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Message started by idb on Jul 9th, 2009 at 11:28am

Title: Non-Emergency Healthcare Services
Post by idb on Jul 9th, 2009 at 11:28am
http://www.ofcom.org.uk/consult/condocs/three_number_non_emergency/summary/

Executive Summary

1.1 Ofcom (The Office of Communications) is undertaking this consultation in order to meet a request from the Department of Health ("DH") in England for the designation of a three-digit telephone number to access NHS non-emergency healthcare services in England. The aim of the service to be provided via the number is to act an entry point for patients seeking NHS services: trained call-handlers will respond to requests for health or service information (whether urgent of not) and assess the medical needs of callers to identify which NHS services are best place to meet those needs.

1.2 The three-digit telephone number will initially be piloted in a number of Strategic Health Authority ("SHA") areas in England from spring 2010 but the intention is for the service to be fully rolled out across England in the long-term, subject to a positive evaluation of those pilots. The DH has decided on the underlying policy behind the service and this consultation relates only to the communications issues, for which Ofcom has responsibility.

1.3 The devolved administrations may also consider whether to introduce the three-digit number with a similar or comparable service in Wales, Scotland and Northern Ireland respectively. However, given that this consultation is based on a DH initiative, we have focussed on the proposed service as envisaged in England and have referred to the devolved administrations where appropriate.

1.4 As the regulator responsible for communications matters in the UK, including the administration of the UKs numbering resource, we have been asked by the DH to make a three-digit telephone number available for the delivery of its proposed non-emergency healthcare service. In order to make such number available for use by all communications providers, we would need to add it to the list of numbers in General Condition 17 of the General Conditions of Entitlement, which covers the allocation, adoption and use of telephone numbers (the "Numbering Condition").

1.5 The DH has chosen 111 as its preferred number for the service. We advised the DH on available number options, including full length numbers from existing ranges in the National Telephone Numbering Plan (the "Numbering Plan"). The DH considered these options and decided that a three-digit number (similar to the 999 and 112 numbers used by the emergency services, and the 101 non-emergency number initiated by the Home Office) would be the most suitable choice. It concluded that, of the possible three-digit numbers available, 111 was its preferred option.

1.6 While the DH is committed to the provision of the proposed service on a three-digit number, other options are available. The purpose of this document, therefore, is to seek stakeholders views on the DHs preferred and alternative numbering options, and to set out why the DH has chosen the three-digit number 111 for its proposed service.

1.7 As regards to the tariff for the number, three-digit numbers have no inherent tariff structure. The DH plans to implement the tariff for the number through negotiation with the selected service provider and communications providers. The DH has drawn up potential tariff options and we have set out these options on behalf of the DH. We do not propose to intervene in setting the tariff for the number and this consultation does not therefore propose regulatory measures on the matter of call charges. As the tariff will not be regulated, each tariff option could vary depending on the operator, and the price will depend on the commercial arrangements of each operator. The DH has pointed out that experience with 101 (the three-digit number initiated by the Home Office) showed that negotiation with telecoms providers can result in the same call charge across virtually all operators. Nevertheless, as the call charge will be a commercial decision by each provider, we will keep open the option to revisit the tariff issue at a later stage if it proves appropriate. If it is necessary for us to consider regulatory measures on the tariff in the future, we would need to carry out a further consultation on the specific issues and proposals.

1.8 The main body of this document sets out the background of the proposed service and a discussion on the options for the number and tariff. Section 4 also contains an impact assessment which evaluates the different options for the number. In addition, Annex 8 contains a draft notification of the necessary modification to the Numbering Condition in order to designate 111 for "Access to NHS Non-Emergency Healthcare Services" (Type A Access Code).

1.9 We invite comments on the draft notification, the specific consultation questions we have set out, as well as on the issues raised generally in this consultation document, by 20 August 2009.

http://www.ofcom.org.uk/consult/condocs/three_number_non_emergency/main.pdf

Title: Re: Non-Emergency Healthcare Services
Post by irrelevant on Jul 9th, 2009 at 3:31pm
re 1.7 - interesting... Ofcom's press release here says;

Quote:
Ofcom has set out a range of price options for calls to the service on behalf of the Department of Health, including making calls free to the caller, ten pence per call, 3 pence per minute or charged at a local or national rates. The Department of Health will decide on the price of the calls through negotiations with communications providers.

