This accessibility statement applies to the website and/or domain associated with Richmond Hill Practice Ltd. Our website is hosted by Dene Healthcare and we work in conjunction with our host to enable as many people as possible to use our website. This means that users should be able to:

• Change colours, contrast levels and fonts
• Zoom in, by up to 300%, without the text splitting off the screen
• Navigate most of the website using only the keyboard
• Navigate most of the website using speech-recognition software
• Listen to most of the website using a screen reader (including but not limited to JAWS, NVDA and VoiceOver)

In addition, we have made our website text as simple as possible to understand. If you need any further advice on making your device easier to use, particularly if you have a disability, click on the following link: AbilityNet

The accessibility of our website

We are aware that some parts of our website are not fully accessible and unfortunately this cannot be rectified. The issues in some areas are:

• The text will not reflow in a single column if you change the size of the browser window
• Users are unable to modify the line height or the spacing of text
• Older versions of PDF documents are not fully accessible to screen-reader software
• Live video streams do not have captions
• Some (not all) online forms may prove difficult to navigate when using only a keyboard
• The main content page cannot be skipped when using a screen reader
• There are magnification limitations on the map (on the ‘contact us’ page)

Feedback and how to contact us

If you need information that is shown on our website in a different format, such as large print, easy read, audio recording, Braille or as a PDF, you can contact us by:

• Email admin.p81025@nhs.net
• Phone 01282 911401

Once we receive your request, we will respond to you as quickly as possible. Please note that if you are unable to view the map on the ‘contact us’ page, you are requested to call or email us using the details shown above for directions.

Reporting accessibility problems with this website

We are constantly looking to improve the accessibility of our website. Should you find any problems not listed on this page, or think we are not meeting the accessibility requirements, please contact the IT Manager, Joanna Saunders on 01282 911401.

Enforcement procedure

The Equality and Human Rights Commission (EHRC) is responsible for enforcing The Public Sector Bodies (Websites and Mobile Applications) (No. 2) Accessibility Regulations 2018 (the ‘accessibility regulations’). If you are not happy with the way in which we respond to any complaint, contact the Equality Advisory and Support Service (EASS).

Contacting us by phone or visiting us in person

Find out how to contact us on the ‘contact us’ page via Contact us. Please be advised that we provide a text relay service for people who are D/deaf, hearing impaired or have a speech impediment. Our reception and consulting rooms have audio induction loops or, if you contact us prior to your appointment, we can arrange to have a British Sign Language (BSL) interpreter.

Technical information about this website’s accessibility

Richmond Hill Practice Ltd is committed to making its website accessible, in accordance with The Public Sector Bodies (Websites and Mobile Applications) (No.2) Accessibility Regulations 2018.

Compliance status

We are committed to making our website accessible, in accordance with The Public Sector Bodies (Websites and Mobile Applications) (No. 2) Accessibility Regulations 2018.

We are working towards making our website fully compliant with the Web Content Accessibility Guidelines version 2.1 AA standard.

If you have a complaint or any concerns about the service you have received from the Doctors or any staff working for Richmond Hill Practice Ltd, please let us know. We operate a practice complaints procedure as part of the NHS system for dealing with complaints.

• Complaints Procedure Patient Information
• Complaints form

Complaining on Behalf of Someone Else

Please note that we keep strictly to the rules of medical confidentiality. If you are complaining on behalf of someone else, we have to know that you have his or her permission to do so. A note signed by the person concerned will be needed, unless they are incapable (because of physical or mental illness) of providing this.

Freedom Of Information Policy

Introduction

The following policy sets out a possible approach to the Freedom of Information (FoI) Act by a practice.

