Violence and Aggression Policy


The purpose of this policy is to address instances of unacceptable behaviour which may cause harm or the fear of harm to any person within the Practice.
The scope of this policy is therefore:
Instances of violence or aggression committed by:

  • Any person, whether patient, visitor or any other person working within the practice


  • Any patient, visitor, or other person working within the practice.


Violence and aggression are defined as:

  • Violence is the use of force against a person and has the same definition as “assault” in law (i.e. an attempt, offer or application of force against the person).   This would cover any person unlawfully touching any other person forcefully, spitting at another person, raising fists or feet or verbally threatening to strike or otherwise apply force to any person.
  • Aggression is regarded as threatening or abusive language or gestures, sexual gestures or behaviour, derogatory sexual or racial remarks, shouting at any person or applying force to any practice property or the personal property of any person on the Practice.   This would cover people banging on desks or counters or shouting loudly in an intimidating manner.

This policy applies throughout the premises, including any car park and grounds. It also applies to any employee or partner away from the practice but only in so far as it relates to the business of the practice.

TPP System 1 – There is a panic button shown on the middle of each screen, if you have any problem of any type please press this button and two members of staff will come to your aide.


Employee Responsibilities:

  • Employees have the responsibility to ensure their own safety and that of their colleagues at work. It is essential, therefore, that all employees are familiar with practice policies and procedures, equipment and precautions adopted to combat the risk of physical and verbal abuse.
  • Familiarise themselves with the practices general policies and procedures, guidelines and instructions.
  • Use any equipment or devices provided for ‘at risk’ situations i.e. alarms.• Participate in relevant training made available by the practice.
  • Report all incidents of physical and verbal abuse (threatened or actual).• Record details of incidents in compliance with practice procedures.
  • Contribute towards reviews concerning any incidents in which they have been involved.
  • Suggest precautionary measures involving changes in the layout of the work environment that can reduce risk.
  • Make use of any available staff support and counselling through the practice.
  • Advise the practice manager of any perceived risks involved in work activities.

Practice Responsibilities:

  • Carry out 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.
  • Assess and review the duties of employees, identifying any ‘at risk’ situations and taking appropriate steps to reduce or remove risk to employees particularly if they are working alone.
  • Assess and review the layout of premises to reduce the risk to employees.
  • Assess and review the provision of personal safety equipment i.e. alarms.
  • Develop practice 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 and take any remedial action to ensure similar incidents are prevented.

What To Do

If violence and aggression is encountered:

  • In the first instance a member of the staff should ask the perpetrator to stop behaving in an unacceptable way.  Sometimes a calm and quiet approach will be all that is required.  Staff should not in any circumstances respond in a like manner.
  • Should the person not stop their behaviour the practice manager/ partner should be asked to attend and the member of staff should explain calmly what has taken place, preferably within hearing of the perpetrator.
  • If the person is acting in an unlawful manner, causes damage or actually strikes another then the police should be called immediately.
  • Should it prove necessary to remove the person from the practice then the police should be called and staff should not, except in the most extreme occasions, attempt to manhandle the person from the premises.
  • If such a course of action proves necessary then those members of staff involved must complete a written note of the incident, detailing in chronological order what has taken place and the exact words used prior to leaving the building at the end of their working day.
  • It is the policy to press for charges against any person who damages or steals Practice property or assaults any member of staff / visitor or patient.

Procedure Following an Incident

  • Review the incident with the practice partners in order to determine severity
  • Determine if the patient should be removed from the practice list forthwith
  • Decide if a written warning should be given
  • Decide whether to take further action if the matter has been sufficiently dealt with by the advice already given

The details of any incident other than no further action will be entered into the patient’s permanent record or the employee’s personal file.

Any employee / patient or visitor who receives any injury, no matter how small, should be the subject of an entry in the practice Accident Book and will be examined by a doctor before they leave the premises.

Every violent incident involving staff will be reasonably supported by the provision of medical or other treatment as necessary and all incidents should be brought to the attention of the practice manager, if not already involved.

The practice re-affirms its commitment to do everything possible to protect staff, patients and visitors from unacceptable behaviour and their zero tolerance of any incident that causes hurt, alarm damage or distress.

Support for Employees Subjected to Abuse

The practice takes a serious view of any incidents of physical and verbal abuse against its employees and will support them if assaulted, threatened or harassed.

After an incident the first concern is to provide appropriate debriefing and counselling for affected employees. Depending on the severity of the incident this counselling may be undertaken by trained professionals.

The practice manager will assist victims of violence with the completion of the formal record of the incident and where appropriate will report the incident to the police.

In the event of serious physical and verbal abuse patients will be removed from the practice list.

Appendix 1 – Action in the event of Panic Button activation. Refer to the Emergency Incident Procedure
Appendix 2  –  Do’s and Don’ts when facing angry patients:


  • Recognise your own feelings
  • Use calming body language
  • Put yourself in their shoes
  • Be prepared to apologise if necessary
  • Assert yourself appropriately
  • Allow people to get things off their chest


  • Meet anger with anger
  • Raise your voice, point or stare
  • Appear to lecture them
  • Threaten any intervention unless you are prepared to action it
  • Make them feel trapped or cornered
  • Feel that you have to win the argument.