KILBIRNIE MEDICAL PRACTICE
REMOVAL OF PATIENT FROM PRACTICE LIST
RATIONALE
Kilbirnie Medical Practice aims to provide the best possible health care for their patients. However there may be circumstances when it would be considered reasonable, or in the best interests of the patient, to remove patients from the list.
The purpose of this policy, therefore, is to define the practice guidelines for when it is reasonable to remove a patient from the practice list and to ensure that any concerns about removing patients from the list are dealt with fairly.
Situations which justify removal
Violence
When a patient:-
- Is physically violent or threatening towards a doctor, practice staff or other patients on the practice premises.
- Causes physical damage to practice premises or other patient’s property.
- Gives verbal abuse or makes verbal threats towards the doctor, practice staff or other patients.
- Gives racist abuse, orally or physically.
- Is violent or uses or condones threatening behaviour to doctors (or some other members of the primary health care team) while visiting the patient’s home. Such behaviour may involve the patient, a relative, a household member, or pets (such as unchained dogs).
Crime & Deception
Where a patient:-
- Fraudulently obtains drugs for non-medical reasons.
- Deliberately lies to the doctor or other member of the primary health care team (e.g. by giving a false name or false medical history) in order to obtain a service or benefit by deception.
- Attempts to use the doctor to conceal or aid any criminal activity.
- Steals from practice premises.
Distance
- Where a patient has moved out of the designated practice area:
KA25, KA24, KA15 and has failed to register with another GP.
Embarkation
- Where a patient has moved abroad for a period of 3 months of more
Failure to attend pre-booked appointments
- Where a patient fails to attend pre-booked appointments on a number of occasions during a given period and has received warning notification, by letter, of intent to remove.
Irretrievable Breakdown of the Doctor-Patient Relationship
- Where a patients behaviour falls outside of that which is normally considered reasonable and leads to an irretrievable breakdown of the doctor-patient relationship
Procedure for Removal
Violence / Crime and Deception
Any incident involving violence, crime or deception will be reported to the Practice Manager, who will bring to the attention of the Partners.
Each individual case will be discussed at a Practice Meeting and a majority agreement will be reached.
Following agreement, the Practice Manager will write to the patient and explain the reasons for removal.
The exception to this is if a patient has to be reported to the police for violent behaviour towards any member of the practice staff when s/he may be immediately removed (VPR Scheme).
Distance
On notification that the patient is no longer living within the practice boundary, a letter will be sent to the patient advising of the need to re-register within the next 30 days. If the patient completes a ‘change of details’ form at reception it is the responsibility of the receptionist on duty to ensure the new address is within the Practice area. If it is not the receptionist must advise the patient to register with a GP closer to the new address.
If the patient has not re-registered, or contacted the surgery with a reasonable explanation, within the 30 day period, they will be removed from the practice list.
Please note: some patient may move just outside the Practice area and prefer to remain with the Practice. This will be discussed at the Practice Meeting.
Embarkation
On notification that the patient has moved abroad the patient will be removed from the practice list within 3 months of that notification.
Failure to attend pre-booked appointments
If a patient fails to attend a pre-booked appointment on more than 2 occasions in the last year, a warning letter will be sent to the patient, advising them that a further occurrence could risk removal from the practice.
If the patient fails to attend another appointment, the matter will be discussed at a Practice Meeting and a majority agreement will be reached as to whether the patient will be removed from the practice list.
Following agreement, the practice manager will write to the patient and explain the reasons for removal.
Guidance on removing patients due to irretrievable breakdown of the doctor- patient relationship
Occasionally patients persistently act inconsiderately and their behaviour falls outside that which is normally considered to be reasonable. In such circumstances there may be a complete breakdown in the doctor-patient relationship