Policy

• The Practice will comply with the FoI Act and sees it as an opportunity to enhance public trust and confidence in the Practice
• The Practice will maintain a comprehensive ‘Publication Scheme’ that provides information which is readily accessible without the need for a formal FoI Act request.
• The Practice will seek to satisfy all FoI Act requests promptly and within 20 working days. However, if necessary we will extend this timescale to give full consideration to a Public Interest test. If we do not expect to meet the deadline, we will inform the requester as soon as possible of the reasons for the delay and when we expect to have made a decision
• The Practice will continue to protect the personal data entrusted to us, by disclosing it only in accordance with the Data Protection Act 1998
• The Practice will provide advice and assistance to requesters to facilitate their use of FoI Act. We will publish our procedures and assist requesters to clarify their requests so that they can obtain the information that they require.
• The Practice will work with the current CCG or other bodies with whom we work to ensure that we can meet our FoI Act obligations, including the disclosure of any information that they hold on our behalf.
• The Practice will apply the exemptions provided in the FoI Act and, where qualified exemptions exist, the Practice will disclose the information unless the balance of public interest lies in withholding it.
• The Practice will consult with third parties before disclosing information that could affect their rights and interests. However, according to the FoI Act, the Practice must take the final decision on disclosure
• The Practice will charge for information requests in line with the FoI Act Fees Regulations or other applicable regulations, including the Data Protection Act 1998
• The Practice will record all FoI Act requests and our responses and will monitor our performance in handling requests and complaints
• The Practice will ensure that all staff are aware of their obligations under FoI Act and will include FoI Act education in the induction of all new staff

Introduction

1. 1. Policy statement

All staff should feel comfortable to raise concerns and be confident these will be acted on appropriately. Therefore, it is important to Richmond Hill Practice that any fraud, misconduct or wrongdoing conducted by employees, partners or others who work in the organisation are reported and properly dealt with. This organisation encourages all individuals to raise any concerns that they may have about the conduct of others within the organisation or the way in which the organisation is run.

Freedom to speak up, or whistleblowing, can only be disclosed should it be in the public’s interest, that is, that any claim must affect others and not have been made only in the claimant’s own self-interest. Whistleblowing itself is a protected category and, as such, any claimant will be protected under the Public Interest Disclosure Act 1998 that protects the whistleblower from unfair treatment following any disclosure.

Freedom to speak up is about encouraging a positive culture where people feel they can speak up, their voices will be heard, and their concerns and suggestions acted on with no retribution. This policy sets out the way in which individuals may raise any concerns that they have and how those concerns will be dealt with in conjunction with the Freedom to Speak Up Policy for the NHS.

Further reading can be found in the CQC’s GP Mythbuster No 87: Freedom to speak up and their Guidance for Providers.

All NHS organisations and others providing NHS healthcare services in primary care in England are required to adopt the national Freedom to Speak Up policy as a minimum standard to help to normalise speaking up for the benefit of patients and workers. Its aim is to ensure all matters are captured and considered appropriately.

2. 2. Status

The organisation aims to design and implement policies and procedures that meet the diverse needs of our service and workforce, ensuring that none are placed at a disadvantage over others, in accordance with the Equality Act 2010. Consideration has been given to the impact this policy might have regarding the individual protected characteristics of those to whom it applies.

This document and any procedures contained within it are non-contractual and may be modified or withdrawn at any time. For the avoidance of doubt, it does not form part of your contract of employment. Furthermore, this document applies to all

employees of the organisation and other individuals performing functions in relation to the practice such as agency workers, locums and contractors.

Considerations

3. 3. Requirements

All workers are to be reminded that if they are aware of something that they feel is not right, they should not wait for further evidence or proof, as it is appropriate that they raise the matter while it is still a concern. It does not matter if they turn out to be mistaken, especially if they are genuinely troubled. Any matter raised under this procedure will be investigated thoroughly, promptly and confidentially and, in most circumstances, the outcome of the investigation will be reported back to the person who raised the issue.

Any member of the organisation who makes a protected disclosure or ‘blows the whistle’ has protected rights, meaning that they have the right not to be dismissed, subjected to any other detriment or victimised because they have made a disclosure. This means that continued employment and opportunities for future promotion or training will not be prejudiced because a legitimate concern has been raised. The victimisation of any member of the organisation for raising a qualified disclosure will be a disciplinary offence.

