Re: http://www.ashleymedicalcentre.co.uk/website/Z00256/files/NEG_RESPONSE_TO_DAILY_MAIL_ARTICLE_AND_OTHER_ANTI_084_CAMPAIGNERS.doc


Quote:

NEG RESPONSE TO DAILY MAIL ARTICLE AND OTHER ANTI 084 CAMPAIGNERS. Anti-0844 campaigners have been circulating material to surgeries claiming they will be in breach of their contract if they continue to use 084 numbers.  They simply have got their facts wrong.

Untrue. The Secretary of State has recently stated:
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
0844 numbers are clearly banned.


Quote:

As the leading provider of enhanced telephony services to NHS Primary Care, we were delighted by the announcement on 14th September 2009, by Health Minister Mike O’Brien MP that GPs and other NHS professionals and organisations will in future remain free to choose 084 number based solutions for local services, so long as the cost of the call is no more than the equivalent cost of calling a geographical number.

Consulting a list of call charges from all major landline and mobile providers shows that calls to 0844 numbers are more expensive than calls to 01/02/03 numbers.


Quote:

We very much welcomed the Government’s conclusions at the end of its consultation process on the use of 084 numbers in Primary Care, namely that: the Government accepted that 084 numbers are not always significantly more expensive for patients to call;

Don't try to make out that "only slightly more expensive" would be OK. It isn't.


Quote:

the Government recognised that some telecoms providers (e.g. NEG) “have chosen to charge no more for an 084 call than a call to a geographic number when dialing from a fixed line”;

This is completely false. NEG do not set the call cost. The call cost is set by the callers supplier. They will charge a rate for the call and then add on the "premium" that has to be passed on to NEG.

And, while you might falsely claim compliance by talking about calling from landlines, the "arrangement as a whole" has to be considered. This includes calls from mobile lines and calls where the caller has inclusive minutes. In both of those cases, callers pay considerably more to call 0844 numbers. Where inclusive minutes are involved, these are usually only for 01/02/03 and 07 numbers. This is the reason that 0844 numbers are banned.


Quote:

the Government said it wishes to see a marketplace evolve in the NHS in which 084 numbers compete alongside 01, 02 and 03 numbers.   We were also delighted by the release on 22nd December 2009 of formal Directions to the NHS instructing them to enable this to happen.  As you may know this was accompanied by guidance in the form of a letter to the NHS from Nick Hall, Senior Civil Servant at the Department of Health, stating;   “these Directions do not prohibit an organisation from using specific number ranges for the purpose of contacting NHS services. Organisations remain free to use non-geographical number ranges such as 084, providing that patients are not charged more than the equivalent cost of calling a geographical number to do so.”

Calls to 0844 numbers do cost more than calls to 01/02/03 numbers. They are therefore not allowed to be used.
 

Quote:

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.

The call rates for all major providers are available online. It would take just a few minutes to confirm that 0844 numbers cost more to call than 01/02/03 numbers.
 

Quote:

Having held many meetings with the Department of Health over the past 3 years, and having been involved in the original discussions leading to the formulation of the DH regulations, we understand that the Department of Health would be happy for an NHS body such as yours to get this reassurance in the form of a letter from NEG to you confirming that the cost of calls via the Surgery Line solution is no higher.  We have provided this to all PCTs and surgeries that have requested them.  We also shared this letter with DH in advance of sending it to surgeries.

The letter is worthless. Since the price of calling 0844 numbers includes a premium that has to be passed on to the GPs telephone services supplier, and callers with inclusive minutes cannot use them to call 0844 numbers, 0844 are banned from use. This is very clear to see.
 

Quote:

You might also find it useful to know that the British Medical Association has confirmed our understanding in guidance to its members, issued on 8th January 2010, which states: “GP practices (and all others bodies within the NHS using 084 numbers) should obtain written confirmation from their phone service supplier that the charge for a call to their number is no more expensive than making an equivalent local call.

It isn't BMA guidance that GPs should be following. It is the DoH guidelines and the wording of the GMS contract.

Additionally, the GPs service provider cannot provide these assurances. There are several reasons for this. There is no such thing as a 'local call' and it is the callers provider that sets the call charges not the GPs.

Quote:

The DH has been assured by the main phone service supplier, NEG (Network Europe Group, a national provider of telephony services such as Surgery Line), that this is the case. This does not mean that the use of 084 numbers in itself has been banned. As long as the tariff is equivalent to local rates, and the practice obtains a written guarantee from their phone supplier (usually NEG) that they are charging rates in line with local geographic calls, then they will be deemed to have fulfilled their medical services contract."

There is no such thing a "local rate" and hasn't been for many years. However, there is a "geographic rate" and calls to that cost less than calling 0844 numbers. Where callers have inclusive minutes they pay nothing for the individual call when calling 01/02/03 numbers. 0844 numbers are banned.
 

Quote:

The Department of health has not banned the use of 084 numbers in the NHS.

