Dealing with Unreasonable, Violent and Abusive Patients Policy

 

 

Version	Edited by	Date issued	Next review date
3	Janet Butcher	17.03.2026	17.03.2027

  

Position	Named individual
Practice Manager	Janet Butcher

 

Table of contents     

1     Introduction   3

1.1       Policy statement 3

1.2       Status  3

2     Identifying challenging behaviour  3

2.1       Unreasonable behaviour  3

2.2       Inappropriate behaviour  4

2.3       Violent or abusive behaviour  4

2.4       Classifications  4

3     Managing unreasonable and inappropriate behaviour  4

3.1       NICE guidance  4

3.2       Process to manage unreasonable and inappropriate behaviour  4

4     Managing violent, abusive or threatening behaviour  5

4.1       Prevention   5

4.2       Process to manage violent, abusive or threatening behaviour  5

5     Raising the alarm    6

5.1       Use and activation of an alarm    6

5.2       Response procedure  6

5.3       Police assistance  7

5.4       Bomb threats and suspicious packages  7

5.5       Dynamic lockdown procedure  7

5.6       Lone working   7

6     Removal of the patient 7

6.1       Guidance  7

7     Reporting of incidents  7

7.1       Internal reporting   7

7.2       Clinical record   8

8     Risk assessment 8

8.1       Requirement 8

9     Effects on staff and patients  8

9.1       Supporting the team    8

9.2       Debriefing the team    8

9.3       Supporting patients  8

Annex A – Legislation and further reading   9

Annex B – Classifications  10

Annex C – Process to manage unreasonable behaviour  11

Annex D – Available actions to remove a patient 13

Annex E – Warning letter  15

Annex F – Cooperation letter  16

Annex G – Behaviour agreement 17

Annex H – Letter to remove a patient 19

Annex I – Risk assessment template  20

 

1.1      Policy statement

The purpose of this document is to provide guidance to staff at this Practice about how to manage unreasonable, violent and abusive patients in the workplace in line with extant legislation. This Practice has a zero-tolerance policy towards violent, threatening or abusive behaviour towards staff, patients or visitors. 

The Health and Safety Executive (HSE) advises that healthcare workers are four times more likely to experience violence at work than those in other vocations and provides guidance in its webpage titled Violence in health and social care. Therefore, effective risk assessment and incident reporting is essential to support the Practice in the appropriate management of offenders, thereby reducing risk to staff, visitors and service users. 

It is the responsibility of all staff to ensure that they recognise, respond to and take the necessary action when dealing with any patient who is behaving in a violent, threatening or abusive manner towards colleagues, contractors or patients. It remains a management responsibility to ensure that all staff have undertaken the necessary training to be able to respond appropriately. 

Legislation to support this subject and further reading can be sought from Annex A.

 

1.2      Status

In accordance with the Equality Act 2010, we have considered how provisions within this policy might impact on different groups and individuals. This document and any procedures contained within it are non-contractual, which means they may be modified or withdrawn at any time. They apply to all employees and contractors working for the Practice.

 

2.1      Unreasonable behaviour

There are many reasons why a patient’s behaviour may become unreasonable, including substance misuse, should they be scared, anxious or distressed, or if they are frustrated, unwell or in pain. As a result of this, staff may experience patients who are either demanding, unwilling to listen and/or uncooperative.

There are several factors associated with difficult and challenging interactions with patients, such as a lack of resources, waiting times and interruptions during consultations. For these reasons, the ‘demanding’ or ‘difficult’ patient can potentially consume a large amount of the clinician’s and manager’s time.

It should be noted that unreasonable behaviour may be directed at patients and visitors in addition to staff. A standardised approach is to be adopted to manage any episode of poor behaviour.

2.2      Inappropriate behaviour

Inappropriate behaviour is defined as being unacceptable if:

·         It is unwanted by the recipient.

·         It has the purpose or effect of violating the recipient’s dignity and/or creating an intimidating, hostile, degrading, humiliating or offensive environment.