If misconduct is discovered as a result of any investigation conducted under this procedure, the disciplinary procedure will be used in addition to any appropriate external measures and as detailed within the Disciplinary Policy and Procedure.

Maliciously making a false allegation is a disciplinary offence. An instruction to cover up wrongdoing is itself a disciplinary offence. If told not to raise or pursue any concern, even by a person in authority such as a manager, workers should not agree to remain silent.

2. 2. Speaking up

1. 1. About

The Freedom to Speak Up Review conducted by Sir Robert Francis highlighted the importance of speaking up in the NHS and ensuring support is in place for individuals to speak up safely and raise concerns in their place of work without fear of reprisals.

The review recognised that several workers lost valuable skills or even left their employment after raising a concern. This not only caused a significant adverse impact on individuals but also a loss of expertise and resource to the NHS. Freedom to speak up is about encouraging a positive culture where people feel they can speak up, their voices will be heard, and their concerns and suggestions acted on with no retribution.

This organisation recognises there are times when speaking up issues are overly complex and do not always bring the resolution desired. From experience, it is recognised that these issues can impact on workers and organisations.

All organisations that provide NHS services are encouraged to ensure:

• • The Partners, Practice Manager and Freedom to Speak Up Guardian (FSUG) are all aware of the national Speaking Up Support Scheme offer

• • Their policies and processes reflect the principles in the guide for leaders in the NHS and organisations delivering NHS services

• • Workers have easy access to information on how to speak up and the Speaking Up Support Scheme as detailed at Chapter 5 and actively refer individuals to the scheme

• • They are mindful of those workers who may have cultural barriers to speaking up or who are in lower paid roles and less confident to do so, and those who work unsociable hours and may not always be aware of or have access to the policy or processes supporting speaking up

• • They communicate with all their workers by identifying the best channels to do so

• • They reflect on any learning to build healthy cultures in which everyone feels safe to speak up

Further reading on ‘what will happen when I speak up’ can be found at Appendix A of the Freedom to Speak Up Policy for the NHS.

2. 2. Freedom to Speak Up Guardian

While the CQCs GP Mythbuster 87 states that it is not compulsory in primary care, there is an expectation that a FSUG will be nominated.

The CQC advises that this can be achieved by working with other local practices or with other stakeholders, PCNs or ICBs. The FSUG is to be independent of both line management chain and/or the partnership.

At this organisation, the FSUG is Dr Lisa Brooke, and they will:

• • Understand and promote the organisation’s speaking-up culture to enable speaking-up processes and strategies to work well

• • Work in partnership with senior leadership but maintain their ability to challenge poor practice and act when quality of services and worker experience do not meet the expected standards

• • Respond to members of staff who want to speak up and manage each case

• • Examine and address any barriers to speaking up

• • Ensure there is appropriate training on how to speak up

• • Produce regular reports for the senior team or board, when needed

The FSUG will need to undertake the National Guardian’s Office’s (NGO) programme of training on appointment and throughout their tenure. The NGO leads, trains and supports a network of FSUGs in England and conducts speaking up reviews to identify learning and to support the improvement of the speaking up culture of the healthcare sector.

The NGO provides learning and resources on its website, including the provision of a job description for this role. Training will include the five elements to managing the freedom to speak up process, which include:

• • Recognising something is wrong

• • Speaking up

• • Thanking the person who raises the concern

• • Undertaking the necessary actions to remedy

• • Providing support to the member of staff throughout the process

It should be noted that while the CQC advises that there are no specific regulations governing any practice’s freedom to speak up arrangements, should a practice not be able to provide evidence when asked, the practice may risk breaching the following overarching regulations:

• • Regulation 12 (Safe care and treatment) 

• • Regulation 13 (Safeguarding service users from abuse and improper treatment and improper treatment)

• • Regulation 16 (Receiving and acting on complaints) 

• • Regulation 17 (Good Governance) 

• • Regulation 20 (Duty of Candour)

Further details in relation to regulatory requirements can be sought within the GP Mythbuster 87: Freedom to speak up.

3. 3. What is a qualifying disclosure?

