Zero tolerance towards abusive patients is under threat, GPs warn

The principle of zero tolerance towards abusive patients is under threat from a lack of support from NHS management and an uncooperative ombudsman, LMCs have warned.

Abusive patients: LMCs called for more support for practices (Photo: JH Lancy)
Abusive patients: LMCs called for more support for practices (Photo: JH Lancy)

GPs reported that practices whose staff faced verbal abuse and threatening behaviour had met with resistance when they had tried to remove the offending patients from their lists, which is allowed under current regulations.

A motion passed at the annual LMC conference in York last week said the profession 'deplores the fact that the principle of zero tolerance towards abusive and threatening patients has been totally emasculated by management fudge and a hostile ombudsman'.

Dr Mark Corcoran, a GPC member from Avon, said his LMC had concerns about the response to rudeness and lack of respect shown by 'a tiny minority' of patients towards receptionists and surgery staff.

He said: 'I'm not talking about violence, or threatening behaviour; there are clear mechanisms to deal with those.

'But we need to be clear that such behaviour when it occurs is unacceptable. More to the point, we need to be supported when we confront bad behaviour, and I suggest such support is not always forthcoming when perhaps it should be.'

'Bruising experiences'

He said two practices in his area had 'very bruising experiences' at the hands of the Parliamentary and Health Service Ombudsman, which investigates complaints against practices.

Dr Corcoran said: 'Vile, vitriolic behaviour that leaves receptionists in tears is unacceptable. We need to be supported, if and when we have reason to point that out.

'I'm completely happy to treat my patients and their relatives with upmost courtesy and respect. In return, the vast majority treat my staff the same way. However, there are a few who don't comply with the conventions of civilised society.

'Their unpleasantness is not sufficient to confine them to the restrictions and inconvenience of the violent patient scheme. However, I would like the ability to tell them that I don't want to see them any more and, then, for me to be properly supported when I apply the existing rules appropriately.'

'Flagrant disregard'

However, Dr Alexandra Freeman from Hampshire and Isle of Wight LMC said GPs often hadn't applied the zero tolerance policy themselves. 'Look at yourself and say, am I actually practising zero tolerance myself? Because if you're not... how can you hope to have other people support you?'

Dr Berge Balian from Somerset LMC said the 'flagrant disregard for our safety must not be allowed to continue'.

Dr Robert Morley, chairman of the GPC's contracts and regulations subcommittee, said violent patient provisions and regulations for the removal of patients through the standard procedures were 'fit for purpose'.

He said: 'Clearly, the problems are because they're not being actioned properly, either because area teams are unaware of the proper regulations or choosing to ride roughshot over the needs of practices and the safety of their staff, and we've heard also because the ombudsman seems to be acting either inappropriately or outside her remit as well.'

He reminded GPs that practice staff only need fear for their safety for there to be grounds for removing a patient. 'It's important that all practices are made aware of the regulations,' he said. 'It's important that area teams follow them properly and protect practices; they have a duty of care as well.'

The motion passed unanimously.

A spokeswoman for the Parliamentary and Health Service Ombudsman said: ‘Our powers are set out in legislation and our remit is to investigate fairly and impartially without taking sides. GP practices, like any organisation we investigate, are given an opportunity to comment on draft reports and decisions affecting them before findings are published.’

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