Healthcare is an emotive issue and it can be difficult to manage expectations and balance competing interests. This can sometimes lead to difficult and confrontational behaviour.

If a patient or individual is dissatisfied - whatever their reason may be, legitimate or otherwise - they may lash out. Their anger may be directed towards individual staff members or perhaps the organisation as a whole. From personal  confrontations, to persistent and threatening emails or defamatory statements on social media, it can be a stressful time for those on the receiving end.

As an organisation, you will naturally want to address their complaint as fully and as quickly as possible, yet you will also be concerned about the impact on your employees and will want to avoid any unnecessary negative publicity.

There is no universal solution to dealing with challenging individuals and your approach will need to adapt depending upon the individual situation. There are a number of things to consider:

  • Is the individual known to the organisation? Have they complained before, and why? Was the complaint justified and how was it resolved?
  • Has the individual received treatment? If there is any potential for an allegation of negligence, then legal advice should be sought as early as possible.
  • What do you know about the individual? This may assist in identifying an agenda, and in turn, help you assess which course of action to take.
  • Who is dealing with the individual? Are they properly supported and have they received sufficient training to deal with the situation? Supporting the employee will help you manage and monitor the situation and ensure that all communications are consistent.
  • Keep a record. Maintaining a record of all interactions with the individual such as blogging and social media posts, emails, or calls can be a useful method of measuring whether the behaviour is escalating, and will help to demonstrate that you have dealt with them fairly. Keeping screenshots of any electronic communication will ensure that you preserve the evidence should it later be edited or deleted.

If the situation escalates, there are steps you can take. Not all will be suitable for every situation and it is important to seek advice on the most appropriate course of action.

Letter and suggestion of a meeting

A formal letter will show that you are taking matters seriously. The individual should be made aware of what behaviour is appropriate and within what parameters you are prepared to communicate with them. Set out the appropriate forums available to address their concerns, and provide information about how to make a formal complaint, either within the organisation or to the relevant professional body.

You should provide details of a single point of contact for the individual to engage with to ensure that the concerns can be properly addressed. An offer to meet will demonstrate a willingness to resolve matters and provide an opportunity to gauge what the individual wants to achieve.

The letter should not dismiss or inflame the situation, but should instead demonstrate a willingness to resolve the matter.

Report to the police

If an employee feels threatened or harassed by the individual’s behaviour, it may be necessary to report it to the police.

For an offence under the Protection from Harassment Act 1997, there must be evidence of words or behaviour on two or more occasions causing harassment, alarm or distress. If a complaint is made, the police should investigate and will usually issue a warning. The threat of a criminal conviction may be sufficient to put a stop to the behaviour.

The police may also consider investigating under the Malicious Communications Act 1998 or the Communications Act 2003 which deal with the use of letters, articles or public electronic communications sent with intent to cause annoyance, inconvenience or anxiety.


Defamation is a civil action to prevent damage to reputation and is covered by the Defamation Act 2013. Defamation includes libel (written comments) and slander (the spoken word). You will need to show that the defamatory comments have been made in the last year and have caused serious harm. The allegations must be specific in naming an individual, and must be defamatory insofar as they would tend to lower the target in the estimation of right thinking members of society generally.

The individual may be able to defend a claim for defamation if the comments were published in the pursuance of a pressing legal, social or moral duty to protect or further a legitimate interest, or if they can be shown to be substantially true.

Defamation is a developing area of law, but can be an expensive option with a risk of adverse publicity. Given that for many healthcare providers the cost would be met from public funds it is often a last resort.


Dealing with challenging individuals can be difficult and stressful for all involved. It is important to keep a record of all interactions with the individual and direct them towards official complaints procedures where possible. Adopting a calm and tailored approach to each situation will enable you to choose the most appropriate way to address it. However, there is no one size fits all approach and often, the best way to protect yourself and your employees is to seek advice.