Interestingly, the Criminal Justice and Immigration Act 2008


created an offence and power to remove from certain NHS premises those creating a nuisance. The legislation does not cover GP premises but rather hospital and other facilities operated by an NHS Trust or Foundation Trust. Options that GPs do have include removing an individual from the practice list if certain criteria are met. There is a careful process to follow but violent or threatening behaviour can be grounds to justify removal of a patient from the list. Practices should have a policy on dealing with difficult behaviour, such as escalating correspondence and setting out how decisions will be taken, including clinical input. These steps often act as a pre-cursor to removing a patient and help establish a clear and reasonable process for the practice to follow. In cases of harassment or violence, the police have a range of


powers that can be used and there are various criminal offences. Liaising with MDDUS and police would be the first recommendation. In certain circumstances, a practice might consider taking action itself. The Protection from Harassment Act 1997, which creates a criminal offence of harassment, also gives a civil court the power to issue an injunction (a court order) preventing someone from carrying out acts of harassment against other specified individuals. The threshold for acts that constitute harassment is relatively high and to obtain an injunction it is necessary to show a course of conduct causing alarm or distress. In 2012, that Act was updated to include specific offences and remedies in relation to stalking. Whilst seeking an injunction from the court comes as something of a last resort, Capsticks have successfully obtained them: for example in regard to the release from a psychiatric unit of a patient known to be fixated on a former healthcare professional still living in the area.


WHAT TO TAKE AWAY Here are some key tips to consider for protecting practice staff and complying with legal obligations: • Have the environment and staff procedures been risk assessed and identified actions completed?


• Can the physical environment be adapted to be safer? •


• Make sure staff are trained in how to respond. •


Are appropriate equipment and safeguards in place?


• Keep a record of any incidents that take place, and consider ‘debriefing’ staff.


• Where appropriate, report incidents to the police. •


Seek further advice if necessary.


Daniel Kirk is an associate in the litigation division and member of the dedicated GP team at Capsticks Solicitors LLP


WWW.MDDUS.COM 09


Ensure policies are up-to-date (dealing with violent patients, lone working etc).


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