The document posted below was pulled from either the DH web site or BT web site last year. Unfortunately I cannot locate the original URL. The document is entitled "Carson Recommendation Brief" and is produced by British Telecommunications Plc, 81 Newgate Street, London, EC1A 7AJ.

The front cover displays both BT and NHS logos.

Document date is Oct 18, 2005

I have omitted the preamble, version control history, review, authorization, distribution list and content list.

The document's purpose is "to describe methods that are available to meet the recommendations pertaining to telephony in the Carson Report" - stemming from "The primary telephony focus from a NHS paper (Raising Standards for Patients. New Partnerships in Out-of-Hours Care (October 2000)) written by David Carson, developed what has become referred to as The Carson Recommendation. This recommends Trusts to ensure that when a patient/member of the public attempts to make telephone contact with a doctor or health centre, outside of normal operating hours, only a single phone call is required"

According to the N3 web site -http://n3.nhs.uk/ , N3 is "part of the National Programme for IT (NPfIT). It will provide the entire NHS with fast broadband networking services. Without N3 it would be impossible to deliver other components of the Programme, all of which rely on greater bandwidth than the earlier networks NHSnet and N2 gave. In facilitating Programmes like the NHS Care Records Service, Choose and Book and the Electronic Transmission of Prescriptions, N3 is essential to the future of a modern NHS. It will enable the delivery of better care to patients and a truly 21st century infrastructure. It is the largest Virtual Private Network in Europe and is a project of a scale and complexity that has never been attempted before, in the UK or abroad.

It will deliver:

A fast and reliable network for every NHS site in England, supporting all National Applications, both current and new.

The flexibility to cater to future needs of the NHS, including the ability to take early advantage of updates and improvements in networking technology.
Bespoke networking solutions and services for the individual needs of different NHS organisations.

Support for NHS organisations in implementing innovative new services – for example, the use of video conferencing for appointments with consultants.

Substantial savings on the cost of telephony by enabling NHS organisations to converge their voice and data networks."


The document's original format is MS Word. If anyone requires the original document, please send a PM and I can email it.

(edit - the original document was at www.n3.nhs.uk/n3/publications/ListDocs.cfml?category=4 but it does not appear to be there now!)

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2.3      0845 Call Routing

This service is one of several “non-geographic services” offered by PSTN suppliers, this means that a caller can dial the 0845 number from anywhere in the country and know that they will only be paying a fixed amount, typically 5 pence per minute.  The network can be set to deliver (route) calls made to a 0845 number to a permanent exchange line or DDI number. Call plans can also be set up to provide time of day options or divert on busy/no answer to ensure calls are delivered to another number if required.  This service would appear beneficial to callers if they were previously making National Rate calls, with the NHS paying for the service.

It should be noted however that should other NHS Trust users call the published 0845 number then the call costs are at a higher rate than for a normal PSTN local calls, typically 5pence per minute, and not included within any pre-paid call bundling or call option “deals”.  This would erode savings made by the reductions in current PSTN service tariffs.  
Most suppliers provide a 0845 number service and typically they all charge a similar amount to the calling customer, some suppliers will offer a refund to the called customer, but this is not as prevalent as it is with 0844.

Some NHS organisations have attempted to get round the above problem by utilising the unpublished geographic numbers - that is they dial the exchange number/DDI number that the 0845 is pointed to, this has usually resulted in loss of routing functionality and other problems.

2.4      0844 Redirection

This service is similar in operation to the 0845 service but the tariff structure is different and is not fixed to the PSTN local charge.  The supplier charges a higher tariff to the caller and, in most circumstances, makes a refund to the called customer (typically around 1pence per minute).  Some suppliers are offering this service free to NHS customers but retaining any customer rebate. Redirected calls to a mobile attract particularly high tariffs on the caller.

Calls from within the NHS to the published 0844 will attract a higher tariff than that for a PSTN call of similar duration and distance thus reducing savings.

2.5      087x Redirection

Whilst this service is similar in operation to the 0845 service the tariff structure is different and is not fixed to the PSTN local charge but the national charge.  The supplier charges a higher tariff to the caller and in some circumstances recompense the called customer. This compensation may be used to pay for the costs involved in publishing the number change, usually motivated by a service or functionality improvement. Some suppliers have offered this service as part of a package to NHS customers which can include provision of telephony equipment. More generally the caller paid for the national rate call even if the called number terminated locally, higher tariffs to mobiles applied and generally the NHS organisation received financial compensation based on the number of minutes the supplier’s network is in use.

