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October 16, 2005 10:00 AM

NHS Greater Glasgow has gone a step further in protecting staff against violent or aggressive behaviour by introducing new procedures which include the ability for staff to withhold treatment if patients physically or verbally assault hospital staff.

The new procedure, to be used only in the most extreme circumstances, is intended primarily as a deterrent.  It has been introduced as part of Glasgow¡¦s first citywide policy on dealing with violence and aggression towards NHS staff.

NHS Greater Glasgow's Chairman, Professor Sir John Arbuthnott, said: "Unfortunately evidence shows that incidents of violent and aggressive abuse are a serious factor for healthcare workers in our hospitals and communities. This is clearly unacceptable, and NHS Greater Glasgow is totally committed to reducing and deterring such incidents as well as ensuring staff are trained to deal with situations when they do arise.  We must do all we can to protect the delivery of healthcare 24-hours a day, seven days a week and enable staff to fulfill their duties.

"Clearly withholding treatment will only ever be a last resort and stringent safeguards have been put in place to ensure that the new procedure is managed closely. But there are circumstances where the protection of staff must take precedence.¡¨

Emergency patients would never be refused treatment under any circumstances and neither would those who are not able to take responsibility for their own actions, such as those with a learning disability or head injury.

Sir John added: "Coping with people who need to find a reason why accident or illness has occurred and perhaps need to find someone to blame is an everyday part of the job for our staff.  First and foremost it is our duty to care and therefore it is our preference that we never reach the situation where we have to withhold treatment; preferring instead to de-escalate a situation before it gets to that stage."

The ability to withhold treatment is just one small part of a wider policy which takes in a range of issues providing staff with guidance, knowledge and empowering them to deal confidently with difficult situations.

Ensuring a consistent approach across all of Glasgow's healthcare settings, the new policy will also see NHS staff given the opportunity to complete a City and Guilds Certificate in dealing with aggression.  The course equips staff with de-escalation techniques  - giving them the confidence to deal with difficult situations.

A&E Consultant Dr Phil Munro, based at the city¡¦s Southern General Hospital, has welcomed the new policy.  He said: "My colleagues and I are all too aware from personal experience what it is like to deal with an aggressive situation. The new policy therefore is helpful to us as it is clear, pragmatic and based on common sense. NHS staff work incredibly hard to provide the best possible care to all patients regardless of the circumstances. In return I think they deserve basic courtesy and respect and to be able to work without fear of intimidation, abuse or violence."

Royal College of Nursing Officer for Greater Glasgow, Joe Gallagher, said: "This policy sends out the message that violence against healthcare staff will not be tolerated under any circumstances.  It also encourages staff to report incidents as well as them being given the skills and support to deal with difficult situations when they arise."

"Nurses have the right to come to work without the fear of assault or abuse.  They want to deliver the highest quality of care possible.  These new guidelines will allow them to do that in a safer environment for both for them and other patients."

UNISON's Scottish Organiser for Health, Glyn Hawker, believes the policy will empower staff to deal with difficult situations more confidently, she said: "UNISON has been campaigning for a long time to get recognition of the difficulties and dangers regularly faced by NHS staff.  We are very pleased to see this policy implemented In NHSGG, it will help to create a safer environment for staff and patients alike."


For further information please contact the press office on 0141 201 4429.

Notes to editor:

„h Following unacceptable violence or aggression a formal written warning ¡¥Yellow Card¡¦ is issued. If the behavior continues a ¡¥Red Card¡¦ will then be issued which would exclude the patient from receiving treatment on that particular occasion. Each case would be reviewed every time the patient returns for treatment.

„h The only persons who could take the step of withholding treatment would be senior clinicians.  Their experience and knowledge of the patient and the patient¡¦s condition - in addition to their responsibility for the wellbeing of the staff in their departments, as well as of other patients and visitors - would be factors in making a decision.

„h The new policy will cover all of NHS Greater Glasgow¡¦s healthcare settings including hospitals, GP surgeries and clinics.

„h Between April 2004 and end March 2005 there were 2024 incidents of violence and aggression in our acute hospitals.  Of this total 42% were actual physical assaults and 40% verbal abuse.  This means that in our hospitals each day there are around three incidents of assault each day.

„h For the same year, in Mental Health and Primary Care community based settings, there were a total of 8166 incidents with 77% due to some form of violence.  That¡¦s around 20 incidents of physical violence each day.

Images of Professor Sir John Arbuthnott and Dr Phil Munro are available on the NHS Greater Glasgow picture desk at

Photo call¡K Photo call¡K Photo call¡K Photo call¡K Photo call¡K

NHS Greater Glasgow¡¦s Chairman, Professor Sir John Arbuthnott, will be officially launching the policy on Monday 17 October at a special event at Glasgow Royal Infirmary.

The event will see a series of presentations by staff including A&E Consultant Dr Phil Munro.

¡P You are welcome to send a reporter and photographer/camera crew to the event which begins at 10am in the Lecture Theatre One, University Tower Block, Queen Elizabeth Buildings, Glasgow Royal Infirmary.

¡P Alternatively a photo call has been arranged at 11am after the event at Glasgow Royal Infirmary¡¦s A&E department.  Available for interview will be Professor Sir John Arbuthnott, NHS Greater Glasgow¡¦s Chairman, A&E Consultant Dr Phill Munro, Royal College of Nursing Officer for Greater Glasgow, Joe Gallagher and UNISON¡¦s Scottish Organiser for Health, Glyn Hawker.

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Last Updated: 06 February 2015