ZERO TOLERANCE POLICY
The NHS Zero Tolerance Zone is a nation-wide campaign to tackle violence and abuse, both physical and verbal, against all members of staff working in the NHS. Its two principal aims are:
- To inform the public that violence against staff working in the NHS is unacceptable and the Government is determined to stamp it out
- To inform all staff that violence and intimidation is unacceptable and is being tackled. The practice fully supports this campaign and its legal requirements to provide, as far as is reasonably practicable, conditions of working that are conducive to the prevention of and safe management of violence.
In January 2000, the Department of Health (DOH) issued guidelines to Health Authorities to introduce local initiatives as part of a Zero Tolerance Campaign which addresses any incident where a General Practitioner (GP), or their staff are exposed to violent or abusive behaviour. As well as having a right to protect themselves, GPs have a duty, as employers, to protect their staff and as providers of a public service, those with reason to be on their premises. The DOH established the following definition for violence/abuse – “Any incident where a GP, or their staff, are abused, threatened or assaulted in circumstances related to their work, involving an explicit or implicit challenge to their safety, wellbeing or health”. The definition does not define violence just as physical assault but also includes threats that challenge the “safety, wellbeing or health of staff”.
ZERO TOLERANCE at Meadows Medical Practice
The practice operates a Zero Tolerance Policy towards any member of our staff or patients. Patients are expected to be considerate and act reasonably. Management cites but does not restrict, the following unacceptable behaviour within its Zero Tolerance Policy:
- any display of a violent temper
- shouting, raised voices, sarcasm, pointing fingers.
- repeated or insistent points being made; not engaging with staff in a positive way; being pushy or trying to intimidate staff
- hostile or aggressive behaviour
- threats, swearing, spitting
- any mention or display of any object that could be used as a weapon
Should a member of staff (or patient) feel that they have encountered behaviour that could be classed as unacceptable within the Practice Zero Tolerance Policy, a complaint should be made to the Practice Manager. Once the matter has been reviewed by the Practice Manager the person in question will be sent a formal warning letter, depending on the severity of the incident they may then be removed from the practice list. We will have no hesitation in having the patient removed from the building by the Police should their behaviour warrant it.
POLICE INVOLVEMENT – If an incident is taking place and staff feel that a Police presence is required, regardless of the circumstances, the Police will be called to deal with the incident. It is our responsibility to protect our staff and patients and therefore no hesitation will be made if a Police presence is required. If the patient has left the premises and there is no immediate danger, the Police will still be notified of the incident so it can be recorded for future reference. The GP will also keep a record of the incident.
WARNING SYSTEM – Following an incident where a complaint has been made about a patient’s behaviour a formal warning letter will be sent. The letter will notify the person that their behaviour was unacceptable and will not be tolerated, if the person is a patient at the surgery, they will be warned that they run the risk of being removed from our practice list. The letter will clearly state that if there is any reoccurrence of their behaviour in any way that they will be removed from the Practise list. A permanent record of the warning, including the date and reason for the warning, will be made and retained. Although this procedure will be generally applied, there may be occasions where the Management Team feel that an episode of behaviour is so serious that a patient will be removed from the Practice list with immediate effect. Where this is the case, the police will usually have been called to attend the Practice and one or more members of staff or patients will have been threatened or attacked or narrowly avoided being attacked. It is important to remember that it is not the intention of the perpetrator that is relevant, rather than the perception that is generated by the actions and behaviour of the perpetrator that will generate the Practice response.
Removal from the Practice List
Removal of patients from this Practice list is an exceptional and rare event and is a last resort. The practice must respect the safety and wellbeing of their staff and patients, and if a patient at the surgery is unable to respect the staff and treat them with courtesy, then it is in the best interest of the patient in question and, more importantly, our staff that they register elsewhere. If the decision to remove a patient from the practice list is made, Practitioner Services will be notified for the protection of other NHS staff members. If a patient is removed from the Practice list, they will also be banned from entering the Practice premises or contacting Practice staff in any way. Any clinical queries a patient may once they have been removed from the Practice list should be communicated in writing only.
Notifying the Patient
The Practice will take immediate steps to contact the patient to inform them of the action being taken. The patient will be informed in writing to their home address. Once this decision has been made the deduction will not be revoked under any circumstances, and the subject will not be entertained by any staff member and will be only considered as harassment.
Removing other members of the household because of the possible need to visit patients at home, may be necessary. The prospect of visiting patients where a relative, who is no longer a patient of the practice by virtue of their unacceptable behaviour resides, or being regularly confronted by the removed patient, may make it too difficult for the practice to continue to look after the whole family. This is particularly likely where the patient has been removed because of violence or threatening behaviour and keeping the other family members could put Doctors or their staff at risk.