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Hundreds of practices still using 0844 telephone numbers

More than 800 GP practices across England are still using 0844 numbers, despite increasing pressure for surgeries to abandon premium-rate telephone lines, according to Government auditors.

A report from the National Audit Office into the use of the higher rate phone lines by the NHS and other public bodies found that 8% of GP practices still use 0844 numbers.

Practices in Yorkshire and Humber, together with the East Midlands, had the highest use of 0844 lines, but the NAO examined a sample of 60 higher rate lines used by GP practices and found that around half also listed geographic numbers as an alternative.

NHS England has said it supports Department of Health guidance which says that GP practices should not enter into any new contracts for telephone services which involve patients paying more than the cost of a geographical call to contact a practice. It announced earlier this year that it had asked local area teams to identify practices still using 0844 numbers, and pledged to ‘act upon’ the findings in due course.

While many GPs are tied up in contracts that last for up to seven years, one of the major telephone service suppliers, the Daisy Group, said last month that practices are able to change to a cheaper number within the terms of their contract.

The NAO report found that a third of all Government customer telephone lines used 084 numbers, despite efforts by the Government to reduce their use. The DH is the only major Government department to rule out the use of numbers costing more than the geographic rate. The Department for Work and Pensions, the Department for Business, Innovation and Skills and HM Revenue and Customs had the highest proportion of higher rate numbers, the report said.

Callers paid £56 million in total call charges to premium numbers in 2012/13, it added, while changing all numbers to 0800 numbers would save callers £46 million a year and cost the Government £21 million a year.

The report said: ‘GP practices predominantly use geographic numbers. In our population of 10,716 GP practices in England, 91% (9,911) predominantly used geographic numbers and 8% (805) operated higher rate lines.’

Commenting on the report, Amyas Morse, head of the National Audit Office, said: ‘Each department needs to take a clear approach to using higher rate numbers and protecting vulnerable callers, and improve their understanding of how to get the best value from telephone services for both callers and taxpayers.’

Mr David Hickson of the Fair Telecoms campaign said: ‘We are supporting NHS England in its work to ensure that all GPs move swiftly back into compliance with their contracts. Offering an inferior service on a cheaper parallel number has no place in the NHS. We are astonished that any GP could consider offering a “two tier” service.

‘The option to offer the full service on a geographic rate number is available - without any penalty under the terms of existing system contracts - we cannot think why any NHS GP would choose to continue taking subsidy from its patients.’

Readers' comments (4)

  • Nice job working in a think tank just thinking all day!

    Get out you bunch of thinkers and actually see some real live patients!!!

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  • YES and by the time the poor patient has gone through the options they could be dead not to mention St. Matthew Passion playing making them feel as if they were dead! It's a shocking and dreadful service.

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  • Extract from the DoH Website Feb 2005:
    “The only special service numbers the NHS will be able to use in future are freephone numbers or those that offer patients a guaranteed low rate call, such as '0845' or '0844' numbers.”
    This is why my practice has an 0844 number. We wish we didn’t. However, the option offered by the Daisy Group to switch to a lower rate number by taking on responsibility for payment of the revenue share can hardly be described as a solution. Our telephony charges are already huge and the company has made a handsome profit from the practice in the 6 years we’ve had its phone system. Giving up the revenue share at this stage would be the only thing that would make us consider staying with them when our contract is up.

    Nobody seems to take on board the fact that if all our patients call us using our geographic number, the calls won’t be managed in the “cloud” and at busy times all 10 of our lines will be taken up with incoming calls, with the result that the GPs and nurses will not be able to phone out. We book a lot of telephone appointments and we call the patients (yes, even to expensive mobiles) which already costs a small fortune. If all the phone lines are taken up with incoming calls then this popular service will have to cease.

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  • Someone should find out who advised the DoH in 2005 about
    "a guaranteed low rate call, such as '0845' or '0844' numbers."
    as it simply isn't true. CAP has advised since 2005 that any such "low call rate" claim when used to describe 084 numbers is a "misleading price indication" and ASA has taken action on that on several occasions.