Yes they have. 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


Quote:

In fact, both at the time that the Department announced the results of its consultation on the use of 084 numbers and subsequently in parliamentary written answers, DH's repeated stated position is that    "NHS organisations remain free to use non-geographical number ranges such as 084, providing that patients are not charged more than the equivalent cost of calling a geographical number to do so."

They did this based on the false assurance that most calls to 0844 numbers cost the same as 01/02/03 numbers. This can easily be shown to be untrue. Additionally, 'most calls' no longer cuts it as the "arrangement as a whole" has to be considered.
 

Quote:

The reason why DH has adopted this position is that, contrary to the myths propagated by anti-084 campaigners, 084 numbers are not always more expensive to call than a geographic number.

They are almost always more expensive. The vast majority of callers pay more or substantially more to call 0844 than to call 01/02/03 numbers. There are very few circumstances where this is not the case.


Quote:

OFCOM has looked into this matter on several occasions and, as recently as December 2010, have stated that   “calls to geographic numbers can be as high as 8.5pm with a call set up fee of up to 11p (fixed) and up to 25 ppm (mobile), and 084 numbers can be as low as 0.5ppm with a call set up fee of 3p (fixed) and 20ppm mobile.”

While this might be the case, stating the lowest price for 0844 and the highest price for 01/02/03 numbers hides one fact. These are unusual prices: for the vast majority of callers, 0844 will always be more. For callers with inclusive minutes this is especially so as they cannot use them to call 0844 numbers.


Quote:

OFCOM are also aware that the general public vastly overestimate the general cost of calling 084 numbers, stating   "Not only are consumers generally uncertain of non-geographic rate retail prices, many tend to overestimate non-geographic prices. For example, the price expected on average by callers for an 0845 call was 30ppm for calls from a landline and 46ppm for calls from a mobile."

Whether they over-estimate the cost or not is completely irrelevent. And why mention 0845, we're talking about 0844 here. The fact is 0844 numbers do cost more than calling a geographic number, and are therefore banned.
 

Quote:

The telephony provider therefore has the ability, if they so choose, to set the rate at which a call to their number is charged at the geographic rate or below.

No they do not. There's the little business of the "premium" which the caller has to pay to the GPs service provider. If the callers provider were to absorb that cost, they would have to make a loss on every 0844 call they handled.


Quote:

This was recognised in the DH response to the 084 numbers consultation, which stated “some providers have chosen to charge no more for an 084 call than a call to a geographic number when dialing from a fixed line”.

This is very misleading. The GPs provider can set only the amount of premium the caller will pay on top of the normal price for the call. The callers provider sets the actual call cost that the caller will pay.


Quote:

This is precisely what NEG have done and, in doing so, have complied with the DH regulations and the relevant BMA guidance to its members issued on 8th January 2010.

NEG do not have to comply with anything the BMA has said, especially when BMA guidance is both misleading and incorrect. NEG has to comply with the provisions of the GMS contract issued by DoH. In that regard, they are not compliant.

Quote:

The relevant legislation covering this area is "The National Health Service (Primary Medical Services) (Miscellaneous Amendments) Regulations 2010" These state that surgeries must: "review the arrangement and consider whether, having regard to the arrangement as a whole, persons pay more to make relevant calls than they would to make equivalent calls to a geographical number."

It is easy to show that call from landlines to 0844 numbers and calls from mobiles to 0844 numbers cost more than calls to 01/02/03 numbers for the vast majority of callers.

It is clear that for GPs, 0844 numbers are banned.


Quote:

The BMA guidance makes clear the mechanism whereby surgeries should demonstrate compliance.  The BMA guidance states   "GP practices (and all others bodies within the NHS using 084 numbers) should obtain written confirmation from their phone service supplier that the charge for a call to their number is no more expensive than making an equivalent local call.

Since the GPs service provider does not set the price that callers pay, any such assurance is false. The callers call proces are set by the callers provider. 0844 numbers cost more to call then 01/02/03 numbers.


Quote:

The DH has been assured by the main phone service supplier, NEG (Network Europe Group, a national provider of telephony services such as Surgery Line), that this is the case. This does not mean that the use of 084 numbers in itself has been banned. As long as the tariff is equivalent to local rates, and the practice obtains a written guarantee from their phone supplier (usually NEG) that they are charging rates in line with local geographic calls, then they will be deemed to have fulfilled their medical services contract.”

0844 numbers are banned. That is clear to see.


Quote:

The Department of Health have confirmed with NEG that under the Regulations it is up to an individual practice to satisfy itself that it has had confirmation from its provider that patients are not charged more than the equivalent cost of calling a geographic number.   They have also confirmed that the correct action that a Surgery or PCT should take to adhere to the legislation is to obtain a written confirmation from their telephony provider that the cost of calls using their number is no more than the equivalent cost of calling a geographical number Which I have attached along with this information. .

Any such confirmation is false. 0844 numbers are banned.
 

Quote:

You can be confident therefore that Ashley Medical Centre and its telephony supplierNEG has fulfilled its obligations under both the terms of the Government's guidance and the relevant legislation.

