The following is a response to a FOI request from DH, made by kk. The response itself covers 31 A4 pages, so I have posted the most important bits.

To:
SECTION 40
From:
SECTION 40


Date:15 February 2005

CC:
SECTION 40


Announcement on Banning National Rate telephone Numbers

Purpose

This note sets out further guidance in preparation for the announcement due tomorrow. A core script is attached at Annex A.

Announcement

An announcement is scheduled for Wednesday 16th February 2005 on a ban on entering into national rate telephone number services from April when regulations and directions are laid. The ban will require transitional measures. These will be tailored to meet the agreement we have with NEG PLC, at present that would require practices to change their 0870 arrangements no later than 30 April 2005. To allow for any last minute changes to these arrangements the transitional issues will be dealt with through Secretary of State Directions.

The Department has identified funding up to £150,000 to assist with the costs of switching from National Rate numbers to Local Rate numbers. This funding is specifically for the one-off cost of changing numbers. An outline agreement has been made with NEG plc, the principal supplier, on these one-off costs.

The line to take is "The Department will provide financial assistance to practices in making the switch from national rate to local rate numbers."

Transitional Issues

The main supplier of the services are NEG plc who appear to be near sole provider of these systems with 290 surgeries across the UK  (approximately 25 are in Wales and Scotland, which will be excluded from the announcement planned for Wednesday 16th February, above).

In a meeting with NEG plc on 14th February 2005 the outline agreement consists of:

Following an announcement on 16th February 2005 all necessary work by NEG can be completed by 30th April in English GP practices;

The cost of undertaking this work is on average around £500 per practice but will vary dependent on the amount of different numbers a practice use (three is the maximum per practice)

The cash back rate of 2 pence per minute will be maintained to practices. This goes to off-set the cost of system lease (between £100 and £400 per month). The practice can not make a profit from these systems.
This agreement covers practices in England only.


Financial Issues

There are two options for paying for the switch of numbers:
· The practice pays NEG and the costs are reclaimed via PCTs from the DH or
· DH enters into an agreement with NEG. NEG have offered to "discount" the cost to the DH if there is a direct payment.

Advice from SOL confirms that the Secretary of State does have powers under sections 2 and 3 of the NHS Act 1977 to make these payments centrally to NEG plc although, it is for each practice to agree to having its number and its contract with NEG varied to allow for this change.  There will be a written agreement with NEG which sets out the circumstances in which payments will be made and how the amounts will be calculated.  This would need to have proper contractual terms attached and is something which SOL Commercial will be involved in.

An embargo on making new commitments against 2004/05 budget and 2005/06 was issued on 26 January. We have agreed that this commitment can be made despite the embargo.

SECTION 40

Annex A
Premium rate numbers - core script


We are committed to ensuring that patients do not have to pay over the odds to access local services.  

The use of 0870 and similar national rate telephone numbers, for patients to access local care, runs counter to this principle. It places additional costs to patients and has to be stopped.

That is why we are acting now to ban the future use of these numbers by organisations providing local care to patients.  This will be done through guidance and legislation.  

The indications are that the use of national and premium rate numbers to access local NHS services by organisations other than GPs and out-of-hours providers is not widespread but we are acting now to nip further use in the bud.

GP practices currently using national rate telephone lines will change these to numbers charging no more than the local rate.  The switch to these numbers should be completed by the spring.

The Department will provide financial assistance to practices in making the switch from national rate to local rate numbers.

087 and premium rate numbers can provide specific functions useful to callers and the organisations, but these can be provided by alternative numbers, such as 0844 and 0845, which do not place an undue charge on patients.

This is in line with the recently published Central Office of Information guidance which states that 'national rates should be treated with caution, particularly when targeting individuals'.

...continued

Q&As


General

When will the ban come into force?

We expect the ban to come into effect in April.

What numbers will be affected?

Numbers beginning with 087, 090 and 091 will be affected.

What needs to be done to enforce the ban - does it need new regulations/ a change to the GP contract?

