VIOLENT patients will be scrutinised by security guards and cameras in a new scheme which will allow them to see volunteer GPs from April 1.

Ealing Hospital's A&E department is one of only two in London pioneering a project which will ensure that dangerous patients are not stripped of their right to primary care while keeping medical staff safe.

It is estimated that between 20 and 30 patients in the Ealing, Hammersmith and Hounslow Health Authority have been removed from GP lists in the past year because of violence. Police are called in to practices to help deal with dangerous situations about five times a year.

Primary Care Groups (PCGs) have initiated training for all practice staff on how to deal with violent situations. In addition, the health authority and PCGs have developed a scheme where specific services can be provided at a secure unit in a hospital A&E department so doctors can inform patients that there are CCTV cameras and security guards on site.

The plan is to provide at least one site per borough at which troublesome patients can be seen but at present, only Ealing Hospital and Charing Cross Hospital have advanced plans.

It is hoped that the A&E department will be used as a temporary arrangement to allow the GP to assess troublesome patients. Depending on that initial assessment, future appointments are expected to be back at the main practice, although still subject to safety conditions. A report on the scheme notes that an important principle of the scheme is to 'rehabilitate patients and ensure them a normal service provision as soon as possible'.

Liz Shutler, director of Mental Health and Primary Care Services, said: "We are not prepared to put staff at risk from patients with a violent history, but nor are we prepared to leave people without access to primary care."