred to as the Alternative Treatment Service Scheme, means a practice manager or GP can request a patient is removed from the patient list if they are violent or aggressive.
Living with fibromyalgia, Mila says the toll of the job exacerbated her symptoms and the constant stress left her body in a state: “It zapped my quality of life.”
At one point, the pressure became so intense that she was signed off work for a number of weeks.
“I don’t know what would have happened if I’d tried to fight through it,” she says. “I’d gone to my GP and asked to go on antidepressants not long after the job started, hoping that could carry me through, but it didn’t.”
While her colleagues and management were supportive during this time, Mila says the time off didn’t make her feel any better. “I can’t say I felt better as I knew I’d have to go back, but it took a brick off the pile in terms of stress,” she adds.
The former receptionist dropped her hours when she returned to work, but says things didn’t change. The final blow eventually came when, one day, Mila dealt with an abusive caller. Not long after, she left the job.
“It wasn’t the worst abuse I’d ever received, but on top of the ever-growing pressure of everything else, it broke me,” she concludes.
*Names have been changed to protect Mila’s real identity.