Still that "local or national rate" creeps in ... sigh ...

Title: Re: Non-Emergency Healthcare Services
Post by SilentCallsVictim on Jul 9th, 2009 at 4:23pm

irrelevant wrote on Jul 9th, 2009 at 3:31pm:
Still that "local or national rate" creeps in ... sigh ...

Although most residential call packages currently offer the same rate for both, the distinction does still exist. Nothing is being misrepresented here - it is misrepresntations (e.g. of 084 as "local") that we must attack.

Comments on the proposal are found in the media.

It is now seen that the NHS Direct service will definitely continue as it is on 0845 4647, if only for a few years before 111 replaces it. A complete number change to 0345 4647 would therefore not be appropriate. For the benefit of those who incur premium rates in calling 0845 numbers, 0345 4647 must therefore be switched on immediately as an alternative.


Title: Re: Non-Emergency Healthcare Services
Post by Barbara on Jul 9th, 2009 at 7:51pm
Surely, if these calls to 3 digit numbers are charged at a tariff above "standard" (or whatever we choose to call it) & thus excluded from inclusive call packages or more expensive than standard on mobiles, does this not fall foul of the same "free at point of use" argument as currently being pressed against GPs & Hospitals using 0844?  There will be more and more pressure on patients to contact this 3 digit number rather than their GP particularly out of hours ( as is currently the case with NHS Direct who are pretty useless anyway, I understand) and any additional cost is unacceptable.  Is this just the DH trying to circumvent the system?  Is this OFCOM again ducking its responsibilities to consumers?  Am I overreacting or have I understood it correctly?

Title: Re: Non-Emergency Healthcare Services
Post by SilentCallsVictim on Jul 9th, 2009 at 9:28pm
The issue of what rate will be applied can be covered in the Ofcom consultation, however it will come down to the DH negotiating terms with the telephone service providers.

I understand "free at the point of need" to refer to the delivery of the health care, not to the absence of any incidental costs e.g. the bus fare to the doctor's surgery. If the service is being delivered, rather than accessed, by telephone then this becomes more difficult, as the cost of the telephone call ceases to be incidental. There could be an argument for the NHS (i.e. the taxpayer) bearing the full cost of the service, with zero call charges for all, however this is not the way that the DH is thinking.

The problem with the "standard (i.e. 01/02/03) rate" approach, which is the best available for ordinary telephone numbers (i.e. those starting with 0), is that it reflects the particular tariff applicable to the caller's telephone service. The 101 model, which is being used as a base point, disregards whether one is on an inclusive package, a landline or a mobile etc, and simply charges 10p for any call of any duration. This is agreed, by negotiation, to represent the level at which telephone companies recover their costs overall, as no other money changes hands in relation to their delivery of the service as originators. The fixed fee is seen as being the fairest way to distribute the costs amongst callers.

For the health number, I would be happy with a "standard" approach, a universal rate per minute or a universal fixed fee (whichever is thought fairest). Before hearing the arguments and considering the implications, I have not formed a view. I would however strongly suggest that call inclusive packages be adapted to include calls to this number.

Immediate responses to the news reflect Ofcom's concern about the suitability of 111. It is the numbering issue that is likely to dominate discussion in the present consultation, pricing comes later.

I have little fear that this matter will get into the issue of "revenue sharing", as I believe that the point made in this forum and elsewhere about NHS Direct has been accepted.

I want to see this matter used to put pressure on the need to do something with NHS Direct immediately (see my previous posting). It can also be helpful in relation to GPs and others with 084 numbers. The argument must be that they need to change to avoid those who refuse to contribute to a revenue share invariably trying to contact them via 111, and refusing to re-dial.

Title: Re: Non-Emergency Healthcare Services
Post by SilentCallsVictim on Jul 10th, 2009 at 11:07am
Some may be amused by this contribution to the debate:

http://i.dailymail.co.uk/i/pix/2009/07/09/article-1198563-05A8E7CF000005DC-128_233x533_popup.jpg

Title: Re: Non-Emergency Healthcare Services
Post by sherbert on Jul 10th, 2009 at 11:23am

SilentCallsVictim wrote on Jul 10th, 2009 at 11:07am:
Some may be amused by this contribution to the debate:

http://i.dailymail.co.uk/i/pix/2009/07/09/article-1198563-05A8E7CF000005DC-128_233x533_popup.jpg



Brilliant. Sums it up well. ;D

Title: Re: Non-Emergency Healthcare Services
Post by Barbara on Jul 10th, 2009 at 1:11pm
Agreed, absolutely brilliant - do hope the Dept of Health have seen & understood!

