RT Journal Article
SR Electronic
T1 Supporting patients with female genital mutilation in primary care: a qualitative study exploring the perspectives of GPs’ working in England
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP e749
OP e756
DO 10.3399/bjgp20X712637
VO 70
IS 699
A1 Sharon Dixon
A1 Lisa Hinton
A1 Sue Ziebland
YR 2020
UL http://bjgp.org/content/70/699/e749.abstract
AB Background Female genital mutilation (FGM) includes all procedures that intentionally harm or alter female genitalia for non-medical reasons. In 2015, reporting duties were introduced, applicable to GPs working in England including a mandatory reporting duty and FGM Enhanced Dataset. Our patient and public involvement work identified the exploration of potential impacts of these duties as a research priority.Aim To explore the perspectives of GPs working in England on potential challenges and resource needs when supporting women and families affected by FGM.Design and setting Qualitative study with GPs working in English primary care.Method Semi-structured interviews focused around a fictional scenario of managing FGM in primary care. The authors spoke to 17 GPs from five English cities, including those who saw women who have experienced FGM often, rarely, or never. Interviews were audio recorded and transcribed verbatim for thematic analysis. Lipsky’s theory of street-level bureaucracy was drawn on to support analysis.Results Managing women with FGM was experienced as complex. Challenges included knowing how and when to speak about FGM, balancing care of women and their family’s potential care and safeguarding needs, and managing the mandated reporting and recording requirements. GPs described strategies to manage these tensions that helped them balance maintaining patient–doctor relationships with reporting requirements. This was facilitated by access to FGM holistic services.Conclusion FGM reporting requirements complicate consultations. The potential consequences on trust between women affected by FGM and their GP are clear. The tensions that GPs experience in supporting women affected by FGM can be understood through the theoretical lens of street-level bureaucracy. This is likely to be relevant to other areas of proposed mandated reporting.