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Supporting staff dealing with violent patients DES (England)

A summary of what is involved in England's violent patients DES.

Provision of GP services to patients who have been subject to  immediate removal  involving a police presence, from a practice list and/or have been assessed by the PCT as posing a potential or actual threat to the safety of primary care team members.


Wales, Scotland and Northern Ireland have their own schemes.

£2,168 annual retainer to a GP practice contracted to provide GMS services to violent patients; £50 per consultation (away from the practice’s premises); £25 per telephone consultation.

What it involves

  • The PCT will notify the provider practice of the allocation of the patient to the DES and provide the clinician with a history of the patient’s ’aggressive behaviour and try to ensure the practice gets the patient’s medical record before they need to be seen. 
  • The PCT also informs the patient in writing about why they have been allocated and how to access services.
  • If a face-to-face consultation is required the patient will initially be seen in a designated place of safety usually with a police/security presence.
  • Care of the patient under the DES is subject to quarterly and 12-monthly reviews to determine if the patient can return to normal primary care.
  • Claims for consultation fees must be submitted with a month of the consultation date.

The information above is on based on NHS East Lancashire’s 2012/13 specification for this DES. Arrangements in other areas may vary.

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