Inappropriate behaviour does not have to be face-to-face and may take other forms including written, telephone or e-mail communications or through social media. This is covered in the Practice’s Patient Social Media and Acceptable Use Policy.

What constitutes inappropriate or unreasonable behaviour could be viewed as a subjective matter. Therefore, to ensure objectivity and prior to any further actions being taken, incidents of inappropriate behaviour will be discussed with Practice Manager.

Any person, be they staff, visitor or service user, who encounters unreasonable behaviour will be fully supported by the Practice Manager with a standardised approach being taken.

2.3      Violent or abusive behaviour

This Practice has zero tolerance towards such behaviour and is committed to reducing the risk to staff and other patients resulting from such behaviour. The HSE provides a definition of violence in the workplace in its guidance titled How employers can protect workers from violence and aggression at work.

While for staff, the Assaults on Emergency Workers (Offences) Act 2018 details the legalisation that supports those who work in general practice, Section 3 (1) (j) (ii) defines an emergency worker. Should violent or abusive behaviour be directed towards a patient or visitor, then ordinarily further action will be taken, including reporting the incident to the police as appropriate.

2.4      Classifications

Further details to support classifications of inappropriate, violent, abusive and assault can be found at Annex B.

 

3.1      NICE guidance

All staff are to adhere to NICE Clinical Guidance 138 which explains that patients value healthcare professionals acknowledging their individuality and, by tailoring healthcare services for each patient, this can enhance continuity of care and build positive relationships, thereby reducing the risk of unreasonable and/or inappropriate behaviour. 

3.2      Process to manage unreasonable and inappropriate behaviour

The stepped approach to managing challenging behaviour can be found at Annex C.

 

4.1      Prevention

NHS England’s Violence prevention and reduction standard (version 2) provides detailed guidance on actions that can be taken to support managing unreasonable and inappropriate behaviour. This Practice will aim to implement any recommendations to promote a safe and secure working environment for employees.

This Practice will also adhere to the guidance detailed in the BMA’s Preventing and reducing violence towards staff as well as the HSE’s workplace violence guidance.

Do’s and don’ts when confronted by violence:

DO	DO NOT
Recognise your own feelings	Meet anger with anger
Use calming body language	Raise your voice, point or stare
Be prepared to apologise if necessary	Attempt or appear to lecture them
Assert yourself appropriately	Threaten any intervention unless you are prepared to act upon it
Allow people to explain themselves	Make people feel trapped or concerned

 

An aggression and violence preventative measures for staff poster is available. 

4.2      Process to manage violent, abusive or threatening behaviour

The Practice does not expect any staff member, patient or visitor to tolerate any form of behaviour that could be considered violent, abusive or threatening or that becomes so frequent it makes it more difficult for the Practice to undertake its work. Action will be taken to manage this type of behaviour whenever it occurs, including inappropriate behaviour on social media. 

Should the episode of behaviour be significant, warranting an immediate application to remove the patient from the Practice list, the steps within the Practice’s Removal of Patients Policy are to be followed. The BMA document titled Removing patients from your practice list titled should also be consulted. 

It should be noted that the same standards of zero tolerance also apply should patients demonstrate violence towards other patients or visitors.

Should an incident merit a warning, then the process at Annex C is to be followed. Furthermore, sample letters can be sought within the annexes to support any type of poor behaviour. These can be amended to suit any situation.

Guidance on the removal of a patient process is at Annex D.

 

5.1      Use and activation of an alarm

Panic alarms are used to inform staff that assistance is required in situations of aggressive behaviour. During induction, all staff are given an overview of the panic alarms available at this Practice and how they work e.g. via the clinical system red button. 

Furthermore, staff will be advised during their induction of the alarm(s) to be used for a clinical emergency and actions taken should they feel threatened by a situation involving:

• Verbal or physical disruption.
• Verbal aggression.
• Physical aggression or the threat of physical violence or mental distress.
• Physical violence.
• The receipt of a bomb threat or coming across a suspicious package.

