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Tuesday, 28 February 2012

Daisy Group confirms how its Surgery Line users fail to comply with NHS Regulations on use of 084 telephone numbers

UPDATE !! (1 March 2012)

Since this blog entry was first published, the content of the Daisy Group document being discussed and linked to below has been removed, being replaced with the legend "Update Coming Soon".

I am not aware of any change to the nature of telephone tariffs that could affect what is needed to achieve compliance with regulations that cannot be amended without the approval of parliament.

When the updated version is published, I will reconsider the comments published below.

In the meantime (for reference purposes only), I have uploaded a copy of the release of the document to which the comments below refer. It may be viewed at this link.

Daisy Group has, perhaps unintentionally, placed NHS GP users of its Surgery Line telephone system in an almost impossible position, if they are seeking to pretend that they can continue to use 0844 telephone numbers.

It has published a document, oddly entitled "Statement of Compliance with NHS Regulations". The statement suggest a possible basis for compliance, but only in the event that all callers to the practice can be shown to fall into certain very particular groups. As this does not include subscribers to the most widely-used landline tariff - BT Unlimited Anytime - it is difficult to see how any GP could possibly comply.

This Statement has to be seen in the context of the recently published confirmation of the relevant regulations, issued by the Department of Health - "The use of 084 numbers in the NHS".

This guidance confirms what is necessary for a user of a 084 number to achieve compliance:

The GP must be able to establish that all callers are not paying more to call its number than they would to make an equivalent call to a geographic number.
OR... if it is unable to do so ...
The GP must be able to show that the cost imposed for following any remedy (e.g. migration to the equivalent 034 number) is "unreasonable".

Daisy addresses these points as follows:

It suggests ways in which a severely limited and highly selective view of the array of relative call costs incurred under the terms of the many tariffs available to callers could lead one to conclude that callers do not pay more to call the 0844 numbers that it provides to its Surgery Line customers. (See below)
It confirms that Surgery Line users may operate the system effectively by using either 084 or 03 numbers. Daisy confirms elsewhere that this includes the 034 range which is reserved exclusively for the purposes of migration from existing 084 numbers (see "Surgery Line - Different Number Ranges"). Daisy offers no evidence to show that it imposes unreasonable charges on those who choose to migrate.

The latter point is especially important, because this dismisses the argument of the BMA, which claims that the costs of compliance which would be incurred on migrating from a 084 to a 034 number are unreasonable (see "BMA disputes DH guidance on premium rate practice phone numbers").

For the statement to offer a full assurance of compliance, and to support the allegations made by the BMA, it would have to provide clear evidence that Daisy imposes "unreasonable" costs for migration.

How GPs could be able to comply whilst continuing to use a Daisy 0844 number

The relevant regulations have always allowed for the possibility that 084 numbers could continue to be used under very particular circumstances. It is for the GP to demonstrate that these circumstances exist for their callers.

The Daisy statement offers some such examples, suggesting that its customers may be able to demonstrate that these apply to them. As it is necessary to make a determination "having regard to the arrangement as a whole", calls from all types of telephone service and tariff have to be considered. I highlight a summary of the position for each, as given in the Daisy statement, below.

The statement confirms that Surgery Line customers generally use "type g11" and "type g6" 0844 numbers, "because a portion of the income generated from calls (equivalent to roughly 4p and 5p per minute respectively, including VAT) can go towards funding the cost of the enhanced telephony system and other improvements to the surgery". One might think it foolish to pretend that such income could be provided other than through additional call charges, however Daisy contends that a GP may be able to show that only perverse cases apply to callers to its surgeries, so as to support a claim of compliance with the regulations.

Public Payphones

Daisy states that calls from public payphones represent less than 1% of calls made.

As the rate for calls to all 0844 numbers is greater than that for calls to geographic numbers (£1.00 vs £0.60p for the average duration call claimed by Daisy), a GP seeking to show compliance would have to demonstrate that this low rate of usage of public payphones was in fact zero in the case of calls to its surgeries.


Daisy offers only what is described as being the "best possible comparison". These words are well chosen, as is the particular singular example used - "BT Unlimited Weekends". (I refer to "best" as being from the perspective of one seeking to demonstrate compliance - this example is in fact most unusual and even perverse.)

BT is prohibited by regulation from adding to the rate of the revenue share passed on to the benefit of the user of a 0844 number. The rates for these calls are fixed (see above) and they are not included in any Calling Plan. The rates charged by BT for geographic calls are not regulated (this regulation ended in 2007).

BT offers customers the choice of a Call Plan to reflect the times when they make calls. The "Unlimited Weekends" Plan covers calls to geographic numbers made at the weekend. If making calls to geographic numbers at other times there is an "out of plan" penalty charge, currently 7.95 pence per minute for weekday daytime calls.

The most popular Call Plan for BT customers is "Unlimited Anytime", which covers calls to geographic numbers at all times. If any significant number of callers to a GP subscribe to BT Unlimited Anytime" - the most commonly applicable landline tariff, then it cannot comply with the regulations all calls to 0844 numbers will cost more - ensuring non-compliance.

