The public are provided with ngns to access a diverse range of services and information.  As we all know, GP practices and NHS services are also accessed via these.  Because of the cost of these calls, this is a social exclusion issue.  The exclusive nature of the costs of ngns impacts on the very people who are least able to bear these costs.

Improving access to primary care is currently a big political imperative. The Department of Health has a Primary Care Access Team.  They deal with access to primary care issues, such as providing timely access, and making sure that services reach the neediest.  For those of you not familiar with the jargon, the GP and NHS advice line are usually our first (primary) points of contact when we have a health problem or need information - so they are 'primary care'. Hence, the PCAT is a good starting point for us.  I think the PCAT used to be based in London with the DH, but I believe it is now tucked away in the provinces somewhere.  I will find out, and post it if anyone wants the info.

The current situation: the Dept of Health states the standards under which GP practices operate.  It lays out the regulations and guidelines under which this aspect (GP provision) of Primary Care is procurred.  This subject is called Primary Care Procurement.
Now, GPs are private contractors - they are self-employed.  The services they provide are bought by individual Primary Care Trusts.  And that is how you get your doctor's services.  Under DH guidelines, the PCTs work to 'best value'.  Best Value of course need not be measured solely in monetary terms.....

The NHS advice line belongs to the DH, but the IT backup is procurred from 'outside' companies.

Think about 'best value' - for who, exactly?
Think about ease of access to who those who need it most
Think about guidelines - they are merely that: just guidelines.  I am sure you senior members know far more about how big orgs treat 'guidelines'

Think particularly long and hard about access and social exclusion and the exclusive nature of accessing health services via a ngn:

High Frequency Users of health services are extremely likely to be in low Socio-Economic Groups.  HFUs are more likley to live in poverty.  Lower SEGs are more likely to use health services sooner in their lives, more frequently and more urgently.  They are unlikely to have the confidence, resources, money or knowledge to self-medicate when compared to, say, a higher socio-economic group.

Think about someone having to decide whether to blow their familiy's entire food money for the day on a ngm call to get precious health care or advice..... or forget the doctor's appt they need, because it's more important to feed their children.

So, you have a situation where GP practices are Small Businesses, your PCT is buying those services for you, and you are paying (but you don't know what that cost is) when you start dialling for those essential services. Hmmmm....

I strongly urge you to explore and pursue Social Exclusion through a Dept of Health route

Primary Care Procurement Team - who are part of the DH - who is the head of the PCPT?  who in the DH has recommended that the current regs and guidelines be adopted?

Primary Care Access Team - who are part of the DH - who is in charge of this? PCAS measure such things as ease of access.   How easy is it to get a GP appt?  How long do you have to wait?  Obviously what I am concerned about is the cost and difficulty of actually accessing GP services.  Call them to task on the exclusive nature (costs) of accessing something so essential as a gp appointment.  Am I put off even phoning for an appt because I don't know what it's going to cost me?  In other words - what is the cost to me of actually making an appt? ( the technical term for making an appt is a Request for First Contact)

Primary Care Trusts - they are procurring (buying) GP services for us - provision should be made in their contracts with GPs that thos serivces are accessible on geo numbers.

The Cabinet Office (cabinetoffice.gov.uk) I think now deals with Social Exclusion issues - you should be able to find out the person in charge of their Social Exclusion Unit.  Remember that people try to budget for and control their living costs by buying inclusive calling plans.  This is particularly important for poorer people.  I'm sure the Govt will have a policy somewhere on Taking Control of Ones Finances.  And they will have a team working on it.

I think the DTI will also have a SEU.

Don't presume that if you deal with 1 govt office, the other will somehow know of your communications.   They are 2 seperate offices, working on their own briefs.

And this is only highlighting the situation re: Dept of Health.  What about other depts who use ngms?  The same social exclusion issues apply......so go forth and multiply!

But for goodness sake, remember: generic letters and signed petitions fare badly against honestly written, acute, pertinent individual communication.  Get the name of the adult in charge of whatever dept or team or org you're writing to, and if appropriate, the name of their boss, and their boss's boss etc.  Above all, find out how such orgs work and which depts and teams allow services to be provided in this way.  Good luck.

Sorry - forgot to say: what I want is for health services to be provided and procurred under the condition that geo numbers are given upon request/stated alongside the relevant ngn number.

Besides the cost, are there any particular points that the older and wiser forum members can tell me about, regarding health services, apart from what is posted on the forums?

BTW, I'm not even going anywhere near the phone services available to hospital patients, for the moment anyway - gp access alone is enough to be going on with - phew!

Personally, I'd wait until the new 03x range is available.

Those government departments using 0845 are probably doing so for the network features like IVRs (Interactive Voice Response) and call based routing to multiple call centres across the UK.

However, I believe those using other number ranges (including surgeries 0844) are doing so purely for the revenue.

I plan on complaining to many of them once the new 03x range is available which would then allow government departments to utilise the same network features but the cost to us consumers is the same as a geographical and included in any inclusive minutes.

there was a GP claimed once here ( i forgot his name) that he is not aware about the revenue from  the 0844 calls to his own practice ;)

gudman wrote on Nov 22^nd, 2006 at 6:50pm:

there was a GP claimed once here ( i forgot his name) that he is not aware about the revenue from  the 0844 calls to his own practice ;)

If you read this thread which, via FOI, obtained emails concerning surgeries moving from 0870 to 0844.  The Department of Health specificially wanted to ensure that once surgeries moved from 0870 to 0844 they would still receive money from phone calls.

If you go to NEG Plc 'Surgery Line' section here and read a case study from an actual surgery, you'll see that on the right-hand side NEG state the surgery do get some money back from each call received.

gudman wrote on Nov 22^nd, 2006 at 6:50pm:

there was a GP claimed once here ( i forgot his name) that he is not aware about the revenue from  the 0844 calls to his own practice ;)

I could imagine that!  If a practice manager is responsible for creating revenue, and also keeping down expenses, they may well have advised their GPs that a particular system is 'the best for us' and I suppose an individual GP may well not query 'why?' but just accept that practice managers advice>  Am I being too naive here?!