Violence, Abuse or Threatening Behaviour Policy

The NHS operate a zero tolerance policy with regard to violence, abuse or threatening behaviour. The practice has the right to remove violent patients from the list with immediate effect in order to safeguard practice staff, patients and other persons. Violence in this context includes actual or threatened physical violence or verbal abuse which leads to fear for a person’s safety. In this situation we will notify the patient in writing of their removal from the list and record in the patient’s medical records the fact of the removal and the circumstances leading to it.

Zero Tolerance Practice Policy

In line with the rest of the NHS, this practice has a zero tolerance policy whereby aggressive, threatening or violent behaviour towards our staff will not be tolerated under any circumstances. The GPs, nurses and staff in this practice have the right to do their work in an environment free from this type of behaviour and everything will be done to protect that right.

The practice feels sure you will understand that proper behaviour is absolutely necessary for our staff and patients and that non-observance will not be accepted. The practice takes it very seriously if a member of staff is treated in an abusive or violent way. The practice supports the government’s ‘zero tolerance’ campaign for health service staff. This states that GPs and their staff have a right to care for others without fear of being attacked or abused. To successfully provide these services a mutual respect between all the staff and patients has to be in place.

Our practice staff aim to be polite, helpful, and sensitive to all patients’ individual needs and circumstances. They would respectfully remind patients that very often staff could be confronted with a multitude of varying and sometimes difficult tasks and situations, all at the same time. The staff understand that ill patients do not always act in a reasonable manner and will take this into consideration when trying to deal with a misunderstanding or complaint. However, aggressive behaviour, be it violent or abusive, will not be tolerated and may result in you being removed from the practice list and, in extreme cases, the police being contacted.

In order for the practice to maintain good relations with their patients the practice would like to ask all its patients to read and take note of the occasional types of behaviour that would be found unacceptable:

• Using bad language or swearing at practice staff
• Any physical violence towards any member of the primary health care team or other patients, such as pushing or shoving
• Verbal abuse towards the staff in any form including verbally insulting the staff
• Threatening or intimidating behaviour to staff
• Racial abuse and sexual harassment will not be tolerated within this practice
• Persistent or unrealistic demands that cause stress to staff will not be accepted. Requests will be met wherever possible and explanations given when they cannot
• Causing damage/stealing from the practice’s premises, staff or patients
• Obtaining drugs and/or medical services fraudulently

We ask you to treat your GPs and their staff courteously at all times.

Definition of Physical and Verbal Abuse and Violence

Physical and verbal abuse includes:

• Unreasonable and / or offensive remarks or behaviour / rude gestures / innuendoes
• Sexual and racial harassment
• Threatening behaviour (with or without a weapon)
• Actual physical assault (whether or not it results in actual injury) includes being pushed or shoved as well as being hit, punched or attacked with a weapon, or being intentionally struck with bodily fluids or excrement
• Attacks on partners, members of staff or the public
• Discrimination of any kind
• Damage to an employee’s or employer’s property

Removal from the Practice List

The removal of patients from our list is an exceptional and rare event and is a last resort in an impaired patient-practice relationship. We value and respect good patient-doctor relationships based on mutual respect and trust.

Any patients who are deemed to have breached this policy will be sent a letter from the practice advising that this behaviour will not be tolerated. Any future violation of this policy may result in removal from the practice list. There will be no appeal process.

When trust has irretrievably broken down, the practice will consider all factors before removing a patient from their list, and communicate to them that it is in the patient’s best interest that they should find a new practice. An exception to this is in the case of immediate removal on the grounds of violence e.g. when the police are involved.

Removing Other Members of the Household

Because of the possible need to visit patients at home, it may be necessary to terminate responsibility for other members of the family or the entire household to ensure the safety of practice staff. The prospect of visiting patients that is the residence of a relative who is no longer a patient of the practice, or the risk of being regularly confronted by the removed patient, may make it difficult for the practice to continue to look after the whole family. This is more likely where the removed patient has been violent or displayed threatening behaviour, and keeping the other family members could put doctors or their staff at risk.