questedh wrote on Jan 7
th, 2009 at 11:12pm:
respondants are misled into believing that some of the 'useful features' are only available with 084 and not 01, 02 or 03.
There is no question that the document does not properly distinguish between non-geographic (084 / 03) and geographic (01 / 02) numbers. The truth about 03 is in there, but it struggles to emerge.
In a spirit of genuine open enquiry, I seek enlightenment on the main point of contention in the posted comments.
I understand that many features exploited by telephone systems on non-geographic numbers use facilities hosted at the network telephone exchange. Use of these features comes at a cost which is met by a part of the revenue share income when available, or by additional charges to the user when not.
I also understand that similar or identical features can be provided by facilities on equipment at the (surgery) premises on the end of any number. Again these would come at a (possibly lesser) cost. There may however be differences in the nature of the feature, e.g. a local line fault may leave the whole service out of order and the size of the queue of waiting callers is constrained by the capacity of the incoming lines, which would otherwise only need to accomodate actual conversations in progress.
I had understood that it is possible for some of the facilities available with non-geographic numbers to be hosted on some geographic exchanges. Again this would be at a cost charged to the user, although I am not sure if this would be different to that applied when on a non-geographic number. I also understand that there can be clever tricks achieved by re-routing calls to geographic numbers through other exchanges to take advantage of facilities not otherwise available and then back again. This facility would also incur a cost.
The posted comments seem to suggest that the exchange hosted facilities available on non-geographic numbers are equally available on geographic numbers in all cases and in all respects. This would mean that the only valid reason for incurring the expense of a 03 number would be a desire to avoid the service being associated with any geographic locality.
I would be most grateful if my understanding could be enhanced.
The weak references to 03 (and possibly further misleading information) leave the consultation dangerously close to presenting the option of a better service only being available at a higher cost to patients. I cannot disagree with the suggestion that the consultation is thereby flawed, however those behind the consultation do know very well that this is a false choice, and what is more they know that we know that they know this.
I am confident that the results of simple responses to the consultation will indicate both that patients want better telephone services and that they do not wish to pay for NHS services as they access them. If the latter point were to come out in the other direction, Darzi would have to start his work all over again as he reported overwhelming support for the principle of "free at the point of need" in the NHS. This principle currently occupies a leading place in the draft NHS Constitution.
Patient satisfaction surveys have repeatedly shown that improved telephone systems lead to a significant increase in satisafaction ratings, so it is unlikely that respondents would reject the idea of improved systems.
The true purpose of the Consultation is to provide a period of public discussion and debate, with the engagement of key players, to determine how a ban on use of 084 numbers could be put into effect without compromising the quality of telephone systems. As all features have to be paid for in some way, the difficult question is, who (if not the patient) should pay?
This question is particularly difficult in the case of GP systems that are subject to long term contracts and are currently funding through revenue sharing. It has been suggested that these systems could be migrated to 03 numbers with revised funing arrangements. If, as is suggested, they could equally well be migrated back to the local numbers that were used previously, then this would represent a significant breakthrough. I urgently need confirmation on this point.
As those who can offer feature-rich telephone systems on geographic numbers must be regarded as key players in the Consultation, I look for them to come forward to show their hand and make their case in the public debate.