One of the regulars on here has posted questions & answers from the commons,(idb, I think, could have been  bbb_uk), re how much governments departments make from 084/087 numbers, could some one point me in the direction re NHS Directs rake in from their number please?

Also is there somewhere re  Ofcom,ASA, COI, that "suggests" that 01 numbers are given alongside 084/087 numbers for government departments?

Info needed for FOI appeal letter.

Thanks

derrick wrote on Aug 8^th, 2007 at 3:49pm:

Also is there somewhere re  Ofcom,ASA, COI, that "suggests" that 01 numbers are given alongside 084/087 numbers for government departments?

Here's one from http://www.ofcom.org.uk/media/news/2006/04/nr_20060419

"Public bodies

Ofcom continues to recommend that public bodies should not use NTS numbers exclusively (ie: without giving equal prominence to a geographic alternative) especially when dealing with people on low incomes or other vulnerable groups."

Thanks for that, it's a start.

pw4 wrote on Aug 8^th, 2007 at 4:34pm:

derrick wrote on Aug 8th, 2007 at 3:49pm: Also is there somewhere re  Ofcom,ASA, COI, that "suggests" that 01 numbers are given alongside 084/087 numbers for government departments? Here's one from http://www.ofcom.org.uk/media/news/2006/04/nr_20060419 "Public bodies Ofcom continues to recommend that public bodies should not use NTS numbers exclusively (ie: without giving equal prominence to a geographic alternative) especially when dealing with people on low incomes or other vulnerable groups."

Interesting.  That's certainly one to throw at Essex County Council (Barbara?).

Wouldn't a GPs' surgery be a 'public body' too?

Heinz wrote on Aug 8^th, 2007 at 4:45pm:

pw4 wrote on Aug 8th, 2007 at 4:34pm: derrick wrote on Aug 8th, 2007 at 3:49pm: Also is there somewhere re  Ofcom,ASA, COI, that "suggests" that 01 numbers are given alongside 084/087 numbers for government departments? Here's one from http://www.ofcom.org.uk/media/news/2006/04/nr_20060419 "Public bodies Ofcom continues to recommend that public bodies should not use NTS numbers exclusively (ie: without giving equal prominence to a geographic alternative) especially when dealing with people on low incomes or other vulnerable groups." Interesting.  That's certainly one to throw at Essex County Council (Barbara?). Wouldn't a GPs' surgery be a 'public body' too?

I thought doctors got round the "public body" issue by being "private" as against being "in" the NHS service?

Source: Healthcare Republic

http://www.healthcarerepublic.com/news/PRACTICESTAFF/781087/Minister-cut-NHS-Direct-charges-set-example-GPs/

<<

Minister to cut NHS Direct charges to set example for GPs

04-Feb-08

A DoH minister has pledged to cut charges for calls to NHS Direct to set a good example for GP practices that have signed up to high-rate phone services.

The standard cost of a call to NHS Direct is between 3p and 5p per minute, but people calling from mobiles or non-BT landlines may be charged more.

Asked for an assurance that NHS Direct would not be allowed to continue to use 0845 or other higher-rate telephone charges when its phone contract is renewed, junior health minister Ivan Lewis told MPs: ‘I can give a cast-iron guarantee that that will not be allowed to continue.

‘That provides a very important example of the government leading by example in this area.'

A spokeswoman for NHS Direct recognised that some telephone providers may charge high rates on top of the basic cost of a call to the service.

‘We are in discussion with the DoH, which set up the 0845 number in 1997, and we are looking at other options,' she said.

She said that using a freephone 0800 number had been ruled out by the DoH in the past because research suggested it would attract too many hoax callers.

The spokeswoman said the phone line was likely to be changed in 2008.

>>

Intersting article in E-Health Insider - NHS Direct calls cost £16 each

This reports that the NHS Direct service is found to cost on average £16.54 per call answered.

Given that the taxpayer is happy to contribute on this scale, how absurd it is for this amount to be subsidised by a few pence per call by the patient. Mobile callers to 0845 4647 are boosting the profits of their providers by much more than this.

Let us have an "03" number so nobody is subsiding anybody.

