Zero Tolerance Policy

 Introduction

We are committed to providing a safe, respectful and inclusive environment for patients, staff and visitors. The practice supports national NHS principles that violence, aggression or abuse towards staff or other patients will not be tolerated. We will ensure that actions taken are reasonable, proportionate and considerate of individual circumstances.

2. Unacceptable Behaviour

Unacceptable behaviour includes any actions that are aggressive, threatening, abusive, harassing or unreasonably persistent whether verbal, physical, written or digitalwhich affect the safety, well-being or ability of staff to deliver care or disrupts the care of other patients.

This includes, but is not limited to:

• Physical violence or threatening behaviour.
• Verbal abuse, including shouting, swearing, intimidation or sarcasm delivered in an aggressive manner.
• Harassment or discrimination targeting protected characteristics or marginalised groups.
• Sexual harassment or inappropriate comments directed at staff or other patients.
• Damage or theft of practice property.
• Fraudulent use of services, including dishonestly seeking medication.
• Persistent refusal to access care through appropriate pathways after reasonable explanation.
• Unreasonably and persistently refusing to accept a suitable alternative practitioner when clinically appropriate.
• Insisting on routine services being treated as urgent to the detriment of patients with genuine urgent needs.
• Directly contacting staff members via personal channels (e.g. social media or private email).
• Repeated or persistent aggressive challenges to clinical judgement – refusal to accept signposting or clinical outcomes.
• Behaviours such as finger-pointing, invading personal space or making implied threats.
• Repeated hostile comments that create a toxic or intimidating atmosphere.

3. Persistent and Unreasonable Complaints Behaviour

We recognise a patient’s right to raise a complaint and to seek resolution via the formal complaints process. However, the following is considered unacceptable:

 

• Refusing to accept a final response to a complaint and refusing escalation options clearly outlined in the complaints policy.
• Repeatedly reopening resolved issues without new evidence.
• Making ongoing complaints about unrelated or marginally related matters in a manner that is persistent, targeted or harassing.
• Using the complaints process to personally target or pressure individual staff.

Such behaviour will be managed in line with this policy and may result in formal warning and behavioural agreements.

4. Response

We will assess each incident individually and respond proportionately considering the following:

• Intent, severity and impact of behaviour.
• Whether the behaviour is a one-off or unreasonably persistent.
• Any contributory factors such as confusion, mental health, communication barriers or distress.

1. Process for Addressing Unacceptable Behaviour
2. Informal discussion (where appropriate) – staff may seek to de-escalate and explain boundaries.
3. Formal Warning Letter & Behavioural Agreement – sent when behaviour is deemed unacceptable. A behavioural agreement may be issued, requiring a signature within 30 days.
4. Monitoring Period (typically up to 12 months) – reoccurrence within this period may result in removal.
5. Immediate removal – in cases of serious harm, threats, violence or intimidation immediate deregistration may occur. Police may be involved.

6. Police Involvement

Where staff or patients feel at risk or an offence has been committed, the police will be contacted immediately. Incidents may also be reported retrospectively for documentation.

7. Removal from Practice List

Removal is a last resort and reserved for serious or persistent breaches. NHS England will be notified and alternative care arrangements facilitated in accordance with NHS regulations. In some cases, other members of a household may also be removed where continuing visits would pose a risk.

8. Record Keeping

All incidents, warnings, agreements and decisions will be documented. This ensures transparency, fairness and reference for any future escalation.

9. Ongoing Commitment

We remain committed to respectful, open communication with all patients and will take a pragmatic, fair and person-centred approach to resolving any issues before escalation wherever possible.