bazzerfewi wrote on May 29^th, 2011 at 7:27am:

Indeed. All calls carry the premium, irrespective of whether the charge is BT's (regulated) abnormally low charge of 4.084 pence per minute or T-Mobile's 41 pence per minute. For more on this, see my blog: How do 084x numbers work?


bazzerfewi wrote on May 29^th, 2011 at 7:27am:

This is not the worst thing. Any organisation which uses these numbers is fully entitled to justify its decision if its so chooses (or perhaps if it feels the need to).

What is the worst thing is the lie that "For all patient calls, our local GP number will not be more expensive to call than using an ordinary number". Ravenswood Medical Practice says that the company which supplies its new phone system has demonstrated that this is the case but provides no supporting evidence for this very dubious claim.

It also chooses to refer to the premium Business Rate number as a "local GP number".

Had it given qualification to the work "all", that it excludes certain tariffs, then it would be clear to see what game this practice is playing. If it has evidence that its current and future patient-base does not (and will not) subscribe to any of these tariffs, then it should present it.

These are the daytime rates with some landline providers:

Tariff	Geographic/03 ("Ordinary number")	0844 387 [g11] ("Local GP number")
BT Unlimited Weekend/Unlimited E&W	7.60	4.084
BT Unlimited Anytime	0	4.084
Virgin Media - all except Talk Unlimited	8.68	8.16
Virgin Media - Talk Unlimited	0	8.16
Sky Talk Freetime	6.03	4.09
Sky Talk Unlimited	0	4.09
Post Office Homephone	5.36	4.08
TalkTalk UK Evening & Weekend	7.6	6
TalkTalk Anytime	0	6

Those in green show the cheapest and the ones in red show the most expensive for each respective tariff.

It is interesting that these surgeries are now adopting g11 0844 numbers which are one down from the top type, g6, which they used to be moving to.

This table rather suggests that they choose not acknowledge that patients have inclusive packages. The 'per minute' cost of calls is that high that it is worthwhile to switch to an inclusive package if only a few calls are made. That is, to get to the break even point between non-inclusive paid-for (per minute) calls and the additional charge to have calls inclusive requires very very few calls to be made.

A 'per minute' geographic rate is therefore a penalty for making such calls outside of the times of inclusivity.

I won't even bother comparing call charges with mobiles because they all charge more for 0844 calls!


So, as I say, the "all" does not include a number of patients, but this practice chooses not to mention this, which makes its statement misleading due to the sheer size of this group.

"I don't know what percentage of patients use mobiles to call that surgery but round here I reckon it's over 50%"

And most of the rest will use landline inclusive packages of some sort or other.

The percentage for whom the cost will not be more will be minuscule.

If the law states that calls to a Doctors surgery should not cost more than a local call can this be legally challenged.

I am not qualified to comment on the law, is there anybody that may know a way to take these surgeries to task. It is my intention to meet with the local M P Dan Jarvis as he has offered to assist in the misuse of 08 numbers

I've sent (very polite) emails to two of the recent GP surgery's to move to 0844 numbers - No surprise that they have ignored me.

I have also followed up with my local PCT. I am awaiting a full reply, but their acknowledgement from their complaints officer was (I think) possibly illuminating:

"I will look into your concerns about the 0844 numbers and reply to you when I know more"

Could it be that although this is high on our priority list this is just one of too many issues they are dealing with and low in priority on their "to do" list.

I (probably unreasonably) assumed they would know all about the issue and have a policy and plan.

Could this be why we keep seeing the standard replies from the PCTs in the press when it hits the newspapers; paraphrasing - provided it costs no more than a local call it is ok. A correct and easy reply, but of course if they actually checked the cost (which takes effort) they would see their GPs are breaking this rule. Stating the rule is easy and takes no time; checking it is true and doing something about it when you find out it isn't takes a lot of effort.

It could just be the PCTs are over worked (as most of us are) and this does not come high enough on their to do list.

Please find below my email correspondence with Surrey PCT. Their reply is very informative. See my reply to their reply in the next post.
________ 

Hello xxx, you probably don't remember me but we spoke several years ago
regarding this topic.

As I know you will be aware the new rules came into play in April re the GPs use of
0844 numbers.

The response (at least from what one can gather from the press and internet) from
most PCTs regarding this matter appears to be disappointing.

Most PCTs seem to state that as long as GPs using 08xx numbers ensure the cost
is no more than that of a local call they are free to continue. If the GPs claim this is
so then no further action appears to be taken, even though the evidence regarding
the cost is clearly contrary to this statement.

