A healthcare centre's protocol must also cover the patient who attacks
Nextica Law & Tax drafts and implements the healthcare centre's anti-harassment protocol and handles the internal investigations when a complaint arrives. The duty to have a protocol and procedure comes from art. 48 of Organic Law 3/2007 and, for sexual harassment and harassment on grounds of sex, from art. 12 of Organic Law 10/2022. But a clinic has a second layer the generic protocol does not cover: aggression and harassment coming from the patient or their family, which are not a dispute between colleagues but an occupational risk under art. 14 of Law 31/1995 and must appear in the job's risk assessment, with protective measures for reception, emergencies and closed-door consultations. On top of that sits the clinical hierarchy — doctor, nurse, assistant — which shapes who dares to report and to whom.
The protocol downloaded from the internet does not say what to do when the harasser is the patient.
What's included
1. A protocol with a written procedure and an ALTERNATIVE investigator provided for in advance, because in a small centre the investigator usually reports to the person complained of or shares a rota with them.
2. Adapting the procedure to the clinical hierarchy
doctors, nurses, assistants and administrative staff do not have the same room to report, nor the same person to report to.
3. Interim measures that do not penalise the complainant
reorganising shifts or clinics cannot mean moving her out of the department.
4. Handling the file's data at the level a healthcare centre already knows
restricted access, separation from the clinical record, and retention with a deadline.
5. Bringing third-party violence — patients and companions — into the job's risk assessment, with measures for reception, emergencies and closed-door consultations.
6. An incident log and de-escalation training, which is what evidences that the centre knew and acted when something serious happens.
7. Written criteria for withdrawing non-urgent care from someone who is violent, coordinated with the duty of care the centre cannot abandon.
HERE THE RISK DOES NOT ALWAYS COME FROM INSIDE
The generic protocol covers disputes between colleagues. In a clinic that is half the picture: the patient shouting at reception, and the hierarchy that stops anyone telling.
Having no protocol or specific procedure
the law requires employers to promote conditions that prevent sexual harassment and harassment on grounds of sex, and to put in place specific procedures for its prevention and for channelling complaints, negotiated with employee representatives.
art. 48 of Organic Law 3/2007A copied protocol that does not say who investigates when the person complained of is the one in charge: the rule requires procedures to offer real guarantees, and an investigation run by someone reporting to the respondent taints the file even where the merits are resolved well.
art. 12 of Organic Law 10/2022 on comprehensive guarantee of sexual freedomLeaving patient aggression outside the prevention system
third-party violence towards staff is a job risk and must be identified in the assessment with associated measures. Without a prior incident log, on the day of the serious episode there is no way to show the centre knew the risk and acted.
art. 14 of Law 31/1995 on Occupational Risk PreventionFrequently asked questions
An assistant reports harassment by a doctor she shares a consulting room with. Where do we start?
By separating the investigation from the hierarchy. If the investigator reports to the person complained of, or shares a clinical rota with them, the file is flawed from birth even if the merits are resolved well. The protocol must provide for an alternative investigator and, in small centres, for external investigation. From there: interim measures that do not penalise the complainant — reorganising shifts cannot mean moving her to another department — written deadlines, and a file documenting every step, because that is what will be read if the matter ends up in court or before an inspection.
A patient routinely insults and threatens reception staff. Does that fall under the harassment protocol?
It falls under the prevention system, even though it is not harassment between colleagues. Third-party violence towards staff is a job risk and, as such, must be identified in the risk assessment and carry measures: an incident log, de-escalation training, counter design, an alert protocol and written criteria for when a patient is asked to leave the centre. Documenting it also has a practical effect: without a prior log, the day something serious happens there is no way to show that the centre knew and acted.
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