We are confident that Ashley Medical Centre has been fed misleading and incorrect information by their supplier. In effect AMC has been hoodwinked into taking a deal which is bad for patients and which also sees NEG raking off a percentage for all calls placed to the surgery.

There are several more comments to add to the above, which I will do later today (or tomorrrow)...


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.

catj wrote on Jun 16^th, 2012 at 8:12am:

There are several more comments to add to the above, which I will do later today.

Again, well done for addressing the appalling detail.

Much of this is lifted from an earlier document, which was later re-issued. Some of the same words are found on this web page and in this press release.

I have not dedicated effort to addressing all of the specific points of this material, however I have dealt with a more recent item at some length - see Supporting Surgery Line.

(These comments, and what follows, are not intended to undermine, or be set against, the fine work being done by catj. I seek simply to ensure that relevant material is noted and to perhaps ensure that effort is not unnecessarily duplicated.)

---

The following comments provide some detail about the essential element of the NEG misrepresentation of the issue of call cost. (As referred to above, Daisy is now taking a slightly different line, following publication of the Department of Health "Further Guidance".)


Quote:

The telephony provider therefore has the ability, if they so choose, to set the rate at which a call to their number is charged at the geographic rate or below. This was recognised in the DH response to the 084 numbers consultation, which stated “some providers have chosen to charge no more for an 084 call than a call to a geographic number when dialing from a fixed line”. This is precisely what NEG have done

These statements cleverly conflate two separate issues -
[list bull-blacksq]

Provision of telephone service to the GP

Provision of call services to the caller They pick on truths and misrepresent their context and relevance. It is not that easy to untangle the web of confusion which has been created.


A primary network telephone service provider has the ability to choose the absolute price per minute charged by BT Retail (up to "5p" per minute) for a block of 0844/3 numbers which are allocated to it. For the blocks assigned to NEG as a reseller TO GPs, Talk Talk Business (which was then known as "Opal Telecom") chose type 'g6' (5p per minute) and type 'g11' (4p per minute) when acquiring these allocations.

(The rates given were set inclusive of VAT at 17.5%. When VAT was raised to 20%, it was the VAT-exclusive rates which remained fixed. This principle was applied to all NTS ranges.)

Since 2004, there has been no meaningful absolute value for a "geographic rate" from BT. The former "BT Standard" tariff ceased to be the basis for BT call charges from that date and it now no longer applies to any customer.

It is therefore no longer possible for the rate for a call to a 0844/3 number to be set with reference to a "geographic rate". (This was only ever true for BT anyway, but even that is now history.)


The issue of relevance to the contractual conditions imposed on GPs in April 2010 (not the Directions to NHS bodies of December 2009) is what callers actually pay to make telephone calls to the surgery, as against the cost of an equivalent call to a geographic number. This is determined by their choice of arrangement with their telephone service provider .

There is no such provider which has set its rate for calls to type 'g6' and type 'g11' numbers at less than that for geographic calls. There are however cases where subscribers have the option to choose a Call Plan excluding weekday daytime calls to geographic numbers. When making these "Out of Plan" calls, there are some cases where they incur a "penalty charge" that exceeds the charge for calls to type 'g11' and perhaps also 'g6' numbers. (In the case of Virgin Media, the "Out of Plan" penalty charge currently falls between the rates for g11 and g6.)

The NHS serves those who do not choose a telephone call plan that excludes weekday daytime calls to geographic numbers, as well as the majority, which does not have the option to choose to pay more for weekday daytime calls to geographic numbers.


Although NEG, as a separate company, or now as a member of the Daisy Group, neither applied for a block of 0844 numbers, nor sets call charge rates, it may be of interest to look at what Daisy Group has "chosen to do".

Daisy Group (which acquired NEG after the quoted words were drafted, but before they were published in the document referred to) is a provider of telephone services to businesses. Although the NHS serves only individuals, not corporate entities, a business may have cause to make what are referred to as "relevant calls" in the GP contract.

The respective rates for the relevant call types in the Daisy Base Fixed Line Call Tariff are as follows:
[list bull-redsq]

Geographic (Local/Regional/National) - 2p per minute

g11 - 6.5p per minute

g6 - 8p per minute

Is this the place that NEG admits that patients of GPs using 0844 services have been overcharged by more than 27 million pounds for their calls so far?

http://www.phonepayplus.org.uk/For-Business/Consultations-and-Invitations-to-Tender/Previous-consultations/~/media/Files/PhonepayPlus/Consultation%20PDFs/084%20number%20range%20response%20Surgery%20Line%20response.pdf

Thanks for posting the link to the NEG/Daisy cries of pain at possibly having their activities chopped off  ;D

Havent had such a good laugh in ages - lovely to see them squirm - they poked their fingers in their own eyes so often I lost count. (in effect admiting 0844 didn't comply) but they cant see it. 

Can you find any more like that from the Consultation responses - would love to have another good laugh.

Wouldn't the bit in the EU Directive about these numbers not being allowed for Contact if there is Contract, Subscription or Membership - surely being on the GP Register is same as this. ::)