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Doctors' phone line use reviewed - DH consultation (Read 293,646 times)
jgxenite
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Re: Doctors' phone line use reviewed - DH consulta
Reply #45 - Jan 5th, 2009 at 8:51pm
 
It certainly looks like the NHS is moving (albeit slowly) from 0845 numbers towards 0300 123 numbers - Change4Life being probably the first example of an NHS related body using an 0300 number.
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Re: Doctors' phone line use reviewed - DH consulta
Reply #46 - Jan 5th, 2009 at 9:43pm
 
Dave wrote on Dec 29th, 2008 at 3:48pm:
“If they use BT, it costs 4.2p a minute.”...

Mr Cheston evidently believes that those telephoning from BT landlines will be VAT registered. Should expenses which are exclusive of VAT not be spent as part of operating a business?
I think it's more of the likes that NEG may be telling surgeries it costs 4.2p and forgetting to mention that doesnt include VAT.

My main concerns, which I will put in my consultation response, are:-  
    *NHS is meant to be free at point of use

    * Patients who may not have a landline, or be financially better off (who is these days?) are penalised by ringing a 084x rather than a geographical or 03x which, if applicable, is included in any inclusive minutes.

    * Surgeries generally believe this to be a local or lo-call rate and it's NEG themselves that maintain this deception

    * It may not be diallable from some operators outside the UK

    * It really hard to say that calls are answered sooner because if a surgery only has one person able to answer a call at any one-given time then you may not actually get through any quicker compared to a surgery that operates a geographical and not a 084x number.  Yes, it would save redialling but on the flip side you could be held in a queue for several minutes (maybe even 10mins or more) at a cost of 5p/min (from a BT landline but obviously considerably more from a mobile) whereas ringing a surgery with a geographical number it could be included in any inclusive minutes and it doesnt cost anything to receive an engaged tone.
The last point, I belive, is one that some people may forget.  It's a matter of choice. I personally dont want to wait a long time in a queue at upto 40p/min when I could ring a surgery on their geographical number and get and engaged tone and just keep ringing back when convenient until its not engaged.  However some people may not care about waiting ages in queue and paying upto 40p/min.

If a surgery operated both a 0844 number and their underlying geographical number and callers were aware of advantages/disadvantages of each number then that would prove that the surgery (and ultimately NEG) are doing it to "benefit" patients rather than just to make money.  As far as i'm aware surgeries arent aware of any underlying geographical number as NEG keep this to themselves for obvious reasons
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SilentCallsVictim
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Re: Doctors' phone line use reviewed - DH consulta
Reply #47 - Jan 6th, 2009 at 12:07am
 
bbb_uk wrote on Jan 5th, 2009 at 9:43pm:
The last point, I belive, is one that some people may forget.  It's a matter of choice. I personally dont want to wait a long time in a queue at upto 40p/min when I could ring a surgery on their geographical number and get and engaged tone and just keep ringing back when convenient until its not engaged.  However some people may not care about waiting ages in queue and paying upto 40p/min.

If a surgery operated both a 0844 number and their underlying geographical number and callers were aware of advantages/disadvantages of each number then that would prove that the surgery (and ultimately NEG) are doing it to "benefit" patients rather than just to make money.  As far as i'm aware surgeries arent aware of any underlying geographical number as NEG keep this to themselves for obvious reasons

This is an interesting point. I am not sure if this is seen as only applying in the event of use of revenue sharing numbers not being banned.

Let us say for example that a NHS practice decided to continue using Surgery Line, but on a 0344 (or even a geographic) number, funded other than by patients. How far would the principle of choice demand that patients were offered alternative ways of making contact by telephone?

Furthermore, does the principle of choice work the other way around; should all surgeries be required to provide patients with the option of waiting in a queue (at no cost if they have an inclusive package) if that is what they would prefer?

My own view is that it is for each practice to decide how best to serve the needs and wants of its patients, however the use of revenue sharing telephone numbers should not be an option available to it. I do not believe that there should be a two-tier service; with one option available at a fee and another, which some would see as inferior, available without a charge being made by the practice.
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Re: Doctors' phone line use reviewed - DH consulta
Reply #48 - Jan 6th, 2009 at 8:04am
 
It appears that an otherwise moderately-behaved campaigner has been caught "fuming", or should that be "smoking", over the revelation that NHS Direct is operating a total of 69 revenue sharing 0845 numbers (if one adds 46 47).

