http://www.worcestershirehealth.nhs.uk/Internet_Library/Primary_Care_Trust/board...

USE OF NON-GEOGRAPHIC (‘0844’) TELEPHONE NUMBERS BY GP
PRACTICES

Introduction

There has been considerable media debate regarding the use of 0844 (nongeographic)
telephone numbers by GP practices. In Worcestershire there are
eleven practices using 0844 numbers.

Background

In April 2005 the Department of Health wrote to PCT Chief Executives stating
that Ofcom was considering changes to the pricing arrangements, which could
mean that revenue sharing on 0844 numbers would not be possible. The letter
made PCTs aware that the Department was reviewing the use of all nongeographical
numbers and that practices should bear this in mind if they were
considering switching.

In September 2005 Ofcom proposed that providers of 0844 numbers should be
required to publish more comprehensive and accurate pricing information, and
stated that it planned to monitor the types of services offered on 0844 numbers
and would consider taking action if providers started to offer services on 0844
numbers which were better suited to other number ranges.

In December 2006 the Department of Health wrote to PCT Chief Executives
regarding the introduction 03 numbers which will be charged at the same rate as
calling a geographical number and can be included in any inclusive or low-cost
call packages.

Contractual Obligations

Within Worcestershire the eleven practices with 084 numbers are contracted to
four service providers – Connaught Communication Systems Ltd, Midland
Communications, STL Communications Limited and NEG Telecom Limited. Two
practices have purchased systems outright whilst the rest have contracts which
have between 2½ and 6½ years to run.

Cost of Calls

There is a significant variation in the cost of calling 0844 numbers from mobiles
and the patient is very much in the hands of his or her service provider. For those
patients with a BT residential landline on a standard contract the cost of a
daytime call to an 084 number is 4.255 pence per minute (excl. VAT) 5.00 pence
(incl. VAT). In comparison the cost of making a local BT call in on standard
contract in the daytime is 3.36 pence per minute (excl. VAT) 3.95 pence (incl.
VAT) with a connection fee of 5.10 pence (excl. VAT) 6.00 pence (incl. VAT). On
the face of it there is very little difference between the two. However, significant
numbers of patients will be on low cost call packages, either with BT or other
providers, which may include free daytime calls but will exclude 0844 numbers.

084 vs 03 vs local Number

A practice using an 0844 number will receive a share of call income from the
service provider. This will either be a payment directly to the practice or will be
used to reduce their lease payment.

If a practice moved to an 03 number patients would benefit as these numbers
can be included in low cost call packages. However, 03 numbers will not be
attractive to a practice as not only would they lose their revenue share but they
would also pay to receive incoming calls.

Practices could revert to a local number which could benefit the patient. The
downside from the practice’s point of view is they would once again lose their
revenue share.

Summary

Practices are independent contractors and as such the decision on the type of
telephone system they use is entirely theirs. However, the PCT could
recommend that, in future, practices do not migrate to an 0844 number and this
could be made a the prerequisite for funding of a GP premises development.

The telephone market is extremely competitive and whilst there is little to choose
between the cost of a call to an 0844 number and to a landline on a BT standard
contract the reality is that, for a significant number of patients, this is not a valid
comparison because of the availability of discount call packages.

Migration to an 03 number is not an attractive option for practices as not only
would they lose their revenue share they would actually pay to receive incoming
calls.

Migration to a local number would mean practices would lose their revenue share
but a significant number of patients would benefit from their discount call
packages. Essentially we would be returning to a pre-0844 era in that practices
would pay the full cost of their telephone lease.

Paul Bates

October 2007

More public comments on the Mail website : ---

Scandalous that already grossly overpaid GP's can fleece us for phoning them to make an appointment. They'll be charging us for sitting in the waiting room next.

- Kp Nuts, Thornbury, UK

"..A spokesman said the system benefitted patients because it allowed them to be placed in a queue.."

Err, I'd rather hear an engaged tone than be connected to a queue and pay for the privilege of hearing piped messages/music for 3 to 4 minutes, and PAY for it all as well. These G.P's are onto a nice little earner on top of their wildly inflated salaries, all at the expense of their patients. How greedy and diabolical of these G.P. surgeries.

- David, UK

Our library here in Hampshire has this 'new, improved service' for residents, with an 0845 number. No doubt we are being fleeced with that, on top of the £3 million spent on a library and council tax having doubled.

- Bryan Lawrence, Gosport UK

It is a pity that Network Europe Group's perception of patient satisfaction does not concur with that of the patients whose interests they hold in contempt. Meanwhile, the company has provided an 0800 number for its customers, so at least it does not cost any money to berate them for finding this unique opportunity of exploiting the sick.

- David Elliott, Brighton, UK

Kick out the spivs and wideboys and return to a proper state funded National Health Service is the answer to this problem.

- David, Andorra La Vella, Andorra

Some while ago, my father-in-law, who lives 50 metres away from his doctors surgery in kent walked there to make an appointment, only to be told that these were only given by telephone so he had to return home and then spend money to get the appointment he wanted. What arrogant people make these rules?