The ban will be effected with legislation and guidance. For example we will issue directions to Trusts and amend the GMS contract regulations.


Use of Numbers

How many GPs are currently using these numbers?

We do not collect data on the usage of these numbers. We know anecdotally that at least 300 GP practices have already established national rate lines for accessing their services.

What services other than GP and OOHs services will be affected?

The indications are that the use of national and premium rate numbers to access local health care services by organisations other than GPs and out-of-hours providers is not widespread however we want to ensure that in the future no organisations providing NHS services will be able to use these numbers to charge patients national or premium rates to access local services.

What services are they currently using this number for?

For calls to make appointments at primary care clinics, for repeat prescriptions, to access secondary care services.


Transitional Issues

What about organisations already using 087x numbers

Following discussions between the Department of Health and the principal telecoms supplier, GP practices currently using national rate telephone lines will be required to change these to numbers charging no more than the local rate.

How will practices be re-imbursed for the additional cost of transition?

The Department will make funding of up to £500 per practice available for them to switch from national rate to local rate numbers.  The Department will be working with PCTs to identify which practices will be entitled to the additional funding.

Other NHS Services

Does this mean NHS Direct will need to change its number?

No, NHS Direct is an 0845 number.

Are hospital bedside telephone services going to have to change their numbers?

No, because these are not telephone services used by patients to access local NHS care.

Why aren't we including Pharmacists and in the ban?

We have no evidence that pharmacies are using premium rate number lines to support the provision of their NHS services at present. However, we will monitor the position and consider appropriate action if necessary.

Pharmacies remain able to use premium rate numbers to support their private commercial activities


What about Dentists?

Dentists will be included in the ban, however it will take longer to make the changes to the relevant legislation.  We expect the ban to be in place by summer 2005.

Why aren't we banning the use of 0870 numbers for NHS organisations such as the National Clinical Assessment Agency (NCAA) and the Appointments Commission

We want to ensure that patients are not charged over the odds to access local healthcare services.  These are national organisations which do not provide healthcare services and as such we will not be affected by the ban.

What about Optometrists (Ophthalmic Opticians)?

Optometrists will be included in the ban, however it will take longer to make the change to the relevant legistration. We expect the ban to be in place by summer 2005

What about Hospitals?

We are not aware of hospitals using these numbers for accessing local services. However, we are including hospitals in the ban being announced today. This ban does not affect bedside telephone services.

What about Foundation Trusts?

We are not aware that any foundation trusts are using these services. Should this become an issue we will discuss this with the Foundation Trust and their regulator, monitor.

The next part of the reply consists of two case studies, provided by NEG. Unsuprisingly they speak about the wonderful benefits of Sugery Line. There is also an email from a sugery using the system, which has had its name kept secret under Section 40 of the Freedom of Information Act. The same email appears here uncensored.

...continued

Inter office e-mail

From:
SECTION 40



To:
SECTION 40
18/02/2005 11:39
Subject:
Re: Offer from NEG

Section 40

Thanks for this.  On costs I agree if we can do a central procurement - single payment of costs - to make these changes and therefore substantially reduce costs (which is what Auditors will largely be looking to ensure VFM) then we should do this.  Have you any idea of possible discount - given in essence will be a single payment I would hope we could at least achieve 25% reduction on the £540 figure i.e figure of say £400 per practice?  I do not think we (DH) should be paying for any additional lines in the surgery - essentially this is about main patient line to surgery being 0845 or 0844 number and if practice has other national rate lines then that is for them.  They can retain or pay the £35 + VAT to switch to local rate!

I gather their are 25 or so practices in Scotland and Wales who have similar facilities and I wonder if our colleagues in those countries would like to try and piggy back on the deal you are seeking to agree with NEG.  Therefore if you have no objections I shall ask SECTION 40 to forward the NEG letter to our Devolved Administration colleagues for them to make a quick decision and get back to you (I am seeing them on Monday so perhaps could get a verbal response then!)