It is perhaps odd that this highly tabloid piece did not make something of the potential soixante-neuf allusion that was offered, perhaps with a picture.

It is perhaps more odd that the fuming campaigner apparently did not make any reference to the on-going consultation, but then you can never trust what you read in the papers.
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Re: Doctors' phone line use reviewed - DH consulta
Reply #49 - Jan 6th, 2009 at 8:33am
 
Ahem!

"They should be concentrating on running telephone services for patients that cost no more than a local call."
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SilentCallsVictim
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Re: Doctors' phone line use reviewed - DH consulta
Reply #50 - Jan 6th, 2009 at 5:14pm
 
A far less tabloid piece here.

No reference to "local calls" or the agitated state of mind of a campaigner, and properly placing the particular issue in the broader context.

Publication of the Mirror piece has however excited interest from other organs of the media, of which more may be seen in due course.
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SilentCallsVictim
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Re: Doctors' phone line use reviewed - DH consulta
Reply #51 - Jan 7th, 2009 at 12:33pm
 
SilentCallsVictim wrote on Jan 6th, 2009 at 8:04am:

I now understand why this story was put together for publication hurriedly, late in the day, after a change of mind on the part of the editor, who had initially decided not to run it.

It was needed as the basis for editorial comment.

To have "The Voice of the Mirror" so clearly on our side perhaps shows that this issue transcends Party politics.
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Re: Doctors' phone line use reviewed - DH consulta
Reply #52 - Jan 7th, 2009 at 2:43pm
 
The EHealth Insider report cannot even get the NHS Direct number correct ...

" ... In addition to its main 0845 4567 helpline number ..."


I despair at these incompetents  Angry
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DH consultation flawed
Reply #53 - Jan 7th, 2009 at 11:12pm
 
Those who have been able to review the DH consultation document on use of 084 numbers may have picked up that it seems to be written to get a particular response.  Essentially, respondants are misled into believing that some of the 'useful features' are only available with 084 and not 01, 02 or 03.

I've asked the DH consultations co-ordinator to respond to the following:




I have a copy of the consultation document and will provide comments in the normal way.

However, there are serious and substantial errors in the consultation document.  These include:

p4 'These functions are not generally available with local rate numbers'.  As there is no such thing, on the UK telecoms network, as a 'local rate number', it is assumed the reference is to a geographic number.  All the call managment features available with 084 numbers are available with 01, 02 and 03 numbers.  The choice to provide such features is made by the provider; it is not determined by the number used to access the service.

p4 'Why are these extra functions needed?'.  The inference is that the fuctionality is connected to 084.  This is not the case.

p5 'What are the extra functions provided by 084 numbers?'.  The statement that these functions are provided by 084 is untrue, in the sense that each of them is perfectly possible with any other category of number.

p5 'Is there another way to provide the extra functions?'.  Whilst the suggestion of 03 numbers is helpful, 01 and 02 numbers should not be excluded.  Again, the same point applies.

p5 'Why are GP practices increasingly using 084 numbers?'.  Again, the listing suggests that these features are only available via 084 numbers.  Untrue.

p7 'GP practices and other NHS organisations using 084 numbers do not make a profit.'  To describe this statement as being economical with the truth would be to be very polite.  The deal with telecoms systems providers means that the extra call revenue is diverted into providing systems in which GPs would otherwise have to make a capital investment.  This is no different than suggesting that making patients buy their own wound dressings would not lead to GPs making a profit - it would reduce their essential overhead costs which has the same effect as increasing profit.

p7 'How to local rate, 084 and 03 numbers compare?.  The features attributed to 'local rate' (sic) numbers are, as outlined above, incorrect.


As you will gather I am very clear that the presentation of information as 'facts', when they are not, seriously undermines this consultation.  This is so serious that any results will be rendered meaningless.

I would be grateful if, by return, you will let me know what action you intend to take.

