Feeling unsafe at work - what would you do?

[onyxtulip]

Hi all, would love some advice from anyone who has been through similar or has better knowledge of employment law than I do!

I'm a GP. I often work evening clinics where there are just 2 staff in the building - myself (female) and one (also female) receptionist.

I have a patient who has recently been released from prison. He has a history of violence against men, women and medical personnel. He has addiction issues (crack, cocaine, speed, alcohol). I recently saw him during an evening clinic and, whilst he was entirely appropriate throughout, I did feel in hindsight that perhaps he should have been booked to see me during the day as there would be more people around should anything untoward occur. I raised this with the partners and management at my surgery and was informed that to restrict this patient to appointments M-F 9-6 would be discriminatory and therefore not possible.

During the appointment, this patient described ongoing impulses to hurt others, often strangers and impulsively. He also told me the police suspect him of an attempted murder by stabbing but currently don't have enough evidence to arrest/charge him. My managers and the partners are aware of these details.

Surely they have a duty of care to me and our receptionists, in terms of reducing our risk of harm?

I don't know what steps to take next to be honest. I don't feel comfortable with it but don't want to rock the boat too much/risk my job!

I started reading & my first thought was lone worker policy.

its not discriminatory to ensure this patient is seen when others are around for safety reasons. I don’t know how the relevant services have allowed him out of prison without some kind of plan.

he should have some kind of probation plan that should restrict/plan for how/when he can attend appointments (such as being escorted or requesting no 1:1 appointments.

something has failed in the system here, I would be contacting your union at the very least. Your surgery also needs to conduct a risk assessment

MDDUS have always been very helpful in my experience.

I'm a nurse/site manager and at the very least he would be "nursed in 2's", especially with the ongoing impulses to hurt others. Security would also be made aware he was in the hospital and he'd probably be recorded on our violent patient register as a risk to staff. Your surgery is doing you a disservice!

BadgernThe Garden, I agree with all you say.

Also, the client should only have appointments offered within a window of time when doctors have security on hand. The booking staff should see a notification on his file that directs them to offer only certain time slots for the safety of you workers.

It is more comfortable for the client that he is not placed in a position of temptation.

I would put your concerns in writing to the practice manager via email or similar. Say you accept their offer to have him moved to a male doctor, but you strongly advise a risk assessment as you feel he is a risk to staff in the surgery. I think it’s then a case of self protection and escalation if anything happens. Make sure you have a paper trail.

I agree with PPs comments, plus criminal records are not a protected characteristic under the Equalities Act, so discrimination cannot apply. And safeguarding of staff would surely take priority. I think if you have concerns about the individual’s MH, and the safety of staff, there ought to be a way to flag this patient as one that can only come to surgery during fully staffed operating hours? I would speak to the BMA and your local NHS Trust about safety protocols.

Nope, probably not sectionable. I hear voices telling me to do awful things but I’ve been told I’m not sectionable.

Agree with a pp, discrimination reales to specific characteristics. I would push your practise manager on this and ask to see the policy. You are not discriminating against him by limiting him to daytime hours

This!

When I worked in a GP surgery the GPs would just ask the receptionists to make sure patients like this were booked during normal hours, not the extended hours, for everyone's safety. Having said that we always had at least 3 people there during late opening, usually 4 or 5, but still safer in the day time

And no you haven't breached any confidentiality and don't blame you for asking for opinions considering your surgery are clearly being unreasonable

I’d want to know if there was any MAPPA meetings about this individual…where risk has already been assessed

Sorry to hear this. Could a spn bre added to his file to say should attend hospital, not p.
I think it’s disgraceful you are put at risk like this. At least hospital have security

If there's a risk to staff (which there clearly is in this case) it's perfectly reasonable to only offer appointments in a setting that keeps staff safe. I do community visits. If I ever feel unsafe, I will only offer to see them in clinic rather than at home, and my manager would get the patient transport to facilitate this if needed. If we need to visit in twos, then appointments are only offered when 2 staff are available to go at the same time - which naturally reduces flexibility / availability for them.
For patients that are abusing substances regularly, we only book morning appointments to reduce the risk of them being intoxicated if it's later in the day.
All in the name of keeping staff safe.

I wouldn't be happy with this being brushed off - it's not discrimination at all ffs. It's a basic risk assessment. Definitely get the union involved if necessary.

Do you have an alarm system or way of quickly summoning help if anything were to happen?

I’m shocked this is allowed to happen. A few years ago I worked as a charge nurse, a prisoner who was released suffering with dementia was admitted. He threatened other residents and staff. Demanded nicotine and alcohol which his state pension could not fund and medical care from GP on demand. He said he got all of this in prison! It was a difficult situation to manage and at the same time protect other residents.

Op, Does the patient have a probation worker assigned to him? Or any other case worker? Could you ask he be accompanied by them? Could this also facilitate daytime appointments?
@onyxtulip