Patient removal from GP practice list was unreasonable

What happened

Mr P attended a scheduled consultation with his GP for various minor complaints. During the consultation, Mr P became unhappy with the GP's response to his concerns, as the GP did not agree to conduct further tests or refer Mr P for other investigations. Mr P and the GP have differing accounts of what happened next, but both agree that the GP ended the consultation and Mr P left, raising a complaint with the Practice manager. Mr P says the GP was unreasonable in his refusal to conduct further tests and so he complained. The GP said Mr P showed aggressive and intimidating behaviour, putting him at significant risk of physical harm, therefore he decided to have Mr P removed from the Practice's list. This removal was relayed to Mr P at the end of the Practice's complaint response letter.

What we found

When we compared the actions of the GP and the Practice with the Practice's own policy on removing patients, we found that while accounts of events differ, there was no evidence in the records to suggest that Mr P acted in such a way as to have posed a significant threat of harm. The policy states that if this is the case, the police should be informed, and this did not happen.

Our investigation did not consider whether or not Mr P's behaviour was reasonable. It was clear, however, that the decision to remove him after this one incident, with no previous history of difficulty and without any specific information from the GP about exactly what was said or threatened, without talking to Mr P or giving him any warnings, and without any other steps, as set out in the policy, was unreasonable.

Putting it right

The Practice agreed to our three recommendations. It has reviewed its policy and all staff are aware of the steps that should be taken to conduct fair and reasonable patient removal or manage difficult patients.

It has paid Mr P £150 for the inconvenience suffered by his removal. And it has apologised to Mr P and sent a copy to us and to the relevant clinical commissioning group.