SECTION 40

Letter from NEGPLC

SECTION 40
Department of Health
Room SECTION 40
Quarry House
Quarry Hill
Leeds
LS2 7UE

Dear SECTION 40,

Thank you for your time recently. Please find below the confirmations and ratifications as discussed.

I agree to roll out a lo-call 0844 number to replace all 0870s currently in circulation in the English NEG Surgery Line sites. To cover our costs we will charge the surgery £540.00 + VAT for the first number change and £35.00 + VAT for subsequent numbers at the same location. This cost will cover the following:

Change to number change message held at public telephone exchanges, (this number has now changed to 0844…etc)

New message notification at site notifying the new number, (If someone calls the 0870 number they will also here the new locall number) but still have their initial call dealt with hence only one call.

Software enhancements at both surgery and our networks to enable number translation to work on 0844, (to facilitate no change in the surgeries cashback functionality.)

Professional recording and re-recording of all messages.

Programming and number allocation to all sites.

New posters for the surgery notifying patients of the new number.

The offer of a press release for each surgery to go to their local paper again informing of the change.

We will roll out the new solution to the surgeries upon payment as opposed to 30 day invoices etc as I do not want the expense of my accounts department chasing individual payments from hundreds of surgeries hence I think it prudent that you let the PCTs/ surgeries know this in advance so as not to delay my commitment that this rollout will be complete by the end of April 2005.

I agree to continue all cashbacks up to 2 pence per minute. There are around 10 surgeries, which receive a slightly higher cashback i.e. 2.5 p, and we will have to cross those bridges if the water were to rise at a later date.

SECTION 40 as you are aware I feel we are being more than helpful in proffering this help along with my commitment that we will not seek compensation due to the £3.5 million loss in network revenue over the next seven years which is why I reiterate my desire for some sort of notification being included to the PCTs and or surgeries telling of the fact that the Surgery Line is a good solution and compliant with the Department of Health whilst not of course saying we are the proffered supplier of telecoms. I did also ask if something could be released generally to aid in any way Re the fact that our good name has been tainted by the Departments choice to U turn on the 0870 issue within GP surgeries or local services, which is of course only our service.

I look forward to your written confirmations and would again like to offer my assurances that I will continue to work with you to resolve these issues.

This letter is also in hard copy and en route.


Yours Sincerely

SECTION 40

...continued

Inter office e-mail


SECTION 40
17/02/2005 08:10

To: SECTION 40

Subject: Re: Telephone systems

SECTION 40

The specific question that you asked  me relating to costs is not clear-cut as the NEG £500 per  practice is an ad-hoc charge rather than one arising from accurate  costing.

The fact that NEG has verbally stated that it is  prepared to honour the level of cash-back to Practices is very important and  quite a concession given that their revenue will be significantly less as  callers will be paying NEG local, rather than national call rates.  NEG will be taking quite a loss of anticipated income over a 7 year  agreement term and I can only assume that they are doing that in order to  avoid any adverse publicity as they need to continue to sell their systems to  the NHS. Their profitably will be significantly affected by this so not  surprisingly they are after some compensation in the ad-hoc  charge.   The tasks that NEG has identified in moving from 0870  to 0845 numbers are all relevant and even though I think can all be done  remotely it is difficult to challenge the cost of £500 per practice,  except on the grounds of economy of scale. If DH is paying  the cost for all transfers then I think there is some scope here for agreeing  an all-inclusive figure that takes account of the total volumes of transfers  nationally, in order to obtain a significant discount. The fact that NEG has itself already suggested a discount shows that  there is some room for negotiation. Also the fact that NEG is stating that all  transfers can be actioned within a month doesn't particularly  sit well with a total charge of £145,000 given that the majority of  costs relate to employee costs and you can pay for a heck of a lot of  telephone engineers for £145,000. By the way it would also be prudent to  confirm whether the figure finally agreed is inclusive or exclusive of VAT.  

