Don’t let DoH off the hook on 084 ban in rush to go green

By , Wednesday, 28 January 2009, 1 Comment
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Hats off to the DoH for its ‘Saving Carbon, Improving Health’ strategy launched yesterday.


The Guardian either broke the embargo on Monday or received an early briefing when it reported that greater encouragement of GP telephone consultations would form part of the push.


All of which brings the DoH’s current consultation on banning the use of 084 numbers for practices into sharper focus. Pharmacists think it a good idea which should be enough to ring alarm bells.


There is an interesting debate at the heart of the consultation: 084 numbers enable callers to queue, be redirected and book automatically yet can cost patients more than local landline calls, which don’t offer such facilities. 084 also offers practices the ability to offset some of the cost of providing the system.


As a patient, I prefer the ability to navigate through a system rather than face a constant engaged tone.


To these eyes the consultation seems heavily weighted to the conclusion that 084 (indeed, all NHS) numbers should be replaced with 03, which do not offer the same financial incentives for practices but do boast the better quality of 084 at no extra cost to patients. One question the consultation asks is who should pick up the tab if 084 is substituted for 03?


It seems to me that if practices are not careful it will be they who foot the bill as the NHS pursues the twin objectives of going green and making the cost of telephone access to practices more equal.


It seems curious that the DoH is happy with NHS Direct having an 0845 number when until recently BT was charging higher rates for these.


Also at least one LMC is reporting that it was a health authority and not the pesky GPs which requested practices make the switch to 084.


In cases like these surely the onus of picking up any bill should fall with the primary care organisation and not the practice?


After all, the NHS isn’t exactly strapped for cash. As HCR reports today basic salaries for the most senior managers rose 9% to £150,000 plus in 2008/9 – yes, you read that right, an inflation-busting 9%.


Perhaps we should be grateful that quality leadership is a ‘new priority’ for the NHS. We’re certainly paying through the nose for it.


It would appear a little sharp manoeuvring by BT has let NHS Direct off the hook.


The consultation closes on 31 March, don’t let your practice face the charges for the government’s bid to go green and equalise England’s call costs for patients.


We’d like to know what you think: did your health authority encourage you to go 084? Do you think it’s reasonable for practices to meet the costs of going 03? Or do you agree that the DoH should not be let off the hook and that the NHS should foot the bill?

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  • http://homepage.ntlworld.com/davidhickson/NHS.Patient/ David Hickson

    The Department of Health has long promoted the idea that the additional features available with non-geographic telephone numbers should be utilised to provide a better service to NHS patients. There is a debate amongst system providers over whether these are truly necessary for operations of the scale of GP surgeries, however some clearly believe that there are cost-effective benefits to be derived.

    Where this is the case the telephone service, under the contract in place, must be transferred from 0844 to perhaps the equivalent 0344 number, which is reserved for this purpose. Unless there is good reason to do so, there is no need to incur the costs involved in breaking the contract.

    The Department of Health promoted the idea of moving to 0844 numbers in the wholly mistaken belief that all callers’ telephone companies subsidised the use of these features without imposing any additional charge on callers. Now that it has discovered its error, it does indeed have a duty to “put its money where its mouth is” by footing the bill for use of these features where appropriate. This must however be offered to all NHS service providers on a consistent basis, not just to those who failed to spot the error or chose to disregard it.

    (The BMA has adopted the absurd position of suggesting that all callers’ telephone companies should be required to behave as the DH mistakenly believed that they did. Attempts have been made to get it to adopt a more sensible and constructive position. Furthermore, no-one should be misled by the fact that BT is uniquely able to do cross-subsidising tricks with 0845 numbers that no other provider could readily copy.)

    Many practices are presently benefiting further from revenue sharing at the expense of patients, as it is funding not just use of the advanced telephone network features but also leases on equipment in use at the surgery. This is a different matter; there is no justification for some practices having this funded by the NHS, whilst others have to pay for it out of the practice budget. It may be reasonable for the DH to assist with renegotiation of the lease if the terms could not be easily met, however those who were wise enough to avoid getting caught up in this situation should not miss out on benefits provided to those who did.

    NHS Direct, some PCTs, Hospitals, Out of Hours providers and others who currently use 084 numbers for NHS services will be fully covered by the ban. This is not a swipe at GPs, most of whom have not adopted 084 numbers, it is a necessary step to preserve the principles of the NHS which I suspect that most GPs will support.

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