Title: Re: Non-Emergency Healthcare Services
Post by SilentCallsVictim on Jul 10th, 2009 at 8:43pm
Having now reviewed the complete consultation document to pick out key points, it may be helpful for me to share some of these. I focus on matters relevant to the forum.

I quote directly from Ofcom (commenting in italics and placing textual additions / alterations in brackets) – I suggest using a word search to locate the extracts in context.
  • [The only three digit] Codes still available for service designation are: 102 103 104 105 106 107 108 109 110 111 113 114 115 117 119

  • We advised the DH on available number options ... 111 was its preferred option ... other options are available – no change (i.e. maintain existing NHS Direct 0845 4647 number), number from the Numbering Plan (e.g. 030), Harmonised European six digit number starting with 116.

  • During the pilot stage, anyone ringing the NHS Direct number from the pilot areas would be re-routed through to the new 111 service. Similarly any calls made to 111 from non-participating areas will be routed to NHS Direct. In the long term 0845 4647 could be switched off. All services currently provided by NHS Direct would be accessible through 111.

    This statement, from the DH in the annex, appears to contradict the statement in the DH news release 111 will not replace existing local telephone services or NHS Direct. My argument that 0345 4647 should now be turned on as an alternative however still stands. Indeed, if so, that would provide a bulwark against 111 being more expensive to call.

  • If the DH were to [retain the] existing [NHS Direct] number they may, nevertheless, need to consider changing the number to 0345 4647 or another 03 number in the light of its recent consultation.

    Interesting that Ofcom appears to think that something will, or should, come of the DH consultation.

  • [The DH] recently issued a consultation to gather views on how valuable the extra functions provided by 084 numbers are and how they might otherwise be provided without patients having to pay more than the cost of a local call rate for them, for example by using 03 numbers instead.

    Ofcom expresses its view on what the outcome of the DH consultation might be. A possible return to geographic numbers with the same features specially deployed is not precluded by use of “for example”.

  • The DH’s initial assumption is that callers should contribute to the cost of the telecommunications element of calling the proposed service.

  • Three-digit numbers have no inherent tariff structure ... We do not propose to intervene in setting the tariff for the number

  • Our position is that it is inappropriate for public bodies to rely on chargeable 08 numbers exclusively (i.e. without, at a minimum, giving equal prominence to a geographic number alternative)

    Ofcom goes on to say that, although it holds this position, it does not however believe that it has the powers or the duty to impose this view over that of other (more directly accountable!) public bodies.

  • The DH has considered the possible tariff arrangements and has selected the following potential options for specific consideration by stakeholders: free to caller, 10 pence per call, 3 pence per minute or genuine local or national rate (i.e. charged the same as a landline call or a call to an 03 number).

    We know that local and national rate are commonly the same on residential packages.

The three research reports referred to are available at http://www.dh.gov.uk/en/Healthcare/Urgentcare/3DN/index.htm (one level below the URL given).

Although not a matter for Ofcom, the DH has asked it to invite comments on the pricing options. This is a little difficult, as if the telecommunications element of the service is to be self-funding, respondents have to assume that their proposals would be found acceptable by all the telcos. We must accept that this will have to be something of a fudge and the emphasis is presently on the same approach as used with 101. I believe that the only way it could work would be to demand use of the same call pricing model as 03, with the DH negotiating with each operator over a supplementary payment if they feel that this does not adequately cover their costs.

101 has failed as a national scheme and therefore does not provide a good model, as it relied on central funding which was withdrawn. It will be the government that will emerge from the next parliament (of whatever party or parties) which will have to implement this. Is it likely to be in favour of greater central control and public spending on the NHS, or more devolution of decision making to local bodies, with choice about spending exercised at the lowest possible level?

If a discussion develops here I will offer further comments.

Title: Re: Non-Emergency Healthcare Services
Post by SilentCallsVictim on Jul 13th, 2009 at 1:03am
I do not like getting into personalities, however I must comment that the performance by Mike O'Brien, the new Minister of State (Health Services) on You and Yours - listen here - when added to other performances I have witnessed, gives me continuing cause for concern. It was atrocious! Please nobody tell me that presentation of arguments is not his strength - he is a QC!

