GP practice's removal policy was wrong

What happened

Mrs G had an operation in spring 2013. Her husband contacted the Practice by telephone the next morning at 9.45am to arrange a visit from a district nurse. He heard nothing, so went to the surgery in the early afternoon and discussed his concerns with a receptionist who was unaware of his earlier telephone call. Unfortunately, the receptionist could not arrange a visit because the district nurse had left for the day.

Mr G was unhappy that the Practice could not arrange a home visit. He became upset and, by his own admission, loud from frustration. The Practice manager felt Mr G was intimidating and was becoming aggressive so she asked him to leave and said she would call the police if he did not. Mr G left the building after another staff member asked him to.

The Practice wrote to Mr and Mrs G to tell them that it had removed them from its patient list because of Mr G's unacceptable behaviour. Mr G complained to the Practice. It responded fully to the points he raised and sent him a copy of its removal policy to support its decision.

What we found

We looked at the Practice's removal policy and the procedure it followed when it considered removing a patient from its list. In Mr G's case, it had followed its policy for situations in which staff believed the removal was straightforward because it was the result of, for example, persistent failure to attend appointments or inappropriate behaviour or language.

The Practice's removal policy, however, was not in line with the law that governed the Practice's contract to provide healthcare. The law says that the Practice's removal policy must include an agreement to warn patients before removing them. The Practice's policy did not have this agreement.

The Practice should have acted in line with its contract, which stated that the Practice's policy must include warning patients about a possible removal. There is no evidence that the Practice considered issuing a warning to Mr G. Instead it removed him from its list immediately.

Putting it right

The Practice wrote to Mr and Mrs G to acknowledge that it had not handled their removal properly. It apologised for removing them immediately rather than warning Mr G about his behaviour.

It also reviewed its policies to bring them in line with the relevant laws.