Those who believe that the NHS should apply consumerist principles would doubtless wish for a premium rate line to be used. This would perhaps need to be charged at around £5 per minute.

Source: Rob Marris MP

http://www.robmarris.org.uk/index.php/?p=747

0845 Victory – NHS Direct changes it’s number!

28 July 2008

<<
Rob has welcomed progress on the change of the NHS Direct telephone number from the high-rate 0845, to the standard rate 0345. Unlike the 0845 number the new number will be charged at a standard rate, which will in the future be included in any pre-paid packages.

In January this year, Rob championed a call for the number to be altered and was “delighted” to receive a ‘cast iron’ guarantee from the Under Secretary of State for Health that the contract for NHS Direct would not be renewed with an 0845 number, this news confirms that the this transition is currently in progress.

BT Wholesale has announced* that NHS Direct will be changing its main telephone number from 0845 4647 to 0345 4647. However, there is a slight disappointment in that the 0345 number is currently only connected to a test message, but the date of a change-over is soon to be announced along with the results of a Department of Health enquiry into the NHS Direct telephone service launched in January this year.

Commenting on the announcement Rob said: “the progress on the usage of 0845 and 0844 numbers is a step forward not just for the NHS Direct service, but also for other public services with which a similar transition could be implemented, easing the burden on those who can least afford it.”

Rob said earlier in the year: “I am pleased that the Government is listening to the many concerns being raised around the widespread use of these numbers and look forward to future measures being considered that ensure that the most vulnerable in our society are not penalised through excessive charging when trying to access essential services.”
>>

* The notice was published on BT Wholesale's website and was only on there for a day before being removed.

Dave wrote on Jul 29^th, 2008 at 10:38am:

Source: Rob Marris MP http://www.robmarris.org.uk/index.php/?p=747 0845 Victory – NHS Direct changes it’s number!

Mr Marris, or more likely, whoever generates his web site, seems a little confused regarding "it's" and "its".
Anyway, more significantly, a welcome development.

idb wrote on Jul 29^th, 2008 at 12:39pm:

Dave wrote on Jul 29th, 2008 at 10:38am: Source: Rob Marris MP http://www.robmarris.org.uk/index.php/?p=747 0845 Victory – NHS Direct changes it’s number! Mr Marris, or more likely, whoever generates his web site, seems a little confused regarding "it's" and "its". Anyway, more significantly, a welcome development.

It is not happening!

I saw the announcement by BT but it has now been withdrawn.

http://www.ehiprimarycare.com/news/nhs_direct_says_it_has_no_0845_plans

Perhaps this will help explain what is going on... or not, as the case may be...

This is clearly a “developing story”.

The story so far appears to be:

1) April 2007: BT reserves the 03454 64 range of numbers

2) January 2008: In parliament, Ivan Lewis offers a “cast iron guarantee” to Rob Marris that use of 0845 4647 will not continue, subject to the obligations under its contract to BT.

3) May 2008: A representative of NHS Direct advises that its current contract with BT “does not tie NHS Direct into the use of 0845 4647 and instead allows the use of any non geographic number hosted by BT”. (This was not an authorised public statement and needs to be verified.)

4) 24 June 2008: Murray Bain, director of IT at NHS Direct, tells E-Health Insider that one of his two favourite websites is Google “– it is such a fountain of knowledge”.

5) 23 July 2008: BT Wholesale publishes an announcement that 0345 4647 “will eventually replace 0845 4647”. This web page (https://www.btwholesale.com/pages/downloads/News_and_Briefings/Interconnect_Briefings/Additional_Number_Range_NHS_Direct_13608.pdf) is found by Google and cached.

6) 25 July 2008: The web page referred to above is found to have been removed. The “fountain” appears to have been blocked or muddied. There is no formal explained withdrawal or cancellation of the announcement. The Google cached copy remains.

7) 29 July 2008: E-Health Insider publishes an explanation from NHS Direct – “There are currently no plans to utilise this number. NHS Direct asked BT Wholesale to take the note down as it was misleading.” The article also reports that Rob Marris has written to Ivan Lewis to ask for an explanation of what is going on.


