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GP practice in successful defence of abusive patient’s discrimination claim

by Anna Colivicchi
13 September 2023

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A GP practice has successfully defended a legal case brought by a patient claiming their list removal for abusive behaviour amounted to discrimination.

Medical defence organisation the Medical Defence Union (MDU), which represented the practice in court, said the judgement should give confidence to practices dealing with abusive or violent patients.

The claim arose from a 2018 incident in which the patient became ‘abusive and threatening’ after asking for an amendment to be made to a repeat prescription.

The patient had demanded an amended prescription ‘immediately’, becoming ‘angry and aggressive’ and threatening staff and the GP registrar who had seen him.

The police were called to the incident and a decision was taken by the practice to remove the patient from the list because of the level of aggression involved.

The patient’s claim alleged the surgery treated him ‘unfavourably’ because of his underlying condition and that they ‘failed to make reasonable adjustments’.

The MDU, who supported the practice in defending the initial claim, brought under the Equality Act 2010, and two later appeals, defended the case on the basis the practice did not discriminate, treating the claimant ‘exactly as they would treat any other person acting as he had done’ and given their need to protect staff.

The defence team argued that removing the claimant from the practice list was ‘proportionate and reasonable’, given the intimidating behaviour exhibited.

The GP, practice manager and reception manager gave evidence in court and described how they had felt ‘intimidated and threatened’.

Both the GP and reception manager described ‘physically shaking’ as a result of the incident and the reception manager considered leaving the job.

The practice manager explained in court that seeing the distress caused to staff by the degree of aggression exhibited by the patient, the decision was taken to remove the patient from the list and that this was only the second time the practice manager had taken this action during a 28-year career.

Dismissing the claim in court, the judge found that the patient had behaved in an ‘aggressive and intimidating’ way and that ‘others felt threatened by him’.

In the judgement, the judge said: ‘It seems to me that it is legitimate and necessary to protect frontline staff from abuse especially where it reaches the level of putting them in fear.’

The patient later appealed to the Court of Appeal and Supreme Court but these cases were dismissed.

Dr Claire Wratten, senior medical claims handler at MDU, said: ‘This is an important judgement for GP practices and should give them confidence in following their zero tolerance approach to dealing with violent, abusive and threatening behaviour.

‘While not common, the MDU is seeing more claims involving allegations of discrimination on the grounds of disability against members.

‘During the court hearing, it was distressing to hear both the GP and the reception manager describe in their evidence how they felt intimidated, threatened and were shaking as a result of the exchange.

‘Sadly, this type of incident is increasingly common with eight in 10 GP members responding to an MDU survey reporting increasing levels of abuse from patients and their representatives.’

Last month, GPs were encouraged to identify abusive or violent patients who may benefit from a rehabilitation programme.

NHS England has launched a new programme aiming to reduce violence against staff working in general practice, which is being piloted over the next three to six months and will be free to participate in.

A version of this story first appeared on our sister publication Pulse.