Section 5Complaints
Removal of a violent patient leads
to a complaint
A GP member of an MDU group scheme practice With regard to the complaints process, a conciliation
contacted the MDU advice line seeking assistance meeting with the patient’s sister subsequently took
in dealing with a complaint. place. However the complainant remained dissatisfied
The complainant was the sister of a patient, a
and requested an independent review from the
middle-aged man with learning difficulties who
Healthcare Commission which was, at that time,
exhibited challenging behaviour. For example he would
responsible for reviewing unresolved complaints.
often not allow medical examinations to be carried out. The Commission determined that the sister’s complaint
The GP member explained that a request for a home visit
on behalf of her brother be upheld. It felt the practice
had been made because this patient had suffered an
could have done more to resolve the sister’s concerns.
episode of rectal bleeding. When the GP visited, the
Recommendations were made to the practice to
patient and his elderly father were present. The patient
address the concerns raised.
did not seem to want to be examined and wandered The practice again contacted the MDU following the
about the house while the GP spoke with his father. Healthcare Commission’s decision. While the practice was
However the patient then approached the member happy to follow the recommendations, it felt that some
acting aggressively before grabbing hold of the member of the recommendations had already been put in place,
and hitting him repeatedly. Fortunately, the GP was able and the Commission had been informed of these.
to get away from the patient and leave the house.
The MDU adviser explained that it was possible to
On returning to the practice the GP informed his partners approach the Healthcare Commission to ask it to
of what had happened and a decision was taken to reconsider the report and offered to contact the
remove the patient from the practice list. But the Commission on the practice’s behalf.
patient’s sister complained about this, alleging that the
GP had provoked her brother and had not in fact been
With the help and support of the MDU the practice
assaulted. The practice was mindful that ordinarily
wrote to the Healthcare Commission. The practice
patient consent would be required before a response
stressed that it disagreed with the decision to uphold the
could be provided to a complaint from a patient’s
complaint. It explained that the recommendations made
relative but in this case considered that the patient
by the Commission had largely been implemented, and
lacked capacity to provide it. It sought MDU advice on
that the Commission should have been aware of this
how best to respond.
from earlier correspondence.
Some three months after the practice had approached
the Commission, the Commission responded indicating
MDU advice
that the decision had been reconsidered. During the
review, the original complaint file and the additional
The practice drafted a thorough and detailed response
documentation provided were reviewed by the
for the MDU to review. It explained that during the visit
Commission and advice was taken from an independent
the GP had been struck several times and had left the
adviser.
house in a very distressed state. The review concluded that the original decision made by
It was also explained that the decision to remove the
the Healthcare Commission case manager had been
patient was taken by all the partners under their policy
wrong and the complaint should not have been upheld.
on violence towards staff. The partners did not believe
It also found that the recommendations were
the patient had struck the GP through malice or
inappropriate and unnecessary.
premeditation and accepted that it was likely to be It found that the practice had responded to the complaint
related to his learning difficulties. However, it explained appropriately, had followed correct procedure in
the practice had reflected carefully on these events and removing the patient, and that full explanations were
with regret maintained its position that the patient given about the work being completed at the time and
should be removed from the practice list. work planned for the future. This was not taken into
The practice was aware that allowances needed to be
account when the original case manager reached his
made for patients with disabilities, and explained that its
decision.
policies, where possible, catered for such needs. Indeed The practice was satisfied with the outcome of the
this attack had been treated as a significant event and Healthcare Commission review.
analysed and reflected upon. As a result of the analysis,
the practice said it intended to produce a written
protocol for treating patients with learning difficulties
within the next six months. The practice also planned to
invite a local expert in offering medical services to “…the decision to remove the
patients with disabilities to discuss the practice processes
in general and staff training in particular. The practice
patient was taken by all the
believed that further recommendations would emerge
partners under their policy on
from this initiative.
violence towards staff…”
30
Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74