Discussions about use of a new national three-digit number for urgent (but non-emergency) access to medical and social care services have been going on for some time. These are likely to continue for a long time to come as these services are currently provided by a wide array of private sector commercial companies, public bodies and co-operatives, each with their own telephone number for each local service. The Darzi process has revealed that each Strategic Health Authority (representing the regions of England) has a different view of the need and the feasibility of such a national service.

If such a service were to be introduced, it is possible that NHS Direct would be invited to tender for some level of involvement. This is however quite separate from the role that NHS Direct currently performs in providing general health advice for England and Wales. There is no published proposal to remove the contract for provision of non-urgent health advice from NHS Direct, nor for such advice to be accessed using a national three-digit number.

It could be said that this separate issue represents a “red herring” in the context of the need for NHS Direct to cease use of revenue sharing 0845 numbers.

As hinted in the article, it could be that NHS Direct is compelled to use 0345 4647 for its services under contract to NHS Wales. But that would be to add further confusion …

We await developments.

Some snippets from the recently published NHS Direct Annual Report for 2007/8.

1. It spent around £7.5 million on telecommunications, £0.5 million less than in 2006/7.

How much greater would its BT bill have been if the “almost 5 million” calls to 0845 4647 had been made to 0345 4647?

How much additional profit did the various telecos make on these calls as a result of excessive surcharges imposed over that necessary to cover the revenue share?

2. There is no figure given for the number or percentage of “urgent” non-emergency calls. The percentage of all calls that resulted in emergency or urgent referrals was 25.4%.

This suggests that non-urgent calls represent at least 75% of those received. The percentage is actually much higher as callers are said to under-assess the urgency of their situation; if callers assessed their condition properly then NHS Direct would not receive any “emergency” calls. This figure is important, as Darzi refers to the proposed three-digit national number as being for cases that the caller regards as “urgent”. (see previous postings.)

3. The suggestion that NHS Direct is using confusion over the nature of the proposed "three-digit number", as an alternative to moving to 0345 4647, to deflect attention from the need to make this change, is reinforced by the following statement in the report:

“A possible move to a single number for non-emergency access to healthcare, as suggested by Lord Darzi in his report, has significant implications for NHS Direct.”

Darzi does not suggest a single number for non-emergency access to healthcare. That would replace the numbers used by every doctor’s surgery and hospital! He only refers to plans in SHA “visions” for a special number for “urgent, unplanned care needs” (this includes “social care”) that will need to be "considered".

4. NHS Direct proudly declares its role in providing the “access and assess” element of GP out-of-hours services for 12% of the population.

This is quite separate from the 0845 4647 service. It is here in competition with private sector providers and GP co-operatives. This is one of the many areas that would be covered by the three-digit number, if it ever happened. One could wonder if perhaps NHS Direct has its eye on the other 88% and is perhaps looking to upgrade all of its telephone services to operate as if every call was urgent.

There may be a case for improving access to urgent care, however this must not be allowed to delay or impede the delivery of properly funded access to non-urgent health advice, which was sought on around 4 million occasions last year by NHS patients in England and Wales.

Great news, if the Government hold to it's word but it might not. Why should anyone who is on has telephone package's like Talk Unlimited or any other package which includes local numbers in the package who needs to seek advice's from NHS Direct pay over the top!

ew.walgrove wrote on Aug 15^th, 2008 at 6:22pm:

Great news, if the Government hold to it's word but it might not. Why should anyone who is on has telephone package's like Talk Unlimited or any other package which includes local numbers in the package who needs to seek advice's from NHS Direct pay over the top!

Not to mention why should those who have a contract mobile phone with 500 inclusive minutes a month to all 01/02/03 landlines and uk mobiles have to pay 25p per minute or whatever to call NHS Direct. >:(

Also what is the end date of the contract and why the hell do we have to wait till the end of the contract?

If the DoH made such a balls up in its original choice of phone number and it is impeding the ability of the poorest and most disadvantaged citizen consumers to contact NHS Direct then they should renegotiate the contract right now.  They can also remind Ian Livingston (CEO of BT) that if BT Global does not agree to change to let it use 0345 4647 right now at no penalty then they will go public with an announcement reminding Mr Livingston of his previous announcements to The Scotsman newspaper about 0845 numbers being a rip off and his wanting to see them all scrapped.

