Patients report that GPS turn them away to be dealt with by dialling 111

sir – A worrying trend that I have recently encountered is patients reporting that their GP practice is closed or that phones are not answered when they try to ring.

Sometimes patients report speaking to a GP and being asked to call 111 for a face-to-face appointment with the out-of-hours service.

As a result, doctors such as myself who work in out-of-hours practices see far more patients, who are not best managed in these settings. They need either ongoing care from a GP or specific referrals.

This all has the potential to compromise patient well-being and delay suspected cancer referrals. NHS England was clear in its recent update on GP contracts that all practices must deliver face-to-face care where clinically indicated. At present this is not happening.

I would ask all my colleagues in general practice to reflect on this. If I can see patients, why can’t they?

Dr Milan Dagli

Harrow, Middlesex sir – Neil Mortensen, the president of the Royal College of Surgeons (report, August 28) estimates that NHS surgeons are working at 50 per cent capacity because of procedures to protect against the Covid-19 virus.

Why are these still in place when (by the only measures that matter, deaths and hospital admissions) the epidemic is over and has been for some time?

This egregious damage to health services, the economy, education and social cohesion has gone on too long.

John Black FRCS

President, Royal College of Surgeons 2008-11

Malvern, Worcestershire

sir – The sterling efforts of health workers in the NHS cannot hide the fact that a radical overhaul is long overdue for the NHS itself.

With face-to-face appointments with a GP almost non-existent, with ever-lengthening queues for lifechanging replacement surgeries, with cancer treatments curtailed or postponed, with many hospital wards still without patients and with private hospitals effectively closed for business (while they work out their lucrative contracts with the NHS), is it not time for a change?

The response to the Covid crisis may have avoided a Dunkirk, but we are poorly prepared for overall victory and urgently need to refocus, rearm and retrain, while developing a vision of what success will look like.

We need a rallying cry to persuade the Government that our country urgently needs an NHS fully serving the nation’s needs. To persuade Boris Johnson to be bold enough to bring about such change, what suggestions are there for such a rallying cry?

Dr Jeremy Mantell

West Lavington, West Sussex

sir – Can Matt Hancock explain why he has decided to change our National Health Service into a National Covid Service that only treats one condition. The rest of us suffer and die in silence.

Dr Mary Castle

Claygate, Surrey