Zero Tolerance

Wheatfield Surgery is committed to taking all reasonable precautions necessary to ensure the health, safety, welfare and wellbeing of its employees, patients and visitors. We endeavours to ensure that all employees are protected from physical and verbal abuse while they are working.

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 staff are aware. In addition, where deemed necessary, appropriate support will be put in place, e.g. staff member does 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 employee’s or employer’s property.

The practice supports the NHS policy of zero tolerance which defines violence as:

“Any incident where staff are abused, threatened or assaulted in circumstances related to their work, involving an explicit or implicit challenge to their safety, well-being or health”.

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”.

Types of difficult / angry patients

  • Withdrawn, secretive, vague – limits information as a form of control.
  • Critical – everything is wrong, bad.
  • Intimidating – highly sarcastic, cutting.
  • Sad sack – dwell on all the misfortunes, make others feel guilty.

Anger can be a common and normal reaction

  • Often due to a loss of control, feelings of powerlessness.
  • Can sometimes be justified – e.g. due to late/missed diagnosis, medical errors, fatalities, poor quality care, inadequate pain control, excessive waiting times, rudeness, etc.

How you might recognise when someone is angry:

  • Raised voice/shouting.
  • Flushed face.
  • Wild gesticulations.
  • Angry words.
  • Rigid body.
  • Withdrawal.
  • Sarcasm.
  • Dismissive comments.
  • Gritted teeth, clenched jaw.


This document sets out our policy for dealing with violence and aggression whether it is committed by or against any patient, visitor, or person working in the practice.

This policy applies throughout the practice premises, including car parks, grounds and any outbuildings.