All this crap about waiting for the end of the contract without saying when the end of the contract simply amounts to to yet more playing for time by the charlatan revenue grabbing shysters at BT Global and NHS Direct. :o >:( [smiley=thumbdown.gif] [smiley=thumbdown.gif] [smiley=thumbdown.gif]

ew.walgrove wrote on Aug 15^th, 2008 at 6:22pm:

Why should anyone who is on has telephone package's like Talk Unlimited or any other package which includes local numbers in the package who needs to seek advice's from NHS Direct pay over the top!

They should not. It is unacceptable. It is contrary to the terms of the proposed NHS Constitution for NHS service providers to use revenue sharing numbers. This must be resolved before the Constitution comes into force. If necessary, Parliament must vote to sanction this exception to the principle of "free at the point of need".



NGMsGhost wrote on Aug 15^th, 2008 at 7:18pm:

… what is the end date of the contract and why the hell do we have to wait till the end of the contract?

NHS Direct has stated that the present contract with BT ends in 2011. As reported above, it does not however tie NHS Direct to use of 0845 4647.

One suspects that Ivan Lewis, or the questioner to whom he was responding quite properly (see Hansard), may not have been aware of this point of detail when he offered his "cast-iron guarantee". Alternatively he could have been making allowance for the time it would take to determine which alternative number to use (given that there were, and remain, loosely formed proposals for a special three-digit number to be used for some services provided by NHS Direct) and to complete the process of transition.



NGMsGhost wrote on Aug 15^th, 2008 at 7:18pm:

… the DoH made such a balls up in its original choice of phone number

Some would disagree, as they see the benefits of a national service.

The original launch of NHS Direct began with pilotting in certain areas, which funded and supported the scheme. It was however hoped to establish and roll this out as a national service, which is why each area did not publish separate numbers.

There are advantages to use of a single memorable number that can be publicised nationally. Originally, callers were directed to the appropriate regional centre. Now the only clear distinction is between England and Wales, although calls are automatically distributed amongst different centres.

There are benefits in the ready access to intelligent features available on non-geographic numbers, which are not directly available on all geographic numbers.

When the service was launched, the 03xx range was not available in its present form. Landline callers at the time benefitted from a "local rate" call, regardless of where it was answered. There was no cheaper non-geographic number available at that time.

The situation has however changed. The DH should have been preparing for the necessary change of number for NHS Direct for the last 3-4 years. Part of this preparation is now seen to have been reservation of 0345 4647. BT is obviously ready to start the change-over as soon as requested to do so. There is no good reason for any further delay.

Proposals for a nationwide three-digit number for "urgent" but non-emergency access to health and social care services are a separate issue that should not be conflated with the existing role of NHS Direct, as the vast majority of its work is not with cases that are not thought to be "urgent". As with the ill-fated "101" project, there must be very serious doubts about whether such an idea would ever get off the ground. NHS Direct would have to retain a number for non-urgent cases anyway, unless it is proposing to withdraw this telephone service!



Scanning this thread, I came upon a comment that warrants a response:


derrick wrote on Aug 8^th, 2007 at 4:52pm:

I thought doctors got round the "public body" issue by being "private" as against being "in" the NHS service?

NHS Primary Care services in England are provided by Primary Care Trusts, which are public bodies. (Similar bodies have this role in the other nations.) These services are mostly delivered by GPs under contract. The Ofcom recommendations do therefore apply where NHS services are being provided.

The terms of these contracts prohibit receipt of remuneration from patients. They do not however explicitly prohibit use of all revenue sharing telephone numbers to this end. In 2005 the Department of Health somehow came to the absurd conclusion that 0844 and 0845 numbers offered a "guaranteed low rate" (see news release). The Departmental of Health has subsequently confirmed that by a "low rate" it means "the equivalent of a local call" (see letter).

The "guarantor" has not been identified - if they were, they would owe a lot of people a lot of money.

SilentCallsVictim wrote on Aug 15^th, 2008 at 9:23pm:

There are benefits in the ready access to intelligent features available on non-geographic numbers, which are not directly available on all geographic numbers.

No there aren't.  That is an oft repeated lie by the NGN vending snake oil salesmen to try to justify their sordid and tawdry trade.

