Zero Tolerance


Section 1


Eccleshill Village Surgery has a duty to provide a safe and secure environment for patients, staff and visitors. Violent or abusive behaviour will not be tolerated and decisive action will be taken to protect staff, patients or visitors

Those patients who, in the expert judgement of the relevant clinician, are not competent to take responsibility for their actions will not be subject to this procedure.

The use of the policy will only apply to violent/ abusive patients and visitors who are aged 18 years and over.

All staff have a duty in the implementation of the policy.


There has been an increase in recent years in the level of violence, abuse and threats faced by staff, and sometimes visitors and patients, within the NHS. There is widespread recognition among staff and management of an outstanding need to tackle such behaviour effectively and a belief that fear of violence can seriously effect morale. The practice has a statutory duty to provide a safe and secure environment for its staff and others, as well as a moral duty to take reasonable steps to protect and support staff.


This policy is designed as an important step in improving the Practices’ ability to tackle incidents involving violence and abuse. This policy details the behaviours that are unacceptable, and (where deemed necessary) the sanctions available for management of such behaviour. In extreme or persistent cases of unacceptable behaviour, could mean a patient being excluded from the practice.

This policy has been introduced in the context of the government’s Zero Tolerance initiative against violence in the NHS.

Section 2


The following are examples of behaviours that are not acceptable on the practice premises, or during visits to patients’ homes:

  • Excessive noise e.g. loud or intrusive conversation or shouting

  • Threatening or abusive language involving excessive swearing or offensive remarks

  • Racial or sexual remarks

  • Malicious allegations relating to members of staff, others visitors or patients

  • Abusing alcohol or drugs whilst on Practice premises, (however all medically identified substance misuse will be treated appropriately).

  • Drug dealing

  • Wilful damage to practice premises, equipment etc

  • Theft

  • Violence

  • Threats of violence and/or threatening behaviour

It should be noted that violence can be either physical or non physical as outline below:


  • Assault causing death
  • Assault causing serious injury
  • Verbal Abuse
  • Racial or Sexual Abuse
  • Minor Injuries Threats
  • Kicking Physical Posturing
  • Biting Threatening Gestures
  • Punching Abusive telephone calls
  • Scratching Threatening use of dogs
  • Use of weapons/missiles Harassment in all forms
  • Spitting Swearing
  • Sexual Assault Shouting
  • Name Calling
  • Bullying
  • Insults
  • Innuendo
  • Malicious Allegations

Section 3

The following are sanctions that are available to be taken against visitors or patients who display the behaviours detailed in section 2

Adult Patients

  • Following any incident the Manager/Clinician will explain to patient (either verbal or by letter) that his/her behaviour is unacceptable and explain the expected standards of behaviour that must be observed in the future.

  • If the behaviour continues, the Manager/Clinician will give a warning (either verbal or by letter), which includes the possible consequences of further repetition

  • Failure to subsequently assist will result in the patient being removed from practice list. The practice may request that the patient be placed on North Bradford Primary Care Trust “Procedure of Care of Individuals who are Violent and Abusive”. (Further details available upon request)

  • Staff faced with violence, abuse or threats are instructed to contact Police


Visitors who display any of the above behaviours will be asked to desist and offered the opportunity to explain their actions

Continued failure to comply with the required standard will result in the Manager or Clinician being contacted, and or the police being called, and removal of the offending individual form practice premises.

Any individual behaving in an unlawful manner will be reported to the police,

The practice reserve the right to continue to exclude any individual removed from practice premises.

Local Services, Let
Local Services, Let