Calls from within the NHS to the published 0870 will attract higher charges than for PSTN calls of similar duration and distance made to geographic numbers.

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5      Ofcom Comment

Ofcom today (28/9/05) published new proposals to increase consumer protection measures governing the use of 0870/1 and 0844/5 numbers.
0870/1 and 0844/5 numbers (known as Number Translation Services or NTS) were introduced in 1996. Calls made to these numbers, which are not geographic numbers, have been priced at a level that has enabled businesses to share the revenue generated by per-minute call charges.
These numbers benefit consumers and businesses by enabling access to a range of services, including dial-up pay-as-you-go internet access, travel enquiries, tele-voting, telephone banking and many others. However, the growth and spread of usage of these non-geographic numbers in recent years has generated high levels of consumer concern about the lack of clarity in the pricing and marketing of these services.

Ofcom's initial proposals, published last October, prompted a range of responses from consumers and industry, including some significant disagreement.
Ofcom is now consulting on its new proposals. The key points include:
1.      0870: End to revenue sharing. Ofcom proposes that all calls to 0870 numbers should cost the same as calls to national-rate geographic numbers. This change would bring the cost of calling 0870 numbers down significantly. This price reduction would effectively end revenue sharing on 0870 when combined with other proposed changes to NTS call regulation.
Communications providers wishing to charge more than the rate for calls to national-rate geographic numbers would be required to provide a pre-announcement informing the caller of the cost of the call.
Ofcom proposes that providers should have up to 12 months to implement these changes. In the interim Ofcom proposes that 0870 call prices should not increase beyond their current levels.
2.      0871: Re-classified as premium rate. Companies using 0871 numbers would be regulated by the premium rate services regulator, ICSTIS, and would be subject to the same requirements as companies using 09 numbers.
3.      0845: No changes for the next two years. Many Internet Service Providers (ISPs) currently rely on 0845 numbers to offer dial-up pay-as-you-go internet services. Maintaining the current arrangements would protect these services for more than 5 million UK dial-up internet users. At present it is also often more cost effective for more than 1 million consumers on low incomes using BT's Light User scheme to dial an 0845 number than to make a national-rate call to a geographic number.
4.      0844: Increased price transparency. Changes to current prices (up to 5p per minute, with a 5p minimum charge, for BT customers) are not proposed at this time. However, Ofcom is proposing that providers should be required to publish more comprehensive and accurate pricing information. Ofcom plans to monitor the types of service offered on 0844 very carefully and will consider taking action if providers start to offer services on 0844 which are better suited to other number ranges.
5.      Improved consumer information. Ofcom proposes to require providers to give consumers better information about the cost of calling 087/084 numbers. To implement this, Ofcom is consulting separately on changes to General Condition 14, set under the EU Telecommunications Framework.
6.      Advertising and marketing. Ofcom will continue to provide support to the Advertising Standards Authority/Committee of Advertising Practice ('ASA/CAP'), whose guidance requires advertisers to provide consumers with pricing information for calls to NTS numbers. The guidance currently states that advertisers should not refer to 087 or 084 numbers as being charged at the "national" or "local" call rates.
7.      Use of NTS numbers by public bodies. Ofcom has already stated that, in its view, it is inappropriate for public bodies to use NTS numbers exclusively (i.e. without giving equal prominence to a geographic alternative) when dealing with people on low incomes or other vulnerable groups. Ofcom has also contributed to the Government's Central Office of Information (COI) best practice guidance on how NTS numbers should be used. Ofcom would like to see greater compliance with the COI's guidelines.
These measures aim to give consumers improved confidence in services using 0870/1 or 0844/5 numbers. Ofcom believes that the new proposals will prevent inappropriate use of these numbers and deliver clarity for consumers without disrupting important existing services such as dial-up internet access. Ofcom also believes that this approach will deliver greater certainty for telecoms companies carrying NTS calls.

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idb wrote on Oct 3^rd, 2007 at 3:09am: