We are committed to ensuring that all patients are heard, understood, and treated with respect. While we strive to be open and accessible to everyone, there are rare occasions when an individual’s behaviour becomes unacceptable, particularly when it involves abuse towards our staff or misuse of our processes. In such cases, we must take appropriate steps to protect our team and maintain our ability to deliver care effectively. This policy outlines how we will manage these situations.
Aggressive or abusive behaviour
We recognise that patients may feel angry or upset about concerns they raise with the Practice. However, when that anger escalates into aggression directed at staff, it becomes unacceptable. We do not tolerate any form of violence or abuse. This includes physical threats, verbal and written language that causes staff to feel offended, threatened, or distressed. Each situation will be considered on a case-by-case basis, and we remain mindful that individuals may be emotionally affected when they contact us.
Language intended to insult, degrade, or demean, including racist, sexist, homophobic, transphobic, or otherwise discriminatory remarks, or serious accusations made without evidence, is not acceptable. In some cases, even comments directed at third parties may be considered inappropriate if they have a negative impact on our staff.
Unreasonable levels of contact
Excessive or prolonged contact from an individual can become problematic for the Practice. This may happen over a short period, such as multiple calls within a single day or hour, or over a longer duration. For example, a patient repeatedly makes lengthy phone calls or sends numerous letters or emails, including duplicates or irrelevant information. Contact becomes unacceptable when the time required to manage it affects our ability to address the issue effectively or compromises the care and support we provide to other patients.
Unreasonable use of the complaints process
Patients have the right to raise concerns about the Practice through appropriate channels, and to submit more than one complaint if new issues arise. However, repeated complaints become unreasonable when their effect is to harass the Practice or to obstruct us from carrying out legitimate actions or decisions. While we recognise the importance of access to the complaints process, we reserve the right to take appropriate action in exceptional cases where repeated use of the system becomes disruptive or abusive.
Examples of how we deal with other categories of unreasonable behaviour
We are sometimes required to take action when unreasonable behaviour affects the effective operation of our Practice. Our goal is to manage such situations in a way that still allows the patient to engage with our processes. Any action taken will be proportionate and aimed at resolving the issue, while also considering the individual’s personal circumstances, the seriousness of the concern, and their specific needs.
Other actions we may take
When a patient repeatedly phones, visits the Practice, raises multiple issues, or sends large volumes of documents with unclear relevance, we may take steps to manage this contact in order to protect the efficiency of our services. Actions may include:
- Limiting telephone contact to specific times and days
- Designating a single member of staff to manage all future communications from the patient
- Requiring the patient to attend the Practice by appointment only
- Restricting communications to written correspondence only
- Returning irrelevant documents or, in extreme cases, informing the patient that further unrelated documents will be destroyed
- Taking any other appropriate action necessary to manage the situation
If we consider continued correspondence on a wide range of issues to be excessive, we may notify the patient that only a limited number of concerns will be addressed within a given timeframe and ask them to prioritise or focus their requests.
In exceptional circumstances, we reserve the right to decline to consider further issues or complaints from an individual. In doing so, we will take into account both the impact on the individual and whether there is a broader public interest in reviewing the matter further.
Patients will always be informed of any actions we take and the reasons behind those decisions.
How do we let people know we have made this decision
When a Practice staff member responds immediately to offensive, aggressive, or abusive behaviour, the patient will be informed of the action taken at the time of the incident.
If a decision is made by the Senior Management Team to issue a formal warning or remove a patient from the Practice list, the patient will be notified in writing. This written communication will include the reason for the decision, along with any relevant details such as the duration and conditions of a warning. This ensures the patient has a clear and formal record of the action taken.
The process for appealing a decision
Patients must have the opportunity to request a review of decisions. A patient may appeal a decision to issue a warning or to remove them from the Practice list. Appeals will only be considered concerning the warning or removal itself, not the original issue or complaint, nor the outcome of any complaint process.
Valid grounds for appeal may include, for example:
The behaviour was incorrectly identified as unacceptable
The response was disproportionate to the behaviour
The decision fails to take into account the patient’s personal circumstances and the potential impact
The appeal will be reviewed by the Practice Manager or a GP Partner who was not involved in the original decision. They will assess the case based on the available evidence and have full discretion to uphold, amend, or revoke the original decision.
The patient will be informed of the outcome in writing, including any changes to the warning or removal. Warnings may also be reviewed periodically or upon further request, depending on the circumstances of each case.
What actions does the Practice consider to be unacceptable?
We understand that people may behave differently during times of stress, and that distressing circumstances may raise a concern or complaint. We do not consider a patient’s behaviour unacceptable simply because they are assertive or persistent — persistence can be valuable in resolving an issue. However, actions that place unreasonable demands on the Practice or involve unacceptable behaviour towards our staff will not be tolerated. This policy is intended to help us manage such situations appropriately.
Unreasonable demands
A demand becomes unacceptable when it significantly disrupts the functioning of the Practice or diverts staff time and resources to the detriment of other patients. Examples of such behaviour include:
- Repeatedly requesting responses within unreasonable timeframes
- Frequently asking for early supplies of medication
- Requesting replacements for stolen medication multiple times without providing a valid Police Incident number
- Consistently ordering prescriptions outside of the designated ordering period
- Insisting on speaking with or seeing a specific member of staff when this is not possible
- Continually changing the nature of a complaint or raising unrelated concerns
- Repeatedly requesting medical treatments that lack clinical evidence or justification
- Failing to ensure a follow-up or review appointment is arranged before the current medication runs out
Such actions may place an excessive burden on staff and hinder our ability to provide care to others.
Unreasonable refusal to co-operate
When addressing an issue or complaint, we ask patients to work collaboratively with us. This may involve agreeing on the matters to be reviewed, providing additional information or evidence when requested, or helping to clarify concerns, such as by completing a form or offering a summary.
While we will always support those who have a genuine difficulty in meeting these requests, it is unreasonable to raise a concern and then repeatedly refuse to engage with our reasonable efforts to resolve it.
Examples of how we manage aggressive or abusive behaviour
Any threat or use of physical violence, verbal abuse, or harassment towards Practice staff is unacceptable and may result in a formal warning from the Senior Management Team. Incidents involving physical violence or threats will be reported to the police.
Practice staff are authorised to end telephone calls if a caller becomes aggressive, abusive, or offensive. Staff have the right to make this decision, inform the caller that their behaviour is unacceptable, and terminate the call if it continues.
We will not respond to correspondence, regardless of format, that contains abusive language or unsubstantiated allegations against staff. Where possible, such correspondence will be returned with an explanation that the language used is considered offensive, unnecessary, and unhelpful. We will request that the sender refrains from using such language and advise that if the behaviour continues, future correspondence will not receive a response, and a formal warning may be issued.
The process we follow to make decisions about unreasonable behaviour
Any member of the Practice staff who is subjected to aggressive or abusive behaviour has the authority to respond immediately in a way they deem appropriate, in line with this Policy.
Except for immediate actions taken during an incident, any decision to issue a formal warning or to remove a patient from the Practice list will be made only after careful consideration by the Senior Management Team.
Wherever possible, patients will be given the opportunity to modify their behaviour before any formal action is taken.
How we record and review a decision to issue a warning
All incidents involving unacceptable behaviour by patients are documented. When a warning is issued, a record of the decision is added to the patient’s file and relevant computer systems.
A quarterly report of all imposed restrictions is submitted to the Senior Management Team to ensure consistent and appropriate application of this policy.
Decisions to issue a warning may be reviewed periodically or reconsidered upon request.
