Johnson steps up pressure on 0844 numbers

Tags: 084 Alert BMA Contract DH GP GPs NHS Choices PCT PCTs

11 Mar 2008

Health secretary Alan Johnson has stepped up the pressure on practices using 0844 telephone numbers as campaigners draw up a list of more than 800 surgeries with such numbers.

The health secretary, who is MP for Hull and Hessle West, criticised the use of 0844 numbers in his local paper as the Department of Health’s consultation on use of the numbers ends this month.

Practices have switched to 0844 numbers as part of schemes which provide them with more modern telecoms systems and the BMA claims that many practices using 084 numbers are often able to deal with their calls more efficiently and quickly, therefore costing patients less overall. However patients will normally pay 5p per minute when using such numbers compared to lower local call costs which may also be free as part of telephone call packages. The DH wants to see greater use of new 03 numbers which cost the same as a local geographic call number.

Earlier this month Mark Britnell, commissioning director, wrote to PCTs instructing them to issue an alert to practices over the investigation into 084 numbers.

He told PCTs that the investigation would conclude by the end of this month and the government would then decide if further action was necessary.

He added: “I would like to re-iterate the government’s position that patients should not be expected to pay more than the equivalent of a local call, and ask you to consider what action would be necessary to ensure that this is achieved. This will be particularly relevant to primary care service providers who are considering contracting or re-contracting for the provision of an 084 number system.”

Johnson told the Hull Daily Mail “We don't want to have a service here where we tell GPs who are all privately employed how to run their businesses. But what we do is we send out guidance and the guidance we have recently sent out was very clear about not using these 084 numbers."

The current consultation is a result of an adjournment debate held in January on the use of 084 numbers in which health minister Ivan Lewis said that it was “entirely unacceptable” for patients to be charged more than the local rate for contacting their GP surgery. Graham Stuart MP told the House of Commons that as many as 1500 practices use 084 numbers.

Mr Johnson told the Hull Daily Mail: "We are having this consultation and the clear inference there is that if we have to take further measures, we will, because we want to get them to move across to these 03 numbers."

In the meantime campaigner David Hickson, who previously led a campaign to prevent companies making ‘silent’ telemarketing calls, has drawn up a list of 807 surgeries in England which use 084 numbers, compiling the information from the NHS Choices website.

He has made the list available to MPs and some local newspapers have used it to publicise the names of practices using 084 telephone numbers. Hickson’s lists shows Leeds PCT has the greatest number of practices using 0844 numbers, a total of 27, while Calderdale PCT has the greatest percentage of practices using 0844 numbers, a total of 33%.

Hickson believes that use of such numbers breaches clause 483 of the GMS contract which prohibits receipt of remuneration from patients and says Alan Johnson also backed that view in the House of Commons debate in November.

He told EHI Primary Care: “GPs must use the best technology and systems available to provide the best possible service to patients within their budget. Service improvements cannot however be used as an excuse for departing from the fundamental principle that NHS services are provided "free at the point of need".

Last month the BMA’s GP committee advised practices using 084 numbers that they need to publicise their use of such numbers and the costs involved on practice leaflets.

Reader's Comments

0844 Numbers for GP's

11 Mar 08 11:03

Thanks for the informative article. I believe that it will be difficult for the local practices to make swift changes to the numbers 0844 that they are running with as many of them would have signed lengthly contracts on the numbers to subsidise the cost of the new telephone system. If the local GP's are forced to change to more local numbers (01 or 02) then who will pick up the cost of the phone equipment? And what about the practice stationery?

I am of the same opinion that 0844 numbers should NOT be used for local GP's. They suit more industry related companies with the need for additional revenue generation.

A fair period of parallel running (2 numbers 0844 and 01/02) should be introduced to allow the local practices to end the term of the 0844 contracts and then the numbers should be banned from use by the PCT's. Ofcom are starting to regulate this more heavily now and with the introduction of 03 numbers this can only help.

Kind regards James Carty http://www.citynumbers.co.uk

National Vs Local

12 Mar 08 00:03

Many posts on this subject have missed the most significant point.

National services (NHS Direct, Choose and Book's Appointment Line etc.) need a single number for the whole of England. An 084 number is usually cheaper than an 01 number unless you happen to live near the national call centre.

Most patients live close to their GP Practice, and a growing majority of us have free calls to local numbers as part of our phone contract.

Having recently changed GP, I can now call my GP Practice at no cost. My previous Practice had an 084 number that would cost me for every minute of every call (and that could involve several minutes on hold listening to Vivaldi's 4 bloody seasons).

