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.
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:
- practical steps to deal with online abuse and harassment
- how to report abuse to social media platform providers
- guidance on refusing to treat abusive patients
- how and when to involve the police.
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.
Support your Surgery
GPs and their teams have faced an extremely challenging time during the COVID-19 pandemic. The restrictions have meant that face-to-face contact with patients has been limited in order to keep practice staff and patients safe.
The Support Your Surgery campaign provides GP practices with the tools to both manage expectations and to provide patients with the reality of issues facing general practice: Support your Surgery