PRIMARY CARE Patients feels exploited by national-rate numbers

Published: 13/01/2005, Volume II5, No. 5938 Page 12

GP surgeries that have installed national-rate 0870 numbers are facing growing complaints from patients who say the system is wasting time and money.

Patients in Leicester told HSJ they felt exploited after their doctor switched to an 0870 number - with one complaining she had spent 23 minutes on hold.

And in recent months the Patients Association has logged a spate of complaints from irate Londoners who resent paying extra to contact their GP.

Non-geographic 08 numbers are part of a group controlled by communications watchdog Ofcom.

Although 0870 numbers are often advertised as national-rate calls, competing tariffs and services mean they can cost more than any other national call. Ofcom wants BT to impose a price ceiling of 8p per minute on 0870 numbers, and has called for national guidance for government departments using such numbers.

The Patients Association is so concerned that director of policy Simon Williams has raised the issue with John Hutton, the minister responsible for patient access.

'It really does irritate us that It is a convenience to the practice, not the patient, ' Mr Williams said. 'The whole ethos and feeling is not right - it makes it less accessible for patients.

But There is little you can do about it apart from complain to your GP.' An 0870 number can be freely moved and pointed to any UK landline number. It costs from£10 to set up, rental is free and GPs can earn up to 3.4p per minute on peak calls they receive.

GPs usually buy 0870 numbers as a package with call diversion services, a call recording facility plus a 'virtual switchboard' on which callers enter numbers for different options.

Recorded messages explaining the policy on repeat prescriptions and surgery opening times, plus voicemail facilities for cancelling appointments, can save reception staff time during busy periods.

Dr Geoffrey Cook, senior partner at the Merridale medical centre in Leicester, said calls cost just under 2p more per minute - rather than the 4p extra some patients claim to be paying - and that the new system would be better in the long term.

'The extra money raised will fund the night line and other practice costs. We are certainly not making money out of patients, ' he said.

But one patient in Leicester said the new system was always clogged up: 'This means that they're not only making a profit from calls, but It is taking ages to get through.' Another patient argued that many old patients cannot afford to pay the extra: 'It is bad to think that money can be made out of this, ' she said.

When HSJ contacted the Merridale medical centre we were put on hold for five minutes before the 'general enquiries' option was answered.

Practice manager Lynn Matts said she would report the delay.

'The waiting time should only be a matter of seconds, ' she said.

What other GPs say

Dr Sarah Smith, senior partner at The Willows medical practice in Chigwell, Essex, acknowledged that some patients had complained about the higher call costs since her practice converted to an 0870 number in August 2004.

But she said the existing phone system needed upgrading, and the new number could be retained when the practice moves to new premises.

Harrow primary care trust said that although one of its practices uses an 0870 number, this has not been raised as an issue yet and added that it was a matter for GPs as independent contractors to choose the phone system they want.

Kensington and Chelsea PCT said it did not monitor which phone systems practices were choosing to use.

'We do not regulate any of that from the PCT level - It is up to every individual practice, ' said a spokeswoman.

She said that if a patient could not get through to their GP they should contact the PCT to look in to it.

Many GPs are cautious about the growing use of automated non-geographic telephone systems.

Lincolnshire GP Dr Ruth Livingstone said she would not use such a system herself, although she said the advantages were obvious.

'It could be quite difficult for people on very low incomes, but you can understand that for a big practice with 20,000 patients the volume of calls can be quite overwhelming.' She added: 'On the other hand I would have concerns about such systems because an elderly, confused, upset person would have difficulty using it.' Chichester GP Dr Grant Kelly has no problem with 0870 numbers, but he described the automated call handling used by banks, rail companies and now by surgeries as a 'misuse of technology - and a cheapskate way of doing things'.