Given that there's a direct correlation between the need for health care services and poverty, it's yet another example of Primary Care ignoring the needs of its most frequent consumers.

I've yet to see any argument for 084 numbers that held water.

I don't personally believe that GPs' greed is the motivator.

For those that signed up to 084 contracts without thinking it through, I think it's complacency, a susceptibility to pushy marketing and a lack of consideration for patients' circumstances.

Banning 0844 and 0845 numbers

12 Mar 08 07:03

Can anyone remind me what the number for NHS Direct is?

Perhaps I could contact the Labour party HQ about this issue. Their website gives the phone number , so it's nice and easy: 0870 5 900 200.

0844

daryl.mullen@nhs.net

12 Mar 08 12:03

But what about were a practice uses 0844 numbers to transfer calls eg to an OOH provider. Several practices use an normal geograpgical number but OOH the call is forwarded on automatically using 0844 numbers. This has advantages to the patient as there is no need to copy a second number from an answering machine and make a second call.

Greed or susceptibility

16 Mar 08 17:03

I am with the second poster. If GPs have the best interests of their patients in mind, they should not do it. I have met some pushy GPs, whose morals I would doubt, but they are the exception. Far more likely the majority accepted the benefits in the sales pitch without realising the pitfalls.

It has always been possible to set up redirection between numbers - I remember when the local practice number diverted to the GP on-call's home. So that is not unique, nor an excuse for 084-greed

Inequalities of access

ted.yeoman@nhs.net

19 Mar 08 08:03

I am with poster number 2, First having raised my concerns with a DPH in early 2007, after having declined to change a number on a child health letter. I fail to see how public healthy and the the equalities agenda have allowed the group with the greatest need end up paying to access services. Most people in this group now use a pay as you go mobile phone being barred from contract services by poor credit histories. They now have to pay over the odds for access to many services, GP, NHS Direct, The Benefits Office and many more. There is a national campaign against 0845 join it!

Reply from NHS direct

john@priestmanj.freeserve.co.uk

25 Mar 08 23:03

I contacted NHS direct about their use of 0845 numbers and received this reply:

Many thanks for your recent comment to the Contact us section of the NHS Direct website.

In 1997 when NHS Direct was created, the Department of Health wanted a single memorable low cost number. At the time 0845 4647 was deemed to be the most appropriate way of achieving this requirement. NHS Direct recognises that although the cost of calling this number from a BT landline is still relatively low, nevertheless some providers are now free to charge higher rates. We are therefore currently in discussions with the Department of Health regarding alternate options.

The 0845 number is currently delivered by a network based platform known as the IN (Intelligent Network). This platform provides features such as load balancing / sharing between our 5 main Automatic Call Distribution systems and disaster recovery. Under normal circumstances calls are delivered into the 5 main systems and routed across a data network to the other 17 call handling sites. In the event of a failure, calls can be redistributed directly into any of our 22 call handling sites.

Although there are numerous underlying geographic numbers, they cannot be published for safety reasons. The geographic numbers are presented to each site on a finite number of lines. Alternative numbers are used in the event of a failure or site evacuation. If these numbers are dialed directly, callers would risk not being answered or getting an engaged tone. This is because there is no guarantee that there will be lines or agents available. In extreme circumstances this could also impact on the main service by actually causing line congestion.

Kind regards, The NHS Direct Contact Us Team

0844 more or less?

26 Nov 08 21:11

I fail to agree with most of the points in relation to the arguments put forward by NHS Direct. Most of the Disaster Recovery and Load Balancing between call centres can be achieved via programming of their hardware and as a result they do not need to live with 0845 or is CISCO not that good afterall ! I doubt the DR service has ever been invoked, and I bet a freedom of information request would bear this out.

Contractual issues would also not prevent them using an alternative number as it could simply be phased in alongside, no-body is forcing them to use the number. BT would like to supply the 0345 equivilent number as its in their interests.

Yes, I agree its morally reprehensible to over charge the most needy for patient health care via 0844 numbers but really we dont have it too bad in this country following the introduction of the NHS in 1947.

We are lucky that we live in a country where telecoms deregulation is so far advanced that consumers probably pay about 30p/min less per minute for local and national calls than they did 15 years ago and as such why are we so concerned that a single call costs circa 15/20p. Thats one cigarette. I dont think the Doctors have consciously been out to rip off clients, otherwise they would be captains of industry not GPs.

I also believe consumers should have choice and indeed Ofcom have introduced 03 numbers that some doctors can now take advantage of. See http://www.intelesis.co.uk/03-VirtualUK08.php

Thanks and regards Noel