Surely you recall Tanllan's written and verbal evidence to the Information Tribunal that all the features of an intelligent number can be just as well delivered via a geographic phone number.  That is why the Foreign & Commonwealth service have such an intelligent network for which all the primary access numbers are London 020 numbers but that also include geographic phone numbers in various parts of the world.

I fail to see why any long established member of this website genuinely opposed to the misuse of 084/7 numbers would certainly to try to turn themselves in to defence counsel for NHS Direct?

There were always disadvantages to the use of an 0845 number from the outset for a significant proportion of callers (for instance those using lowest cost call routing services to call geographic phone numbers) and it would always have been possible for NHS Direct to use a single virtual geographic number (eg London 020) from the outset that redistributed the calls around the country in the same way as 0845 4647.

NGMsGhost wrote on Aug 15^th, 2008 at 11:58pm:

... defence counsel for NHS Direct? There were always disadvantages to the use of an 0845 number from the outset for a significant proportion of callers

The views I express here are my own, I act in defence of nobody. I note points for possible disagreement.

There were indeed disadvantages to the use of a 0845 number in 1998, notably for callers from mobile phones, as well as others on special deals. These have to be set against the disadvantage to those outside London who would have had to pay the "national", rather than "local", rate to call a 0171 number at that time. Cheaper NHS services for Londoners, or indeed those at any location, would have been found politically difficult. Even though there is no longer any issue of cost difference for most residential callers, the idea that a national service is more "local" to some than others presents political difficulties.

This point is however primarily a matter of history. If anyone disagrees with the need to change from 0845 to 03xx now, then that is worthy of extensive discussion.

It is generally accepted that "not all geographic telephone numbers offer ready access to intelligent features", which are available as standard on non-geographic numbers. That is not to say that anything is impossible, nor is this assertion disproved by any number of examples of cases where such features are apparently deployed on geographic numbers. Like most generally accepted facts however, this could be a lie.

Conspiracy theories proliferate because they are generally impossible to disprove. In my view every trade, including my own, is sordid, tawdry and based on deception to some degree. I see nothing unusual about that in telecomms in general or NGNs in particular.

I am content to continue campaigning vigorously on issues that we share without the need to feel that I am fighting some particular evil. I have attempted to expose what could be seen as the improper delaying tactics being deployed by NHS Direct at present (I actually believe that the motivation for this may be more complex than simply protecting the revenue share). Those who may feel that I seek to advance the interests of NHS Direct as a body are entitled to their opinion, however I do not feel that any further public discussion of the motivation of those who post to the forum would serve any useful purpose.

Who is making £1 million per year from NHS Direct's 0845 number?    A report has been published today in Healthcare Republic : ---

NHS Direct calls have cost patients £1 million
12-Feb-09
Call charges - Ministers fail to cut NHS Direct charges but GPs are being pressed to quit 084 phone numbers
Patients have paid more than £1 million in call charges to NHS Direct, research suggests.

But both the health service and BT deny having seen any of the money.

Most 084 numbers divide the call revenue between phone providers and the body receiving the call.

David Hickson, who campaigns against such numbers, has calculated that NHS Direct should have received nearly £1.1 million in revenue from calls to its 0845 number.

But NHS Direct says that, in line with government guidance, it does not receive this money 'either directly or indirectly'.

A spokeswoman said it was paying 'the market rate to BT for the usage of our 0845 service'.

BT said it could not discuss a commercially confidential contract. But sources close to the company deny it is making excessive profit from NHS Direct patients. Instead they suggested the contract was structured to take account of this revenue.

If true, this would mean NHS Direct was indirectly benefiting from these charges.

'That million pounds is going somewhere,' said Mr Hickson.

Meanwhile, the DoH has delayed plans to move NHS Direct to a cheaper number - even as it pushes practices to abandon their 084 numbers.

Last February health minister Ivan Lewis gave a 'cast-iron guarantee' that the cost of calls to NHS Direct would be slashed. He said it would not be allowed to continue charging high rates.