·         Any consideration of terrorist activity.

·         Planning for staff who work during periods of low manning should be considered.

5.2      Response procedure

Upon activation of the alarm or upon seeing the clinical system generated alarm then:

·         All available staff should respond immediately.

·         Two members of staff will go to the incident location, proceeding with caution.

·         The first member of staff is to knock and then enter the room.

·         The second is to remain in the doorway, ready to summon additional support if necessary.

 

The specific nature of the incident will determine if:

• Additional staff are required for support.
• The police are required to attend and take any subsequent action.
• The situation can be resolved by the clinician with support from a staff member.

 

Staff should always try to minimise the risk of harm to themselves and others. In the first instance, a member of the staff should ask the perpetrator to stop behaving in an unacceptable way. Sometimes a calm and quiet approach will be all that is required. Staff should not, in any circumstances, escalate or mirror the patient’s behaviour.

Should the person not stop their behaviour, then a nominated member of staff should be asked to attend, and an overview of the situation should be calmly detailed, preferably within hearing of the perpetrator. Should the person be acting in an unlawful manner, causing damage or assaulting another person, then the police should be called immediately. 

Should it prove necessary to remove the person from the Practice then the police should be asked to attend. Staff should never attempt to manhandle the person from the premises. 

 

5.3      Police assistance

The police should be called in instances when physical assault is likely or when         weapons or drugs have been identified.

 

The Practice Manager is required to notify the CQC of any incident that is reported to or investigated by the police as detailed within CQC’s GP mythbuster 21: Statutory notifications to CQC.

5.4      Bomb threats and suspicious packages

In the event of a bomb threat or a suspected package, the procedures detailed at Annex C and Annex T respectively within the Practice’s Health, Safety and Risk Management Handbook are to be followed.

5.5      Dynamic lockdown procedure

Should there be an immediate threat to the building and its occupants, staff are to adhere to the Stay Safe principles as detailed within Annex F to the Practice’s Health, Safety and Risk Management Handbook

5.6      Lone working

When considering staff who may be lone working, or those who work during periods when there is minimal manning, then actions within the lone working guidance at Annex L to the Practice’s Health, Safety Handbook and Lone Worker policy are to be followed.

 

6.1      Guidance

It is acknowledged that Practices are permitted to remove patients in appropriate circumstances as detailed within the GMC’s Ending your professional relationship with a patient and the BMA’s Removing patients from your practice list guidance. 

However, removal should never be based on the grounds of race, gender, social class, age, religion, sexual orientation, appearance, disability or medical conditions.

Actions available to the Practice can be found at Annex D. A sample letter can be found at Annex H.

 

7.1      Internal reporting

All incidents are to be reported to the Practice Manager at the earliest opportunity. They will ensure that any subsequent reporting action is taken while supporting staff in the completion of the significant event report and as detailed within the Practice’s Significant Event and Incident Reporting Policy. 

7.2      Clinical record

A factual entry is to be made in the patient’s healthcare record detailing exactly what occurred; the record should include timings, the build-up to the incident and details of staff members and witnesses present. Further information can be found at Annex C.

 

8.1      Requirement

The Practice’s Health, Safety Handbook provides comprehensive guidance on managing specific risks and should be read in conjunction with the HSE guidance titled How employers can protect workers from violence and aggression at work.

A template for conducting a risk assessment can be found at Annex I.

 

9.1      Supporting the team

Any staff member who has been subjected to inappropriate behaviour will be supported. Staff who experience incidents of violence, aggression or assault may experience subsequent after-effects that may require support from the team or external resources.

A respect our staff poster detailing that violent, threatening or abusive behaviour will not be tolerated is available.

9.2      Debriefing the team

Clinical debriefing refers to learning conversations that occur soon after an event and involve those who took part. This is also known simply as ‘debriefing’ or could also be ‘hot debriefing’ or ‘proximal debriefing’. 

