General Medical Services provision - patients displaying violent behaviour: comparative review

Nationwide comparative review of the provision of General Medical Services for patients displaying violent behaviour in Scottish GP practices.

Appendix 1: Questionnaire

Challenging Behaviour Services nationwide review

Request by Michael Taylor, Senior Policy Manager, Primary Care Division, Scottish Government

Please provide information below about your Board's Challenging Behaviour Service (Violent Patients Scheme) as part of a nationwide review aimed to establish current practice and guide future services.

Please provide as much detail as possible in your responses.

Please return to by Friday 11th October.

NHS Board:
Contact details:

Referral process
What are the criteria for referral to your service?

Do you only see patients who have been subject to immediate removal from their GP practice?
i.e. instances where the police or procurator fiscal have been involved.

Please provide details of other circumstances under which patients are seen and approximate % of patients who fall into each category.

How many referrals did your service receive in the 12 month period between 01/09/18 and 31/08/19?

How many referrals were accepted in the 12 month period between 01/09/18 and 31/08/19?

Broadly describe the nature of the referrals which were not accepted and how these were dealt with.

How are referrals screened?

What is the timescale between receiving a referral and the first face-to-face contact with the patient?

Service design
How many patients do you see annually and what is your current service capacity?

What was your approximate annual cost per patient in the 12 month period between 01/09/18 and 31/08/19?

Describe how patients interact with/access your service.

Please include all members of staff patients have contact with eg. to make appointments or for enquiries etc.

Where are patients seen?

What arrangements are in place when patients are seen?

Please provide details of who is present, security arrangements and how other patients are protected eg. separate clinic times.

How many minutes do you have to see each patient?

What support/input do you have from other services?

E.g. Clinical psychology

Describe any additional training that staff involved in the service have received.

Please consider all staff who patients interact with e.g. reception staff, practice manager etc.

Describe the support available for staff involved in the service.

E.g. debriefing, mechanisms for raising concerns, access to counselling.

What times does your service operate?

Outside of these times, where can patients receive care?

E.g. are they eligible to access out of hours GP?

While waiting for their first appointment with your service, where are patients expected to receive care?

Do you offer home visits?

What transport arrangements are in place for patients travelling to access your service?

Return to mainstream General Practice
What is the average length of time that patients are cared for in your service? Do you have time limits or targets?

How does your service attempt to address the underlying issues that led to a patients referral?

What, if any, steps are taken by your service to rehabilitate patients into mainstream general practice?

How do you determine a patients' readiness to return to mainstream general practice?

Are patients able to return to their previous practice?

How is the handover process to the receiving practice managed/facilitated?

Is any ongoing monitoring or support provided for the receiving practice?

Service evaluation
What data do you routinely collect about any aspect of your service?

Do you collect any data on subsequent violent behaviour in primary care?

How do you evaluate your service?

Have you undertaken any audits of your service?

If so, please provide details and indicate whether you would be willing to share this data.

Have you evaluated the patient experience of your service?

Please provide details.

Challenges encountered
What are the main challenges your service faces?

If you have received complaints about your service, please provide details about the broad nature of these.

Broader perspectives on challenging behaviour services
Why do you think some patients are violent in GP settings?

What sort of patients are typically violent?

What do you think the role of your service is?

What does your service try to achieve?



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