Practices use of 0844 numbers to be investigated

Tags: 084 Contract GP GPs NHS Direct

29 Jan 2008

The government is to gather evidence about the use of 0844 telephone numbers by GP practices and its impact on patients, ahead of a possible clampdown on their use.

Health minister Ivan Lewis told a House of Commons debate that GPs making use of 0844 numbers should consider whether it is “best professional practice” to charge patients above the local rate.

He also gave a “cast iron guarantee” that the government will not allow NHS Direct to use an 0845 number when the NHS Direct contract comes to an end.

Lewis said: “It is entirely unacceptable for any professional working under the banner of the national health service to rip patients off by charging them more than the standard local call rate for contacting their surgeries. That is the Government's position.”

He told MPs that there were difficulties since GPs were self-employed, and also because some individuals had already signed up to contracts with telephone companies, but said he was happy to send a “strong signal” to practices considering signing up for 0844 numbers.

The health minister was taking part in an adjournment debate secured by Graham Stuart MP for Beverley and Holderness who claimed he had been contacted by patients after almost a dozen GP surgeries in east Yorkshire switched to 0844 numbers.

He told the House of Commons that service provider Network Europe Group have more than 1,200 GP surgeries using 0844 numbers and claimed that more than 300 other practices have had 0844 or 0845 numbers installed by other companies.

Lewis said a motion tabled in the House of Commons in November calling for an end to the use of 0844 numbers had been signed by almost 60 MPs and that the Department of Health had received more than 100 letters of complaint on the issue since January 2007.

He added: “This issue has united politicians, residents and patients groups alike - people who can spot an unfair practice when they see one, and who do not like it when the chronically ill, the old, the disabled and those on low incomes are taken advantage of. That is what I believe is currently happening, under the present system, under the present Government.”

The BMA’s General Practitioner Committee has defended the use of 0844 numbers. Last September it hit back at press criticism of use of 0844 numbers by GP practices which is claimed was “particularly galling” when many other public services including NHS Direct and many hospitals also use similar numbers.

It added: “Whilst we fully support the view that practices should not seek to make significant financial gains from their telephone systems, there is no evidence to suggest that using an 084 number allows practices to do this. In fact, many practices using 084 numbers are often able to deal with their calls more efficiently and quickly, therefore costing patients less overall.”

Link

The House of Commons debate

Related articles

Practices encouraged to use new 03 numbers

National rate NHS phone numbers to be banned by April

Reader's Comments

Breach of contract

29 Jan 08 13:01

One wonders how the minister can believe that it could be "best professional practice" for NHS GPs to charge for delivery of NHS services at all! It is a breach of the GMS contract (clause 483) to receive any remuneration from patients.

Third party costs of access are a separate issue. With a "revenue sharing" 0844 number the GP actually becomes a party to the arrangement between the patient and their telephone service provider. In many cases patients pay nothing at all for calls to local numbers as, unlike 08xx numbers, they are part of an inclusive package.

The GMC suggests that income earned in the way is OK, unless it is "significant". GPs who require use of a "non-geographic" telephone number to assist call handling should therefore be using a 03xx number, which would deny them the "insignificant" income from revenue sharing. Patients can call 03xx numbers on exactly the same terms as calls to local (01/02) numbers.

Perspective

30 Jan 08 08:01

Even on 'pay as you go' tariffs, the cost of a call to 0844 is typically 15p/minute. (The highest I could find was 25p/min). So a 5 minute call would cost 75p.

My local hospital charges 45p/min for a phone call and £1.50/hour for parking yet I am yet to see a minister saying this should come to an end. The reason is, of course, is that the hospital has a PFI car park and a deal with a telecom firm to provide equipment. The patient charges fund these developments and the government wants to avoid paying the cost itself.

Most 0844 practice are in contracts that use the money to pay the lease on equipment in exactly the same way. They often do not see any of the money themselves. The alternative (that my practice took) was to pay up front for the equipment. We, therefore, are not 'making money' out of patients but it means we could not go for as sophisticated a system and also had to defer other investment, including building improvements that also would have benefited patients.

0844?

paul.smith@gp-n81030.nhs.uk

30 Jan 08 09:01

Pot Kettle Black? There are over 300 instances of government and its agencies using non geo-graphic telephone numbers, including the flood line alert?

