Discussion Paper for GPC Wales Thursday 27th January 2011 VIOLENCE IN NHS Primary Care New Direction 1. Case Managers Violence, or threats of violence including abusive / threatening langauge to all NHS Staff are subject to a Zero Tolerance consideration. This has the co-ordinated support of the Courts, CPS and Police, with custodial sentances in mind. Previously NHS Staff in Trusts / Secondary Care were offered assistance to bring prosecutions supported through their employers / management. Primary Care Doctors and their staff were left to feel isolated and unsupported As a direct action of input from WAG & LHBs there now exist in all areas of Wales Case Managers who will assist and support and manage any incident, however small, and take the lead in prosecution if indicated. Primary Care through GPCW and LMCs need to inform all members of GP Surgeries and staff that this facility is available. An incident of actual violence, threat of violence or even threatening or abusive phone- calls to any member of our staff must be taken seriously. Such incidents may cause differring levels of distress in employees and doctors all should be given the opportunity of recording their concerns and obtaining the support of the Case Manager if requested. No incident is minor or trivial and ALL should be logged as significant events and data collated for reporting [to LHBs] to demonstrate the activity levels. How many Practices currently log all abusive incidents and phone calls? 2. Lone Worker Alert System. The Contract [for 3 years ] has been awarded to Reliance and capital monies provided to purchase devices for lone workers in all 7 LHBs, who are at varying stages of introducing it. Cardiff & Vale have 1200 who have allocated to High Risk Lone Workers at their discretion. LHBs and WAG wish to see GPs having these devices- there is some capital money still available til end March 2011 and a pilot needs to be undertaken to evaluate uptake in primary care. Not all GPs will use them all the time, some may never this is an unquantified unknown , also would a large Group practice need one device for each Doctor? The device requires a considerable training element and is only issued after this takes place. Prior to this detailed administration and user profile form has to be completed to include vehicle/ id/ work pattern of the device holder. An escalation contact form also has to be completed, which is device specific. Up to 3 people can be assigned to each device and an individual can be assigned to up to three different devices. All paperwork MUST be signed off before any training is undertaken. The device requires activation by pressing the amber button which relays the position by voice message. A separate red alert button can be used to summon help. This is a one way microphone being heard and recorded at the call centre, and depending on perceived level of danger police may be summoned or perhaps a nominated contact telephoned, simply to confirm/ report the activation. The device enables distress to be heard, assault or intending assault and any appropriate response can then be escalated. Charles Allanby

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