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Zero Tolerance

Zero Tolerance

Patients who exhibit habitually unacceptable behaviour, can be a common problem in general practice. Handling such behaviour puts a huge strain on time and resources and causes unacceptable stress for staff, who may need support in difficult situations. The following guidance has been developed by the LMC to reflect guidance from a number of sources including NHSE, the BMA and the GMC.  It aims to provide practices with guidance on issuing warning letters and behaviour contracts to patients whose behaviour is unacceptable.

The vast majority of patients do not display such behaviour, these guidelines are for the small minority who do and should only be used on an exceptional basis.

The procedures outlined in the below guidance document should only be used as a last resort and after all reasonable measures have been taken to try to resolve issues at informally practice level or formally through the NHS complaints procedure. Judgment and discretion must be used in applying the criteria to identify such behaviour and in deciding on the action to be taken in each case.

Practices should consider the below guidance alongside their complaints and zero tolerance policies.

Wessex LMCs Zero Tolerance Guidance Document

Wessex LMCs Example Patient Behaviour Agreement

You may also wish to read our webpage on "Removing Patients from Practice Lists"

Protecting yourself online

GPs and their staff are increasingly facing abuse from patients on social media. It is as unacceptable to abuse practices online as it is face-to-face, so you must understand how to protect yourself.

The BMA has published  a toolkit  for GPs, which covers:

Doctors may also wish to access the BMA's wellbeing services  .

Abuse is not in a day’s work

The majority of people who need support from GP Practices do so in a respectful way that helps create a safe environment for all. Sadly, there are a very small number of people who can be abusive and aggressive to both staff and other patients. To help support your practice in a zero tolerance approach we have produced the below images which you can print as posters, use on your website or circulate via your social media channels. With thanks to Leeds CCG. #NotInADaysWork

Right click on the images to save a copy for your use.

Word Document Version of Images





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Updated on Tuesday, 10 May 2022 8824 views