NHS Zero Tolerance

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:

  • Offensive or abusive language, verbal abuse and swearing which prevents staff from doing their job or makes them feel unsafe.
  • Loud and intrusive conversation
  • Unwanted or abusive remarks
  • Negative, malicious or stereotypical comments
  • Invasion of personal space
  • Brandishing of objects or weapons
  • Threats or risk of serious injury to a member of staff, fellow patients or visitors
  • Bullying, victimization or intimidation
  • Stalking
  • Spitting
  • Alcohol or drug fuelled abuse
  • Unreasonable behaviour and non-cooperation such as repeated disregard for NHS
    policy ie. Smoking on premises, or
  • Any of the above which is linked to destruction of or damage to property

NB – It is important to remember that such behaviour can be either in person, by telephone, letter or e-mail or other form of communication such as graffiti on NHS property.

Violence at work

The Practice acknowledges that there may be instances where violence and / or aggression forms part of a patient’s illness. In these circumstances, the issue will be discussed with the patient and form part of their care planning.

This information will be recorded in the patient’s medical record and flagged to ensure that members of staff are aware. In addition, where deemed necessary, appropriate support will be put in place, e.g. staff members do not see the patient alone.

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. 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 at 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.