The aims of debriefing are to:

·         Discuss how, why and what occurred.

·         Promote learning and reflection for individuals and teams.

·         Identify opportunities for improvements in workflows, processes and systems.

·         Identify any key points and lessons learnt.

·         Ensure that the health and wellbeing of staff members are not adversely affected.

The Practice Manager and Partners will support all staff members following any incident, no matter how minor it may seem. Both positive and negative points should be considered that can support Practice-level training in the support of any future events.

9.3      Supporting patients

Should any patient be subjected to violent, abusive or aggressive behaviour then, as for staff members, they may need support, and this may be from a clinical or non-clinical member of the team. It is likely that the minimum would be to have a debriefing about the incident although in many cases the police would need to be involved.

External support may also be required.

 

The following legislation supports this policy:

·         Health and Safety at Work Act 1974

·         Management of Health and Safety at Work Regulations 1999

·         Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR)

·         Assaults on Emergency Workers (Offences) Act 2018

·         Safety Representatives and Safety Committees Regulations 1977

·         Health and Safety (Consultation with Employees ) Regulations 1996

 

Further reading can be sought from:

BMA	Preventing and reducing violence towards staff At the sharp end: handling patient violence On the receiving end: violence aimed at doctors
GMC	Ending the professional relationship with a patient
HSE	Violence and aggression at work Violence at work
LGBTQ+	For managing inclusive behaviour visit Stonewall Gender Identity Toolkit for General Practice
MDU	Dealing with challenging patients
NHS E	Violence prevention and safety

 

 

Unreasonable and inappropriate behaviour

Some examples of inappropriate behaviour that is deemed to be unreasonable includes, but are not limited to the following: 

·         Aggressive or abusive behaviour, such as shouting or personal insults, in person or via social media.

·         Discrimination or harassment when related to a protected characteristic under the Equality Act 2010.

·         Unwanted physical contact.

·         Spreading malicious rumours or gossip or insulting someone.

·         Stalking.

·         Offensive comments/jokes or body language.

·         Persistent and unreasonable criticism.

·         Unreasonable demands, impossible requests and persistent, or blatant disregard of treatment or requirements by the Practice. This could include regular failures to attend appointments without being able to give any reasonable explanation.

·         Coercion, such as pressure to subscribe to a particular political or religious belief.

 

Violent or abusive behaviour

• Any incident in which “an employee is abused, threatened or assaulted in circumstances relating to their work” (HSE 1996).
• The intentional application of force to the person of another, without lawful justification, resulting in physical injury or personal discomfort.
• The use of inappropriate or discriminatory words or behaviour causing distress and/or constituting harassment.
• Behaviour that is hostile, destructive and/or violent.

 

Assault

·         Physical assault is the intentional application of force to the person of another, without lawful justification, resulting in physical injury or personal discomfort.

·         Non-physical assault is deemed to be the use of inappropriate or discriminatory words or behaviour causing distress and/or constituting harassment.

 

 

The following process is to be taken to support poor, or unreasonable behaviour at this Practice: 

·         Discuss

When interactions become challenging, staff are advised to discuss these more difficult consultations/conversations with their peer groups, seeking guidance when applicable and assurance that they have handled the situation in the most appropriate manner.

·         Record keeping

To support any decisions made on behalf of the Practice, members of staff who experience patients who are challenging and make unreasonable demands must record the events as accurately as possible. Any record should be strictly factual.

MPS states in its guidance titled From the advice line: documenting aggressive behaviour that if a patient’s behaviour is likely to be relevant to their health, then it should be documented factually within the medical record. However, if incidents arise outside the context of a consultation, say in reception, or when telephoning, it should be considered as to whether the behaviour should be documented in the medical records or not. 

There can be circumstances in which it would be more appropriate to record any incidents with a patient in a separate folder. Any information about a patient stored outside the records would still be required to be disclosed on request by the patient under data protection legislation.

