Zero tolerance policy

1. Introduction
2. Scope
3. Definitions and Duties
4. Process & Reporting

Introduction

Bristol Dental School recognises that discriminatory, violent and aggressive behaviour and language including microaggressions not only affects staff and students personally, but it also has a negative impact on the standard of service and delivery of patient care. Aggressive and violent behaviour, language and microaggressions can also be distressing and disturbing for patients and their visitors who witness incidents. Bristol Dental School is committed to creating and maintaining a positive and inclusive environment for staff, students and members of the public.

This policy aims to protect Bristol Dental School staff, students and where necessary, patients and visitors from aggression and violence from any individual and/or individuals, and to minimize the risks of any incidents occurring.

Bristol Dental School is committed to complying with health and safety legislation and associated guidance plus Care Quality Commission Regulations for service providers and managers relating to a safe and secure environment. Therefore, the scope of the document applies to all staff and students including agency and locum workers.

The purpose of this policy is to ensure that the Bristol Dental School has a structured, consistent approach to achieve the avoidance, reduction, and management of risks associated with violence and aggression. That allows staff to work and students to study in a caring and respectful environment for the benefit of positive patient outcomes.

Scope

Bristol Dental School is committed to protecting the health, safety and welfare of its employees, students, patients, visitors, and others. Violent and threatening behaviour or language by patients, visitors, students, colleagues or others is unacceptable. Bristol Dental School strives to provide and keep a safe and secure environment and recognises its responsibility to minimise the risk, and to protect staff, patients and the public from violence or the threat of violence in all its forms. It is important that staff feel safe in their working environment. 

This policy does not replace the University of Bristol policies relating to acceptable behaviours of staff and students.

Whilst we always aim for a 'zero tolerance' approach, it is recognised that violent and aggressive behaviour or language can occur in clinic settings due to medical factors or conditions beyond the control of the individual. Such conditions may include but are not limited to:

• Trauma;
• Dementia;
• Mental illnesses or disorders;
• Cognitive impairment;
• Learning difficulties.

In such cases where there is reason to believe the individual does not have the capacity to manage their comments and behaviours, we will work with relevant care professionals to determine best course of action.

Although specific techniques and interventions may differ, the importance of positive engagement and communication cannot be over-emphasised. Individuals who present with challenging behaviours and who may be vulnerable should not be labelled or stigmatised as being violent and aggressive. Often, challenging behaviour is a function of a patient’s inability to communicate their needs and wants. Staff should be mindful that there may be occasions where an individual appears to breach standards of behaviour due to a communication barrier. 

All reasonably practicable steps will be taken to protect patients from assaults by fellow patients. Mandatory training is provided to staff on Conflict de-escalation.

In order for the Bristol Dental School to maintain a safe and secure environment for staff, students and patients; discriminatory, violent and aggressive behaviours including but not limited to those listed below will not be tolerated and may result in patients being asked to leave the premises and in some cases, Site Security and the Police being contacted, and the patient may be discharged in line with our Patient Terms & Conditions signed by patient at the point of acceptance for treatment. This list is not exhaustive:  

• Using bad language or swearing at staff or students 
• Any physical violence towards any member of the Dental School team or other patients, such as pushing or shoving 
• Verbal abuse towards the staff in any form including shouting or verbally insulting the staff 
• Racial abuse  
• Microaggressions  
• Including comments and/or behaviours that make students, staff, or other patients feel singled out based on stereotypes or personal characteristics. 
• Persistent or unrealistic demands that cause stress to staff will not be accepted. Requests will be met wherever possible and explanations given when they cannot 
• Causing damage/stealing 
• Obtaining drugs and/or medical services fraudulently 
• Harassment (including but not limited to sexual harassment) 

Inappropriate behaviour or comments to staff or students in person or via social media or other electronic communication (phone, email, text etc).

Definitions and Duties

Zero Tolerance is an approach and attitude of the Bristol Dental School to address all incidents of microaggressions, violence, discrimination, harassment and aggression that occur on Bristol Dental School premises. The School reserve the right to discharge patients who contravene the definitions as set above. 

Work-related violence: Health and Safety Executive defines work related violence as, “Any incident in which a person is abused, threatened or assaulted in circumstances relating to their work”. This can include verbal abuse, threats and physical assaults.

Racism is prejudice or discrimination against a person or people on the basis of their membership of a particular minoritised racial, ethnic, or religious group.

Microaggressions are comments or behaviours that either consciously or unconsciously convey insensitive or disparaging references to a person's identity or background. 

Harassment is behaviour that causes alarm or distress. The behaviour may occur on more than one occasion but it does not have to be the same kind of behaviour on each occasion. Harassment includes: comments, physical touch, texts, voicemails, letters or emails, or threats.

Aggressive Behaviours: This is a broad term but defined for the purposes of this policy as any behaviour committed with reasonable expectation of physical and/or psychological harm to the victim.

Process & Reporting

Patients who have concerns about students, staff or other patients are encouraged to complete feedback on the student individually but can also provide more in-depth feedback via Radar (our incident reporting system). Patients can request to speak to a member of staff on clinic in the first instance. Bristol Dental School has a published patient complaints policy found on the website and highlighted in waiting rooms. Any concerns raised about staff or students will be dealt with under the relevant University policy.

The examples of unacceptable behaviours listed is not exhaustive and there may be occasions when we have cause to issue a warning or take action, including removing patients from our patient list or activating a complaints process.  

We trust this policy is clear and supports a mutually respectful environment for all students, patients, and staff.