Qualifying disclosures (also known as protected disclosures) are legitimate concerns that any member of the organisation raises about specific matters, and which are reasonably believed to be in the public interest (this means it affects others, for example the general public and is not a personal grievance).

These are covered under the Public Interest Disclosure Act 1998.

A qualifying disclosure is one made in the public interest by any member of the organisation who has a reasonable belief that any of the following is being, has been, or is likely to be, committed:

• • A criminal offence

• • A miscarriage of justice

• • An act creating risk to health and safety

• • An act causing damage to the environment

• • A breach of any other legal obligation

• • Concealment of any of the above

Further reading on making a protected disclosure can be found at Appendix B of the Freedom to Speak Up Policy for the NHS.

4. 4. Who can speak up

Any worker in NHS healthcare may become a whistleblower and they can speak up to report certain types of wrongdoing, usually something they have seen at work. This can be in person, by phone or in writing (including email).

Workers should speak up about anything that affects patient care or their working life. This may be something which does not feel right, e.g., a way of working or a process that is not being followed, when the worker feels they are being discriminated against or if they feel the behaviour of others is affecting their wellbeing or that of their colleagues or patients.

This may include:

• • Unsafe patient care

• • Unsafe working conditions

• • Inadequate induction or training for staff

• • Lack of, or poor response to, a reported patient safety incident

• • Suspicions of fraud, financial irregularity, dishonesty

• • A bullying culture (across a team or the organisation rather than individual instances of bullying)

• • Malpractice, corruption, bribery

• • Unethical conduct

• • Medical or prescribing errors

Speaking up captures a range of issues, some of which may be appropriate for other existing processes (HR, patient safety or quality). The organisation will listen and work with the employee to identify the most appropriate way of responding to the issue raised. The most important aspect of speaking up is the information provided, not the identity of the person providing it.

Individuals have a choice about how they speak up:

• • Openly

They are happy that the person they will speak up to will know their identity and that they can share this with anyone else involved in responding

• • Confidentially

They are happy to reveal their identity to the person they choose to speak up to on the condition that they will not share this without their consent

• • Anonymously

They do not want to reveal their identity to anyone. This can make it difficult for others to ask for further information about the matter and may make it more complicated to act to resolve the issue. It also means that the worker might not be able to access any extra support they may need or receive any feedback on the outcome

In all circumstances, workers should be ready to explain as fully as they can the information and circumstances that prompted them to speak up.

3. 3. Reporting a concern

1. 1. Initial concerns

If any member of the organisation is unsure whether to raise a concern, in the first instance they should discuss the issue with their line manager, the Organisation Manager, the FSUG or one of the organisations listed in Section 4.5.

The procedure below should be followed when reporting a whistleblowing concern:

2. 2. Stage 1: Notification

Unless the reporter reasonably believes the Organisation Manager to be involved in the wrongdoing, any concerns should be raised with the Organisation Manager. If they believe the Organisation Manager to be involved, or for any reason they do not wish to approach them, then they should proceed directly to Stage 3.

The matter for review may be best considered under a specific existing policy/process, e.g., the organisational process for dealing with bullying and harassment. If so, this will be discussed with the reporter. If the issue does not fall into a HR or patient safety incident process, then the matter will be addressed under this policy.

When the organisation is made aware of a concern, it will be recorded, and the reporter will receive an acknowledgement within two working days. It is important that the organisation takes action to resolve the issue whenever possible. In most cases, it is important that the opportunity is fully explored which may be facilitated by conversations and/or mediation.

3. 3. Stage 2: Resolution and investigation 

When an investigation is needed, this will be objective and conducted by someone who is suitably independent (this may be someone outside the organisation or from a different part of the organisation) and trained in investigations.

The Organisation Manager will undertake appropriate arrangements to investigate the matter or immediately pass the issue to someone in a more senior position.

The investigation will be documented and may entail the reporter, and any other individuals involved providing a written statement. The statement will be considered, and the reporter will be asked to comment on any additional evidence obtained.