Any entry made in the patient’s healthcare record should detail exactly what happened, including timings, the build-up to the incident and those staff members present. Care should be taken not to record opinions or perceptions that may prejudice others in the event of the patient seeking to register elsewhere for any reason.

 

·         Speaking to the patient

In the first instance, and to maintain an effective relationship with the patient, it is recommended that the patient be spoken to by the clinician who is treating them. The clinician can provide reassurance to the patient about their condition and address any concerns.

A recommended approach to help in such scenarios is to verbalise the difficulty, such as: “We both have very different views about how your symptoms should be investigated and that is causing some difficulty between us. Do you agree?”  

Verbalising such difficulties may enhance the level of trust between the clinician and the patient, enabling feasible options for care and treatment to be discussed. 

Clinicians will not be forced into giving a diagnosis or treatment if they are uncertain. This should be explained to the patient while also explaining that it is in their interest that the most appropriate solution be found and that it can take time to confirm a diagnosis. 

 

·         Writing to the patient

Should the patient’s behaviour remain unreasonable despite the above actions having been taken, the matter will be referred to the Practice Manager who will then write to the patient using the template at Annex E.

The correspondence will, where indicated, also include links to relevant, evidenced literature or approved websites to enable the patient to carry out their own research.

 

·         Cooperation

Should the patient not be cooperating, or it is judged that their behaviour is not acceptable, then a further letter at Annex F may be more appropriate.

 

·      Behaviour agreement

If a patient continues to act in an unreasonable manner despite being issued a letter about their behaviour, the Practice may establish a ‘behaviour agreement’ that allows boundaries to be detailed and agreed to. 

This agreement should be retained in the patient’s healthcare record and reference will be made to the agreement should the patient’s behaviour deteriorate once again. A sample behaviour agreement can be found at Annex G.

 

·      Removal from the Practice

Should the patient be non-compliant as per the behaviour agreement in a manner that contravenes the agreement then consideration should be given to removing the patient from the Practice list.

This final stage should never be taken lightly and will be agreed by the Practice Manager and Partners. The patient will be advised that the doctor/patient relationship has deteriorated to such a degree that there is no longer any trust between the parties and the relationship is not viable. 

The patient will be asked to register at another Practice as detailed in the Practice’s Removal of Patients Policy. Further guidance can be sought within GMC’s ethical guidance titled Ending your professional relationship with a patient.

A sample letter can be found at Annex H.

  

 

Actions available to the Practice

 

a.    Warnings

·         For unacceptable, threatening or abusive behaviour, the patient will be warned that the Practice is considering removing them from its list.

·         The letter template at Annex E is to be used and this advises that, should there be any further incidents of inappropriate behaviour, they will be removed and requested to register elsewhere.

·         Records of all warnings should be retained and, if a warning has been given in the preceding 12 months, there are grounds for requesting removal.

·         Should a patient not be cooperating with treatment then the letter at Annex F can be used.

·         When behaviour is an issue, this Practice will do all that it can to ensure that this is rectified. In these instances, a behaviour agreement can be raised and a template for this can be sought at Annex G.

 

b.    Removal

Prior to seeking formal approval to remove a patient from the Practice list, the following is to be adhered to:

·         Judgement is to be exercised in determining whether a patient’s violent behaviour is a result of their medical condition. When doubt exists, further guidance should be sought from the Local Medical Committee and/or medico-defence representatives.

·         There must always be a justifiable reason(s) for seeking approval to remove the patient from the Practice list.

·         For instances when there is deemed to be a breakdown of doctor-patient relationship or should there be any repeat of the inappropriate behaviour within a 12-month period since the previous warning, then the patient can be removed.

·         Should a patient be violent, e.g., when the police are involved, then in these cases the patient will be removed immediately. It should be noted that if the removal is on the grounds of violence or threatened violence, the police must always be informed, and a police incident number obtained.

·         If it is for a clinical reason as to why the patient’s behaviour was deemed inappropriate, consider changing the patient’s GP internally.

