Zero Tolerance

As a practice we must continue to follow the strict infection, prevention and control measures to limit the risk of the virus to you as patients and to our staff. This means that where possible staff and clinicians will remotely triage and assess your needs before determining if a face to face appoint is needed. If your needs can be met safely via the telephone or video consultations then this will take place. If a clinician feels you require a face-to-face appointment then this will be arranged. We have been opening this way since the start of the pandemic in order to continuing providing all patients with access to our services.

The current pandemic situation is challenging for everyone in different ways and we appreciate that the situation we all find ourselves can be frustrating sometimes. Unfortunately a number of our staff have recent experience foul and abusive language or behavior from a minority of patients. This is not acceptable and we will not tolerate this sort of behavior towards our staff of whom continue to work tirelessly during the pandemic. In line with our Zero Tolerance Policy if you are found to be abusive towards member of staff then appropriate action will be taken.

Zero Tolerance Policy

The Practice recognises that they have a legal duty to ensure so far, as a reasonably practicable the health, safety and welfare  of their employees (Health and Safety At Work Act 1974). This policy is intended to embrace all current guidance and legislation in regard to the management of violence and aggression within the practice and will form part of the practice’s overall Health and Safety Policy.

Definition of Violence

Any incident where a GP or his/her staff are abused threatened or assaulted in circumstances related to their work, involving an explicit or implicit challenge to their safety, wellbeing or health.

This includes:

  • Verbal abuse or threat where this is judged to turn into actual violence.
  • Serious or persistent harassment including racial and sexual harassment.
  • Threaten with anything which could be regarded as a weapon.
  • Major and minor injuries.
  • Harassment (sexual, racial or disability) this also includes harassment by other members of staff.


The Practice recognizes the difficulty and complex nature of health care delivery by its staff, including dealing with patients/clients (who may be physically or mentally ill, under stress or confused and that relatives of friends of their patients/clients may contribute to the potential for violence. In the past violence at work in General Practice has often been accepted as part of the job. The Practice would view such a situation as being totally unacceptable.

The Practice recognizes and accepts their responsibilities, in accordance with the Health and Safety Work Act 1974 and Good Employment Practice, to provide as far as is reasonably practicable the following conditions related to the prevention and containment of violence.

Effective and comprehensive systems at work must include:

  • A working environment including the provision of adequate levels of staff, conducive to the management of potential or actual violence.
  • Provision of information and training for staff/GP s o handling potential or actual violence, including summoning of assistance.
  • Positive support for staff/GPs involved in violent incidents.
  • A system of monitoring and reviewing violent incidents.

The Priorities

It should be clearly understood by all concerned that is any situation, the prevention and avoidance of violence is of paramount importance and that active defence will be a last resort. Where patients are involved, the emphasis must be on safeguarding them from harm, even in the cases where they contribute to the disturbance.

Responsibilities Involved

Management Responsibilities

The overall responsibility within the practice to deal with violence and aggression lies with the GP’s as the employer. The practice will provide a coherent framework within which to assess the risk of violence and aggression, and wherever practical avoid the situation arising. It will develop clear strategies for the risks that remain and provide a suitable training and response strategies.

Individual Personal Responsibility

Notwithstanding the Practice’s responsibilities defined in the earlier section – this policy makes it clear that employees have a personal responsibility for their own safety and that of others i.e. patients, visitors, colleagues, Section 7 Health and Safety at Work Act 1974.

Extract From The Surgery’s Removal of patients From Practice List Policy

The Surgery aims to provide the best possible care for patients. However there may be circumstances when it would be considered reasonable, or in the best interests of the patient, to remove them from the list.

The purpose of this policy, is to define the practice guidelines for when it is reasonable to remove a patient from the practice list and to ensure that any concerns about removing patients from the list are dealt with fairly.

Situations which justify removal

Violence – when a patient:

Is physically violent or threatening towards a GP, practice staff or other patients on the practice premises.

Causes physical damage to practice premises or other patient’s property.

Gives verbal abuse or makes threats towards the GP, practice staff or other patients.

Gives racist abuse or makes threats towards the GP, practice staff or other patients.

Gives racist abuse, orally or physically.

Is violent or uses or condones threatening behaviour to GP’s (or other members of the primary care health team) while visiting the patient’s home. Such behaviour may involve the patient, a relative, a household member or pets (such as unchained dogs).

Crime and Deception – where a patient

Fraudulently obtain drugs for non-medical reasons.

Deliberately lies to the GP or other members of the primary health team (e.g. by giving a false name or false medical history) in order to obtain a service or benefit by deception.

Attempts to use the GP to conceal or aid criminal activity.

Steals from the practice.

Irretrievable breakdown of the Doctor-patient relationship – where a patient’s

behaviour falls outside of that which is normally considered reasonable and leads to an irretrievable breakdown of the doctor – patient relationship –

When a patient puts excessive demands on the Surgery i.e. inappropriate and excessive requests for medication – drug misuse