The 0844 problem

Calling a surgery to book an appointment with a doctor or nurse, or perhaps to arrange a prescription with the in-house pharmacy, is increasingly becoming a controversial affair because of the number used to contact the healthcare facility itself.

The reason for all the fuss is the 0844 dialling code. [Other codes also exist, such as 0845]. These codes are now under attack by the NHS, the government and, increasingly, in the press.

The fundamental reason for the problem is that users are being 'ripped off' when calling these numbers.

However, strictly speaking, they are not the victims of a rip off or an elaborate scam.

The published local call rate from BT varies depending on the time of day and the day itself [weekends are cheaper] and can be viewed as the 'rrp' of a local call. This means that dialling 084x xxx xxx should cost the same as dialling xxx xxx. In fact it has the benefit of meaning that, if you are outside of the std dialling code area then dialling 084x xxx xxx would actually be cheaper than dialling 01xxx xxx xxx. In fact, companies used to offer this as a cheap way of contacting them.

Times have changed, though. No-one now is paying the 'rrp' for calls yet this 'local rate' is still promoted as a cheap & easy way to make contact. Additionally, the local rate 08xx numbers have been separated out so that some of them charge the full rrp even though it's a weekend.

Therefore a person sat at home who calls a surgery is effectively dialling a local rate call but being charged more than the cost of a true local call.

Another point to note is that most network rates no longer differentiate between local and national destinations.

Furthermore, many people now have call packages:

• free week-end / evening calls
• call packages [eg a monthly fee which includes adsl, line rental & calls]

So, these people pick up the phone and make a call to the surgery often unaware that the call will be charged to them as 084xxx numbers are excluded from their package. It's not even a small print matter because most adverts state 'calls to 01, 02 numbers only'

The same applies for mobiles. Whether their package is call inclusive or not they will get billed for the call at a mobile rate which can be 30p + per minute.

As a surgery you have now gone from offering a 'local rate' call which people think means about 2p a minute to around 5p a minute if they're sat at home or as much as 35p+ if they're on a mobile phone. If they're at work and their system is set up for call barring they may not be allowed to ring you at all.

But wait, there's more. The auto attendant that answers and says press 1 for appointments, 2 for prescriptions etc is, in virtually all cases, not at the surgery itself but is a voice mail server operated by the service provider. As soon as the user dials they are connected to the server and the call charges commence. This server is told what numbers at the surgery to connect the call to after the user dial 1 etc and will hold that call for as long as it takes. In some cases the number will actually be sent to a direct line at the surgery such as the pharmacy line. This line however may be busy on a long call yet the user thinks it is ringing and holds on. So not only are you, the healthcare provider, costing the patient up to 35p a minute but his call is not even ringing at your end.

The potential for phone abuse exists but has never been detected whereby the server can be told to return ring tone a couple of times before the announcement commences. Yet this ring tone is from the server not the phone network so revenue can be increased by unnecessarily extending the wait  time for the announcement.

The service provider who owns the 0844 numbers makes a profit on every call. this profit may be passed on in part to the surgery or remain with the provider who has provided equipment or services in return for keeping this revenue.

The response from healthcare representatives such as practice managers is usually along the lines of :

• "This is expensive equipment and the 0844s pay for it"
• "Look how efficient it all is"
• "We have to recoup costs"
• "Our old system was rubbish and this is the only way we can pay for a new one"

These responses simply don't wash.

At first glance these solutions seem to be an all round win win scenario especially when faced with a slick rep who sells these services all the time. But if the package is examined then it becomes clear that it is not as good as it seems. Often, phone systems are ripped out when they are perfectly capable of offering the very services the practice manager says are needed. Especially Panasonic & Meridian systems.

The situation is set to worsen because the fact of the matter is that NHS services are supposed to be free. The ultimate end will be the banning of these services.

From the service providers point of view they have already catered for this by packaging the services together and if you choose to stop using the 0844s then that's your business you still have to continue with their phone system and their line rental. There may even be a penalty if the 0844 call traffic drops or ceases.

So what's the answer?

Well, take a look at the SJG XN120 - it will connect to existing lines at the surgery whether they're ordinary, digital or Voip. Also, it offers a real auto attendant built in - not an off-site server. Regarding the auto attendant, there's a strong case that a surgery shouldn't be using it anyway. Particularly when dealing with old or infirm patients and anxious family members. The XN also offers built in PA to allow you to make announcements to the waiting room door access controls and a load of other stuff.

SJG services can advize whether your 'antiquated' system is in fact a perfectly adequate system after all.

SJG services can provide a host of front of house solutions to provide slick services without 'ripping off' patients.