MDU advises GP practices to review zero tolerance policies as new guidance published

New guidance for GP practices in England setting out the type of inappropriate or unacceptable behaviour by patients that could lead to a warning, or removal from the practice list, has been welcomed by the MDU.

An updated version of NHS England’s Primary Medical Care Policy and Guidance Manual (PGM) includes a new chapter on the types of behaviour by patients that could lead to further action. These include swearing and using bad language, racial or sexual abuse, unnecessarily persistent or unrealistic service demands causing disruption, damaging practice premises and stealing from practices.

MDU has backed the call in the guidance for practices to review their policies on unacceptable patient behaviours to ‘explicitly’ include positions on not tolerating any form of discrimination, harassment, or victimisation.

Welcoming the new guidance, Dr Ellie Mein, MDU medico-legal adviser said:

“There is increasing evidence that abuse and violence against primary care staff has worsened over the last two years and we support many practices to take action following an incident. In an MDU survey of over 400 doctors in 2021, nearly 8 out of 10 GPs reported increasing levels of abuse.

“It is never acceptable for healthcare professionals to be abused in the course of their work and this guidance will go some way to reassuring practice teams, who have worked so hard at a time of immense pressure, of the situations when action should be taken.

“We encourage GP practices in England to review and update their policies accordingly. MDU members can also come to us for advice on whether to issue a patient with a warning, instigate an acceptable behaviour agreement or remove a patient from the practice list.”

The revised guidance complements existing guidance on managing patients who are violent towards staff and recognises that unacceptable behaviour can escalate to, or exist alongside, violent conduct.

Chapter 6 states that: ‘Everyone has a right to be treated fairly and equally, with dignity and respect, and free from discrimination and harassment, and violence and abuse.’ NHS England explains that the protection and safety of NHS staff and patients’ mental health ‘is as important as the protection and safety of physical health.’