Patients should be safeguarded from abuse, or the risk of abuse, and their human rights respected and upheld.

(Note: many of the prompts such as "Restraint procedures" are unlikley to apply to a GP setting)

Outcome in plain English

7A Minimise the risk and likelihood of abuse occurring by having a zero abuse tolerance policy

  • Make sure staff know this and how to handle these situations
  • Make sure staff are able to recognise signs of abuse
  • That patients know how to raise concerns
  • Recognise the signs and take preventative action where possible
  • Have a feedback system and ability to do something about it
  • Take action immediately
  • You must have procedures to handle this
  • Separate the abuser from the patient and others at risk
  • Report abuse to authorities
  • Make sure patient is looked after, after the above allegations
  • If your system's not working, get it sorted

7B How you should organise yourself

  • Work with everyone as a team
  • Work with other agencies to learn who does what
  • Must have proper procedures for restraint and safeguarding

7C Your staff should not be involved in the following:

  • Don't have financial or personal dealings with patients as this compromises independence and ethics
  • Don't do patient's wills
  • Don't borrow stuff from patients
  • Don't borrow money from patients
  • Don't sell their stuff and keep the cash

7D Staff ethics

  • Must be committed to patient rights and human rights
  • Be aware of their responsibility in safeguarding patients

7E Staff training and awareness

  • Staff must be trained and follow procedures in abuse situation
  • Understand the impact in different cultures
  • Understand the nature of abuse and the differences in support for children and adults
  • Know what to do if there is a risk of abuse
  • Follow the referral process and timescales required by regulations
  • Understand roles of other organisations involved
  • Active contribution to actions and improvement
  • Collaborate with other services and help in investigative process
  • Staff should be able to report any suspicions freely
  • Follow any agreed plans to prevent further abuse

7F Restraint procedures

  • Staff must understand different forms of restraint
  • Understand appropriate usage of restraint
  • Respect patient rights as far as possible
  • Know permitted forms of restraints
  • Restraint is the last resort

7G Understanding behaviours

  • Understand how stimulating environment affects behaviour and how to communicate and prevent such effects
  • Have prevention skills to help avoid incidents
  • Share knowledge with other members of staff

7H Dealing with risk of adverse behaviour

  • Carry out risk assessments on your techniques
  • Restraint procedures must respect patient rights
  • Get patient consent and document this arrangement where possible
  • Document you plan on minimising restraint
  • Use restraint as a last resort and minimise usage
  • Keep records
  • Follow relevant guidelines
  • Carry out an assessment after restraint is used

7I Listening to patients

  • Take patients and their people acting on their behalf seriously
  • Provide appropriate help and support in reporting the abuse
  • Keep everyone informed
  • Make them aware of available support services
  • Provide support as long as needed
  • Assure them that care will not be compromised if they report abuse

7J Patients should have access to the following information:

  • What abuse is and how to recognise the signs.
  • What to do in suspected abuse cases and who to contact
  • What will happen once the wheels are in motion

7K Patient rights

  • Follow information confidentiality rules
  • Be respectful of patient rights
  • Make sure that staff exercising restraint are properly trained


What the BMA says

Your practice is likely to be compliant if your practice does the following:

  1. Ensures that staff have had safeguarding training, if appropriate to their role, so that they can recognise the signs of possible abuse
  2. Takes appropriate action to protect patients in the event that any member of staff exploits a vulnerable adult or child in any way.  Healthcare professionals at your practice should be reported to the GMC/Nursing Midwifery Council/HPC in cases where they are in possible breach of their professional guidelines. Performers should be reported to the relevant PCT.  
  3. Ensures that patients can raise concerns and make complaints related to abuse. We suggest that you have a mechanism for patients to make comments and a publicised complaints procedure.
  4. Shares relevant information with other providers, in accordance with local safeguarding procedures, when there are safeguarding concerns about a patient.   
  5. Complies with the Vetting and Barring Scheme:  
  • Practices that knowingly employ someone who is barred to work with children or vulnerable adults will be breaking the law.  
  • Practices that dismiss or remove a member of staff/volunteer from working with children and/or vulnerable adults (in what is legally defined as regulated activity)
  • Practices are under a legal duty to notify the ISA of relevant information, so that individuals who pose a threat to vulnerable groups can be identified and barred from working with these groups.

Your practice has the following:  

  1. A safeguarding children (child protection) policy. You could base your practice procedures on the BMA’s Child Protection Toolkit or the RCGP’s Safeguarding Children and Young People Toolkit for general practice.
  2. A safeguarding adults policy.
  3. A patient information leaflet about abuse, containing information on what patients should do if they have suspicions that another person has been abused and what they might expect to happen under safeguarding procedures, is available in your practice.


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