The organisation will inform the reporter:

• • How long they expect the investigation will take

• • How they will be kept up to date with progress

4. 4. Stage 3: Conclusion and communicating the outcome 

A conclusion will be reached within a reasonable timescale (which the reporter will be notified of), and a report will be produced that identifies any issues to prevent problems recurring. Any employment issues that have implications for the reporter or their capability or conduct identified during the investigation must be considered separately.

The Organisation Manager will also report to the senior partner who will take any necessary action including reporting the matter to any appropriate government department or regulatory agency.

When possible, the organisation will share the full investigation report with the reporter (while respecting the confidentiality of others and recognising that some matters may be strictly confidential). When the outcome identifies improvements that can be made, the organisation will ensure necessary changes are made and are working effectively. Lessons will be shared with teams across the organisation or more widely as appropriate.

If disciplinary action is required, the Organisation Manager (or the person who conducted the investigation) will report the matter to the Senior Partner who will instigate the disciplinary procedure.

If the worker is concerned that the organisation has failed to make a proper investigation or has failed to report the outcome of the investigation to the Senior Partner, they should contact the FSUG who will arrange to review the investigation that was undertaken, make any necessary enquiries and make his/her own report to the Senior Partner as in Stage 2 above.

5. 5. Reporting outside the organisation

If, on conclusion of Stages 1, 2 and 3, the worker does not reasonably believe that the appropriate action has been taken, or they wish to speak to someone outside the organisation, they can follow:

• • NGO guidance

• • Whistleblowing: list of prescribed people and bodies

4. 4. Support for those who speak up

1. 1. The Speaking Up Support Scheme

The Speaking Up Support Scheme provides a range of support for past and present NHS workers who have experienced a significant adverse impact on both their professional and personal lives to move forward following a formal speaking up process.

Workers must meet the eligibility criteria for the support scheme and any support will be delivered online via online platforms.

5. 5. Reflection and planning

1. 1. Reflection and planning tool

In tandem with the National Guardian, NHS England advocates the completion of a reflection and planning tool at least every two years which is designed to help to identify strengths and any gaps that need to be addressed.

The self-reflection tool is set out in three stages:

Privacy Notice

Why we hold information about you

• To be able to provide you with high quality health care. This information provides a basis for the health decisions we make about you.
• To provide you with Health protection advice and information, for example this may include messages about the Flu vaccination programme, or health checks.
• As a practice we do engage in research. The aim is to make advances in medicine to improve health care in the future. You may be invited to enrol within a research programme. We may use your personal details to contact you about this.

This information can be in paper or online form.

We access and process the data under the lawful basis of ‘legitimate interest’- of providing health care and public health.

In the cases of research we will use your information under the lawful basis of consent.

What information will we hold?

• Basic details including Name, Date of birth, Address and if provided details of Next of kin, family to contact with your consent
• Clinical consultations, these will include, telephone consultations and face to face
• Correspondences about your health/clinic appointments from the hospital and other health care professionals
• Details of investigations and results for example, bloods and x-rays
• Family history if relevant.
• Other data for outside agencies for example, Gun licensing.

Confidential information

1. All information we keep about you is kept safe.
2. Information is shared only with those who are involved in your health care or if we have gained your consent to share elsewhere. You may be contacted directly by the practice to participate in research.
3. Information cannot be shared with your family members unless explicit consent has been given. There are a few exceptions to this for example if the patient does not have capacity or in cases where consent cannot be gained, (in this situation vital interest would be considered).

Sharing Information

We will share the information with people providing you care or involved in research (unless you ask us). Anyone accessing and using your data must keep this confidential.

Any information shared without permission will adhere to the General Data Protection Regulations 2018 (GDPR) and the Data Protection Act 2018.

Yours Rights

• You have a right to Confidentiality
• Right to access yours records; this needs to be in writing and will require photo identification.
• The right to rectification
• The right to erasure. However if this erasure is seen as harmful to the process of providing health care or fraudulent in erasing information important to insurance companies etc. it can be refused.
• The right to restrict processing
• The right to object
• Right to data portability

Website – Terms of Use

Visitors to our website are granted permission to access published materials (content) subject to these terms. By using the website, you agree to be bound by the terms of use.

