Zero Tolerance

Your GP practice team is here to help you. Thank you for treating us with respect.

The Practice takes it very seriously if a member of staff is treated in an abusive or violent way.

The Practice supports the government’s ‘Zero Tolerance‘ campaign for Health Service Staff. This states that GPs and their staff have a right to care for others without fear of being attacked or abused and to work in an environment free from harassment and unlawful discrimination. To successfully provide these services a mutual respect between all the staff and patients has to be in place.

Our Practice staff aim to be polite, helpful, and sensitive to all patients’ individual needs and circumstances. They would respectfully remind patients that very often staff could be confronted with a multitude of varying and sometimes difficult tasks and situations, all at the same time.  Our team understand that ill patients do not always act in a reasonable manner and will take this into consideration when trying to deal with a misunderstanding or complaint.

However, aggressive behaviour, be it violent, abusive, written or physical, will not be tolerated and may result in you being removed from the Practice list and, in extreme cases, the Police being contacted.

We ask you to treat your GPs and their staff courteously at all times. The types of behaviour that would be found unacceptable:

  • Using bad language, derogarative terms or swearing at practice staff either verbally or in writing
  • Verbal abuse towards the staff in any form including verbally insulting the staff
  • Persistent or unrealistic demands that cause stress to staff will not be accepted. Requests will be met wherever possible and explanations given when they cannot
  • Racial abuse and sexual harassment will not be tolerated within this practice
  • Any physical violence towards any member of the Primary Health Care Team or other patients, such as pushing or shoving
  • Causing damage/stealing from the Practice’s premises, staff or patients
  • Obtaining drugs and/or medical services fraudulently

*This list is not exhaustive.

The Legal Position

As a responsible employer, the Practice has a duty as a provider of NHS healthcare to protect the health, safety and welfare of staff under the Health & Safety at Work Act. This includes a risk assessment of violence towards staff and taking steps to mitigate this under the Management of Health and Safety at Work Regulations 1999.

Each employee has rights under the General Data Protection Regulations and should feel that this place of work is a safe environment. 

Extenuating circumstances

The practice acknowledges that there may be instances where aggression / inappropriate language 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. However the patient may still be removed based on the severity of the situation.

Definition of Physical and Verbal Abuse and Violence:

 Physical and verbal abuse includes:

  • 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 staff or the public
  • Discrimination of any kind
  • Damage to an employee’s or employer’s property

 The Practice supports the Zero Tolerance stance adopted by the NHS.

 The HSE (Health and Safety Executive) defines work-related violence as:

“Any incident, in which a person is abused, threatened or assaulted in circumstances relating to their work”.

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”.


When an incident occurs, full details of date, time and place should be recorded by staff on a Signficant Event Analysis (SEA) form.

Warning Letter

Warning letters may be issued to patients when GP practice partners and / or Management Team believe a patient’s behaviour has been inappropriate and unacceptable.

Removal From The Practice List

The removal of patients from our list is an exceptional and rare event and is a last resort in the event of a breakdown in the patient-practice relationship. We value and respect good patient-practice relationships based on mutual respect and trust. When trust has irretrievably broken down, the practice will consider all factors before removing a patient from their list, and communicate to them that it is in the patient’s best interest that they should find a new practice. An exception to this is in the case of immediate removal on the grounds of violence e.g. when the Police are involved.

Removing other members of the household

The practice may need to consider removing other household members to ensure the safety of our staff. This is likely to happen where other household members may need to attend the practice with the removed individual and / or other household members may require a home visit where the removed individual is resident, which we would be unable to facilitate. The best interest of the remaining household will be taken into consideration when forming a decision.

BMA Guidance