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


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.

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-cos...

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?

who cares as long as the use of the 0845 number is withdrawn?

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

http://www.theyworkforyou.com/wrans/?id=2010-02-25a.317691.h&s=nhs+direct+averag...

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.

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

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 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.)