Violent and Aggressive Patients Policy
LDC is committed to taking all reasonable precautions necessary to ensure the health, safety, welfare and well-being of its employees, patients and visitors, and endeavours to ensure that all employees are protected from physical and verbal abuse while they are working.
LDC have a Zero Tolerance approach to any incidents of inappropriate behaviour towards its colleagues, whether it be violence, abuse, or discrimination. No LDC colleagues should be subjected to violent, threatening, abusive or discriminatory behaviour of any kind, from service users, their relatives, carers, stakeholders, the public or customers. All colleagues have the right to work and carry out the duties of their role in an environment which is free from such behaviours. All colleagues have the right to be treated equally, with consideration, dignity, and respect.
The Practice acknowledges that there may be instances where violence and / or aggression forms part of a patient’s illness. In these circumstances, the issue will be discussed with the patient and form part of their care planning.
Definition of Physical and Verbal Abuse and Violence
- Unreasonable and / or offensive remarks or behaviour / rude gestures / innuendoes
- Sexual and racial harassment
- Threatening behaviour (with or without a weapon)
- Actual physical assault (whether or not it results in actual injury) includes being pushed or shoved as well as being hit, punched or attacked with a weapon, or being intentionally struck with bodily fluids or excrement.
- Attacks on Partners, members of staff or the public
- Discrimination of any kind
- Damage to employee’s or employer’s property”
The NHS Zero Tolerance definition of violence is:
“Any incident where staff are abused, threatened or assaulted in circumstances related to their work, involving an explicit or implicit challenge to their safety, well-being or health”.
Violence and aggression towards a person may also be defined as:
“A physical contact with another person which may or may not result in pain or injury. The contact is uninvited and is an attempt to cause harm, injury or to intimidate. Non-physical aggression includes the use of language which causes offence or threatens the safety of a member of staff”.
Grounds for Blocking, Barring, or Withdrawing Care from Patients
LDC, as an independent private medical provider, retains the legal right to decide whom it accepts, treats, or continues to treat—provided decisions do not breach discrimination law and comply with professional standards and safety requirements.
This policy outlines when a patient may be blocked, barred, refused care, or removed from our services.
Duty to Protect Staff and Patients
Under the Health and Safety at Work etc. Act 1974, LDC must take reasonable steps to protect staff and others from risks including violence, threats, and abuse.
Professional Standards (GMC)
Doctors may end a professional relationship where:
- Trust has broken down
- The patient’s behaviour makes safe care impossible
- Continuing the relationship places staff at risk
Contractual Freedom
As a private provider, LDC may refuse to accept or continue treating a patient for any lawful reason, provided:
- The reason is not discriminatory under the Equality Act
- The patient is not abandoned in a situation requiring emergency or life‑saving care
Grounds for Blocking, Barring, or Removing a Patient
These examples are not exhaustive.
Violent or Abusive Behaviour
Patients may be immediately barred for:
- Actual or threatened physical violence
- Severe verbal abuse
- Harassment or intimidation of staff or other patients
No warning is required in these circumstances.
Police may be contacted when necessary.
Police Involvement
If an incident requires police attendance due to a patient’s behaviour, the patient may be removed or barred with immediate effect.
Irretrievable Breakdown of the Therapeutic Relationship
Examples include:
- Persistent unreasonable or disruptive behaviour
- Harassment of staff
- Persistent, unrealistic or inappropriate demands
- Repeated failure to comply with clinical boundaries
Process for Blocking, Barring, or Removing a Patient
Warnings (Non‑Violent Cases)
Where safe and appropriate:
- A verbal or written warning may be issuedPatients may be given an opportunity to modify their behaviour
Warnings are not required when:
- Violence, threats, or intimidation occur
- Issuing a warning would risk staff safety
Immediate Action for Violent Incidents
- The patient may be barred immediately
- Staff may call police
- The patient does not need to be informed at the time if this poses a risk
Documentation
The following must be completed:
Clear documentation in the patient’s clinical record
- Incident report submitted in Radar
- Discussion of the case in one or more governance forums:
o Clinical Governance
o QPC
o Complaints & Incidents Review
Notification to the Patient
A written notification should be sent unless doing so presents a safety risk.
The communication should:
- State the decision (blocked/barred/removed)
- Provide a brief, factual reason
- Outline any allowed future interactions (if any)
If a blocked or barred patient books further appointments, the booking team may:
- Cancel the appointment
- Issue a full refund
Emergency or Life‑Threatening Situations
Even if a patient is blocked or barred:
LDC may see them in situations of life‑threatening illness or immediate emergency need.
Failure to do so could constitute a breach of the clinician’s common‑law duty of care and GMC obligations.