NHS Direct later reserved a cheaper 0345 number. But a DoH spokesman says the move is on hold while it considers creating a national three-digit number for urgent care.

jonn.elledge@haymarket.com

http://www.healthcarerepublic.com/news/GP/LatestNews/879775/NHS-Direct-calls-cost-patients-1-million/

The £1 million is going somewhere - but where?

Interesting that NHS Direct have strenuously denied making any money either directly or indirectly from their use of 0845 and BT also claim not to be profiteering from patients phone calls.   What is the TRUTH?

loddon wrote on Feb 12^th, 2009 at 11:40am:

David Hickson, who campaigns against such numbers, has calculated that NHS Direct should have received nearly £1.1 million in revenue from calls to its 0845 number. But NHS Direct says that, in line with government guidance, it does not receive this money 'either directly or indirectly'. A spokeswoman said it was paying 'the market rate to BT for the usage of our 0845 service'. BT said it could not discuss a commercially confidential contract. But sources close to the company deny it is making excessive profit from NHS Direct patients. Instead they suggested the contract was structured to take account of this revenue.

I see that as usual one man self publicist David Hickson has taken all the glory on the battle against NHS Direct's ripoff phone numbers for himself and has not mentioned to this journalist the fact that NHS Direct even went to the lengths of going to the Information Tribunal in January 2008 to obstruct a heroic effort by a longstanding member of this campaign (assisted by three other campaign members) to obtain the geographic alternatives for the NHS Direct number.

One wonders if this Mr Hickson's main motivation is therefore actually to bring this ripoff to an end or is simply to have his own name published in the press as frequently as he can manage. ;) ::)

who cares as long as the use of the 0845 number is withdrawn? :)

wrote on Apr 4^th, 2009 at 9:30am:

who cares as long as the use of the 0845 number is withdrawn? :)

Presumably those of us who take the time and trouble to spend a lot of our time campaigning on these matters rather than simply free riding by using the alternative numbers listed here.

And how will 0845 4647 be withdrawn unless the campaigning continues.

Did you spend a whole day of your time attending an Information Tribunal campaign hearing to try and make NHS Direct reveal its numbers and many more hours connected with reading papers for this hearing.  No I thought not.

And did you bother formally responding to the NHS consultation on 084 numbers that closed on Tuesday?  I suspect not?

So how do you think these numbers get withdrawn then and replaced with 03 numbers then?  Simply by magic perhaps?

all i'm saying is does it matter WHY someone is campaigning  - if the campaign gets aired and publicised and in the process someone you may consider to be undeserving gets the thanks/glory etc - so be it.

I'm just grateful to all those who are lobbying on behalf of this.

So thank you

wrote on Apr 4^th, 2009 at 9:48am:

all i'm saying is does it matter WHY someone is campaigning  - if the campaign gets aired and publicised and in the process someone you may consider to be undeserving gets the thanks/glory etc - so be it.

Yes it certainly matters to me why someone is campaigning.

For instance SilentCallsVictim often says he has no problem with call centres that are operated by private sector businesses using 084/7 numbers.

He has become one of the most noisy activists for certain parts of the campaign yet does not support one of the main objectives supported by nearly all the rest of us (all 084/7 numbers being banned completely and only 09 numbers with clear call price announcements and a ban on call queuing being allowed if companies must use extra charge numbers at all).

http://www.theyworkforyou.com/wrans/?id=2010-02-25a.317691.h&s=nhs+direct+average+2010-01-12..2010-03-03#g317691.q0

Michael Penning (Shadow Minister, Health; Hemel Hempstead, Conservative)

To ask the Secretary of State for Health what the average cost of a call to NHS Direct was in 2009.


Mike O'Brien (Minister of State (Health Services), Department of Health; North Warwickshire, Labour)

The information requested is not collected. Calls to NHS Direct cost a maximum of 5p per minute from a BT landline. Mobiles and other networks may vary.

---

I'm not aware of any BT tariff charging 5 pence per minute for 0845 numbers; the highest is 3.95 pence per minute. Maybe Mr O'Brien is confusing 0844 and 0845 numbers or perhaps he is airing on the side of caution. Oh, and there's the nonsense about mobile and "other" networks which may vary, despite the fact that we know it's BT that varies.

