Very occasionally a practice/patient relationship breaks down completely. In this situation the patient may choose to register with a different practice. The practice also has the right to remove that patient from their list. This would generally only follow a prior discussion that had failed to remedy the situation and we would normally give the patient a specific reason for the removal.

The NHS operates a Zero Tolerance Policy with regard to violence and abuse and the practice has the right to remove violent patients from the list with immediate effect in order to safeguard practice staff, patients and other persons.

Violence in this context includes actual or threatened physical violence or verbal abuse, which leads to fear for a person’s safety.

In this situation we are obliged to notify the patient in writing of their removal from the list and record in the patient’s medical records the fact of the removal and circumstances leading to it. The Local Health Board is then responsible for providing further medical care for such patients.