NHS Direct abandons one of its expensive 0845 telephone numbers

Further to my previous release and briefing - NHS Direct - a telephone rip-off (also HMRC and Ofgem) – I can now announce that:
The NHS Choose and Book Appointments Line (TAL) has changed its telephone number from
0845 60 88888 to 0345 60 88888.

Campaigners in the war against use of expensive telephone numbers to access public services are celebrating victory in this modest, but significant and indicative, battle.

Callers pay a premium to call 0845 numbers, except when they benefit from the exceptional low rates (or free calls) offered on BT landlines, as a result of BT being uniquely subject to regulation of its call charges. For an average duration call to NHS Direct (528 seconds) this premium is typically £1.01 from a Virgin Media landline, £1.60 from a payphone or £2.25 from a PAYG mobile. Only 23% of telephone calls are made through BT, 28% of socio-economic group DE households do not have a landline.

It seems that the NHS Direct NHS Trust, which operates TAL, has bowed to pressure from callers who run out of coins or credit. Campaigners have long been arguing that patients should not pay for (“free at the point of need”) NHS services as they access them through use of “revenue sharing” 084 telephone numbers. It has been estimated that NHS Direct should be benefiting from revenue sharing by £1 Million per annum.

Calls to all 03xx numbers are charged at no higher rate than that for equivalent calls to geographic numbers and cannot be subject to “revenue sharing”. This applies to calls from landlines, mobiles and payphones, and also covers the terms of inclusive packages. Use of 03 numbers, as an alternative to 084 numbers, was recommended by Ofcom when a public consultation on banning the use of expensive telephone numbers in the NHS was launched in December 2008 – “The 03 Alternative” (published by Ofcom 16/12/08).

The outcome of the consultation was a Direction to NHS Bodies that they should not use numbers which require patients to "pay more to make relevant calls to the NHS body than they would to make equivalent calls to a geographic number". NHS Bodies have until 21 December 2010 to comply. NHS GPs are subject to a similar requirement through an amendment to their NHS contract; they have until 31 March 2011. We await action in respect of other contracted NHS service providers, e.g. dentists, ophthalmologists and pharmacists.

The 0845 number for TAL will remain in use for now, as it has been widely publicised. The new number is now shown on the Choose and Book web site and in letters to patients.

NHS Direct now needs to do the same with 0845 4647 and the many other 0845 numbers that it will continue to operate for many years, until after national adoption of 111 is completed. 0345 4647 is already set up and ready for use. Other NHS Bodies and NHS service providers need to follow this good example set by NHS Direct.

To avoid possible confusion, given the ongoing switchover to 111, I have always recommended that 0845 4647 remains in use. 0345 4647 is however ready to go and should be made available immediately as an officially acknowledged alternative number. The full cost of publicity and reprinting of material for a complete number change would not be appropriate in this particular case and at this particular time.

Even though money would be lost by giving up the financial benefits of using revenue sharing 084 numbers, this would probably be more than offset by the savings made through avoiding the need to regularly make very costly callbacks.

It is important to note that a switch from a 084 number to the equivalent 034 number is guaranteed and can be undertaken at any time within the term of a contract for supply of telephone service (with the same provider). Those committed to long contracts or with inconvenient renewal dates cannot use this as an excuse for failing to comply with the principles of the NHS, as reflected in the Directions and GP Contract revisions.