Re: http://www.glencrosssurgery.nhs.uk/info.aspx?p=9


Quote:

0844 Phone Numbers Since changing to an 0844 non-geographic telephone number in August 2009, we have has[sic] several queries from patients regarding the cost of the calls. Anti-0844 campaigners have been circulating material to surgeries and the media claiming they will be in breach of their contract if they continue to use 084 numbers. They simply have got their facts wrong. The use of 0844 numbers is not and never has been illegal.

No, not illegal, but nevertheless banned.


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Our supplier NEG Telecom charge 4p per minute for calls to their numbers. What your supplier then goes onto charge you, either on a landline or mobile is at their discretion.

Yes, there's a 4p "premium" added to the price of the call by the GPs telephony provider. This results in the call to an 0844 number costing more than calling a geographic 01/02 number or an 03 NGN number. This directly contravenes the instruction that calls to GPs must not cost more than calling an 01 or 02 or 03 number.


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That is why some telephone providers include 0844 numbers in their inclusive call packages and others do not.

No providers have 0844 numbers within the inclusive minutes.


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It is their choice as a provider to charge you, as their customer, more than 4p per minute. Please make sure you are aware of how much your provider calls before dialling.

If you're seriously thinking that the callers service provider is going to charge the caller 4p per minute and then hand all of that money to the GPs service provider to pay the "premium" and take nothing themselves then you're living in fantasy land. The callers service provider will charge for the call then add the "premium" they have to hand over to the GPs provider on top of that. That's not the fault of the callers provider. That is the fault of the GPs provider.


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We did want to share with you the reasons we chose this system - it enables us to provide a much better service to our patients, to increase access to the surgery and to offer a better quality patient experience.

This is debatable.


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This system allows us to offer our patients a better telephony solutions including; ·+ Prevention of our patients experiencing the brick wall of an engaged tone, and having to call again or use their telephone provider’s expensive call-back function

Rather than hit an engaged tone at no cost and redial later, the call is answered immediately and the user pays a "premium" to listen to musak for an indeterminite time before eventually speaking to someone. In the meatime, 4p per minute is being transferred to the GPs provider.


Quote:

·+ Immediate re-direction to the on-call service when the surgery is closed rather than an answer machine with a telephone number on to write down and redial ·+ The ability to cancel appointments when the surgery is closed ·+ Being automatically directed to the most appropriate member of staff for your call ·+ Receiving timely information via the recorded messages regarding our flu clinics & training days

Whilst these are useful, it is not only 08 numbers that can do this. The same service is available on at least 03 numbers.


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Being placed in a queue is not to everyone’s liking.  No solution ever pleases everyone.  But we believe it to be infinitely preferable to not being able to get through to the surgery at all.

Scaremongering. With the same amount of staff and callers, everyone will still get through. However without the 0844 number, the GPs provider is no longer being provided with 4p per minute for every call made to every GP surgery.


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The popularity with patients of surgeries using enhanced telephony - and the significant increase in quality of experience, access and service - is further borne out by the National GP Patient Survey data.  You may have received a copy of this survey in the post.

You can't claim "popularity". For the surgery with only an 0844 number, 100% of callers used the 0844 number. Callers have NO CHOICE. Give the users a choice of numbers (0844 and 01/02/03) AND list the call prices for each and you'll see the number of calls to 0844 plummet to zero.


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This analysis confirms that the introduction of enhanced telephony results in improved access for patients and increased patient satisfaction in GP practices using enhanced telephony: *· patients find it twice as easy to get through to the surgery on the telephone; *· patients find it more than twice as easy to speak to a doctor on the telephone; * patients find it 3 times as easy to obtain test results on the telephone; and * more than 9 out of 10 patients obtain test results easily on the telephone, compared with 1 in 3 nationally.

Of course they can "get through" easier. The call is answered and charging starts within seconds of dialling. Actually speaking to someone comes only after a number of minutes charged anything from 4 to 50 pence per minute.

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The Directions from the Secretary of State make clear that any NHS organisation is free to choose to continue with an 084 number.  All that is required is for the NHS organisation to satisfy itself that the cost of calls to the NHS body is no higher than equivalent calls to geographical number.

Since 084 numbers always cost more than 01/02/03 numbers any such assurance is FALSE.

In particular, 0844 numbers fail that test and have effectively been banned since April 2010.


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The Department of Health has confirmed that they are satisfied with the evidence that shows that our telephony provider, NEG Telecom, conforms to this Direction.

I would hope not. If so, they have been hoodwinked.