However, more important than a  one-off ad-hoc charge would be to get a written agreement from NEG that they  will maintain the cashback arrangements to Practices as they seem to have  verbally promised to do. The SOLC papers that I have seen state that the  revenue generation for the sample practice is £387 p.m. (this seems very high  as at 2p per minute, that would require the practice to be taking 74  hours of calls every week). With a 7 year term that would equate to £32,500 in  income to the practice and even though most other practices will have much  less income than that from the revenue generation option there will be  much more money involved in that than the £500 ad-hoc charge. DH would need to  avoid any prospect of a claim from GP Practices if NEG withdrew the income  generation option at some time in the future.

I don't think it is correct that PCT's would be  unaffected by a ban on the use of 0870 numbers. Just from my own local  knowledge OOH services in Hull, East Riding of Yorkshire and many parts  of North Yorkshire (other than York) are accessed through 0870  numbers. Since the demise of NYED these services are now PCT led services.  These PCT's may not realise this but the NYED telephony arrangements that they  have inherited include a revenue generating option of 1p per minute for all  those callers that contact the service via the 0870 number (probably c  million patients). When the PCT's move  away from that arrangement, they are liable to incur penalty charges from  the telephone company (Your Communications), the loss of the revenue  generating income, together with having to pay the additional cost over and  above the local call costs that patients will pay (the majority of calls  made will actually incur national charges and therefore the telephony  provider will charge the difference between 0845 charge paid by patient and  national rate - this happens also at NHS Direct).

It might be that this arrangement only applies in  the former NYED area but I think that should be checked at some stage as PCT's  may not be aware of the arrangements that they have inherited, or of  the OOH number used by GP practices on their answerphones.

I am aware of 3 companies other than NEG that  offer number transfer services to the NHS - Your Communications, BT and  Kingston Telecommunications. I have appended details of the services  offered by those companies - all from their Web Sites. I would be surprised if  these companies (particularly YourCommunications which has marketed quite  heavily) has not signed up GP Practices, OOH Providers or PCT's to  national number transfer services.  Therefore it is very likely indeed  that these companies may also seek a transition payment for moving to 0845  numbers and unless these companies also agree to maintain the revenue  generating option to Practices/ OOH Providers there could be a significant  cost relating to lost income.

I assume that you determined the extent of NEG's  involvement in  national number transfer services in the NHS by asking  the company directly? Would you like me to ask the 3 other companies listed  above whether they have arrangements with NHS bodies based on 0870 numbers, or  will someone else be doing this?

...continued
Its probably unlikely that Opticians, Pharmacists  or Dentists have adopted 0870 numbers as the number of incoming calls isn't  great. I do know that the Hull/ York Medical School uses an 0870 number but is  this an NHS service or a University service? I will keep looking for any more  examples but probably the best approach would be to ask the telephone  companies directly.

I suspect that the final extent of the use  of 0870 numbers will only arise after the ban has been announced. If you would  like me to get involved with the negotiation, authorisation and administration  of the transition/ compensation budget please let me know.

Hope this is helpful

SECTION 40

----- Original Message -----
From: <SECTION 40>
To: <SECTION 40>
Cc: <SECTION 40>;  <SECTION 40 >
Sent: Tuesday, February 15, 2005 6:14  PM
Subject: Telephone systems

(See attached file: Progress with Banning National Rate  telephone
Numbers.doc)(See attached file: 0870 submission 11.2.05  v3.doc)(See
attached file: National and Premium Rate Telephone Numbers  lines 27 jan05.doc)(See attached file: 2ndNTSsub.doc)
Attached are some  relevant documents and background. [NB The first document referred to is the first document in this  Annex the others have been deemed exempt under Section 35 on public interest grounds].

