The Department of Health appears to have toughened its stance on use of 084 telephone numbers by GP practices in new guidance for the NHS.
The DH says it has not changed its policy on use of 084 numbers, which is that patients must pay no more than the cost a geographic call.
However, it says it wants to provide “clear guidelines” on how that is implemented.
And its latest advice says GPs must take into account “arrangements as a whole” when deciding whether their telephony system increases costs for patients.
That means looking at the cost to patients of ringing from a mobile phone or payphone as well as using a landline.
The guidance adds: “NHS bodies and primary medical services contractors have to ensure that when entering into the contract with the telephony provider callers using mobile phones are not, taking the arrangement as a whole, charged more to call the 084 number than if they called a geographical number from that mobile.”
The DH advice says it is not sufficient for GP practices and primary care trusts to conclude that there is no evidence of whether patients will pay more or not.
It adds: “If evidence is inconclusive on this point then the contractors will not have satisfied themselves sufficiently and should take further steps to comply with their duties.”
The guidance says practices could gather evidence by obtaining an appropriate sample of call costs from telephone providers and by obtaining information from patients.
It says that GPs who conclude patients are being charged more than the cost of a geographical call must take “all reasonable steps” to ensure this does not continue.
That could include offering patients a ring back service, terminating their telephony contract or renegotiating the terms.
Campaigners against the use of 084 numbers by GP practices claim the guidance is a “positive response” to pressure on the DH about use of such numbers.
Legislation setting out the requirement for patients to be charged no more than the cost of a local call was introduced in 2010, and practices were required to have reviewed their arrangements by April 2011.
However, David Hickson, who has led the campaign against the use of such numbers by the NHS, claims use of 084 numbers is still widespread in the NHS.
He said: “There are currently over 1,000 GP practices using 084 numbers and many NHS bodies also persist in subsidising the cost of their telephone systems at the expense of patients and other callers. All 084 numbers provide a subsidy to the user at the expense of callers.”
Hickson claims the new advice emphasising the need to take into account the cost of calling from a mobile phone, and to have evidence about the cost of such calls, means no 084 numbers can be compliant with the regulations and DH directions.
He claims GP practices using 084 numbers could migrate to an 034 number, which would guarantee patients are charged no more than the cost of a geographic number from the same mobile, landline or payphone.