I find myself once again having to write to practices about this matter. I attach the appropriate regulations which detail the grounds for immediate removal of violent patients and the procedure that practices must follow when a patient has committed an act of violence against any of the persons specified or has behaved in such a way that any of those persons has feared for their safety.
I am aware that recently a patient who committed an act of violence on GP premises was removed under the normal “ 8 day” process, and not immediately removed under the violent patient regulations. As things stand therefore this patient is free to attempt to register with any practice in whose area he resides. Whilst a practice aware of the patient’s history and the consequent risk to safety might then have reasonable grounds to refuse the registration, it may well be that the practice is unaware of the history of violence, or that a refusal to register would itself potentially lead to a risky situation.
The LMC position on this is unequivocal- all practices have a duty of care to remove immediately under the violent patient regulations should the patient’s behaviour fulfil the criteria for patient removal as per the attached regulations.
Furthermore, practices must consider the implications of them choosing not to insist that the police prosecute these patients. Practice staff, patients and the public must be protected and in many cases pressing charges may be the best way to improve the chances of these offenders changing their behaviour for the better in future.
Please do not hesitate to ask for the LMC’s advice in any situation related to violent patient behaviour and guidance on the appropriate action for practices to take.