Scottish hospitals to issue 'red cards' to violent patients

Oct 17 2005

Medical staff in hospitals and health clinics in Glasgow, Scotland, have been given the power to refuse to treat patients who submit them to physical or verbal attacks.

The health authorities in Glasgow say the step was a deterrent intended only to be used in the most extreme circumstances, and staff will be trained to de-escalate difficult situations.

In this, Glasgow's first citywide policy on dealing with violence and aggression towards healthcare staff, hospitals, GP surgeries and clinics, patients will be given a written "yellow card" warning for unacceptable violence or aggression.

If the behaviour continues they will then be handed a "red card" barring them from treatment on that occasion.

The decision to withhold treatment can only be taken by a senior clinician, and reviewed every time the patient returns for treatment.

It is not the intention to refuse treatment to emergency patients, people with head injuries and those not responsible for their own actions, such as those with learning disabilities.

It seems incidents of violent and aggressive abuse are a serious factor for healthcare workers in hospitals and communities.

According to NHS Greater Glasgow's chairman, Professor Sir John Arbuthnott, there were on average three assaults a day on staff in Glasgow's hospitals over the year ending in March, and about 20 incidents of physical violence daily in community-based settings.

He says incidents of violent and aggressive abuse are a serious factor for healthcare workers which is unacceptable.

In future medical staff are to receive advice and guidance on dealing with difficult situations.

Sir John says it would be preferable that the situation where treatment was withheld was not reached and situations de-escalated before reaching that stage.

It is hoped the policy will send out the message that violence against healthcare staff will not be tolerated under any circumstances.

The policy was welcomed by accident and emergency consultants, the Royal College of Nursing, and health workers unions, who say staff deserve the chance to work without fear of intimidation, abuse or violence.