Thank you.
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Re: DH consultation flawed
Reply #54 - Jan 8th, 2009 at 1:27am
 
questedh wrote on Jan 7th, 2009 at 11:12pm:
respondants are misled into believing that some of the 'useful features' are only available with 084 and not 01, 02 or 03.


There is no question that the document does not properly distinguish between non-geographic (084 / 03) and geographic (01 / 02) numbers. The truth about 03 is in there, but it struggles to emerge.

In a spirit of genuine open enquiry, I seek enlightenment on the main point of contention in the posted comments.

I understand that many features exploited by telephone systems on non-geographic numbers use facilities hosted at the network telephone exchange. Use of these features comes at a cost which is met by a part of the revenue share income when available, or by additional charges to the user when not.

I also understand that similar or identical features can be provided by facilities on equipment at the (surgery) premises on the end of any number. Again these would come at a (possibly lesser) cost. There may however be differences in the nature of the feature, e.g. a local line fault may leave the whole service out of order and the size of the queue of waiting callers is constrained by the capacity of the incoming lines, which would otherwise only need to accomodate actual conversations in progress.

I had understood that it is possible for some of the facilities available with non-geographic numbers to be hosted on some geographic exchanges. Again this would be at a cost charged to the user, although I am not sure if this would be different to that applied when on a non-geographic number. I also understand that there can be clever tricks achieved by re-routing calls to geographic numbers through other exchanges to take advantage of facilities not otherwise available and then back again. This facility would also incur a cost.

The posted comments seem to suggest that the exchange hosted facilities available on non-geographic numbers are equally available on geographic numbers in all cases and in all respects. This would mean that the only valid reason for incurring the expense of a 03 number would be a desire to avoid the service being associated with any geographic locality.

I would be most grateful if my understanding could be enhanced.


The weak references to 03 (and possibly further misleading information) leave the consultation dangerously close to presenting the option of a better service only being available at a higher cost to patients. I cannot disagree with the suggestion that the consultation is thereby flawed, however those behind the consultation do know very well that this is a false choice, and what is more they know that we know that they know this.

I am confident that the results of simple responses to the consultation will indicate both that patients want better telephone services and that they do not wish to pay for NHS services as they access them. If the latter point were to come out in the other direction, Darzi would have to start his work all over again as he reported overwhelming support for the principle of "free at the point of need" in the NHS. This principle currently occupies a leading place in the draft NHS Constitution.

Patient satisfaction surveys have repeatedly shown that improved telephone systems lead to a significant increase in satisafaction ratings, so it is unlikely that respondents would reject the idea of improved systems.

The true purpose of the Consultation is to provide a period of public discussion and debate, with the engagement of key players, to determine how a ban on use of 084 numbers could be put into effect without compromising the quality of telephone systems. As all features have to be paid for in some way, the difficult question is, who (if not the patient) should pay?

This question is particularly difficult in the case of GP systems that are subject to long term contracts and are currently funding through revenue sharing. It has been suggested that these systems could be migrated to 03 numbers with revised funing arrangements. If, as is suggested, they could equally well be migrated back to the local numbers that were used previously, then this would represent a significant breakthrough. I urgently need confirmation on this point.

As those who can offer feature-rich telephone systems on geographic numbers must be regarded as key players in the Consultation, I look for them to come forward to show their hand and make their case in the public debate.
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Re: DH consultation flawed
Reply #55 - Jan 8th, 2009 at 5:21am
 
SilentCallsVictim wrote on Jan 8th, 2009 at 1:27am:
I would be most grateful if my understanding could be enhanced.


I'm amazed that after all this time involved with the campaign and having even met the esteemed Tanllan in person that you still seem to struggle to comprehend even these most basic features of the UK telephony systems and its revenue sharing aspects.

Still I expect this persistent Janet and John style approach makes you far more interesting for coverage by say The Daily Mirror.
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« Last Edit: Jan 8th, 2009 at 5:23am by NGMsGhost »  

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Re: DH consultation flawed
Reply #56 - Jan 8th, 2009 at 9:23pm
 
Most of what you say agrees with my understanding, in so much as I am only a member of the public with a specific interest in this technology, and not a participant in the actual industry.

