Zero Tolerance

The NHS has a zero-tolerance policy towards all violence and aggression.  This policy is for the protection of all NHS colleagues, but also the protection of other patients, their families, visitors etc.  In order to ensure that this zero-tolerance approach is adhered to, it is essential to have robust policies and procedures in place.  In General Practice, this will need to cover a variety of situations in which incidents could occur.  Generally speaking, the majority of patients behave in acceptable or manageable way, however the incidence of excessively aggressive or violent attacks in the GP practice is increasing.

The practice recognises that there can be contributory reasons for patients behaving in difficult or challenging ways, however where this tips over into aggression or violence, the practice will adopt a zero-tolerance approach.

Danebridge Medical Practice aims to provide high quality healthcare and we will treat all patients with respect and dignity.  In return we expect all our colleagues to be treated with respect.  We will not tolerate abusive language or threatening behaviour against any team member.  Such behaviour may result in the offender being denied access to the service and / or further measures as appropriate.

In order for the practice to maintain positive relations we would like to ask all patients to note the types of behaviour that would be found unacceptable:

  • Verbally abusive, offensive or intimidating in their behaviour
  • Threatening or subjecting others to physical violence
  • Causing damage / stealing from the Practice’s premises, colleagues or patients
  • Obtaining drugs and/or medical services fraudulently
  • Banging on desks or shouting loudly in an intimidating manner
  • Any form of harassment, including those related to race and sex
  • Making excessive demands and / or maintaining certain expectations and failing to accept that these are unreasonable (e.g., wanting an immediate appointments and becoming aggressive when this is not possible)
  • Insisting that a colleague is dismissed
  • Insisting that treatment is carried out on demands
  • Constantly requesting a different clinician or health care professional.

Removal from the practice list

In rare circumstances, the trust between the healthcare professional and a patient may break down, and the clinician may find it necessary to end the professional relationship. For example, this may occur if a patient has been violent, has stolen from the premises, or has persistently acted inconsiderately or unreasonably.”

If patients have been violent to any team members or have threatened colleagues’ safety, the incident will be reported to the Police.  Patients may also be referred to the Special Allocation Service, which provides primary care medical services in a secure environment.

Even in these circumstances, the practice will inform the patient of the reasons leading to removal from the practice list, unless one or more of the following apply:

  • it would be harmful to the mental or physical health of the patient
  • it would put practice team or patients at risk
  • it would not be reasonably practicable to do so.

The practice will record this in the patient’s records and set out the circumstances leading to removal. Family members should not be struck off GP lists, unless there is a threat to the practice from the ex-patient as a result of keeping these patients on.