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I agree with Kate Venables. Doctors have a duty to co-operate (see GMC publication, Duties of a Doctor). When communication and negotiation with the practice fails, a letter to Hallam Street (enclosing copies of correspondence and details of telephone communication) ALWAYS produces results. I have used this approach twice with reluctant GP practices and the level of co-operation they now provide is amazing. No wonder I'm a supporter of clinical governance!! Dr Bob Guest Occupational Physician