Simply put, when you dial a phone number, the first few digits will identify the operator of the number and therefore the exchange that will handle the call.  For BT's 01 & 02 numbers, this will usually be the local telephone exchange.  For other operators, it need not be anywhere near the subscriber.  It's then up to the exchange what features it will offer the end user.   Numbers can be ported between operators, so it's possible for example for calls to a number originally allocated to BT to be passed over to any other operator, subject to the relevant porting agreements being arranged.

How a given operator gets the calls to the subscriber is up to them - BT mostly run a physical cable (copper or fibre optic) from the local exchange to the subscribers premesis.  Other operators may offer the calls via an internet connection (VoIP), radio waves (e.g. direct to a mobile phone, as per Orange geo numbers) handle it directly (in the case of recorded information services) or simply feed it back into the system by calling another number (how most NTS systems work, forwarding to a landline with its own number).

[it's quote possible for a call to traverse several networks.. e.g. I used to run an 0870 that was forwarded to a BT line. This had divert on busy to a Tesco geographic 0161 number, which was actually provided by VoIP via an internet connection to my local PBX, which if there were nobody in, could in turn forward it to my mobile (via a VoIP service provider..)]

The actual network faciltiies available to the subscriber, queuing, routing depending on time of day or origin, etc., are partly dependant on the operators equipment that the call arrives in on, but more importantly, on the marketing policies of the operator concerned.  e.g. most BT local exchanges can handle call queuing and conditional forwarding, but you'll only get offered them as part of a featurenet package.. (Or in a much watered down form as Call Waiting and Call Diversion)..

So, by porting your number to a more accomodating operator, you can do anything you like with any number.

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Re: DH consultation flawed
Reply #57 - Jan 8th, 2009 at 10:35pm
 
irrelevant wrote on Jan 8th, 2009 at 9:23pm:
I am only a member of the public with a specific interest in this technology, and not a participant in the actual industry.


Are you sure as your last post seems to display the same level of detailed technical awareness of how the whole damn setup works as Tanllan.

Still journalists seem to prefer talking to SCV because of his dogged persistence in pushing forward his KISS arguments that eschew becoming bogged down by the boring technical complexities of what actually is and is not physically achievable on the network.
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Re: DH consultation flawed
Reply #58 - Jan 8th, 2009 at 11:17pm
 
NGMsGhost wrote on Jan 8th, 2009 at 10:35pm:
Are you sure as your last post seems to display the same level of detailed technical awareness of how the whole damn setup works as Tanllan.


You can learn a lot by reading uk.telecom ...
I did work for a company that was part-owned by BT once, but that was 20 years ago...    No, I've just had a technical interest in phone systems ever since I built my own modem and re-wired the house for plug-in phones about 25 years ago; several years before the current BT sockets became available.  Most of my hobby and professional life has been influenced by modem and on-line comms ever since, although only from a consumer point of view. Doesn't stop me reading up on how things work though.
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Re: Doctors' phone line use reviewed - DH consulta
Reply #59 - Jan 15th, 2009 at 5:39pm
 
Source: OnMedica

http://www.onmedica.com/NewsArticle.aspx?id=bffec7e7-3e4d-416d-a9b0-cfb605742428

BT drops practices 0845 phone number charges

OnMedica staff
Monday, 12 January 2009

BT has dropped its charges for 0845 and 0870 phone numbers for its customers if they have a call package, it has been announced.

The decision could ease pressure on the estimated 1,000 GP practices in England alone that use an 084 number – a decision which has prompted much criticism from patients whose call packages do not cover such numbers, forcing them to pay more to call their doctor.

More than 1,000 practices use 0845 numbers, which provide extra functions such as queuing for unanswered calls.

From Friday (Jan 16), patients will be able to phone around 300 practices that use 0845 numbers for free.

The change, however, does not include numbers beginning with 0844, which is the more commonly used prefix for GP practices, but it is hoped that this will, in time, also become included in BT’s call packages and those of other phone service providers.


What planet are these people living on? The call rate for any 0844 number block is chosen by its respective operator. As GPs are customers of these providers, it is ultimately of their own making.

Do they really believe BT, Virgin Media and other originating telephone call retailers are charities? It will cost them about 4 pence per call minute more than had it been an 01, 02 or 03 number and all for their benefit!

It does not help build a good perception of doctors.
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