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and threatening clients. Withholding of treatment to violent and threatening patients, pending on the behaviour is always the last resort, with managers making the final decision if need be.
Patients and those accompanying them should be fully aware of the standards of behaviour expected of them and the actions that may follow due to unacceptable behaviour.

2.2 Procedure Regarding Clients Who Have Been Violent or Abusive to Employee’s

The Zero Tolerance procedure is designed to improve our workplace’s ability to put a stop to incidences involving violence and abuse. It includes a dynamic aspect, whereby patients who are extreme or persistent in their unacceptable behaviour can as a last resort will be excluded from the trust itself. The zero tolerance policy has been introduced in the contexts of the Government’s national zero tolerance initiative against violence in the NHS.
As an example, on our daily duties, working in the Emergency Department we deal with a lot of patients that are a potential risk, acting with such unacceptable behaviour. Such as threatening or abusive language, that could lead to a forthcoming incident, normally when this happens, the security staff are crashed bleeped for assistance and upon arrival will try to diffuse the situation and protect their fellow employees and their clients in the department.
If the patient’s unacceptable behaviour increases, then the client will be asked to leave the department or be removed from the trust property by the security staff. When an act of physical violence towards staff occurs, the police will normally be contacted and the client will be arrested for his actions.
After these such occurrences, an application of the Procedure of Care will be completed, thus the patient in question will receive a formal written warning (a “Yellow Card”), due to the consequences of the incident. This warning will cease after one calendar year, pending on whether the patient complies with the terms, if they agree, their clinical care will not be affected in any way. Failure to comply will include exclusion from the trust (a “Red Card”), unless the patient requires emergency treatment.
In my opinion, this gives the trust a potentially difficult stance, because say for example a patient attends the Emergency Department, strikes a member of staff and gets escorted off the premises. This patient is then issued a Yellow Card, then refuses the Procedure of Care application and is then issued a Red Card. It is then still within the patients rights that he/she can attend the same Emergency department for emergency treatment and thus become a potential risk once again for the employees.
Exceptions to the rule include violence and aggression as a result of an illness or injury, mentally ill patients and all patients under the age of 16. Security will be present at all times when risk to employee’s and clients are at risk.
A police officer is situated in the Emergency Department on Saturday and Sunday nights; due to the increased drink related incidences and violent/abusive patients brought into the department. I personally feel that there should be a 24hr police officer on duty on-site, because there have been many occasions where the police have brought potentially violent patients into the Emergency Department to receive treatment, then vacate the department, leaving the employees with this pote