What I want to assess fairly quickly  is the proposal that NEG are putting to us to charge £500ish per practice  to change the numbers over. I understand that there are 5 issues that need  to  be addressed in doing this:
1. Buying the 0844 number? (offset  could be reselling the 0870 number)
2. Recording the "Rachel" professional  message for the new system
3. Reprogramming the surgery system - this can  be done remotely from NEG HQ
4. Reprogramming the billing system to  recognise the new numbers
5. setting up the network queuing so that the  engaged tone is not
experienced by patients.

You will see from t eh  submission (first document) the terms of the outline agreement with NEG to  provide these systems.

If you can find out any further ruse of these  systems (0870)  by GPs or other NHS organisations incl hospitals,  opticians, dentists, pharmacies that would be grate.

The  announcement is now due for Thursday 24th Feb. An indication by Monday on  the costs would be great.

Please call me or SECTION 40 for any further  info.

Thanks

SECTION 40

Some publicity material from Kingston Communications, BT and Your Communications follows on NTS.

Inter-office e-mail

SECTION 40
02/03/2005 19:07
To: SECTION 40
Subject:Re: Telephone numbers

SECTION 40

As you know I met with SECTION 40 yesterday to move this forward. Key outcomes were:

NEG has 295 Practices in England using 0870  numbers. I have the list of numbers but not the names at this stage. That is  the sum total of the 'NEG' practices in England with 0870  numbers.
On the basis of the prices discussed in SECTION 40  letter to you the charges that NEG were seeking totalled  £156,530. That does not include making changes to fax numbers and DDI  numbers which are typically not used by patients and the practice can give  users a different number to use. On the basis that DH will make a single  payment in advance, I have negotiated the total cost down to £130,000. Once the agreement has been made,  we would be looking for the least amount of involvement with practices,  given that there are nearly 300 of them. Therefore once the practice details  have been established with us NEG will deal with all issues directly and  refer only those that are not within the agreement to PCT's or to ourselves.  

All other arrangements as per your prior  discussions and I will draft those into an outline agreement,  without the 'legalese', and let SECTION 40 have it for the internal legal  advisors as requested.

SECTION 40

----- Original Message -----
From: <SECTION 40 >
To: <SECTION 40 >
Cc: <SECTION 40 >;  <SECTION 40>;  <SECTION 40>
Sent: Monday, February 28, 2005 9:13  AM
Subject: Telephone numbers


>SECTION 40
>
I am away until a week on Tuesday, although  I am going to London Tuesday (tomorrow) for a meeting with SECTION 40. Would you be able to start agreeing the deal with NEG.  Perhaps it would be best if we caught uptomorrow. What we need to do  is:

1. Negotiate the deal with NEG - I think we can get a better deal  if we agree to pay NEG direct
2. The deal needs to be in writing and agreed by our commercial branch of the solicitors  departments (this is not the same as Commercial Directorate). The  person to do this is away until Friday so they have said we can write  a deal with NEG and then let them see it at the end of the week or  early next week. I would also like to sign it off before we agree to  it. 3. We need to start the detailed process of understanding how  many surgeries there are in England and where they are so that we can  ensure they are being done.

Would you be able to make  contact with SECTION 40 who is the SECTION 40 and set  something up for after we have spoken on Tuesday.

Would you  be able to take this on and ensure that all the practices get the new  local rate umbers before the end of April. SECTION 40 will be able to deal  with the policy side of things and ensure we are linking with the  right people.
>
> Thank you
>
SECTION 40>  
> PS I'll call you from the train tomorrow to sort out a best  time.

...continued
Inter office e-mail

SECTION 40
01/04/2005 23:07

To: SECTION 40
Subject: Re: Purchase order for NEG plc

SECTION 40

Could this be VAT- Refundable as a Contracted-Out service? This is work that could have been carried out in-house but has been contracted out.
During my time in NHS finance (which I am trying to forget!) this would have qualified for a refund of VAT, but whether the rules have changed, or indeed don't apply to DH I wouldn't know. Just thought I should mention it in case it was missed but presumably finance will advise?