Whilst content may be accessed, downloaded and used for personal and non-commercial purposes (e.g. private research, study or in-house use); visitors must not reproduce or re-publish any material from this website without permission from the website / copyright owner.

Personal Information

When you voluntarily submit identifiable data on this website (this includes submission of feedback form, questionnaires etc.), the information submitted is used solely to respond to your queries and for its intended purpose. We do not share web user information with third parties.

Virus Protection

We make every effort to check and test material for viruses. However, it is recommended that you run an anti-virus program on all materials downloaded from the internet. We cannot accept responsibility for any loss, disruption or damage to your data or computer system which may occur whilst using material derived from this website.

Disclaimer

Care is taken to ensure that the website content is accurate. Nevertheless, content is provided for general information only, and you use it at your own risk. We will not be held liable for damage or loss ensuing from any act or omission resulting from the use of information on this website.

External Websites

The surgery is not responsible for the content or reliability of any linked websites. We accept no liability in respect of the content or for the consequences of following any advice included on such sites.

Listing should not be taken as an endorsement of any kind.

We cannot guarantee that these links will work all of the time and have no control over the availability of the linked pages or change of website address.

The surgery reserves the right to reject or remove links to any website.

Future Amendments

Subsequent changes to these terms will be made available on this website.

You will be treated with respect.

We will:

• Ensure our patients have 24-hour access to medical advice.
• Aim for you to have access to a suitably qualified medical professional as soon as resources allow, from your initial contact during surgery hours, or in an urgent case, the same day.
• Work in partnership with you to achieve the best medical care possible.
• Involve you and listen to your opinions and views in all aspects of your medical care.
• The prevention of disease, illness and injury is a primary concern.

The medical staff will advise and inform you of the steps you can take to promote good health and a healthy lifestyle.

We would respectfully ask that you:

• Let us know if you intend to cancel an appointment or are running late.
• Treat staff with courtesy and respect. Reception staff may have to ask some personal questions to assist us in providing you with the best service
• Inform the practice staff of any alterations in your circumstances, such as change of surname, address or telephone number. Please ensure that we have your correct telephone number, even if it’s ex-directory.

As patients, you are responsible for your own health and that of any dependents. It is important that you adhere to information and advice given to you by health professionals and co-operate with the practice in endeavouring to keep you healthy.

Zero Tolerance Practice Policy

INTRODUCTION

The Practice takes it very seriously if a member of staff is treated in an abusive or violent way.

The Practice supports the government’s ‘Zero Tolerance’ campaign for Health Service Staff. This states that GPs and their staff have a right to care for others without fear of being attacked or abused. To successfully provide these services a mutual respect between all the staff and patients has to be in place.

Our Practice staff aim to be polite, helpful, and sensitive to all patients’ individual needs and circumstances. They would respectfully remind patients that very often staff could be confronted with a multitude of varying and sometimes difficult tasks and situations, all at the same time. The staff understand that ill patients do not always act in a reasonable manner and will take this into consideration when trying to deal with a misunderstanding or complaint.

However, aggressive behaviour, be it violent or abusive, will not be tolerated and may result in you being removed from the Practice list and, in extreme cases, the Police being contacted.

In order for the practice to maintain good relations with their patients the practice would like to ask all its patients to read and take note of the occasional types of behaviour that would be found unacceptable:

Using bad language or swearing at practice staff
Any physical violence towards any member of the Primary Health Care Team or other patients, such as pushing or shoving
Verbal abuse towards the staff in any form including verbally insulting the staff
Racial abuse and sexual harassment will not be tolerated within this practice
Persistent or unrealistic demands that cause stress to staff will not be accepted. Requests will be met wherever possible and explanations given when they cannot
Causing damage/stealing from the Practice’s premises, staff or patients
Obtaining drugs and/or medical services fraudulently
We ask you to treat your GPs and their staff courteously at all times.