Those who saw his boss - Andy Burnham, the Secretary of State for Health - on Question Time last week, may join me in reflecting with sadness on the loss of Johnson and Bradshaw.

Title: Re: Non-Emergency Healthcare Services
Post by NGMsGhost on Jul 14th, 2009 at 11:09pm
So far as I can see the whole of this disgusting latest so called "consultation" is simply a bid to play for about another two to three years delay while New Labour assures its telecoms buddies that the revenue share gravy train that it allowed to be set up will not be stopped by it but only by any successor political party who will not have been subject to the same need to keep their friends in the call centre industry happy as New Labour has.

Only the abolition of New Labour and its creature Ofcom offers any hope that the continued scamming of the telecoms consumer by the state will finally be brought to an end. >:( >:( >:(

Title: Re: Non-Emergency Healthcare Services
Post by loddon on Jul 18th, 2009 at 3:15pm

SilentCallsVictim wrote on Jul 13th, 2009 at 1:03am:
Those who saw his boss - Andy Burnham, the Secretary of State for Health - on Question Time last week, may join me in reflecting with sadness on the loss of Johnson and Bradshaw.


I agree that the new pair seem rather unimpressive, but we can hardly be sad about the departure of a Secretary of State who was so ineffective because the Hull Daily Mail reported in March 2008 :---    

"HEALTH Secretary Alan Johnson today pledged to stop doctors using controversial 084 numbers that charge patients extra to call them."

http://www.thisishullandeastriding.co.uk/environment/JOHNSON-8217-LL-END-GP-CHARGES/article-174646-detail/article.html

The Hull Daily Mail also reported "The Mail first alerted Mr Johnson to the matter last August and our coverage led to a campaign being launched to stop them."      That would have been August 2007 so Mr Johnson has certainly taken his time on this.

He failed to honour his pledge during the following year+ and left his post with nothing achieved on this pledge.

When a Minister makes a pledge such as this, one would expect that it will be passed on to the successor to see the matter through to an honourable conclusion.    So we will follow Mr Burnham's actions to see if this pledge is indeed made good.

Title: Re: Non-Emergency Healthcare Services
Post by NGMsGhost on Jul 18th, 2009 at 3:40pm

loddon wrote on Jul 18th, 2009 at 3:15pm:
So we will follow Mr Burnham's actions to see if this pledge is indeed made good.


Surely we already know the answer from the new ludicrous consultation on a useless single three digit health service number even though these numbers have already been proven to be a failure and unworkable from the experiences in trialling them by the Police.

Clearly the only point of this consultation is to play for time thereby ensuring that a New Labour government is not responsible for derailing the health service revenue sharing gravy train. >:( >:( >:(

Title: Re: Non-Emergency Healthcare Services
Post by SilentCallsVictim on Jul 18th, 2009 at 5:50pm

NGMsGhost wrote on Jul 18th, 2009 at 3:40pm:

loddon wrote on Jul 18th, 2009 at 3:15pm:
So we will follow Mr Burnham's actions to see if this pledge is indeed made good.


Surely we already know the answer from the new ludicrous consultation on a useless single three digit health service number even though these numbers have already been proven to be a failure and unworkable from the experiences in trialling them by the Police.

Clearly the only point of this consultation is to play for time thereby ensuring that a New Labour government is not responsible for derailing the health service revenue sharing gravy. >:( >:( >:(

The announcement of the proposal to move ahead with the three digit number has ended the cause for delay on including NHS Direct in the action in implementation of Alan Johnson's promise in response to the consultation.

The way in which the matter of charging for the three digit number has been handled reflects a sensitivity on the issue, which is a credit to all those who have been campaigning to bring the matter of revenue sharing to public attention over a very long period. There are many in the regions who are passionate about the idea of a three digit number to simplify the nonsense of different numbers that we presently have. They persuaded Darzi to adopt this and the DH has gone along with it. It seems that the DH is keen to go ahead with pilots, but Ofcom is trying to slow the process down and ensure proper consideration of all of the available options. There are much bigger issues behind this than the relatively small issue of revenue sharing subsidy. Some of these have been removed from the present proposal, but I predict that they will return.