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You might also find it useful to know that the British Medical Association has confirmed to us that NEG Surgeryline calls are “no more expensive than making an equivalent local call. This does not mean that the use of 084 numbers in itself has been banned.“

I'd like to see that proof, especially since there hasn't been such a thing as a "local call" for many years. Every landline provider and every mobile provider charges more to call an 0844 number than to call an 01/02/03 number. In addition for services where 01/02/03 numbers are 'inclusive' and therefore effectively 'free', no providers include 0844 numbers within that 'inclusive' or 'free' allowance.


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Some of our patients may be on a call package, where by they receive a package of free minutes for a monthly amount. It is often a miss[sic] conception that people receive ‘free minutes’ as in fact they simply pay up front, in their monthly fee, for any calls that they will make.

Yes, they are not 'free'. They are 'inclusive'. But you're dodging the point that 0844 numbers are never included in this allowance. This is a factor that should be taken into account when determining if a number used to call a GP costs more than calling an 01/02/03 number. 0844 numbers fail this test.


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If the amount of calls made does not reach the monthly amount then the provider retains the difference and in fact their customers may pay more for calls than they needed to.

Yet more dodging of the point. It is irrelevent as to whether a subscriber users all of their inclusive minutes or not. What is important is that when a subscriber has 'inclusive' calls to 01/02/03 numbers, calls to their GP should also be 'inclusive'. Since 0844 numbers are never inclusive in such plans, 0844 numbers fail this test. Using this criteria, 0844 numbers are therefore banned for use by GPs.


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Also with some of these call packages, the telephone provider may charge above the local rate for 0844 numbers and this is stated in their terms and conditions.

There is no such thing as 'local rate'. There is a 'geographic rate', but 0844 numbers are not geographic and they are not charged at geographic rate - mainly because of the 4p per minute premium that has to be paid to the GPs provider.


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That is where some patient’s telephony providers overcharge their customers.

The overcharging occurs because the GP chose to use an 0844 premium rate number, not because of the callers choice of telephone provider.


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Other providers also use the rounding up method of calculating call charges rather than per second billing and this can distort the actual cost.

Yes. If the GP had chosen an 01/02/03 number the rounding up of zero pence per minute up to the next minute would result in the caller paying .... nothing. By using an 0844 number callers are paying more. Whether call times are rounded or not is irrelevant, the pence per minute rate is already higher for 0844 numbers than for 01/02/03 numbers.


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While we sympathise with some patients who find that their package does not include 0844 numbers, it is their choice, and we would recommend that the patient speaks to his or her provider as they would be able to advise which plan would be best for them especially if they calls 0844 numbers regularly.

Since no plans include 0844 numbers the caller has no way to avoid paying more money to call a GP than they would have done had the GP been using an 01/02/03 number.


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With regards to mobile phones, you will note that the BMA guidance states that "In terms of call tariffs, the call rates which patients are charged depend on their mobile phone service provider. It is a matter for individual members of the public to ensure that they are happy with the terms and conditions of the mobile phone arrangements that they enter into with their mobile phone provider."

You cannot shift the blame on to the caller. No mobile phone provider offers calls at the same rate as 01/02/03 numbers to 0844 numbers. All of them charge more for 0844 numbers. Where plans include free or inclusive minutes to 01/02/03 numbers, none of them include free or inclusive minutes to 0844 numbers.

GPs are required to take these factors into account when choosing a number for people to call them. 0844 numbers fail these test on all counts.

Additionally, it is not BMA guidance that GPs have to follow. It is Department of Health guidance that prevails.

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You can be confident that both this practice and our telephone provider NEG have fulfilled their obligations under both the terms of the Government's guidance and the relevant legislation.

They certainly have not.

In particular the Secretary of State recently said:
We have made it very clear that GPs should not be using 0844 numbers for that purpose and charging patients for them.
http://www.theyworkforyou.com/debates/?id=2012-03-27a.1326.4&s=%28no+OR+not%29+AND+0844+AND+numbers#g1327.0

and in longer form...
http://www.publications.parliament.uk/pa/cm201212/cmhansrd/cm120124/halltext/120124h0002.htm#12012442000359


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To enable our patients to contact the surgery free of charge we have a website at www.glencrosssurgery.nhs.uk where you can order your repeat prescriptions, access opening times, health and travel advice, or inform us any changes to your details. Patients can also attend the surgery when reception is open 8.30am to 6.00pm Monday to Friday, fax us on 08448 15 10 23, email us on reception@gp-b85058.nhs.uk (not for prescription requests) or contact by post on the address above.

Older people often cannot use the internet.
And what's with the odd spacing of the number? Is that an attempt to 'hide' it from looking like an 0844 number: using the more usual 0844 815 1023 format makes that more clear.


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We are also happy to provide a ‘call-back’ service although this may be later the same day due to the demands on the phone lines and staff during busy periods. We also offer telephone consultations when the GP or nurse will call a patient on their home, work or mobile phone after their surgery session.