The rates given by Daisy are the "out of plan" charges which apply to " BT Unlimited Weekends" subscribers, for calls to the 0844 numbers provided to its customers (not all 084 numbers, as stated). There is a minor error made in stating the name of the Call Plan - it is given as "the BT weekend anytime plan". I sincerely hope that this error is not likely to cause confusion between the "Weekends" and "Anytime" plans! If anyone were able to show that any such confusion was deliberately generated by Daisy, rather than being the result of an uncorrected error, then this would be a most serious allegation to make.

Choice of this very particular example, exploits the perverse effect of obsolescent regulation on BT (Ofcom proposes to lift this shortly) and ignores the fact that calls originated by BT represent less than 40% of residential landline calls.

A Surgery Line user contemplating a claim of compliance on this basis would need to offer evidence to support Daisy's claim that consideration limited to this one tariff, under which callers incur a penalty charge for "out of plan" calls to geographic numbers, is adequately "comprehensive".

Mobiles - contract

Daisy claims that one cannot consider the possibility of those who benefit from calls to geographic numbers being included in bundles paying more to call 0844 numbers, which are never included. It suggest that to do so one would have to determine an assumed rate for the inclusive call, which it rightly maintains is "virtually impossible to ascertain".

This suggested theoretical approach ignores the reality of the situation, which is that when making a call the caller has already committed to whatever package they have. If the cost of a non-inclusive call is additional (as it would be for anyone who does not exceed their package allowance) then it must be more expensive.

A Surgery Line user contemplating a claim of compliance on this basis would therefore have to offer evidence to show that no caller would be able to call a geographic number within an allowance, i.e. with no additional cost. As many mobile packages offer "unlimited", rather than "bundled", calls to geographic numbers, this would be rather difficult, one could say "virtually impossible".

Daisy refers to evidence about the average cost of "out of bundle calls ... to an 084 number from a contract mobile phone". This data will include calls to the more numerous 0845 numbers, which have a much lower "revenue share" component, are subject to termination rate penalties imposed by BT and are therefore commonly charged at a lower rate. Published tariffs show that "out of bundle" calls to 0844 numbers are frequently far more expensive. This evidence is therefore of no relevance, as it does not address the particular issue. The issue of compliance in respect of callers from contract mobiles is fully addressed above.

Mobiles - PAYG

Daisy points out that PAYG users make fewer calls than contract users. Indeed the high cost of all calls would mean that they would only use them for important calls, such as contacting their doctor.

Daisy claims to have undertaken an analysis of selected providers "having a 55% market share and found that their charges for calls to (unspecified) "non-geographic numbers" were no greater than those of calling geographic numbers. (Daisy makes no comment about the relative cost of calling the particular numbers in question!)

Whilst there could be quibbles about Vodafone, O2 and Tesco Mobile because geographic calls are only cheaper in some cases, there is no question that Orange, T-Mobile, 3, Virgin Mobile and many others invariably charge PAYG users more for calls to 0844 numbers than geographic numbers.

A Surgery Line user contemplating a claim of compliance on this basis would therefore have to show that none of its PAYG callers subscribed to the tariffs of the providers listed above, or, in some cases, not to particular tariffs..


It is theoretically possible for a GP to conduct the extensive research required to establish that all of their callers fall into the particular groups, as suggested by Daisy, and as necessary to prove compliance. One would hope that any PCT verifying compliance would take the trouble to go through this evidence, so as to ensure that no significant possibilities had been missed. It is very difficult to imagine how such an exercise could be undertaken properly, given the numerous possibilities that have to be excluded.

The one important point, and perhaps the "clincher", is that subscribers to BT Unlimited Anytime - the most widely used landline tariff - invariably pay more to call the 0844 numbers used by Surgery Line customers than an equivalent call to a geographic number. It is for Daisy to advise its customers in whatever way it wishes, however it is fair to draw attention to the omission of the most widely used landline tariff from its briefing.


  1. I've not seen any entries by David since re Daisy Group.
    The reason I am asking is that my surgery is making patients aware of a document published by Daisy Group plc " NHS Regulations - Supporting GPs with Compliance - Dated JULY 2012 (which must be an update on the April document. The surgery claims that calls to 0844 numbers are no more expensive than those to a geographical number. However it does say that the "may be" offering a local number in addition to the 0844 number currently in use.

    1. Apologies for not adding the blog entry - http://nhspatient.blogspot.co.uk/2013/02/the-fair-telecoms-campaign.html sooner.

      The surgery is quite simply mistaken - any simple investigation of telephone tariffs, test calls by members of staff or enquiries of patients will demonstrate that Daisy is trying to construct complex arguments to defend the indefensible. A careful reading of the Daisy document will show that it offers opinions and seeks to mislead without making a clear statement of the obviously false conclusion which the surgery has drawn.

      There are a few perverse exceptional cases where callers incur a penalty charge for weekday daytime calls to geographic numbers, in breach of the terms of their chosen call plan, which is greater than the premium charge for calling 0844 numbers. To seek to pretend that this represents "the arrangement as a whole", as specified in the terms of the GP contract, is ridiculous and without foundation.

      The proposal to offer "two tier" access to the NHS, with a premium number for the best service and an ordinary number for inferior service is a deeper undermining of the principles of the NHS. It simply compounds the breach of the terms of the NHS GP contract which prohibits use of expensive numbers, regardless of whatever options there may be for patients to contact the surgery.


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