Although I didn’t say it at the time, I was quite saddened by what happened to Mrs X. We had a practice meeting as to what should be done and the consensus was that we had tried hard enough and the time had come when we had to admit defeat. It wasn’t an easy decision to make.
When we did try removing Mrs X from the list we were told by the primary care trust that this was not possible. I was pleased to discover that there are quite strict protocols regarding the removal of patients from GP lists. I think this is a good thing. In the case of Mrs X, this did not happen, so we’re obliged to keep her on the list.
The primary care trust has a clear policy which has been developed for dealing with violent patients. There is a designated practice within Manchester which receives extra funding in order to take on this group of patients. The PCT has also made available resources so that these patients can have a dedicated advocate that accompanies them to GP consultations. Unless we follow a defined protocol for removing such patients from a list, this service is not available to them. This helps to protect patients but also recognises the problems that doctors have in looking after them.
Although we could not remove Mrs X from our list, two days later she was again abusive and violent. On this occasion, we followed the protocol for removal of violent patients and she was allocated another practice. At least I know that she will continue to receive healthcare. Someone will still have responsibility for looking after her.