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GP practice successfully defends discrimination case brought by abusive patient

GP practice successfully defends discrimination case brought by abusive patient

A GP practice has successfully defended a legal case brought by a patient claiming their list removal for abusive behaviour amounted to discrimination.

Medical defence organisation the Medical Defence Union (MDU), which represented the practice in court, said the judgement should give confidence to practices dealing with abusive or violent patients.

The claim arose from a 2018 incident in which the patient became ‘abusive and threatening’ after asking for an amendment to be made to a repeat prescription.

The patient had demanded an amended prescription ‘immediately’, becoming ‘angry and aggressive’ and threatening staff and the GP registrar who had seen him.

The police were called to the incident and a decision was taken by the practice to remove the patient from the list because of the level of aggression involved.

The patient’s claim alleged the surgery treated him ‘unfavourably’ because of his underlying condition and that they ‘failed to make reasonable adjustments’.

The MDU, who supported the practice in defending the initial claim, brought under the Equality Act 2010, and two later appeals, defended the case on the basis the practice did not discriminate, treating the claimant ‘exactly as they would treat any other person acting as he had done’ and given their need to protect staff.

The defence team argued that removing the claimant from the practice list was ‘proportionate and reasonable’, given the intimidating behaviour exhibited.

The GP, practice manager and reception manager gave evidence in court and described how they had felt ‘intimidated and threatened’.

Both the GP and reception manager described ‘physically shaking’ as a result of the incident and the reception manager considered leaving the job.

The practice manager explained in court that seeing the distress caused to staff by the degree of aggression exhibited by the patient, the decision was taken to remove the patient from the list and that this was only the second time the practice manager had taken this action during a 28-year career.

Dismissing the claim in court, the judge found that the patient had behaved in an ‘aggressive and intimidating’ way and that ‘others felt threatened by him’.

In the judgement, the judge said: ‘It seems to me that it is legitimate and necessary to protect frontline staff from abuse especially where it reaches the level of putting them in fear.’

The patient later appealed to the Court of Appeal and Supreme Court but these cases were dismissed.

Dr Claire Wratten, senior medical claims handler at MDU, said: ‘This is an important judgement for GP practices and should give them confidence in following their zero tolerance approach to dealing with violent, abusive and threatening behaviour.

‘While not common, the MDU is seeing more claims involving allegations of discrimination on the grounds of disability against members.

‘During the court hearing, it was distressing to hear both the GP and the reception manager describe in their evidence how they felt intimidated, threatened and were shaking as a result of the exchange.

‘Sadly, this type of incident is increasingly common with eight in 10 GP members responding to an MDU survey reporting increasing levels of abuse from patients and their representatives.’

 Last month, GPs were 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.

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.



Please note, only GPs are permitted to add comments to articles

Cameron Wilson 12 September, 2023 11:52 am

Hopefully the guilty party also received a hefty legal bill for their troubles! Can just imagine the amount of worry and time the Practice had to endure dealing with this nonsense!

Decorum Est 12 September, 2023 12:42 pm

An account of the actual incident would be useful.

Bonglim Bong 12 September, 2023 1:07 pm

As per Cameron, I think it is essential that in cases where patients go to court – if the case is defended that:
– full costs are recovered from the complainant
– that outcome is published widely.

There is a real risk of increasing litigation culture. And this is boosted by the tendency for MDOs to settle out of court. I fully understand the reasons for settling (and I would normally prefer that than spending the time and energy contesting decisions) but a regular drip feed of costs to the media would also be useful.

For example an article in the newspapers which says:
patient x made homeless / declared bankrupt after being hit with £300k costs for wrongly claiming discrimination from his GP might make someone who was planning to do the same think twice.

David jenkins 13 September, 2023 1:49 pm

the metropolitan police used to have a policy to pay out on all claims below £5000, on the grounds it was cheaper to pay than to fight.

some years ago they changed this – and fought every single thing.

claims below £5000 dropped by 90 %.

fancy that !!!