Whilst this is helpful, it does not fix the problem that initial telephone contact with the surgery is charged as a "premium rate call" at rates above those that would have been incurred had the GP chosen an 01/02/03 number for their surgery.

The quoted text as shown on the surgery website sets out to blame the caller and their provider for the excessive cost.

In reality the blame is 100% with the GP for using an 0844 number.

0844 numbers were banned for use within the NHS in April 2010 with a one year grace period which expired in April 2011.

No surgeries should be using 0844 numbers.



http://community.virginmedia.com/t5/Telephone/0844-numbers/td-p/1151271

http://www.hi-mag.com/health-insurance/product-area/cash-plans-dental/article395073.ece

Just two general points to add to the fine comments.

In my view, there is nothing to object to about the Surgery Line system, or even the ridiculous idea that a GP surgery needs to take advantage of the features of non-geographic numbers. The point is that in the NHS, the cost of the system cannot be subsidised by patients and other callers, as will inevitably be the case if a 084 (rather than a 03) number is used.

Use of 084 numbers has been "illegal" (not just "banned"), since 2010, because of the terms of the legally enforceable contract between the PCT and the practice. (The references to Directions to NHS bodies, which have no legal force, are spurious because the practice is not a NHS body.) The only way that the practice could demonstrate that it is legal for it to continue using a 084 number would be if it could show that the option of migrating to the equivalent 034 number for the remaining term of the Surgery Line contract (an option which is specifically offered by NEG / Daisy) would cause the practice to incur irregular costs imposed by Daisy that are not "reasonable".

So that people can made up their own mind, here are the detailed call costs.


NHS regulations require that callers pay no more to call a GP than calling a geographic 01 or 02 number using the same method (i.e. calling both from a landine or calling both from a mobile).

Mobile phone contract deals usually come with a number of inclusive minutes to 01/02/03/07 numbers.

Not taking into account the value of any text message allowances and internet access that is also bundled with many of the current deals, and assuming all of the minutes are used, contracts cost in the region of:

• 10 pounds for 50 minutes (20 pence per minute) to 100 minutes (10 pence per minute);
  
• 15 pounds for 100 minutes (15 pence per minute) to 200 minutes (7.5 pence per minute) to 300 minutes (5 pence per minute);
  
• 25 pounds for 300 minutes (8.33 pence per minute) to 400 minutes (6.25 pence per minute);
  
• 30 pounds for 600 minutes (5 pence per minute);
  
• 35 pounds for 600 minutes (5.83 pence per minute) to 900 minutes (3.89 pence per minute);
  
• 45 pounds for 1200 minutes (3.75 pence per minute).

These are approximate figures as each network varies their deals a little.

The inclusive minutes can be used to call 01/02/03/07 numbers. They cannot be used to call 0844 and most other types of non-geographic numbers.

If some or all of the included text message allowance and/or internet allowance is also used, the effective pence per minute rate for calling 01/02/03 numbers is even lower than the above estimates.

If only half of the inclusive minutes are used, the effective pence per minute rate for calling 01/02/03 numbers is, in the vast majority of cases, still very much less than the additional price of calling an 0844 number.

Calls to 0844 numbers cost 20.4, 25, 35, 40 or 41 pence per minute depending on the provider and the deal, and the majority charge 35 pence per minute or more.


Mobile phone 'Pay as you Go' deals are simply charged at a fixed pence per minute rate, with calls to 0844 numbers usually costing more than to 01/02/03 numbers. In some cases it is possible to purchase a larger amount of minutes for calling 01/02/03 numbers for a fixed fee. 0844 numbers are not included. Some of these plans are detailed below.


It is easy to compare the prices for 0844 numbers and for 01/02/03 numbers from the major providers either for out of bundle minutes on contract deals or for pay as you go tariffs. These can be seen below.

Three mobile contract

• 01, 02 or 03 number: free in inclusive minutes; 25, 30 or 35 pence per minute out of bundle (and only 6 to 8.5 pence per minute on business plans).
  
• Add-on bundles for 01/02/03 numbers: 5 pounds for 1000 minutes, 10.21 pounds for 2000 minutes.
  
• 0844 number: 20.4 or 35 pence per minute depending on the plan and never inclusive.

Vodafone mobile contract

• 01, 02 or 03 number: free in inclusive minutes; 35 pence per minute out of bundle.
  
• 0844 number: 35 pence per minute and never inclusive.

Three mobile pay as you go

• 01, 02 or 03 number: 26 pence per minute (even cheaper with a bundle, e.g. 100 minutes for 10 pounds, 300 minutes for 15 pounds or 500 minutes for 25 pounds).
  
• 0844 number: 35 pence per minute.

Vodafone mobile pay as you go

• 01, 02 or 03 number: 25 pence per minute (even cheaper with a bundle, e.g. 100 minutes for 10 pounds, 200 minutes for 15 pounds, 300 minutes for 20 pounds, 500 minutes for 30 pounds).
  
