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At the heart of general practice since 1960

Reduce out-of-hours visits and patients will die

It is most foolish for any out-of-hours service to curb GPs' home visits or referrals to hospital.

It is through such activities that patients end up dying after being dealt with by multiple doctors.

What authorities should do is to analyse individual cases, and whether the doctor's management was appropriate. If it was not, the doctor should be asked for an explanation.

Use of telephone advice is a real scandal. Telephone advice is only suitable for surgeries where the doctor knows the patient, not for modern out-of-hours care.

There is nothing equal to seeing a patient, and all other actions should be based on this.

In order to give telephone advice, the doctor has to be confident that all the relevant information has been obtained and that the problem is simple enough to be dealt with over the phone.

The Government should also make it very clear that no patient on any controlled drugs will get a prescription from out-of-hours services and that if they need one, they should go to casualty, in which case many of them will drop the idea of a prescription at all.

Dr K Rukmani, Coventry

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