1. Policy Statement

Ashgrove Medical Group upholds a zero-tolerance stance against violence, abuse, aggression, or harassment directed at staff, patients, visitors, or anyone on our premises. Such behaviour compromises safety, well-being, and the quality of care. We are committed to fostering a safe environment and will take decisive action to address incidents, including immediate removal of perpetrators from our patient list and/or escalation to authorities.

2. Definitions

  • Violence/Abuse:

    • Physical: Assault, intentional damage to property, or threatening gestures.

    • Verbal: Insults, racist/sexist/homophobic remarks, swearing, or coercive language causing fear.

    • Non-Verbal: Intimidating body language, stalking, or written/digital harassment (e.g., abusive emails/social media).

  • Aggression: Hostile behaviour that creates risk, even if no direct threat is made.

3. Scope

Applies to:

  • All staff (clinical/non-clinical), patients, contractors, visitors, and third parties.

  • Incidents occurring on practice premises, during home visits, or via digital platforms (e.g., social media, telehealth, emails).

4. Responsibilities

  • Staff: Report incidents promptly, support colleagues, and follow de-escalation training.

  • Practice Manager: Investigate incidents, coordinate removals, liaise with authorities, and ensure support for victims.

  • Patients/Visitors: Treat all individuals with respect; adhere to posted behaviour guidelines.

5. Incident Reporting & Response

  1. Immediate Action:

    • Ensure safety: Move to a secure area, call emergency services if needed.

    • Use panic alarms/CCTV where available.

  2. Documentation:

    • Complete an Incident Report Form within 24 hours, detailing:

      • Date/time/location.

      • Parties involved.

      • Description of behaviour.

      • Witness accounts.

    • Upload to the patient’s medical record (if applicable) and secure incident log.

  3. Escalation:

    • Practice Manager reviews within 48 hours.

    • For severe cases, notify NHS Wales and the police.

6. Removal of Patients

  • Grounds for Immediate Removal:

    • Physical assault, threats causing fear, persistent abuse, or damage to property.

  • Process:

    1. Decision ratified by the Practice Manager and senior clinician.

    2. Written notification sent via tracked post within 2 working days, stating:

      • Reason for removal.

      • Effective date.

      • Instructions to register elsewhere (care continues for 14 days for urgent needs).

    3. Notify NHS Wales and update medical records with factual details.

  • Exceptions: Vulnerable patients (e.g., mental health conditions) may require a risk assessment and liaison with local safeguarding teams prior to removal.

7. Support for Victims

  • Immediate Support: Access to first aid, counselling, and paid leave if needed.

  • Legal Assistance: Support with police statements or restraining orders.

  • Confidentiality: Protect victim identities during investigations.

8. Preventive Measures

  • Staff Training: Annual workshops on de-escalation, conflict resolution, and recognising aggression.

  • Security: Panic alarms, CCTV, and secure staff-only areas.

  • Patient Communication:

    • Clear signage outlining expected behaviour.

    • Behaviour clause included in registration documents.

    • Regular reminders via newsletters/website.

9. Appeals Process

  • Patients may contest removal in writing within 14 days. A panel (Practice Manager, clinician, and external NHS Wales representative) will review the case.

10. Monitoring & Review

  • Quarterly reviews of incidents to identify trends and improve safety measures.

  • Policy updated biennially or in response to NHS Wales guideline changes.

Zero Tolerance Is Non-Negotiable
Ashgrove Medical Group prioritises the safety of its community. Violence or abuse will result in swift consequences, including legal action. For further guidance, refer to the NHS Social Media Policy and NHS Wales’s Zero Tolerance Guidance.