Dave wrote on Mar 3^rd, 2010 at 2:37pm:

The information requested is not collected. Calls to NHS Direct cost a maximum of 5p per minute from a BT landline. Mobiles and other networks may vary. I'm not aware of any BT tariff charging 5 pence per minute for 0845 numbers; the highest is 3.95 pence per minute. Maybe Mr O'Brien is confusing 0844 and 0845 numbers or perhaps he is airing on the side of caution. Oh, and there's the nonsense about mobile and "other" networks which may vary, despite the fact that we know it's BT that varies.

This sounds like the same kind of clueless incompetence we see with BBC Radio 4 Feedback (a program for complaints about programs on BBC Radio 4 and other BBC radio stations) that assures us that whilst calls to its 03 numbers from landlines are charged at standard geographic rates and are part of call packages that "calls from mobiles may be higher".  This is even though there is specifically an Ofcom General Condition which makes it illegal to charge any more to an 03 number from a mobile than when calling an 01 or 02 number. ::)

NGMsGhost wrote on Mar 5^th, 2010 at 2:44pm:

Dave wrote on Mar 3rd, 2010 at 2:37pm: The information requested is not collected. Calls to NHS Direct cost a maximum of 5p per minute from a BT landline. Mobiles and other networks may vary. I'm not aware of any BT tariff charging 5 pence per minute for 0845 numbers; the highest is 3.95 pence per minute. Maybe Mr O'Brien is confusing 0844 and 0845 numbers or perhaps he is airing on the side of caution. Oh, and there's the nonsense about mobile and "other" networks which may vary, despite the fact that we know it's BT that varies. This sounds like the same kind of clueless incompetence we see with BBC Radio 4 Feedback (a program for complaints about programs on BBC Radio 4 and other BBC radio stations) that assures us that whilst calls to its 03 numbers from landlines are charged at standard geographic rates and are part of call packages that "calls from mobiles may be higher".  This is even though there is specifically an Ofcom General Condition which makes it illegal to charge any more to an 03 number from a mobile than when calling an 01 or 02 number. ::)

But as the DH has spent years working on this issue, which included an "evidence gathering" exercise and a consultation (at tax payers' expense), it must surely be extremely qualified to give accurate guidance of telephone call charging!

The health secretary, Andrew Lansley, has let slip that the government is planning to scrap NHS Direct ... according to the Guardian :---

http://www.guardian.co.uk/politics/2010/aug/27/nhs-direct-health-phone-service

"]NHS Direct to be replaced by cut-price health advice service.   Department of Health confirms health secretary's slip that government is to axe medical telephone helpline

The Department of Health has confirmed that NHS 111 would replace NHS Direct within three years.

Although the new number is free, it is expected to be far cheaper to run than NHS Direct because it is likely to employ fewer medically trained staff. The department said it did not know how much NHS 111 would cost but admitted that it had a responsibility to save money.

In June, GPs urged the government to scrap NHS Direct because it was a waste of money that did not deliver its objectives. It was set up in 1998 to ease the pressure on accident and emergency wards and GP surgeries, but freedom of information figures released to the medical magazine Pulse earlier this year showed that 12% of callers were sent to A&E or put in an ambulance, and 22% were sent to their GP as urgent or next-day cases. NHS Direct handles more than 27,000 calls a day[/i]."


Whilst we may be heartened and pleased to hear that another Government rip-off 0845 number is to be scrapped I must confess to puzzlement and concern about the way in which this Government is approaching such issues....  or maybe it is more a matter of concern about an incompetent Minister who has demonstrated before that he has great difficulty in understanding a subject properly and grasping the chief aspects of the arguments about a subject.   One wonders just how much intellectual effort and cost analysis, service evaluation and planning has been put into this matter when it is reported that "The department said it did not know how much NHS 111 would cost ...."

It appears that this Minister has also decided that the whole NHS is best run by the GPs to the elimination of almost all other opinions and considerations when we see the quote ---"In June, GPs urged the government to scrap NHS Direct because it was a waste of money ..."  

Also, "Pulse earlier this year showed that 12% of callers were sent to A&E or put in an ambulance, and 22% were sent to their GP as urgent or next-day cases."    So what about the other 66% of callers?    Does this indicate that the GPs want even more calls to be made to their surgeries without any triage service which might help avoid overloading them?   What is really behind this policy decision?   What is Lansley trying to achieve?   Will this result in cost saving or will increased costs be caused elsewhere which will eventually be found to be higher than the current costs??

