Acceptable Behaviour Agreement Nhs
Sometimes called doctor-patient contracts or acceptable behavioral contracts, their goals are generally the same: removing a demanding patient from the list of practitioners is not always justified or feasible. Another strategy is to apply behavioural contracts between practice and patient. Even if, in an ideal world, patients wish to follow this type of process, they may in fact refuse to participate in the agreement or, although they have signed one, continue their behaviour or improve only temporarily before returning. In such cases, the patient may be removed from the list of practitioners. However, this decision should only be made as a last resort and practice must be kept within the formal withdrawal process. The treaty should be seen as a useful tool to save a deteriorating professional relationship, before it can be saved, as a punishment. The MDU advises the use of ABAs only in cases of persistent misconduct, which would inevitably lead to a breakdown of the doctor-patient relationship and the removal of the list of practitioners. The MDU highlights other factors that should be taken into account in the use of behavioural contracts: similarly, the use of positive language may increase the likelihood of an ABA. By explaining what the patient should do – for example, “treating staff with respect” – and not what they should not do – for example, “do not swear, shout or insult staff” – the patient may be more supportive of the request.
However, there will be cases where it will be necessary to explicitly state what behaviour will not be tolerated so that the patient knows what is being asked. NHS Protect described strategies to combat this type of behaviour in its publication Unacceptable Behaviour – Guidance on Warning Letters and other written communications, published in 2012. The guidelines describe behaviours that may be considered unacceptable and in different ways of addressing them, including Acceptable Behaviour Agreements (AAAs). Of course, there will be situations where the application of behavioural agreements will be inappropriate, for example when patients have engaged in extremely violent behaviour, and their immediate removal is necessary to protect employees and other service users from harm. The MDU thanks John Thomson, Senior Legal Case Officer, LPU and the NHS Protect Press Office team for their assistance in their research into this article. The Dos and Don`ts use Chaperones in intimate investigations. Presented by Dr. Ellie Mein. Behavioural contracts are most effective when the patient is involved in the development, as a sense of ownership of the contract can lead to a sense of responsibility in implementation.