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by Angela Sharda
17 December 2018

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Tackling abuse at the root

Working in a practice is by no means an easy job. As if the day-to-day running is not tricky enough, especially with the pressures caused by underfunding, practices face another significant challenge from impatient, frustrated and occasionally rude or violent patients.

To an extent, this behaviour might seem unsurprising as you are dealing with sick, anxious people, and you might expect practice teams to be reasonably robust about this. But there are times when patient behavior oversteps the mark.
Such behaviour takes its toll on everyone in the practice and sometimes it’s hard not to let personal feelings overtake your professional focus.

In October, a new strategy with a zerotolerance approach to violence was launched by the Department of Health and Social Care to help protect NHS staff from attacks and abuse.

This includes closer collaboration between the NHS, the police and the Crown Prosecution Service, and will aim to have offenders prosecuted quickly.

At the time, health and social care secretary Matt Hancock said: ‘I have made it my personal mission to ensure NHS staff feel safe and secure at work and the new violence reduction strategy will be a key strand of that.’

So far, so good. While the Government’s approach to dealing with patients being abusive towards healthcare staff is one solution, practice managers have been handling these situations for a long time.

Standard policies and procedures allow practices to remove abusive and violentorking in a practice is by no means an easy job. As if the day-to-day running is not tricky enough, especially with the pressures caused by underfunding, practices face another significant challenge from impatient, frustrated and occasionally rude or violent patients.

To an extent, this behaviour might seem unsurprising as you are dealing with sick, anxious people, and you might expect practice teams to be reasonably robust about this. But there are times when patient behavior oversteps the mark.

Such behaviour takes its toll on everyone in the practice and sometimes it’s hard not to let personal feelings overtake your professional focus.

In October, a new strategy with a zerotolerance approach to violence was launched by the Department of Health and Social Care to help protect NHS staff from attacks and abuse.

This includes closer collaboration between the NHS, the police and the Crown Prosecution Service, and will aim to have offenders prosecuted quickly.

At the time, health and social care secretary Matt Hancock said: ‘I have made it my personal mission to ensure NHS staff feel safe and secure at work and the new violence reduction strategy will be a key strand
of that.’

So far, so good. While the Government’s approach to dealing with patients being abusive towards healthcare staff is one solution, practice managers have been handling these situations for a long time.

Standard policies and procedures allow practices to remove abusive and violent patients from their lists, but that is a last resort.

Before we get to that, I believe there are further positive steps that can be taken by the community of practice managers. Everyone tackles problems such as abuse and aggression in their own way, and practice managers can share ideas and experiences through networks that allow them to talk about what has worked and what hasn’t.

We can also try to learn more about the root causes of the problem, to help us better understand why aggressive behaviour happens.

For example, if it is exacerbated by a factor in the practice or its systems, practice managers can make helpful changes.

We should also consider contributing factors for individual patients. For instance, we need to identify if the patient is behaving in a certain way because of a health condition – in that case, removal from the list might not be appropriate.

However, if a patient becomes abusive or aggressive simply because the receptionist is unable to offer them an appointment at their desired time, practices need to send the message that this behaviour is not acceptable.