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Practice manager tells of patient attack that led to staff suffering head injuries

by Rima Evans
7 July 2023

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A practice manager has spoken out about her experience of being physically abused by a patient in a violent attack that left four members of her surgery’s team wounded, two with head injuries.

Laetitia Deramchia of Florence House Medical Practice described the incident and what action was taken in its aftermath at a session on preventing abuse of practice staff at the Management in Practice event in Manchester in June.

‘I wasn’t as badly injured as the others who needed to go to hospital,’ she said. ‘Admin staff were attacked and a GP partner was injured.’

The incident, which took place in September 2021 in Manchester, received widespread media attention. Reports at the time had said the GP involved suffered a skull fracture while the others were left with ‘deep lacerations’.

Ms Deramchia described how events unfolded.

‘Because of Covid, the practice was using an intercom system to allow patients in. One patient, a 59-year-old man, managed to sneak through the door when another patient left,’ she said. ‘He proceeded to smash the reception screen, climb over the desk and attack members of staff. Some were then taken to hospital. The man was arrested and later charged’.

‘We closed the practice straight after the attack and immediate support was given to Florence House’, said Ms Deramchia went to explain.

‘Clinical cover arrangements were established within an hour. There was a whole system response across primary care and that involved the LMC, GP federation and providers.’

She said measures put in place to step up security included reconstructing the reception area with a protective screen, improving the already existing CCTV system, and being provided with a security guard.

‘Having a security guard is very reassuring especially at night and when it’s women only on the reception desk. The security guard also escorts staff to their cars when leaving the surgery. This has helped make us feel safer especially when it’s dark outside and because the surgery isn’t in an affluent area.’

Ms Deramchia explained that ensuring welfare of staff has been a top priority. ‘We made sure everyone could speak about what happened if they wanted. That support is still in place. And our lone working policy was changed so now no one leaves the practice on their own and no one stays in the practice on their own. If a GP is going on a home visit, we need to know what time they are going and where.

In addition, the then Manchester CCG adopted a zero-tolerance policy. ‘This policy is posted on our reception screen for patients to see,’ said Ms Deramchia. ‘If anybody faces abuse on the phone or in reception, it is highlighted to the management team. A letter is sent to the patient who behaves badly with a copy of the zero-tolerance policy.’

Steps were taken to support all practices across Manchester with NHS England providing funds worth £180,000 to address security needs and tackle abuse, and a further £594,000 provided by the Manchester Locality team.

As part of that an incident reporting system was created, while security assessors undertook surveys of all GP premises to look at improvements in four priority areas of safety (audio/visual entry into the premises; CCTV in reception and the route to reception; screens at reception; and personal security alarms). Links between community police teams and practices were also strengthened, delegates were told.

Ms Deramchia also explained that now her practice will not register patients from the Special Allocation Scheme because it believes it needs reviewing.

‘That’s us taking a stand on it. We want to see some changes to the scheme.’

Meanwhile, Mike Neville, practice manager and North West England representative at the Institute of General Practice Management, also speaking in the session, warned that abuse levelled at practice staff has become normalised.

‘Receptionists are commonly told by patients, “If I die it will be your fault”. And a lot of staff now don’t even realise that’s abuse because it’s their everyday experience.

‘We need to vocalise that abuse is a problem, and vocalise it together, so we can make change happen,’ he added.