0870 TO 0844

Alastair Campbell
Contact the author via the editor by e-mail at christopher.johnstone@ntlworld.com

They've just said no to 0870 - so what happens now?

After much heated debate, the use of 0870 numbers in GPs' surgeries has now been effectively banned from use across the whole of the UK. On February 24th the Department of Health in London issued a statement saying that the use of 0870 numbers would no longer be allowed. In total, around 300 GPs currently use 0870 numbers, including several in Scotland - so where does this leave them and their patients following the Government's decision?

The first question is - what about the GPs who have already signed up for the 0870 numbers? Well, whilst the Department has stopped this number range, it is happy to endorse the use of 0844 numbers as a replacement - and actually mentioned them in the official statement. The new 0844 numbers are charged at a 'lo-call' rate, so are much cheaper to call than the 0870 prefix. At fractionally over 4p a minute, the cost of calling numbers with this prefix equates to the standard rate charged by BT between 6am and 6pm. This means that the vast majority of patients will see no difference in the charges they pay for calling their doctor. On the contrary, there is growing evidence that, because call durations are decreased, many patients may actually see an overall cost saving. In fact, one surgery in Wales who had concerns over call charges to patients found that the combination of the 'lo-call' number and reduced call lengths had halved the average patients' call charge.

But why on earth would a GP want to change their phone number in the first place? What's wrong with the local number that everybody in the community knows? The original reason that so many made the change is due to the benefits offered by a new system, Surgery Line, developed by a company called NEG. The company devised a way to fund new switchboards, telephones, panic alarms, reception based display boards and 24 hour patient self booking and touch screens - amongst other things. The GP pays nothing for the new kit, but instead receives a few pence from each call coming into the surgery if the number is switched to a selected non- geographic number. Non-geographic numbers include 0870 numbers charged at a national call rate, and 0844 numbers - which are charged at a 'lo-call' rate.

Some media reports seem to imply that GPs are making money out of the national call rate systems. Richard Chapman, CEO of NEG Plc, explains that this isn't an option. "It is impossible for a GP to make money out of a Surgery Line system. The money that comes in from calls helps towards the funding of new equipment which provides a better service for patients. In some cases there is a surplus - if this happens then the money goes towards reducing the surgery's phone bill. But the notion that they are introduced as a money making scheme is pure fantasy."

In a statement issued by the NHS in Lanarkshire, this point was reinforced when one of their surgeries explained why they had opted for Surgery Line. "We would like to emphasise that we introduced the new telephone system purely in the interests of improving the efficiency and quality of service for patients. We have found that after the initial settling in period, many patients are now commenting favourably on the new system. Whilst the cost per minute is slightly higher than a local call, due to the reduced call time, the average overall cost is broadly similar to before. The practice is not profiting from the new system."

Interestingly, from studies carried out across 100 GPs who did switch to non-geographic numbers, less than 1 patient in 400 had issues about the perceived increased cost of calling their GP. This research was carried out before the more expensive 0870 numbers were banned. It is therefore fair to conclude that 0844 numbers will prove less controversial as they cost half as much for patients to call.

Hitting re-dial

So, aside from the new equipment - which it could be argued mainly benefits the GPs because of the money it saves them - what's in it for the patients? The main advantage is probably in the speed with which calls are dealt. Calls are routed directly to the relevant department and processed more quickly because staff know more or less what the patient will ask for. Again, the survey of 100 surgeries showed that, by improving the efficiency of call handling, Surgery Line systems were able to roughly halve the average call duration. Further analysis also shows that calls are more consistently spaced over the day so that the traditional call peak of 8.30am to 10am is not as high, and that more people call the surgery at less busy times. A spin off benefit for patients is that they are significantly more likely to get through to their doctors first time without having to hit the re-dial button because calls are spread more evenly and dealt with more efficiently.

Kay Danks, Practice Manager of the Cander Centre in Stonehouse commented that they introduced the Surgery Line system "to provide a more time efficient service for patients. At peak times, patients complained of continually getting an engaged tone and we had concerns that emergency calls could not get through. Patients now get an answer every time they call, although there may be a delay in dealing with calls at busy times." Staff at the surgery also feel that the system helps them cope more easily with incoming calls. "As a Practice Manager, I would say that staff like the new system: they think their stress levels have come down - with the use of headphones to answer all calls, the constant ringing of a phone has all but ceased."

"Most of the surgeries I have spoken to decided to go ahead because of one of two reasons. Half saw the opportunity of receiving state of the art telephone equipment without having to directly fund it. The rest were concerned about how long it was taking patients to get through to speak to a member of staff, and wanted a way to speed up this process," says NEG's Scottish representative, David Anderson.

Despite the change to the phone numbers, and the change of policy, the Department of Health has made it clear that it does not have an issue with the Surgery Line system itself, or the company behind it. "We are working closely with the company (NEG) on this issue and we are also working with the practices who, with the best intentions, were trying to get a more effective telephone system," said Dr David Collin Thom, National Director for Primary Care. NEG is currently installing systems across Scotland and is pleased that, with the issue of 0870 numbers behind them, patients will be able to benefit from modern phone systems funded by 0844 numbers, without having to pay any more for the overall cost of their call.

For research purposes I have spoken to over 20 Practice Managers about their experiences with NEG Plc and their Surgery Line system. Two things have struck me. The first is that the surgeries all report that their average call lengths have come down, and the engaged tones that patients used to suffer from have all but disappeared. The second is that it seems strange that so much fuss has been made in the media over a system that has improved the majority of patients' experiences when calling their GP. With the introduction of 0844 numbers, in almost every case, patients will pay less to call their GP than before. Surely the media will start to pick up that Surgery Line is a British success story that benefits everybody, including patients, doctors, reception staff, practice managers - and because of the way it is self-funding - ultimately all taxpayers.

Alastair Campbell David Anderson - NEG's senior representative in Scotland can be contacted on 01268 461 547 / 07966 389 877 or by e-mail at davida@negplc.com. Special thanks to the various Practice Managers who helped me with my research especially Kay Danks.

What do you think of 0844 numbers. Write to hoolet and the best reply wins a free telephone.

Other hoolet online articles by Alistair Campbell can be found at:
hoolet edition 44 - 0870 to 0844

hoolet is the magazine of RCGP Scotland. It is supported intellectually, financially and emotionally by RCGP Scotland.

This issue maintained by Robert Hallam.