 

When removal has been found to be justified, the Practice will:

·         Write to the patient explaining why they are to be removed from the Practice list using the template at Annex H.

·         Record the decision, attaching the letter(s) to the patient’s healthcare record.

·         Determine the most appropriate arrangements for continuing the patient’s care and facilitate the timely transfer of the patient’s healthcare record.

 

Actions by PCSE (8-day removal) 

Should there be a requirement to remove the patient following their unreasonable behaviour and a warning has already been provided to them in the preceding 12-months period, then PCSE will remove patients eight days after they receive the request. 

However, if patients require treatment at intervals of less than seven days, the Practice is obliged to provide such treatments until the condition of the patient improves. In such instances, removal will occur on the eighth day after treatment ceases or until the patient is accepted by another Practice.

To request an 8-day removal, PCSE is to be informed via the Patients Removals Form as detailed upon its Patients removal webpage Patients removal webpage or the Removal Request Paper Form can be sent to pcse.patientremovals@nhs.net.

 

Actions by PCSE (immediate removal)

In instances when patients are violent, abusive, threatening or have displayed signs of generally unacceptable behaviour, or where there are concerns for staff and other patients’ safety, the police are to be notified. The Practice can have the patient immediately removed within 24 hours once they have notified PCSE by either telephone or email. 

To request immediate removal of a patient and for further instructions, refer to the PCSE guidance on its Patient Removals webpage. 

The Practice must ensure that the reason(s) for removal is recorded in the patient’s healthcare record, along with any supporting documentation such as previous warnings or information leading up to the removal of the patient. The responsibility for ensuring that the patient meets the criteria for immediate removal.

 

 

 

Dear [insert patient name],

 

I am writing to discuss the report/s I received about [the event / behaviour / incident], which took place on [insert date].

 

I wish to inform you that we will not accept this behaviour from you and a repeat of such behaviour in the future will not be tolerated by the Practice. I wish to warn you that should there be a recurrence of this behaviour, action will be taken to remove you from the patient list, and you will be required to register with another GP practice.

 

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/patients.

·         Using bad language or swearing in a text message/email to the Practice.

·         Posting any derogatory, defamatory, or offensive comments on social media directed to the Practice or members of staff on social networking sites.

·         Any physical violence towards any member of the Primary Health Care Team or other patients, such as pushing or shoving.

·         Verbal abuse toward the staff in any form including verbally insulting the staff.

·         Any kind of abuse including racial abuse and sexual harassment will not be tolerated within this Practice.

·         Persistent or unrealistic demands that cause stress to our 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 always treat your GPs and their staff courteously. Thank you.

 

Yours sincerely

 

Practice Manager

For the partners

 

 

Dear [insert patient name],

 

As the Practice Manager of The Saheecha’s Practices, I am writing to you on behalf of the Partners at the practice.

 

We value you as a patient and our aim is to always provide you with the best level of care. In order to do so, we need you to accept that it is not acceptable to [insert issue here, e.g., make repeated demands for information]. Members of the team have advised me that [insert information, e.g., “over the past [insert time frame] you have called the practice on [insert number] separate occasions to discuss your medical condition].

 

Your GP has informed me that they have advised you a number of times about managing your condition and that they have also written to you to clarify the advice given during your consultation.

 

If, during your consultation, you are unsure about anything your GP has said to you, please ask at the time. Your GP will happily explain everything to you to ensure that you are best placed to manage your condition.

 

Our doctors follow the guidance detailed in Good Medical Practice, specifically our GPs will:

 

·         Listen to patients and encourage an open dialogue about their health, asking questions to allow them to express what matters to them, and responding honestly to their questions.

• Give patients the information they want or need to know in a way they can understand.

 

Our receptionists are not permitted to give medical advice about your condition; the responsibility of your continued care rests with the General Practitioners.

 

Should you seek a second opinion regarding your condition, please arrange an appointment requesting that the appointment take place with a different GP and the reception team will facilitate this.

