Zero Tolerance Policy




As an employer, the Practice has a duty to care for the health and safety of its staff. The practice also has a legal responsibility to provide a safe and secure working environment for staff. All patients are expected to behave in an acceptable manner and violent or abusive behaviour towards staff or patients may result in removal from our practice list or even criminal proceedings. The practice follows the NHS guidance concerning Zero Tolerance.

We will not deal with anyone, in anyway, who shouts at us. We will advise you at the time that we cannot deal with you because you are shouting – and we may begin the process of removal from our patient list

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. To successfully provide these services a mutual respect between all the staff and patients has to be in place. All our staff aim to be polite, helpful, and sensitive to all patients’ individual needs and circumstances. You are respectfully reminded that it is very often the case whereby staff are simultaneously confronted with a multitude of varying and sometimes difficult tasks and situations. 

Zero tolerance works both ways; and our staff are not immune to the policy. We will always investigate cases where our staff have been found to have contravened our policy and will not hesitate to discipline or suspend, pending investigation, anyone who falls below our exacting standards. If you would like to complain about a member of staff please use the complaints form.

If you are seriously unhappy with the quality of service you have the right to register with another practice without notifying us. Similarly, on the very rare occasions when a patient repeatedly ignores their responsibilities to the Practice, we have the right to remove the patient from our Practice list.

The practice has the right to remove violent patients from the list with immediate effect in order to safeguard practice staff, patients and other persons. Please note:

  • Violence in this context includes actual or threatened physical violence or verbal abuse which leads to fear for a person’s safety. In this situation we will notify the patient in writing of their removal from the list and record in the patient’s medical records the fact of the removal and the circumstances leading to it.
  • Intimidation in this context includes shouting or talking in an aggressive or passive-aggressive raised voice; or making inappropriate comments.
  • Harassment in this context includes persistent and repeated telephone calls, or face-to-face confrontations, when the definitive answer has already been given and the person to whom you are talking is unable or does not have the authority to satisfy the demands of your request.

Our staff are trained to treat patients with respect and dignity. Clinical Administrators are trained to recognise difficult situations and how to try and help or signpost the patient in order to meet their requirements. They are not, however, trained to deal with active aggression and so you must raise your concerns with the Practice Manager whenever you have not been satisfied with the initial response from either the Clinician or the Clinical Administrator.

The Practice takes it very seriously if a member of staff or one of the doctors or nursing team is treated in an abusive or violent way. Aggressive behaviour, be it violent or abusive, will not be tolerated and may result in you being removed from the Practice list and, in extreme cases, the Police being contacted.

Inappropriate and unacceptable behaviours may include but are not limited to:

  • Using threatening or abusive language involving swearing or offensive language at practice staff or other service users (this includes but is not limited to swearing, shouting, using sarcasm, throwing objects, being rude)
  • Excessive noise (e.g. recurrent loud or intrusive conversation or shouting)
  • Any physical violence towards any member of the Primary Health Care Team or other patients, such as pushing or shoving
  • Racial abuse and sexual harassment will not be tolerated within this practice
  • 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
  • Causing damage/stealing from the Practice’s premises, staff or patients
  • Obtaining drugs and/or medical services fraudulently

We ask you to treat your GPs and their staff courteously at all times.


Removal from the practice list

A good patient-doctor relationship, based on mutual respect and trust, is the cornerstone of good patient care. The removal of patients from our list is an exceptional and rare event and is a last resort in an impaired patient-practice relationship. When trust has irretrievably broken down, it is in the patient’s interest, just as much as that of the practice, that they should find a new practice. An exception to this is on immediate removal on the grounds of violence e.g. when the Police are involved.


Removing other members of the household

In rare cases, however, because of the possible need to visit patients at home it may be necessary to terminate responsibility for other members of the family or the entire household. The prospect of visiting patients where a relative who is no longer a patient of the practice by virtue of their unacceptable behaviour resides, or being regularly confronted by the removed patient, may make it too difficult for the practice to continue to look after the whole family. This is particularly likely where the patient has been removed because of violence or threatening behaviour and keeping the other family members could put doctors or their staff at risk.