- Kevin Fletcher, France

Yet another rip-off that the Labour and Ofcom will fluster and bluster about then ignore.

Many overseas phone companies won’t connect to 0844 numbers as they are “premium”. So if you are sick abroad and a doctor needs to contact your doctor in a hurry . . . well more money for a £110,000 doctor comes first.

What is so sad is that people put up this.

- David Lewis, Staines, UK

So now our so called 'professionals' have joined the "Feed the Greed" club ... I thought better of GPs - obviously I was wrong. No wonder ordinary decent true Brits are leaving the country in droves.

- Kathy Doyle, Wisbech UK

The doctors surgery I worked at installed an 0870 telephone number and once the patients realised how expensive it was instead of phoning they would come to the surgery. So every morning there were huge queues of people waiting outside most of which were not happy so the poor receptionists had to take the brunt of the complaints not the practice manager who had installed the system.

- Shirley, Wimborne

What a scandal.

Why is the British consumer treated like fish in a barrel? Everyone has their hands in our pockets.

There simply is no honour left.

- Dino Fancellu, Epsom

http://www.timesonline.co.uk/tol/news/uk/health/article2896435.ece

From The Times, November 19, 2007

GPs told to avoid premium numbers

David Rose

<<
Doctors should no longer be using 0844 telephone numbers that charge patients extra to call their GPs, the Department of Health has said.

The Government said that GPs should be using alternatives to the numbers, which are up to 4p a minute more expensive to call from a BT landline than a standard local call. Practices can also receive a rebate on incoming 0844 calls.

The Times reported in July that more than 1,200 doctors’ surgeries are using the numbers, prompting a campaign by consumer lobbyists who say that GPs are unfairly profiting from patients’ calls.

In a statement to primary care trusts, the Department of Health said: “We do not expect GPs to break existing contracts, but they should not be entering new ones that would involve patients being charged more than for a local call.”

Michael Kennedy, a member of the saynoto0870.com internet forum, said: “GPs who have contracted to use these revenue-sharing numbers may well be in breach of their contracts because they are precluded from charging patients.”
>>

Posted here and in the parliament thread:

House of Commons Hansard Written Answers for 19 Nov 2007 (pt 0032)

19 Nov 2007 : Column 602W

Greg Mulholland: To ask the Secretary of State for Health (1) how much his Department estimates GP surgeries receive in revenue from calls to 0844 revenue sharing numbers; [164453]

(2) how many GPs' surgeries in each primary care trust area use 0844 revenue sharing telephone numbers; [164454]

(3) through what mechanism GP surgeries receive payment from calls to 0844 revenue sharing numbers. [164455]

Mr. Bradshaw [holding answer 15 November 2007]: We do not collect information centrally on the use of 084 telephone numbers.

The provision of telephone services for patients and the public is a matter for the local national health service. The Department did however issue guidance in December of last year clearly setting out that patients should not be charged more than the equivalent of a local call.

When will HMG start replacing should with must?

http://www.thisisdorset.net/display.var.1849201.0.gp_practices_defend_using_0844...

GP practices defend using 0844 numbers

By Joanna Codd

<<
LOCAL GP practices have been defending their use of non-local telephone codes after an attack from the Patients' Association.

The association says one in five practices is using 0844 numbers, which can cost as much as 40p a minute to call from a mobile telephone.

Two and a half years ago, the government banned NHS organisations from setting up new premium (09) and national rate (087) telephone numbers for patients contacting local services.

But Katherine Murphy from the Patients Association said even the 0844 number flouts government guidance that the NHS should charge no more than local rates.

"You ring up and are confronted with a long list of options. And all the time it is costing an absolute fortune," she said.

Judith Young, practice manager at the Talbot Medical Centre in Wallisdown, Bournemouth, which has an 0844 number, said its Network Europe Group service helped patients get through to the right person at the right time.

The switch had been made to improve the service for the group's 16,000 patients. "We have had much-improved access to the doctor on the telephone," she claimed.

The Holdenhurst Road surgery, which also has an 0844 number, said patients seemed to feel they were getting a better service, but if new guidance came out, it would look again at its system.

A spokeswoman for Ofcom said: "The cost of calling an 0844 number can certainly be more than calling a geographical number, but that would depend on the package you're on and the line you are calling from.

"Sometimes there can be problems phoning from abroad and these numbers don't tend to be included in discounts.

"Guidance given by the Central Office of Information says public sector bodies should be looking at normal 01 or 02 numbers."

She added that Ofcom had also issued 13 million new 03 numbers, as now used by the Ministry of Defence and RSPCA.

Customers calling them are charged the same as a local call whatever kind of line they are ringing from.

7:00pm Wednesday 21st November 2007
>>

Source: Lynn News
Published: 27 November 2007

http://www.lynnnews.co.uk/news/Doctors-new-39phone-service-slammed.3523239.jp

Doctors new 'phone service slammed

By Amy Collett

<<
A WEST Norfolk doctor's practice has been accused of "robbing its patients" after introducing a new telephone number which charges up to 40p a minute.