The Legal Position

As a responsible employer, the Practice has a duty as a provider of NHS healthcare to protect the health, safety and welfare of staff under the Health & Safety at Work Act. This includes a risk assessment of violence towards staff and taking steps to mitigate this under the Management of Health and Safety at Work Regulations 1999.

Staff members who are victims of violent conduct or assault have the right to sue their employers for compensation if the risk of violence could have been reduced or removed completely, but the employers did not act upon this information.

Examples of security issues:

Security of grounds and car parking
Security of premises – incl. storage, “out of hours”
CCTV
Cash and staff – storing, handling and transferring
Security Systems
Security of equipment – medical devices, computers
Communication of national security alerts
Information records
Contingency planning.
Security of employees
Staff working on their own
(Staff can be lone workers when making domiciliary visits or within a hospital department e.g. out of hours)
This list is not exhaustive.

For example a lone working risk assessment must provide the lone worker full knowledge of the hazards and risks to which he or she is being exposed and what they must need to do will something go wrong. Other responsible persons must know the whereabouts of lone workers and what they are doing;

Violence at Work

The practice acknowledges that there may be instances where violence and / or aggression forms part of a patient’s illness. In these circumstances, the issue will be discussed with the patient and form part of their care planning.

This information will be recorded in the patient’s medical record and flagged to ensure that members of staff are aware. In addition, where deemed necessary, appropriate support will be put in place, e.g. staff members do not see the patient alone.

Definition of Physical and Verbal Abuse and Violence:
Physical and verbal abuse includes:
Unreasonable and / or offensive remarks or behaviour / rude gestures / innuendoes
Sexual and racial harassment
Threatening behaviour (with or without a weapon)
Actual physical assault (whether or not it results in actual injury) includes being pushed or shoved as well as being hit, punched or attacked with a weapon, or being intentionally struck with bodily fluids or excrement.
Attacks on partners, members of staff or the public
Discrimination of any kind
Damage to an employee’s or employer’s property
The Practice supports the Zero Tolerance stance adopted by the NHS.
The HSE (Health and Safety Executive) defines work-related violence as:
“Any incident, in which a person is abused, threatened or assaulted in circumstances relating to their work”.

Violence and aggression towards a person may also be defined as:
“A physical contact with another person which may or may not result in pain or injury. The contact is uninvited and is an attempt to cause harm, injury or to intimidate. Non-physical aggression includes the use of language which causes offence or threatens the safety of a member of staff”.

Under the Health and Safety at Work Act 1974, the practice will also undertake the following measures to ensure a safe work environment:
Carry our risk assessments to assess and review the duties of employees, identifying any “at risk” situations and taking appropriate steps to reduce or remove the risk to employees, particularly if they are working alone.
Assess and review the layout of the premises to reduce the risk to employees where physically possible.
Assess and review the provision of personal safety equipment, such as alarms.
Develop surgery policies, procedures and guidelines for dealing with physical and verbal abuse.
Provide support and counselling for victims, or refer to suitably qualified health professionals.
Make employees aware of risks and ensure employee involvement in suitable training courses.
Record any incidents on a Significant Event form and take any remedial action to ensure similar incidents are prevented in future.

REMOVAL FROM THE PRACTICE LIST

The removal of patients from our list is an exceptional and rare event and is a last resort in an impaired patient-practice relationship. We value and respect good patient-doctor relationships based on mutual respect and trust. When trust has irretrievably broken down, the practice will consider all factors before removing a patient from their list, and communicate to them that it is in the patient’s best interest that they should find a new practice. An exception to this is in the case of immediate removal on the grounds of violence e.g. when the Police are involved.

Removing other members of the household

Because of the possible need to visit patients at home, it may be necessary to terminate responsibility for other members of the family or the entire household to ensure the safety of practice staff.

The prospect of visiting patients that is the residence of a relative who is no longer a patient of the practice, or the risk of being regularly confronted by the removed patient, may make it difficult for the practice to continue to look after the whole family. This is more likely where the removed patient has been violent or displayed threatening behaviour, and keeping the other family members could put doctors or their staff at risk.