 

We have [xxxx] registered patients at The Saheecha’s Practices, which generates a high volume of telephone calls throughout the day. It is essential that our resources are used appropriately if all our patients are to receive the expected level of care.

 

Thank you in advance for your cooperation.

 

Yours sincerely,

 

Practice Manager

For the partners

 

 

 

Dear [insert patient name],

 

As the Practice Manager of The Saheecha’s Practices, I am writing to you on behalf of the Partners at the Practice. We value you as a patient and want to continue to provide you with high-quality care and service [that you/we feel that you] currently receive. To do so, we need to set boundaries and expectations that will foster an effective relationship.

 

It is hoped that this is agreeable and that we can improve upon our relationship to maintain the effective patient/doctor relationship that is required.

 

Please review and sign the agreement carefully. This agreement will be witnessed and retained within your healthcare record.

 

Agreement

 

This agreement is between [insert patient name] and The Saheecha’s Practices.

 

This Practice will endeavour to:

 

·         Consider your needs and provide a professional and confidential service and work in partnership with you, your family, carers and representatives.

·         Consider what would most benefit your health and wellbeing and discuss any decision in a clear and transparent way.

·         Treat you equally and with dignity and respect.

·         Encourage you to take part in decisions about your health and wellbeing by providing you with the information and support to do so.

·         Learn from any mistakes and ensure that, should any occur, we fully investigate. If harm has been caused, we will provide an appropriate explanation and apology.

·         Offer you your named GP, or GPs, of choice where possible for continuity of care.

·         Listen to you and involve you in decision making regarding your treatment options.

·         Consider and respect your feedback.

 

In return, this Practice will expect you to undertake that you will do the following:

 

·         Use our service responsibly and not expect immediate treatment for non-urgent/routine conditions.

·         Take personal responsibility for your own health.

·         Treat staff and other patients with respect and recognise that violence or the causing of nuisance or disturbance these premises could result in prosecution.

·         Recognise that abusive and violent behaviour could result in you being requested to register elsewhere.

·         Provide accurate information about your health, condition and status.

·         Keep to any appointments or cancel within a reasonable time to allow the appointment to be reused for another patient.

·         Follow the course of treatment to which you have agreed and talk to your clinician if you find this difficult.

·         Participate in important public health programmes such as vaccination.

·         Utilise the services of other professional practice staff as a GP is not necessarily the most appropriate clinician to see on all occasions.

·         Allow sufficient time for processing repeat prescription requests and not pressure staff to process unauthorised medication requests.

·         Keep us informed of any name, address and telephone number changes.

 

I also understand that failure to meet these expectations may result in the Practice requesting that I register elsewhere at another GP practice.

 

I have read, understand and agree to the above listed expectations.

 

Patient signature		Date
Practice signature		Date
Witness signature		Date

 

Should you have any questions, can I ask that you please contact the main Practice number and request a meeting with either myself or my deputy [enter name].

 

Yours sincerely, 

[Signature]

 

Practice Manager

For the partners

 

 

[Address]

 

[Insert date]

 

Dear [insert name of patient]

 

Further to my previous letter on [date], this is to inform you that your [unreasonable/abusive/aggressive] behaviour continues to be unacceptable to the Practice.

 

On [date] at [place] it was reported to me that you [insert incident] and today I have requested to NHS England that you be removed from The Saheecha’s Practices list.

 

Therefore, you will need to register at another Practice and…

 

[Delete as appropriate]

 

[this removal will take effect on the eighth day after the request is received by NHS England].

 

[or],

 

[this removal will take effect eight days after completion of the current treatment that you are receiving. Please note, this may be sooner should you have been accepted to be registered at another Practice].

 

Should you need any assistance in finding another GP Practice, it is suggested that you visit the following website:

 

https://www.nhs.uk/service-search/find-a-gp

 

Yours sincerely,

 

[Signature]

 

[Name]

[Partner]