Zero tolerance in general practice: a policy in conflict?

Abstract

Workplace violence is a serious problem within the National Health Service (NHS). To combat this and to reduce the incidence of abuse and aggression shown to staff, a zero tolerance public campaign was introduced in 2007 within the UK. The campaign endorsed employer‐led zero tolerance policies, despite any evidence of the effectiveness of this approach and concerns that it is discriminatory and denies health care to those who most need it. Decisions to exclude patients from GP registers are subject to varied interpretations regarding what is deviant behaviour and the blacklisting of patients is unregulated and subject to ambiguity. Furthermore, staff training programmes, which emphasise de‐escalation strategies, have not proven to be effective and can even increase violent incidences. Initiatives to provide safe havens for those excluded, while initially believed to be effective, raise many ethical arguments about the ‘ghettoising’ of health care for those already socially excluded. Research is needed into these centres in the hope of providing some of the answers, particularly around the triggers of violence, how violence is perceived and how it can be prevented.

Citation

Paniagua, H., Bond, P. and Sallah, D. (2009), "Zero tolerance in general practice: a policy in conflict?", Ethnicity and Inequalities in Health and Social Care, Vol. 2 No. 2, pp. 30-36. https://doi.org/10.1108/17570980200900013