Elderly patients are being turned away from GP surgeries and forced to book appointments online in breach of NHS contract rules — with one 92-year-old woman left to drain a lump on her own hand using a sterilised Stanley knife after failing to secure a consultation for 18 months.
A survey of 926 older people by Re-engage, a charity tackling loneliness in old age, found that as many as one in three people aged 75 and over had been made to submit online forms to see a doctor. The findings, published in a report titled Care On Hold, come despite NHS contract rules explicitly requiring all practices to allow patients to book appointments by phone or in person if they choose to do so.
The Re-engage report warns that the growing digital-first approach is leaving older patients without healthcare, pushing some to self-treat at home, turn to emergency services, or go without care entirely. Jenny Willott, the charity’s chief executive, said: “Many older people are being pushed toward digital routes they cannot easily use. Digital tools and AI can play a role, but they cannot replace human contact, which is often a vital lifeline for older people who are lonely or socially isolated.”
The human cost of the policy failure is stark. Rose, 92, from North Somerset, lived with a walnut-sized lump on her hand for a year and a half before taking matters into her own hands. “I sterilised a Stanley knife on the stove, put my hand on the worktop and shoved the knife into the lump,” she said. A former nurse, she did not blame individual staff but added: “They don’t have the interaction whereby you’re a patient, not an animal.”
Bill, an 81-year-old from the North West of England, spent an hour trying to book an appointment with the help of his daughter — navigating both an NHS account and a separate surgery login — after being turned away in person and told to go online or call a number answered by a machine. “If I had to do it myself, I’d have given up,” he said. His daughter added: “I suspect our experience is being repeated up and down the country, but not everyone has support from a family member or friend to help them.”
The situation has persisted despite NHS England introducing updated GP contract rules in October 2025, requiring practices to keep their online consultation tools open during core hours from 8am to 6.30pm, while also specifying that patients must still be able to contact their practice over the phone and in person for an equitable experience. Despite this, Re-engage’s survey suggests the rules are being widely ignored in practice — and critically, no surgery appears to have faced any sanction for doing so.
Dennis Reed, director of the over-60s campaign group Silver Voices, said he was receiving a growing volume of complaints. “GP contracts require that bookings over the phone or in person should not be refused, but practices which ignore these requirements can do so with impunity,” he said. “Our members who have raised the requirements have been told openly by practice managers that they do not adhere to these. I know of no case where a GP practice has been hauled over the coals, either by the ICB or NHS England, for making online bookings the default appointment process. Practices should lose funding if they flout these contractual requirements.”
He added that there was “absolutely no sign of progress on Labour’s promise to bring back the family doctor.”
The findings come amid broader upheaval in general practice. The new 2026/27 GP contract, backed by a £485 million uplift, brings the total estimated contract value to £13.863 billion, with NHS England emphasising improvements to access. NHS data for December 2025 showed that nearly 7.4 million patients submitted their GP request online — a figure the government has pointed to as evidence of progress. Critics argue those numbers mask the experiences of those unable to use digital systems at all.
Dr Becks Fisher, director of research and policy at the Nuffield Trust, acknowledged the tension at the heart of government policy. “Booking GP appointments online won’t work for everyone and risks excluding some,” she said. “If it fails to protect the option for bookings to be made in-person or over the phone, the Government risks shooting itself in the foot by making access harder for the many older people who tend to be both the highest users of GP services and the most satisfied age group.”
The Re-engage report also noted that some patients had been left to choose between online forms and AI bots on the telephone — a development previously highlighted by The Telegraph, which reported on AI chatbots replacing receptionists at GP surgeries. Re-engage warned that such systems were frequently repetitive, time-consuming and prone to misunderstanding what patients were trying to say.
NHS England was approached for comment.