Patients at Vida Healthcare's Gayton Road Health Centre in Gaywood and Carole Brown Health Centre in Dersingham are being charged more when they ring to make an appointment after GPs switched their local rate number to an expensive 0844 number.

The new number has been slammed by Gayton Road patient and former health authority chairman Roy Spencer, of Lynn.

"Not only does the call now cost more but we have to deal with an automated phone system making our calls last longer and therefore costing more," he said.

Mr Spencer, who was chairman of the former West Norfolk and Wisbech Health Authority 20 years ago, said the move was particularly unfair to the elderly and vulnerable.

"The more you accept these type of things the more it's going to cost us in the end. So much for a free health service. Doctors should stop robbing their patients."

The new number was installed earlier in the year, but Mr Spencer said as no letters were sent to patients he only discovered the change when he made an appointment last week.

It is thought the two surgeries are the only ones in West Norfolk using an 0844 number, which costs 5p a minute from a landline and 40p from a mobile. This compares to a local rate of 3.25p a minute.

When the Lynn News phoned Gayton Road on Wednesday, it took more than two minutes of going through options and being on hold to speak to someone.

By the time the call ended, about the time it would take to make an appointment, it had taken about three minutes – a cost of around £1.20 on a mobile.

In 2005, the Department of Health issued guidance to GP surgeries about the use of high-cost numbers following comSplaints that some surgeries were using premium-rate 0870 numbers, which are even more expensive. The 0844 number, although not technically premium rate, is still much dearer than a local call.

But as GP surgeries manage their own business, the NHS cannot force them to change.

Graham Dickerson, managing partner of Vida Healthcare, which operates both Gayton Road and Carole Brown surgeries, said their phone system has been approved by the DOH and is used in around 1,200 practices across the country.

He admitted mobile suppliers charge high rates to 0844 numbers, as they do many numbers, but said: "That's not really my problem."

He said the system, which handles 25,000 calls a month, was brought in as a direct result of patients' comments about phone access, with many saying they would rather wait in a queue than having to keep re-dialling. The surgeries' two patient groups were also involved.

Jill Brock, chairman of Gayton Road's Patient Participation Group, said posters asking people to attend a meeting to discuss the new number were put up and letters were sent out with repeat prescriptions, but only two of the centre's 17,000 patients turned out.
>>

idb wrote on Nov 28^th, 2007 at 2:00am:


Talk about shutting the stable door after the horse has bolted!  Also if the NHS could previously force all doctors surgeries using 0870 numbers to suddenly stop using them at the same time and move to 0844 surely they have the precisely the same power to force them to renegotiate their contracts with their telecoms suppliers after a certain date so that they can only use 03 numbers.

If renegotiating these contracts to use 03 numbers costs them more money tough.  Its entirely their own fault for entering the contracts in the first place and the costs of funding the reneogotiation should come out of GP salaries at the practices involved to punish them for their own combined greed, stupidity and incomptence.

Of course no doubt we can hardly expect the top management of the NHS who are still holding out against providing an 01,02 or 03 alternative number for NHS Direct to be prepared to do the right thing by their patients.

http://www.northantset.co.uk/news/Patients-pay-more-for-calling.3551428.jp

Patients pay more for calling doctor

By Simon Hughes

<<
PATIENTS in Corby and Wellingborough are having to fork out more money to see their doctors after surgeries installed 0844 telephone numbers.

Four surgeries use the system, resulting in higher costs for patients who want to book an appointment.

Woodsend Medical Centre and Forest Gate Road Medical Centre in Corby have 0844 numbers as do Redwell Medical Centre and Albany House Medical Centre in Wellingborough.

Depending on the supplier, calls can cost up to 10p a minute from a landline and up to 35p from a mobile.

Michael Summers, trustee of the Patients' Association, said: "I think it's inappropriate and my understanding is although those numbers were designed to be helpful, it's not effective and doesn't really speed up the calls.

"It seems wrong that patients are having to pay for a free NHS through their taxes and then pay extra through these calls."

Corby councillor Ray Lilley has demanded to know when the surgeries will change back and accused them of penalising pensioners and young families.

Max Hand, manager at Albany House Medical Centre, Wellingborough, said the 0844 system only charges an extra 1p a minute for most people calling on a landline.

He said: "The additional money goes to the operator, not to us. It's a moot point as to whether a queueing system is better – we think it is because patients don't get an engaged tone now.

"Otherwise it's a complete lottery and this is a fairer system."

Linda Whitehead, manager at Woodsend Medical Centre, said the 0844 number was installed because people complained about the old booking system.

A Department of Health spokesman said: "We do not expect GPs to break existing contracts, but they should not be entering new ones that would involve patients being charged more than for a local call."

Mary Leggart, a patient at The Medical Centre in Forest Gate Road, Corby, said: "I didn't realise that it was more expensive to call. I think it's awful. It should all be the same cost at all the surgeries."
>>