General Practitioners: Telephone Services

Department of Health written question – answered on 6th July 2015.

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Photo of Daniel Zeichner Daniel Zeichner Labour, Cambridge

To ask the Secretary of State for Health, how many GP surgeries use 0844 numbers; and what steps he plans to take to reduce the use of such numbers in the next five years.

Photo of Alistair Burt Alistair Burt The Minister of State, Department of Health

Regulations introduced in 2010 prevented general practitioner (GP) practices from entering into, renewing or extending a contract for telephone services unless it was satisfied that, looking at the arrangements as a whole, patients would not pay more to make calls to the practice than they would to make calls to a geographical number.

The number of practices using premium rate numbers is reducing as contracts come to an end. As at September 2014, over 7,500 (97%) of all GP practices in England were using only local numbers and a large number of practices using 084 numbers also have a local alternative. NHS England continues to work with practices that have premium rate numbers and will review progress periodically.

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Ian G
Posted on 15 Jul 2015 9:14 pm (Report this annotation)

The Regulations were supposed to prevent GP practices in England from entering into new contracts from April 2010, but hundreds more practices continued to sign up each year right up to April 2013. PCTs all over the country had not understood the cost of calling these numbers and had failed to enforce the contractual requirements.

The regulations introduced in April 2010 also gave those practices who were already using 084 numbers one year, until April 2011, to cease usage of these numbers. Most practices appear to have carried on regardless. NHS England eventually sent them a letter in November 2013. The letter warned of potential breach of contract and busted several common myths that practices had tried to use as excuses for inaction.

The letter appears to have had little or no effect. Those practices that are still using 084 numbers are now doing so more than four years after the April 2011 deadline has passed. NHS England appears to have done nothing since sending their letter other than let GPs carry on as before until such time as their, usually, five or seven year contract comes to an end.

The NHS England letter reminded practices that compliance with the regulations could not be achieved by adding an alternative geographic-rate number as there was no room in the NHS for a two-tier system based on willingness or ability to pay. Compliance could be achieved only by changing the number to one beginning 01, 02 or 03, and switching the 084 number off.

The NHS England letter also cleared up the myth that practices had to cancel their telecoms contract thereby incurring massive penalty fees. The principal supplier of 084 numbers to GP practices had already confirmed, long ago, that the 084 number could be swapped to the equivalent 034 number or a new 030 number without charge and with no effect on the contract, and generating no penalty fees.

The only effect of such a number change is that the practice becomes fully responsible for paying the call handling fees for incoming calls and paying the lease on switchboard equipment that came as part of the deal, and has to do so all without the benefit of an illegal subsidy gained at the expense of patients.

New Ofcom regulations came into force on 1 July 2015 which split the cost of calling 084, 087 and 09 numbers into two parts, each separately declared. Those GP practices still using 084 numbers in breach of their GMS or PMS contract are now also required to declare the Service Charge for their number, everywhere that it is advertised.

The new Ofcom regulations expose the fact that where an 084 or 087 number is still in use, GP practices are imposing a Service Charge on callers in direct contravention of the 'free at the point of need' principle of the NHS and in breach of their contractual requirement forbidding them to charge patients.

The Service Charge for an 084 number can be up to 7p per minute. Most practices are using numbers with a Service Charge at that maximum limit and the vast majority of them have no such Service Charge declaration on their website.

Usage of an 084 or 087 number also exposes callers to an Access Charge of up to 12p per minute when calling from a landline or up to 45p per minute when calling from a mobile. In contrast, most people call 01, 02 and 03 numbers as part of their inclusive allowance, and therefore with no incremental cost, on their landline or on their mobile.

We are now at a point that is more than five years since the DoH regulations and GMS/PMS contractual amendments came into force. This cannot be allowed to go on for another five months, let alone another five years.