Practices will already have provisions within their continuity plans to deal with disruptive events but in the context of the current threat from riotous disturbance they may wish to incorporate the following:
1) If a threatening disturbance is planned near the practice
If such an event takes place in the vicinity of the practice, or you are notified by an authoritative source that it is likely, the practice should contact commissioners at ICB or borough level to report this is happening. As part of this call you should notify them that contracted services could be suspended to secure staff, patients and premises.
2) Staff safety
- Safe travel to and from work: work from home or stay late, until safe to travel, travel in pairs if necessary.
- Avoid staff walking home or waiting at bus stops, practice may wish to consider organizing taxis.
- Safety at work: if a local disturbance is reported then see if the practice can allow mobile phones to be left on so family and friends can stay in touch with staff.
- Nominate a member of staff to log check on social media to track any local disturbances. This person should be careful to verify that any information is accurate rather than just rumour, for example seeing if posts purporting to detail hostile gatherings have contemporaneous pictures or video that are clearly showing streets in the area.
- Home visits in the vicinity of disturbances: contact patients/relatives to explain, obtain updates on their condition, and give interim advice. If a home visit is essential call police for advice and assistance.
- Nominate a key individual at PCN level to support with communication, both with practices and other agencies e.g. police
3) Premises
- If notified by an authoritative source of potential local disturbance lock the practice’s external doors and use the buzzer to allow access, advise patients to stay in the practice premises until notified that it is safe to leave by the police.
- Lock all internal rooms that are not being used including doors that secure off parts of the building.
- Keep all staff and patients notified of what the practice is doing.
- Stop taking calls if disturbance in locality is confirmed (you may wish to add an answer phone message explaining why) and have call handlers start ringing patients booked into clinics for the remainder of the day to advise them not to travel to the surgery.
- Nominate key individual to coordinate activity within the premises and be a contact for external agencies.
- If the premises are attacked: lockdown and move all staff and patients to the furthest place away from the attack and ring 999 for police assistance.
- If working from more than one building, then move to one building if possible and lockdown the other.
- Ensure all drugs and prescriptions secure now behind lock and key in a locked room.
Note: The police non-emergency contact number is 101, but 999 is the appropriate response if the practice team or patients feel threatened.
Practices may also wish to refer to our abuse and violent patient guide which covers the more routine issues that practices still sadly face.
Our thanks to Sefton Place team and Sefton Local Medical Committee who created the original version of this guidance.