Those of us campaigning against the use of 08xx clearly would not be campaigning
if it were true that the calls did not cost more (what would be the point?)

However I haven't heard anything regarding the Surrey PCT and as a Surrey
resident I thought it appropriate to ask your position. I hope it is different from other
PCTs, but as I haven't seen our local GPs changing from their 08xx numbers I would
appreciate knowing your position.

Tables have been produced (I can direct you if you wish) comparing all operators
local costs to 08xx costs which clearly show the difference in cost. However one
need not go into that detail. Three simple glaring examples exist which cover the
vast majority of the population namely:

* Landline users with inclusive packages of one sort or another (how many landline
users don't have such packages?)

* Mobile phone uses with inclusive packages

* PAYG mobile users.

All 3 of these users pay significantly higher costs.

The transfer to the equivalent 03xx is straightforward without any loss of functionality.

The poorest in society are those worst hit by the use of the 08xx numbers. For me it
is annoying, but for someone on a very low income using a payphone or PAYG
mobile it can cost several desperately needed pounds just to make that call.

Regards Keith.
                            ________________

xxx,

Just looking for a response re the attached email.

Clearly 0844 numbers cost more to call from:

a) all landlines with inclusive packages
b) all mobiles with inclusive packages
c) most mobile PAYG phones
d) all payphones
e) some non inclusive package landlines.

That puts GPs using 0844 numbers in breach of the rules.

In the case of c) and d) this impacts the poorest in society hardest with the biggest
cost.

What is the position of Surrey PCT regarding this please?

Regards Keith

         ____________________

xxxx,

Any response yet please re my email on the use of 08xx numbers by GPs please?

Can I draw your attention to the following link (you may need to copy and paste into
your browser if the whole link is not highlighted when you receive this email)

http://nhspatient.blogspot.com/2011/06/nhs-gps-using-expensive-telephone.html

From this link you can obtain a list of the cost of all 08xx numbers operated by GPs
which is compared to the price of using an 01/02/03 number for all telephone
providers and all packages.

It also provides a list (and map) of all GPs using 0844 numbers and as you can see
a number are in Surrey.

It is now 2 months since GPs should have ceased using such number (they can very
easily and readily convert to the equivalent 03xx number). This delay costs patients;
in particular the most vulnerable and least well off.

Those worse affected are the poorest in society, those that have to make frequent
appointments and those that use payphones or PAYG mobiles.

Sadly a significant number fall into all 3 categories. Those that can least afford it
should not be forced to pay so much to make an appointment to see their GP.

Regards Keith.

                   __________________

Dear Keith

I write further to your email regarding the use of 0844 numbers in GP surgeries.

Following the recent Department of Health update on the guidance for use of these
numbers (attached), NHS Surrey conducted an audit of all 137 GP surgeries with
whom we have contracts.  Of the surgeries that declared that they still use 0844
numbers (total 14) most are compliant with the Department of Health Guidelines.
Some are looking to change back to a geographical number (i.e. 01483) and one,
which is not compliant but bound to a contract with their phone supplier has been
informed by our Contracting and Commissioning team that they cannot renew the
contract in the future and until then must offer to ring patients back at their own cost.
I can also confirm that all but one surgery (the latter one) do not make a profit from
using these numbers.

Our understanding of the guidance issued by the Department of Health is that no
call to a surgery should cost more than the local geographical number for that area.
We fully appreciate and sympathise with those patients who have telephone
packages that allow free local calls, however, it is very difficult to ascertain the
variation of tariffs available to individuals. If a patient believes they have been
charged more than the local rate and can provide evidence in the form of their
phone bill, the PCT can, and will, challenge the surgery from a contractual point of
view and assist wherever possible to resolve the situation for the patient.

I hope this answers your queries.

Yours sincerely

Sorry additional reply from me (point that I missed)

         ___________________________


Sorry xxx I missed the point where you said "I can also confirm that all
but one surgery (the latter one) do not make a profit from using these
numbers. "

This can not be correct. 0844 numbers are revenue generating. The GPs
may not be taking income in the form or revenue from the calls, but will be
taking a discount on the cost in some way. From both an accounting and
cash point of view this is exactly the same thing. It effects the profit figure
in exactly the same way.

Logic must tell you this is the case. If not why implement an 0844 number
in the first place? Why would it cost them more to implement an 0344
number. The difference in cost is the profit they will be losing.

Keith.

Story from Braintree & Witham Times:

GP surgery changes its number amid complaints

This shows that it can be done!