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Practice staff put at risk after two-week delay in removing violent patient

Exclusive Practice staff have been put at risk after a breakdown in primary care support procedures delayed the removal of a violent patient who had assaulted a GP from the practice list for two weeks.

Pulse understands that a practice was made to wait following the assault because of confusion over the processes, which are now managed by Capita, who provide primary care support services.

The practice reported the assault to the police and to NHS England immediately.

But Capita – which now manages the service – demanded more information ‘beyond what they are entitled to’, Cambridgeshire LMC told Pulse.

Since April, practices have been required to inform Capita – and not their local area team – whenever they wish to remove a patient.

Cambridgeshire and Peterborough LMC said Capita had failed ‘to protect GPs and their staff from violence by flouting the regulations, and thereby putting NHSE in breach of contract’.

Pulse understands there was a further delay because it is still NHS England’s responsibility to approve the request for removal, but this was not done so for two weeks.

NHS England’s regulations on violent patients allow for the removal of a patient to be fast-tracked and NHS England has said it take delays in this process ‘very seriously’.

LMC chief executive Dr Guy Watkins told Pulse: ‘We have a practice that had an incident with a doctor assaulted; they informed the police and then requested an immediate removal under the regulations.’

He added: ‘Capita refused to recognise the removal until further information, outside the regulations, were provided by the practice.’

Dr Watkins added that the information requested was more than Capita was ‘entitled to under the regulations’.

Pulse has learnt that even after this information was provided, there was a two-week delay before the patient was removed.

NHS England’s Policy for managing patient assignments, states: ‘Practices may remove a patient with immediate effect where the patient has committed an act of violence or behaved in such a way that the contractor, practice staff, other patients, or those present at the place the services were provided have feared for their safety.

‘The incident leading to the request for immediate removal must have been reported to the police.’

A Capita spokesperson told Pulse: ‘Clear processes for these requests have been established and communicated to GP practices. We have been working very closely with NHS England to ensure that their procedures are adhered to in a timely manner.’

Simon Evans, locality director for NHS England (East) said: “NHS England takes matters such as this very seriously. We are currently looking into this specific issue to determine what happened and take any appropriate actions if required’.

Pulse has tracked the rise of violence perpetrated against GPs, staff or patients in practices with a 2012/13 investigation finding 53 incidents reported, a jump of 89% in a year.

An MPS survey last year found almost half of GPs have experience violence or aggression from a patient in the past 5 years.

The problems with primary care support services

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Money pic – online

NHS England opted to save £40 million a year from its support services budget and tendered for a single national provider for Primary Care Support England (PCSE).

The winner, Capita, has centralised support services to three national hubs and implemented a single online ‘portal’ for practices to order supplies and ‘track’ the movement of patient records.

Pulse has documented issues, from FP10 shortages, to patient notes turning up in a carpark, that have spiked since April’s overhaul and GP leaders have been urging practices to report every issue to NHS England.

The timetable by Primary Care Support England – the arm of Capita that manages the services – shows that new services for payments, screenings and performers list will be implemented from April 2017.

But the GPC has passed a motion of no confidence in Capita for its primary care support services following a series of failures, which it claims are putting patients at risk. 

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