Can I remove a patient without notice if they've verbally abused and threatened staff?

Yes, but bear in mind the patient's medical condition could be a factor in their behaviour, so document your reasons in case you're later asked to justify the removal.

See below for advice on the process of removing violent patients across the UK. You can also read further guidance on:

England and Wales

In England, you're obliged to report the incident to the police first and obtain an incident number. You should only disclose the minimum information necessary to allow for proper investigation. You should also notify PCSE (Primary Care Support England), which provides support services for primary care providers on behalf of NHS England.

If it's inappropriate or unsafe to provide an explanation to the patient, then PCSE will be responsible for arranging primary care services, if necessary, within a more secure setting.

Practices in Wales can remove violent patients and local health boards will also administer 'safe haven' services. There is an expectation that the police will have been notified of incidents in such circumstances.

Scotland

GP practices must involve the police or a procurator fiscal in such cases in Scotland. Once notified, National Services Scotland will remove the patient immediately from the practice on the Community Health Index (CHI). Each of the 14 Scottish Health Boards is individually responsible for providing ongoing general medical services to such patients under what is usually called challenging behaviour services (CBS).

Read more on removing patients in Scotland.

Northern Ireland

GP practices can remove patients with immediate effect and without prior warning if the patient has been violent or caused someone to fear for their safety.

The violence or threatened violence must have occurred on the GP premises or in a place where the patient was receiving care from the GP practice - and the incident must be reported to the police. Practices should also notify the Strategic Planning and Performance Group at the Department of Health (formerly the Health and Social Care Board), which will write to the patient.

The GP practice should also inform the patient, unless it's not reasonably practical, or unless it would be harmful to the patient's health or the safety of others. Removing a patient and the circumstances that lead to the removal should be recorded in the patient's medical records.

This page was correct at publication on 25/04/2022. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.