Regards
SECTION 40

----- Original Message -----
From: <SECTION 40>
To: < SECTION 40>
Cc: < SECTION 40>
Sent: Wednesday, March 30, 2005 4:18 PM
Subject: Purchase order for NEG plc


SECTION 40

Have we raised a purchase order for the work NEG are doing in transferring 0870 to 0844? I have discussed with helen and agreed it should raise a PO for the full amount in 2004/5. I think this may have to be done by31.3.05.

The value of the agreement is £130,000 + vat (=£152,750) but I am not sure how we account for VAT, i.e. does this need to be in the value of the purchase order.

SECTION 40

they like using their powers under section 40 of the act dont they.

40. - (1) Any information to which a request for information relates is exempt information if it constitutes personal data of which the applicant is the data subject.

     (2) Any information to which a request for information relates is also exempt information if-

 

     (a) it constitutes personal data which do not fall within subsection (1), and

 

     (b) either the first or the second condition below is satisfied.

     (3) The first condition is-

 

     (a) in a case where the information falls within any of paragraphs (a) to (d) of the definition of "data" in section 1(1) of the Data Protection Act 1998, that the disclosure of the information to a member of the public otherwise than under this Act would contravene-

 

           (i) any of the data protection principles, or

 

           (ii) section 10 of that Act (right to prevent processing likely to cause damage or distress), and

 

     (b) in any other case, that the disclosure of the information to a member of the public otherwise than under this Act would contravene any of the data protection principles if the exemptions in section 33A(1) of the Data Protection Act 1998 (which relate to manual data held by public authorities) were disregarded.

     (4) The second condition is that by virtue of any provision of Part IV of the Data Protection Act 1998 the information is exempt from section 7(1)(c) of that Act (data subject's right of access to personal data).

     (5) The duty to confirm or deny-

 

     (a) does not arise in relation to information which is (or if it were held by the public authority would be) exempt information by virtue of subsection (1), and

 

     (b) does not arise in relation to other information if or to the extent that either-

 

           (i) the giving to a member of the public of the confirmation or denial that would have to be given to comply with section 1(1)(a) would (apart from this Act) contravene any of the data protection principles or section 10 of the Data Protection Act 1998 or would do so if the exemptions in section 33A(1) of that Act were disregarded, or

 

           (ii) by virtue of any provision of Part IV of the Data Protection Act 1998 the information is exempt from section 7(1)(a) of that Act (data subject's right to be informed whether personal data being processed).

     (6) In determining for the purposes of this section whether anything done before 24th October 2007 would contravene any of the data protection principles, the exemptions in Part III of Schedule 8 to the Data Protection Act 1998 shall be disregarded.

     (7) In this section-

 

     "the data protection principles" means the principles set out in Part I of Schedule 1 to the Data Protection Act 1998, as read subject to Part II of that Schedule and section 27(1) of that Act;

 

     "data subject" has the same meaning as in section 1(1) of that Act;

 

     "personal data" has the same meaning as in section 1(1) of that Act.

Quote:

We are committed to ensuring that patients do not have to pay over the odds to access local services.   The use of 0870 and similar national rate telephone numbers, for patients to access local care, runs counter to this principle. It places additional costs to patients and has to be stopped. GP practices currently using national rate telephone lines will change these to numbers charging no more than the local rate. The switch to these numbers should be completed by the spring.

So why are 0844 numbers in the 5p per minute range allowed?

That is 66% more than 'local rate'.

Yes that's the problem. It is another example of the smoke and mirrors illusionist approach which covers the whole of this area. It is specifically to avoid doing what would have been right, but appearing to have done something!

can anyone tell me what rules apply to GP's using 0870 nimbers in N Wales?
My GP is still using this number 08704609660

wrote on Jul 9^th, 2005 at 11:44am:

can anyone tell me what rules apply to GP's using 0870 nimbers in N Wales? My GP is still using this number 08704609660

I may be wrong but I think it has something to do with Wales now having its own parliament (The Welsh Assembly) and the English DOH instruction to cease use of 0870 numbers therefore does not apply.