    Most people calling 01, 02 and 03 numbers during the daytime make the call from within the allowances of an "inclusive" call package. However, 0844 numbers are not inclusive and these calls always push up the callers bill.

    Compared to making calls to 01, 02 and 03 numbers within their "inclusive" deal, callers pay 5p to 12p/min extra from a landline and 20p to 41p/min extra from a mobile when calling 0844 numbers.

    In 2005, DoH specifically banned the usage of 087 and 09 numbers. They should have banned 084 numbers at the same time. 084 and 087 numbers have exactly the same revenue share mechanism as 09 numbers. The highest Service Charge used for 0843 and 0844 numbers (g6) is the same rate as the lowest Service Charge used for 09 numbers (p27). This rate is also roughly in the middle of the price range used for 0871 and 0872 numbers (g6).

    In their "0300 eligibility guidance" published on 27 July 2006, Ofcom advised that one of the suitable criteria would be:
    "Having a website address ending in ''. Including such bodies responds to concerns related to Ofcom about health services’ use of chargeable 08 numbers."

    03 numbers became available in 2007 with GPs having the option to move to a new 0300 number or migrate to the 0344 number matching their old 0844 number.

    The reality is that expensive call-handling and call-queueing facilities have to be paid for by someone. Either the patient pays for those through the Service Charge imposed by the usage of a non-geographic 084, 087 or 09 "revenue share" number, or the practice pays for those services and uses an "enhanced geographic" 01 or 02 number or a "non-geographic" 03 number where revenue share is not permitted and no Service Charge is levied on the caller.

    In "our NHS", patients do not pay for services as they access them. This simple principle disallows the imposition of an extra fee, part of which subsidises the practice running costs, when using a telephone to call the practice.

    DoH eventually realised their error (in specifically banning only 087 and 09 numbers) and issued various guidance over the next few years advising not to use expensive numbers. In late 2009, DoH took steps to ban all numbers where the caller pays more than when making an equivalent call to a geographic number. This effectively covered 084, 087, 09 and several other number ranges. The amended GMS Contract took effect in April 2010. No practice should have started using 0844 numbers after that time, yet hundreds did. All practices should have moved away from 0844 numbers by April 2011, but more than a thousand ignored the terms of their GMS Contract.

    Compared to what their phone bills would have been if only 01, 02 and 03 numbers had been called during the last decade, patients have paid hundreds of millions of pounds extra by having to call 0844, 0845 and 0870 numbers to contact their GP. While it is true that only a small proportion of that money passed through practice accounts or was used to discount or subsidise practice phone bills, it's the imposition of the Service Charge that stops the call being inclusive. Once the call becomes chargeable, except for callers using BT, those charges are not regulated. There's no denying that mobile phone companies have seen sizeable revenue on the back of this.

    Once the Consumer Rights Directive is enacted in December 2013, it will become illegal for many types of business to use 084 or 087 numbers for customer service. The condition will apply from June 2014.

    The recent NAO report on the usage of non-geographic numbers within government is damning:
    "Callers do not receive a better service from higher rate numbers and many callers are put off calling government phone numbers altogether. The most vulnerable callers, such as low-income households, face some of the highest charges."
    Having started only a few months ago, HMRC is already on course to move all 0845 and 0870 numbers to 0300 and 0345 within the next few months. It remains to be seen whether the Cabinet Office gets to grips with this issue for the rest of government.

    Once Ofcom's "unbundled tariffs" system goes live in about 18 months time, any remaining users of 084 and 087 numbers will be required to declare their Service Charge. If this were already law, practices using 0844 numbers on the g6 tariff would be required to declare:
    "Calls to the surgery incur a 7p/min Service Charge; your phone provider will add their Access Charge".
    On the g11 tariff used by a small number of practices, the Service Charge is about 6p/min incuding VAT.

    The effects of both the Consumer Rights Directive and Unbundled Tariffs will set in motion a mass movement to 03 numbers over the next year or so. DoH set the rules in April 2010 such that GPs using 08 numbers should have actioned this by April 2011.

    As for the problem of all your lines being busy and being unable to phone out, that's a configuration problem of your system. You should have at least one line that is reserved purely for outgoing calls.

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