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GP practices are to be warned that they will be in breach of contract if they do not take all reasonable steps to stop their patients being asked to use 084 numbers for appointments and advice.
The national office of NHS England is writing to all its 27 Area Teams from today – see the ‘letter to Area Teams regarding the use of 084 numbers by General Practice’, asking that they contact all relevant GP practices to remind them that they will be in breach of contract if they do not take all reasonable steps to stop patients being forced to call expensive 084 telephone numbers.
New rules came into force in April 2010, telling GPs that they could no longer enter into telephone contracts that meant patients’ calls to surgeries cost more than a geographic-rate telephone call of the same duration. The Department of Health also told GPs at that time that they should take all reasonable steps to end or change any existing contracts that didn’t comply with the rules.
But many practices had entered into long-term agreements, meaning their patients were continuing to pay more money, and an audit carried out earlier this year showed that around 8% of practices continued to use 084 numbers.
The letter, from NHS England’s Deputy Medical Director Dr Mike Bewick and Head of Primary Care Dr David Geddes, explains what GPs can do to negotiate contract changes with their telephone providers. It adds that offering an alternative standard local telephone line alongside a more expensive 084 number is not good enough because patients cannot receive the same level of service, including queuing and direct-dialling facilities, as they do through the higher-rate line.
Dr Geddes said: “Most GPs entered into these contracts for the additional services they offer to patients. But these numbers can and do cost people significantly more – especially those using pay-as-you-go mobiles, who are statistically most likely to be the most deprived.
“Research showed that some GPs felt unable to change things, because of real or perceived contracting problems, so we are aiming to bust some of the contracting myths, and to support practices to make sure their patients get the best service.
“If GPs are not doing everything they can to change, then they are not providing an equitable service and are in breach of their contracts. We expect our area teams to use their local understanding and authority to make sure appropriate action is taken wherever GPs are not making this a priority.”
Dr Bewick added: “This is a health equalities issue. There is a real risk that more financially-secure patients will wait on hold to get an appointment, no matter how much it costs them, where a poorer patient will be forced to hang up because they can’t afford the cost of the call, and not receive treatment because of that.
“For the same reason, a two-tier service of an 084 number with queuing and messaging facilities, alongside a local number that relies on a receptionist picking it up, is not a reasonable alternative. The NHS should not offer different levels of service dependent on means to pay.
“As a national body working through its area teams, NHS England is taking co-ordinated action on this issue.”
Since its audit earlier this year, NHS England has worked with the Fair Telecoms Campaign to examine the real and perceived barriers to GPs in changing their telephone systems, finding that many GPs understood they would be charged significant amounts of money for cancellation or change of contracts.
In fact, leading providers of GP telephone systems including Daisy Communications (providers of Surgery Line) have agreed to move GPs to geographic-rate 03, 01 or 02 numbers with no contractual penalties.
NHS England will, through its area teams, continue to monitor GPs’ progress, and will audit practices’ telephony services again in 2014.
David Hickson, of the Fair Telecoms Campaign, said: “The Campaign has worked with GPs, commissioners and phone companies for some time over this issue. Where an 084 number is used, patients are effectively paying for their GPs’ telephony services, and this is not acceptable. The majority already respect the principles of the NHS by complying with the rules that were introduced more than three years ago – but those who are not complying must be held to account.
“GP services represent the front door of the NHS, our most valued public service. We are delighted that national action is being taken to end the use of 084 numbers by GPs in England. We will continue to support this work being extended across the NHS, throughout the UK and to all other taxation-funded services.”