We may indeed have to look forward to a new government that is ready to make good the loss of revenue sharing income for the NHS out of increased borrowing or higher taxation. We must however remember that Mr Lansley's suggestions of 10% cuts in Defence, Police and Education expenditure  were necessary only to protect currently planned levels of public spending on Health and Overseas Aid, not to increase it. Furthermore, they were predicated on the present government's modest proposals for increasing taxation and reducing national debt. More severe cuts in other areas is of course an additional option. Those who have proposed abandoning plans for further taxation, swifter repayment of debt and the addition of Education to the areas being protected have already proposed a move in that direction.

Title: Re: Non-Emergency Healthcare Services
Post by NGMsGhost on Jul 18th, 2009 at 7:03pm
If SCV can offer us a version of his above comments in his last post translated in to plain English then I for one would certainly be interested to read them. :P

Title: Re: Non-Emergency Healthcare Services
Post by SilentCallsVictim on Jul 18th, 2009 at 9:26pm
Having re-railed my gravy, I will have a go at some simpler points.

Until such time as he says otherwise, Andy Burnham inherits the unfulfilled undertakings given by Alan Johnson. When speaking generally as a member of the government, any minister speaks for the government, not themself as an individual. This is especially true for members of the Cabinet. Use of the singular ("I"), rather than the more common plural ("we") adds weight to an undertaking, but cannot change its nature.

The "111" proposal is far too big to simply be a device for delaying addressing the revenue sharing issue (which is relatively small).

If getting into the general politics underlying use of revenue sharing numbers for public services, we must remember that (all things being equal) we are asking for the burden of cost to be shifted from the service user onto the tax-payer. What price any proposal that adds to public expenditure, especially in the current climate?

If, as is common, we try to dodge the point by listing places where the missing money could be found, we must explain why we were not calling for that to be done anyway, as a separate issue.

For those unable to follow the references to the well-repeated remarks from the longstanding-, but shortly to be former-, Shadow Secretary of State for Health, I regret that I cannot offer a simplified version.

Title: Re: Non-Emergency Healthcare Services
Post by NGMsGhost on Jul 18th, 2009 at 9:42pm

SilentCallsVictim wrote on Jul 18th, 2009 at 9:26pm:
Having re-railed my gravy, I will have a go at some simpler points.


And there was I thinking that gravy was merely the hot brown stuff you poured over the Sunday roast. ::)

Anyhow isn't it only tracks that have rails while trains only have wheels. :P

Title: Re: Non-Emergency Healthcare Services
Post by idb on Dec 18th, 2009 at 12:17pm
http://news.bbc.co.uk/2/hi/health/8420327.stm

Non-emergency 111 health number to be piloted

<<
Trials of a new three-digit telephone number for patients seeking non-emergency medical care in England will be launched in 2010.

The North East, East of England and East Midlands will pilot the free 111 number which will act as an alternative to 999 when people do not need A&E.

The service will not initially replace NHS Direct but could do so in the longer term if it proves successful.

Ministers said it would help route patients to the right service.

The move follows a consultation by Ofcom earlier this year.

People calling 111 will be able to get health advice but also information about out-of-hours GP services and walk-in centres.

It is hoped it will take the pressure off 999 calls.

Estimates suggest up to half of 999 calls do not need an emergency response.

Anyone calling the number with an emergency will be directed to 999 for an ambulance to be dispatched, the Department of Health said.

Health Minister Mike O'Brien said: "Patients have told us that they need clear, easy advice on how to find healthcare quickly when its less urgent than 999 and I am delighted that Ofcom has allocated 111 for these purposes.

"This will be particularly useful outside of GP surgery hours and for people who are away from home."

Nick Chapman, chief executive of NHS Direct said: "We believe that it will increase the access that patients have to the information and advice they need to help themselves and make best use of the NHS."

Peter Weissberg, medical director for the British Heart Foundation, said people with symptoms of a heart attack must still call for the emergency services without hesitation.

"Calling 999 as soon as you think you may be having a heart attack gives you the best possible chance of survival.

