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Practices will be forced to keep some violent patients on list

by Lea Legraien
11 February 2020

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A change to the GP contract means that practices will no longer be able to remove certain violent patients from their list.

Following a change to the 2018/19 GP contract, practices have been able to refuse to register patients if they have been flagged by other practices as violent. They can also remove ‘mistakenly registered’ violent patients under normal procedures.

But the updated contact for 2019/20 clarifies patients who have previously been flagged as violent cannot be removed from lists if they are being reintegrated back into primary care after having been placed in the ‘special allocation scheme’.

Patients are placed in the scheme if they have been removed from a practice list following an incident that was reported to the police.

However, the new rules, being brought in from October, mean if a patient has been discharged from the scheme, a practice cannot remove them from their list on the basis of the previous violent incident.

In the new contract, agreed between the BMA GP Committee and NHS England last week, it states: ‘From October 2020, an existing requirement in the GMS regulations relating to the removal of patients who are violent from the practice list will be updated.

‘The regulations currently enable a contractor to remove a patient from their list if they become aware the patient has previously been removed from another GP practice list for committing or threatening an act of violence.’

It added: ‘The change will clarify that patients should not be removed from the GP practice list if, having been previously removed from a GP practice list and entered into a special allocation scheme for violent patients, they have subsequently been discharged for reintegration into mainstream primary care.’

There have been a spate of aggressive episodes directed towards healthcare professionals lately, including a stabbing at an east London practice that led to four people being hospitalised, and a patient’s arrest following an alleged knife attack on a GP during a consultation in Stoke. 

A staggering 79% of the 373 practice managers surveyed by Management in Practice last year said they had been on the receiving end of verbal abuse from patients.

The Primary Concerns 2018: The State of Primary Care report, also revealed that practice managers were the most likely to have received written abuse from patients, with 41% saying this had happened in the last 12 months. A survey by Pulse publisher Cogora in 2017 revealed that two-thirds of GPs had experienced some form of abuse from patients.