The NHS Direct telephone health advice and information service has long been seen as a costly and inefficient way of delivering NHS services. Whilst it aims to relieve unnecessary pressure on emergency and acute services, it has to be geared up to respond to emergency cases, where it represents an unnecessary additional layer, with a structure that also provides on-demand response to very minor needs. It is therefore is a natural target for cost saving.

Unlike NHS Direct, 111 is intended only to address "urgent", but "non-emergency", needs. The loss of the NHS Direct telephone service means no national telephone service to address non-urgent health needs in general. There are specific services for particular conditions.

One must remember that the NHS Direct NHS Trust also provides an extensive on-line library of health information, including videos, as well as performing telephone triage for many Out of Hours GP services, the latter is mainly done on 0845 numbers. It also operates the Choose and Book appointments service, again using a 0845 number. It is only 0845 4647 that is to be scrapped, although the NHS Direct NHS Trust was granted a total exemption from the requirement not to use telephone numbers that are more expensive to call than geographic numbers.

The concept of the 111 service to replace NHS Direct was in the Darzi report and in other plans of the previous government. The present government has taken this on with no perceivable change. The 111 service was again intended to be managed for each locality and there is nothing in the formal announcements to indicate that the areas where it will operate initially are pilots. The roll out will continue, with no announced plans to review it at any particular stage. That is the only difference I can see from the plans of the previous government, which had said that the initial implementations would only be pilots. (I cannot see how Lansley could be seen to have made a gaff, or let slip something which was not clear to anyone who followed these matters closely.)

One issue which I have not seen addressed is the extent to which 111 will cover access to Social Care services. This was intended by the past government as part of its plans to introduce a National Care Service alongside the NHS. The current government has again echoed this general approach, but said very little about how this will work in with the plans that it has announced (I have yet to read all of the White Paper, so I stand to be corrected). I have heard nothing about 111 being used for urgent, non-emergency access to social care services (which are currently commissioned or provided by local authorities).

If (or when) commissioning consortia are established, they will have the responsibility for commissioning the local 111 service. I understand that the NHS Direct NHS Trust will bid for these contracts, indeed it may already be commissioned for some or all of the areas where the launch has been announced.

Although it seems to make sense to check people out by telephone before they visit a GP, experience has shown that life does not work like that. A face to face consultation with a qualified doctor has been found to be a more cost effective way of delivering primary care than the best efforts of NHS Direct. There remains the question of capacity, which is one of the reasons why NHS Direct was set up in the first place.

There are many issues that hang on this, and the lack of proper preparation and planning is a cause for grave concern. This concern, which applies to all of the proposed NHS changes, is aggravated by the fact that there is no extensive contingency funding available to "buy a way out" of the problems that will inevitably arise with any major reconfiguration of services. Experience suggests that there will be very many problems with 111, not least because it is conceived as a national scheme that will be imposed on new local bodies at the same time as they are being granted greater independence than their predecessors.

My personal view is that 0845 4647 will remain in place for many years yet (unless the cost cutting knife is to remove direct telephone access to the NHS from many localities). This is why I have been pressing for 0345 4647 to be brought into use as a formally recognised, but not equally publicised, "alternative" to cover this extended period of transition. As with 101, there will be many areas that will be slow, or totally unwilling, to set up the structures necessary to operate the 111 service. Withdrawal of central funding killed 101, it is unlikely to ever be available for 111.

Whilst I could say that the NHS Direct telephone advice and information service helped save my life some years ago, I am ready to acknowledge that it is far too expensive (even after the £1 million per annum subsidy from callers through revenue share). If spending cuts are to be made, I am happy to see it near the front of the queue. I hope that my fears about there being no effective replacement are not seen to be justified in time.

(With apologies to those who do not look to this forum for this type of informed briefing on issues under discussion.)

http://news.sky.com/skynews/Home/UK-News/Medical-Helpline-NHS-Direct-Is-To-Be-Axed-And-Replaced-By-The-New-111-Service/Article/201008415708224?f=rss