NHS staff have new powers to refuse treatment to violent and abusive patients.
NHS staff have new powers to refuse treatment to violent and abusive patients. New national guidelines to protect staff were published in November intended to balance the need to protect staff with the duty to provide health care. Verbal threats, violence, vandalism and drug and alcohol abuse will all be grounds for refusing treatment. However, patients with severe mental health problems or suffering life-threatening conditions will not be denied care. Patients will be issued a verbal and written warning before treatment is withheld. However if under threat of immediate danger, staff may make an on-the-spot decision to refuse treatment. Health secretary Alan Milburn said: “It is simply deplorable that people who spend their lives caring for others should face the daily threat of verbal or physical assault. Violent and abusive behaviour should not be tolerated in the NHS whether committed by patients or by their relatives. Withholding treatment should only ever be a last resort and must be subject to stringent safeguards. So the guidelines set out the circumstances where the withholding of treatment will be inappropriate, such as when a patient requires emergency treatment or is not competent to take responsibility for their actions. Assault is a crime, and the NHS should always press for the maximum possible penalty for anyone who commits a crime against NHS staff.” The zero tolerance guidelines, titled ?we don?t have to take this?, include good practice from Bedford Hospital (offering a plastic card similar to a credit card which has contact details of support services for staff following an incident), East Lancashire Health Authority, Ulster Community and Hospitals Health and Social Services (HSS) Trust, North Bristol NHS Trust, North Staffordshire Hospital NHS Trust, Sandwell Health Care NHS Trust, Mersey Regional Ambulance Service NHS Trust, West Suffolk Hospitals NHS Trust, Portsmouth Healthcare NHS Trust (for personal safety training), Aylesbury Vale Healthcare NHS Trust (on risk assessment of a intensive observation unit), Hillingdon NHS Trust (for a simple incident report form) and Hull and East Yorkshire Hospitals NHS Trust (where a police room has been established in the Hull Royal Infirmary A & E). See www.nhs.uk/zerotolerance. Singled out is the control room at King’s College Hospital, whose Site Services Manager Chris Doherty describes Pinpoint, a proprietary staff safety system installed in A&E and Imaging: ?The system has a full maintenance contract. It comprises of a staff portable alarm which, if triggered, transmits to a receiver in the ceiling which has a unique address such as ‘Lift Lobby’ or ‘Main Reception’. This signals to all A&E staff bases and to the master panel in Security Control. A&E staff will respond and security staff will be instantly dispatched to the location with the radio message ‘Pinpoint Main Reception’. A&E staff confidence in the system is high and they know assistance will be swift to arrive.