Depends whoose guidance you follow...

30 Jan 08 19:01

This from the 24th Feb 2005 -

Health Minister John Hutton today announced a ban on expensive telephone numbers that charge patients over the odds to call NHS services in their area. The ban will protect patients from paying premium and national rates to call local NHS healthcare services, such as their GP or dentist, in future. From April, NHS organisations will not be able to set up new premium and national rate telephone numbers for patients contacting local services. John Hutton also announced that the GP practices currently using national rate telephone lines will be expected to change these to 'lo-call' rate numbers, which offer patients a guaranteed low call rate. The switch to these numbers should be completed by the spring. John Hutton said: "Sick people and their families should not be asked to pay over the odds to contact local NHS services. The use of premium and national rate telephone numbers is an unfair additional cost for many NHS patients. That is why we are taking this action today." Michael Summers, chairman, The Patients Association, said: "The Patients Association welcomes this announcement. Many patients were contacting us as calls were so expensive, particularly when surgeries were busy or engaged. This decision will be welcomed by patients generally." Around 290 GP practices have established national rate lines, which charge up to 7.5p per minute, for taking patient appointments and for requesting repeat prescriptions. National rate telephone numbers start with an '087' prefix. Premium rate telephone numbers start with the digits '09'. The only special service numbers the NHS will be able to use in future are freephone numbers or those that offer patients a guaranteed low rate call, such as '0845' or '0844' numbers. The ban will be enforced through changes to the relevant legislation and guidance, including revised contracts for GPs and directions to NHS Trusts. It will also apply to NHS dentists, NHS opticians and GP out of hours service provider

Ends

Floods abroad

30 Jan 08 20:01

Unlikely to need to ring the Floodline from overseas. Might need to ring the GP to advise a doctor about medication or ongoing conditions whilst on holiday. I believe this is not possible via 0844 numbers.

And I also believe it is wrong to get patients and other parts of the health service to pay for GPs flashy new telephone exchanges and outgoing calls.

Flashy new exchanges?

31 Jan 08 11:01

You make sound as if practices go through the upheaval of swapping telephone systems just to get the latest 'bling' kit.

We replaced a system that was 15 years old and unable to be upgraded or repaired. The fancy new features we wanted were things like voicemail, ability to divert calls direct to the out of hours service, call recording and integration with our clinical system to allow appointments to be booked, changed and cancelled over the phone 24 hours a day. At the same time we increased incoming lines to make it easier to get through and put on more staff in the mornings to answer them. In the meantime my desktop phone is the base model and would not look out of place in a 1980s movie.

As for outgoing calls; the practices telephone costs have doubled over 5 years, mostly due to the number of calls to mobiles we now make and despite changing telephone company to get the best rates possible.

More pots and kettles

04 Feb 08 15:02

What is the telephone number for NHS Direct, the government-run NHS srvice for advice and Out of Hpours emergencies?

have a guess re the first 4 digits.

Click here http://www.nhsdirect.nhs.uk/assets/images/logo.gif for the answer.

William

costing patients less overall?

05 Feb 08 14:02

"In fact, many practices using 084 numbers are often able to deal with their calls more efficiently and quickly, therefore costing patients less overall.”

How exactly does the number dialled impact on picking up a phone and saying "Good day, the Surgery, How may I help?" so much you can have efficiency savings? How can anything cost an "all inclusive" package owner less?

NHS Direct

05 Feb 08 15:02

I'm not sure what relevance William's comment about NHS Direct's phone number has to this article. NHSD use an 0845 number (i.e. local call rate) and derive no revenue from it. It's a national service run from a number of locations: your call may be routed to a different call centre depending on how busy the service is. So a single non-geographic number makes most sense.

costing less don't think so

06 Feb 08 08:02

I think Williams comment points out that an 0845 number still cost a mobile user more than a local call but it's still not as much as it cost a mobile user to call the 0844 numbers. I have to call a lot of these practices whilst out on my patch using my mobile and I can honestly say I have not found a single one that has improved their service and become more efficient answering my calls. A 5 minute hold waiting to get through to someone is not unusual and now rather than ringing tone I get a message saying I'm connected but just on hold and they can charge me over the odds for the pleasure.