Stop bullying GPs over 084 numbers, GPC warns NHS England

The GPC has accused NHS England of bullying GPs after warnings that practices using 084 numbers could face penalties for breaching their contracts.

Phone: NHS England threat over 084 numbers
Phone: NHS England threat over 084 numbers

NHS England wrote to its 27 area teams on 4 November ordering them to contact practices using the numbers, which can be expensive from mobile phones.

Around 8% of GP practices in England - including the Birmingham practice of the CQC’s chief inspector of primary care Professor Steve Field - will receive letters warning they are in breach of contract.

Practices using 084 numbers must make scrapping them a ‘priority’, or action will be taken, NHS England said.

GPs have warned that cancelling contracts for 0844 phone numbers could cost practices up to £60,000.

NHS England's head of primary care commissioning, Dr David Geddes, a GP in Yorkshire 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.’

The use of 084 numbers is a ‘health inequalities issue’, Dr Geddes said.

‘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,’ he said.

‘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 coordinated action on this issue.’

Birmingham LMC executive secretary Dr Robert Morley said NHS England should put as much effort into supporting practices as it is to eradicating 084 numbers. He said: ‘While I can sympathise with patients who have to pay a little bit more I can also sympathise with the practices that have contracts in place that are not in a position to be released from them.

'It would be nice to see support from NHS England for the various problems that GP practices are facing. Such as workload problems, problems with practice payments and funding issues for premises - all sort of things that NHS England can pull its finger out on but on which it seems to be saying very little. But with this issue they are telling area teams to come down on practices like a tonne of bricks, using a very large sledgehammer to crack a small nut.’

GPC deputy chairman Dr Richard Vautrey said that practices should not be ‘bullied like this'.

‘Practices will do all they can to provide patients with good telephone access but they went into these 084 contracts at the direct encouragement of the DH and former PCTs and they should not be bullied like this now as a result of signing up to long-term contracts,' he said.

‘NHS England should be focusing on the far more important issue of sorting out the NHS 111 service, and it is odd that while they are criticising practices they are at the same time investing more in the 0845 NHS Direct service.’

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