• 0844 number: 25 pence per minute.

Orange mobile pay as you go Racoon

• 01, 02 or 03 number: 12 pence per minute.
  
• 0844 number: 40 pence per minute.

Orange mobile pay as you go Dolphin

• 01, 02 or 03 number: 25 pence per minute.
  
• 0844 number: 40 pence per minute.

Orange mobile pay as you go Monkey

• 01, 02 or 03 number: 25 pence per minute.
  
• 0844 number: 35 pence per minute.

O2 mobile pay as you go

• 01, 02 or 03 number: 25p a minute for the first 3 minutes a day then 5p a minute for the rest of the day.
  
• 0844 number: 25 pence per minute.

O2 mobile contract

• 01, 02 or 03 number: free in inclusive minutes; 35 pence per minute out of bundle.
  
• 0844 number: 20.4 or 35 pence per minute and never inclusive.

Virgin mobile contract

• 01, 02 or 03 number: free in inclusive minutes; 40 pence per minute out of bundle.
  
• 0844 number: 41 pence per minute and never inclusive.

Virgin mobile pay as you go

• 01, 02 or 03 number: 26 pence per minute (16 pence per minute on Daily Bonus tariff).
  
• 0844 number: 41 pence per minute.

Virgin mobile Original pay as you go

• 01, 02 or 03 number: 21p a minute for the first 5 minutes each day then 6p a minute for the rest of the day.
  
• 0844 number: 41 pence per minute.

Someone else may care to look at the charges from T-mobile, ASDA, Tesco, TalkMobile, etc, but they are unlikely to be much different to those listed above.


The most recent DHS guidelines at:
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_132809 ; specifically state the requirements apply equally for callers using landlines and mobile phones.


Calls to 0844 numbers usually cost more than calling 01/02/03 numbers.

0844 numbers are effectively banned for all GPs and have been since April 2010.

This information was so good, I copied it here...



The only way that GPs can continue using 0844 numbers is if NONE of their patients have these call plans:

    Fixed lines:
        AOL "Unlimited"
        BT "Anytime"
        First Telecom "Anytime"
        First Telecom "Evening & Weekend"
        O2 Home Phone "Anytime"
        Orange Home Phone "Anytime Calls"
        Phone Co-op "Anytime"
        Pipex "Anytime"
        Plusnet "Anytime"
        Primus Saver "Phone Max"
        Sky Talk "Unlimited"
        TalkTalk "Anytime"
        TalkTalk Onetel "Total UK Talk"
        Tesco Home Phone "Anytime"
        Vodafone at Home
        Virgin Media "Anytime"
        YourCalls.net "Anytime"
        YourCalls.net "Evening & Weekend"
    Mobile phones:
        3 Pay Monthly
        3 Pay as you Go
        Giffgaff
        O2 Pay Monthly
        O2 Pay as you Go
        Orange Pay Monthly
        Orange Pay as you Go
        T-Mobile Pay Monthly
        T-Mobile Pay as you Go
        Vectone Mobile Pay Monthly
        Vectone Mobile Pay as you Go
        Virgin Mobile Pay Monthly
        Virgin Mobile Pay as you Go
        Vodafone Pay Monthly
    Public payphones:
        BT Payphones

All of the above plans charge "more" to call 0844 numbers than to call 01, 02 and 03 numbers.

Thanks catj for that info - I would like to copy/paste your list into my reply to my PCT after recieving their answer to my complaint about their lack of action regarding the 0844 numbers on their 'Patch' and their intention to recommend the 2 Tier NHS with the added geo. line currently being peddled by Daisy to aid compliance with the 0844 number.(effectively admitting 0844 does not comply)

Your list plus the call cost from a Public Payphone (provided by SCV) is just what I needed for my reply to their letter indicating the actions they will be taking.

Then I will be escalating this to the Health Ombudsman as the PCT suggested if not satisfied.

The list was originally compiled by Dave and posted in a much older thread where I found it the other day.

There are other providers that could be added to that list, but there's no real need to do so. Taking the GMS provisions literally (as you should), as soon as there is one patient that has a phone deal where 0844 numbers "cost more" than 01, 02 and 03 numbers, the GP cannot use an 0844 number for the surgery.

To infer that it is OK for some patients to "pay more" would be to ignore the "arrangement as a whole" clause.

I cannot believe the amount of Brass Neck that Daisy/NEG have shown with their latest wheeze to prolong the life of banned 0844 numbers by promoting a two-tier NHS. The 0844 debacle has been going on for 7 years, and tens of millions of pounds have been pocketed at the expense of NHS patients.

fairtelecoms has published a list of tariffs for which 0844 and 0845 numbers are more expensive as part of its call charges research.