"Every year approximately 86,000 people die from heart attacks, a third of whom die before reaching hospital, often because the patient delays calling for help."
>>

Title: Re: Non-Emergency Healthcare Services
Post by Barbara on Dec 18th, 2009 at 2:29pm
I note within interest that idb's post refers to "the free 111 number" - is this definite?   On what basis will it be "free", that is, as in "freephone" which seems unecessary as I would have thought the cost of a "standard" call as in 01/02/03 would be reasonable, particularly as it would then be included in packages?   What is the position about costs from mobile phones and call boxes?   The announcement seems a bit "wooly" (well, what would one expect from Mike O'Brien etc??)   Also, it occurs to me (bit late I admit) that 111 would be a very easy number to dial accidentally as with any three identical digit number.   Is it intended that all doctor's surgeries out of hours calls will link to this whereas, at the moment, we call a health centre in another nearby town where we actually speak to real people and which uses real local doctors who know where we are etc etc?  If so, I think it's a bad idea; I have always called our GP's out of hours service rather than NHS Direct and generally found it works well, particularly important if one has a family member with a lifelong medical condition.

Title: Re: Non-Emergency Healthcare Services
Post by sherbert on Dec 18th, 2009 at 2:55pm
Have a read here

http://www.ofcom.org.uk/consult/condocs/three_number_non_emergency/statement/

Paragraphs 1.6 & 1.7

Also...

Ofcom also confirmed that the Department of Health intends that calls to the number will be free.

Title: Re: Non-Emergency Healthcare Services
Post by SilentCallsVictim on Dec 18th, 2009 at 4:14pm
A more definitive reference is found in the DH announcement itself.

Quote:
A new free three digit number .......


Ofcom recognises that there will be a new parliament before this comes into effect and any "ministerial commitment" made now will be of no consequence. It therefore states, in para 1.9 of the statement quoted above:

Quote:
If the DHs policy of making calls to 111 free to caller were subsequently to change, or if the DH was not able to achieve this tariff through commercial negotiation with communications providers, we would be likely to revisit the designation of 111.

Title: Re: Non-Emergency Healthcare Services
Post by irrelevant on Dec 18th, 2009 at 4:23pm
Ofcom's press rbelease is here:
http://www.ofcom.org.uk/media/news/2009/12/nr_20091218

Also confirms it will be "free".  I note that they don't use the term "free to caller" that they use when they mean it really is free, from mobiles too.


(Edit:  SCV posted after I started mine.)

Title: Re: Non-Emergency Healthcare Services
Post by SilentCallsVictim on Dec 18th, 2009 at 5:23pm
There has been no specific reference to challenge the suggestion that "free" means "free of charge to all callers". At this stage however, as Ofcom recognises, it can only be a suggestion. Only once negotiations with the telephone service providers have been completed and the cost is known and signed off will be know exactly what is to happen. Public spending budgets have yet to be set for the coming year, so there can be no assurance about any new spending beyond March 2010.

If, as has been suggested by both major parties, spending on the NHS is to be maintained in real terms there would have to be cuts elsewhere to pay for this new service. We must also remember that the total cost of the service would not be covered by anything other than a very high cost premium rate  number. Something like a 0871 number would be unthinkable, but even that would not even come close to paying for the service.

The present focus on securing as complete a ban on use of revenue sharing numbers as is possible through the initiative already underway must be maintained. There are many other issues affecting 111, even at the pilot stage. We have the word "free" clearly on record at or near the very beginning of the respective press releases. We have a commitment from Ofcom that it will look again should there be proposals to dilute or amend the principle of 111 being totally free to caller. We should keep a clear eye open for developments, but there is nothing further to be done about this now.

Title: Re: Non-Emergency Healthcare Services
Post by SilentCallsVictim on Jun 21st, 2010 at 6:19am
The situation with 111 has developed.

It is announced that the service will be "introduced", not piloted, starting in the summer and it will be free to call.

I quote from the DH media release of 18 June - https://nds.coi.gov.uk/Content/detail.aspx?NewsAreaId=2&ReleaseID=413941


Quote:
Health Secretary, Andrew Lansley said: ...

"We are also committed to improving patients' access to urgent care services and end the confusion over what services are available when. In doing so we will introduce a new single telephone number to direct patients to the right service, first time.  This number - 111 - will be free to call and available 24/7.  It will be launched in County Durham and Darlington this summer and in Nottingham City, Lincolnshire and Luton before the end of the year.”

It is important to note that ALL NHS Direct services were exempted from the recently issued Directions prohibiting use of "expensive" numbers, because they were to be replaced by 111. The new service is not just for "urgent" situations, as opposed to whatever other categories of need there are short of "emergency".


