GPs have been encouraged to identify abusive or violent patients who may benefit from a rehabilitation programme.
NHS England has launched a new programme aiming to reduce violence against staff working in general practice, which is being piloted over the next three to six months and will be free to participate in.
In a letter shared by Leeds LMC and seen by Pulse, NHS England said the pilot programme aims to reduce violence against staff ‘by approaching this from a patient perspective’ and ‘offering them rehabilitation (or a safe reflective space)’ to consider how their behaviour is affecting staff and how they can ‘better manage their emotions in situations that they find distressing’.
Pulse understands that so far about 10 ICBs have signed up to the pilot.
GP practices were encouraged to refer patients who have either received a warning letter about their behaviour, or who have already been removed from a practice’s patient list and are in the Special Allocation Scheme.
The letter added: ‘This sits in-line with the contractual aspects in primary care, where patients placed on the Special Allocation Scheme (SAS) must be offered a form of rehabilitation to support them in changing their behaviour.
‘We have partnered with an experienced rehabilitation provider who will be delivering the programme via MS Teams over two half days.
‘Our provider, Intuitive Thinking Skills, has substantial experience of delivering similar programmes in the prison sector and the NHS and many of their trainers have lived experience of completing similar programmes themselves.’
At the end of the programme, patients will attain a National Open College Network (NOCN) Level 1 in Behaviour Management (Aggression), the letter said.
Leeds LMC assistant medical director Dr Richard Vautrey, a GP and PCN lead in Leeds, told Pulse that practice staff, particularly those taking calls or in reception, are ‘regularly subjected to abuse from patients’.
He said: ‘This unacceptable behaviour has a serious impact on the mental and physical wellbeing of our staff and has been the subject of a recent campaign supported by West Yorkshire ICB to highlight how it can also impact the service as a whole.
‘There is a need to do more and we hope this NHS England pilot will help but it will need to be fully evaluated not just from a patient perspective but most importantly listening to the general practice workforce who have experienced these unacceptable abusive situations.’
An NHS England spokesperson told Pulse: ‘Over the last few years, staff working in primary care have shared that they are experiencing higher levels of abusive behaviour and this pilot aims to test a new way to reduce that as well as helping patients with their wellbeing.’
Researchers have called for urgent measures to mitigate the harm to staff as they found aggression towards GP receptionists is a ‘frequent and routine’ occurrence in general practice.
A Pulse investigation published in June showed a 16% rise in crimes involving violence at GP surgeries since 2019, after a drop in incidents during the pandemic.
Crimes involving public order offences and harassment went up by 15% and 61% respectively, while those associated with race or religion, such as assault or inciting fear increased by 100%.
Sounds good on the surface but what if they refuse to be rehabilitated like our DNAs and poor compliance patients?
This ends as a 20 page referral form rejected as you haven’t recorded the sociopathic patients BMI.
I would very much prefer to refer them to the police, and then see the court handing them a fine. That would stop the abuse problem pretty quickly.
These same people are not abusive at the supermarket, where the security guard stands at the door.
The reason they are abusive in a surgery is that there are women sitting behind the counter, and no security guard present, and the aggressive patients know they are basically guaranteed to get away with their behaviour.
The “patient perspective” needs to be fear of prosecution and fines, and then they will suddenly remember to behave in a civilised way.
This is fine but there’s something a little “catch 22” about it.
A patient who is truly remorseful and keen to change is already 80% of the way there. No doubt this service helps them go the extra 20%.
But the patients who are most abusive are least likely to be remorseful and least keen to change. After all, that’s what makes them the most abusive patients. They won’t be interested in this.