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.