In this media release I express concern about whether the government has considered the operational and cost implications of making this number free to call. (They will have been in negotiation with all providers, including mobiles, so there is no danger that they have been forgotten.) I raise other issues there, and also in commenting on coverage of the story in "Smart Healthcare".


I am sure that keen saynoto0870-ers will be quick to discover how far this free service for contacting any part of the NHS can be used nationally whilst it is being rolled out in particular areas. It may be that the cheapest way to contact NHS Direct or Choose and Book will be to use your mobile to be connected via Darlington. Detection of the area from which the call is originated will be essential for the full operation of the service; we wait to see how effectively this will be deployed for calls from mobiles and how it is operated during the roll out.


I have to admit to being wrong to think that the new government would abandon, or defer, this idea because of the sizable costs that will be involved. These will be seen not just in running the service, but in the considerable efforts of reconfiguration and co-ordination that will be necessary to make implementation successful. There is as yet no indication of whether a key feature of the proposal by the previous government - integration with access to social care services, so as to begin the process of integrating the NHS with a "National Care Service" - will remain a feature. This is what the early adopters listed were keenly planning for; will they get the funding they were expecting? will other areas be compelled to follow a similar model, probably at greater cost? which are the other areas of the NHS that will have to suffer deeper cuts in order to pay for this?

Please understand that I am not opposed to free telephone calls. We all know that everything has to be paid for somehow and the government does not see itself as having lots of spare cash at present. Eliminating additional charges on patients should be a greater priority than subsidising the cost of their calls.

Title: Re: Non-Emergency Healthcare Services
Post by sherbert on Jun 21st, 2010 at 8:44am
Is it certain that is going to be 'free' to call from a mobile?

Title: Re: Non-Emergency Healthcare Services
Post by SilentCallsVictim on Jun 21st, 2010 at 12:28pm

sherbert wrote on Jun 21st, 2010 at 8:44am:
Is it certain that is going to be 'free' to call from a mobile?
The DH will have had to make the necessary arrangements with all telephone companies before being able to announce that the implementation is going ahead - this is not like someone announcing a 0800 number. Had there been different charging arrangements for different types of caller, this could have been covered in some way, but the announcement is totally clear on this point.

The announcement is brief and the DH has not offered any further information about the scope of the service, or clarification on any points. One is left having to refer to statements from a previous government. N.B. The previous DH announcement, referred to above in reply #20, is now archived at - http://collections.europarchive.org/tna/20100330144652/http://www.dh.gov.uk/en/MediaCentre/Pressreleasesarchive/DH_110378.

Title: Re: Non-Emergency Healthcare Services
Post by SilentCallsVictim on Aug 17th, 2010 at 5:27pm
111 has today gone live in County Durham and Darlington - http://www.countydurham.nhs.uk/call111.html

Calling from a landline and mobile in London, including with number withheld, delivers an announcement that the service is not currently available in the area from which one is calling.

This suggests that the feature of checking the location of the caller is deployed both on landlines and mobiles.

Failure to provide the latter was seen to offer the potential for misuse.

Those with a mobile phone (or landline) around the fringes of the area covered by NHS County Durham and Darlington may wish to check how effectively the area is marked off.

I will be checking to ensure that the test calls did not incur any charge.

Title: Re: Non-Emergency Healthcare Services
Post by SilentCallsVictim on Aug 26th, 2010 at 12:51pm

SilentCallsVictim wrote on Aug 17th, 2010 at 5:27pm:
I will be checking to ensure that the test calls did not incur any charge.

Confirmed.

Title: Re: Non-Emergency Healthcare Services
Post by Dave on Aug 26th, 2010 at 12:54pm

SilentCallsVictim wrote on Aug 26th, 2010 at 12:51pm:

SilentCallsVictim wrote on Aug 17th, 2010 at 5:27pm:
I will be checking to ensure that the test calls did not incur any charge.

Confirmed.

The relevant page of the BT Price List says that 111, 112 and 116 are "no fee".

Title: Re: Non-Emergency Healthcare Services
Post by SilentCallsVictim on Aug 26th, 2010 at 1:40pm

Dave wrote on Aug 26th, 2010 at 12:54pm:
The relevant page of the BT Price List says that 111, 112 and 116 are "no fee".

We trust that this rule will apply to all providers. I can confirm this in practice for BT, Virgin Media and Orange.

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