CJT-80 wrote on Sep 26
th, 2010 at 2:45pm:
Any help is greatfully appreciated.
Just so as not to disappoint those who clasped their hands to their foreheads on seeing such a request being made of myself
Unless the contract for telephone service ends before 31 March 2011, more prompt action will be necessary to remain in compliance with terms of the GMS contract.
It seems that the Minister, the MP, the PCT and (probably) the practice have been wickedly deceived.
There is no obligation whatsoever on any telephone service provider to charge "no more than the equivalent cost of a standard telephone call to a geographic number" to call a 0844 (call type g6) number. The "should" is nonsense.
BT is required to charge no more than 5p per minute (including VAT), but this regulation only applies to BT and its pence minute rate in absolute terms. The "call setup fee" that BT charges is unregulated, as are BT's rates for calling geographic numbers. Residential BT customers are served by Call Plans which offer calls to geographic numbers as inclusive for the times when one uses the telephone. Those who never make weekday daytime calls are best advised not to take the Anytime Call Plan, whereas those who do are unlikely to find it economic not to do so, especially after the price revisions coming into effect from 1 October.
BT however originates less that 30% of residential calls, according to Ofcom figures. It is possible that the all the patients of the practice in question (bar one) are most unusual, in that they all have BT landlines and the only weekday daytime calls they make are to the doctor (and they never call the doctor's number in the evening, at night or at weekends to access the out of hours service). If so, then they would find the cost of calling a 0844 number cheaper than the cost of a call to a geographic number at present. (The Ofcom proposals to be published in a consultation at the end of October are expected to include removal of the limitation on BT that creates this perverse effect.)
In all other cases the cost of calling the 0844 number is greater than that of calling a geographic number. This is only what would be expected when the additional cost of the revenue share has to be carried on top of a normal (un-prohibited) margin. Under the terms of the revised GMS contract, practices must consider "the arrangement as a whole", they cannot just consider one group of patients. The penalty charge imposed by one particular telephone company on those who make calls to geographic numbers outside the terms of their selected call plan cannot be considered as being a "standard charge". Furthermore, the uniquely regulated rates charged by one telephone company for calls to 0844 numbers cannot be considered typical.
During the time when the changes to 0870 were going through, Talk Talk (Opal Telecom) published a document outlining the option for customers with 087 and 084 numbers to migrate to 037 / 034 within the terms of their contract for telephone service. I referred to this, with links, in my blog posting -
NHS GPs using 0844 numbers can change to 0344. The Opal website has subsequently been revamped and both the old news item and the associated booklet are no longer available. (I do not see this as being a "sinister cover-up", it is just that the big issue with 0870 has now passed.)
The telephone service used by Surgery Line customers is provided by Talk Talk (Opal) - the registered regulated provider, with NEG acting simply as an unregistered sales agent. The line and number through which the telephone service is provided is separate from the other services provided by NEG. It may be that the overall contract with NEG has many years to run, and that the surgery is obliged to take its telephone service from Talk Talk for this period. There is however no reason why the number change necessary for proper compliance with the terms of the contract with the NHS cannot be made.
If the number change could not be made, then the practice would be required to incur the enormous expense and inconvenience of calling back to almost every patient who wanted to make contact by telephone. That would be an absurd and ridiculous lowering of service standards and a waste of money. (I believe that this provision is in the GMS contract simply as a fall back because the NHS cannot compel practices to terminate existing arrangements with providers.)
The question of how NEG and Talk Talk would react to a specific request to change to the equivalent 0344 number has not yet been answered. I have not yet been successful in persuading a practice to make such a request formally and to discuss the response in public. I do have anecdotal evidence of Surgery Line customers moving back to geographic numbers, however I am not sufficiently clear on the full detail to warrant using these to prove some general point. I also have an email message from NEG confirming that all customers are offered the option of using a 03 number!
I see no point now in playing around with "what if's" and theoretical possibilities. We need to get someone to ask the direct question and be ready to publish the direct response. The March 2011 deadline is approaching and there will be plenty of other issues to discuss once the new Health Bill is published.