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BMA demands ‘immediate pause’ of cloud telephony programme amid cost concerns

by Anna Colivicchi and Rima Evans
14 February 2024

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The BMA has asked NHS England to immediately pause its cloud-based telephony project, following concerns that the procurement process is leading to ‘skyrocketing’ costs for GP practices.

This year’s GP contract imposition stipulated that GP practices must procure cloud-based telephony once their current contracts expire, and £240m of funding was announced as part of the recovery plan, with a focus on replacing old analogue phone systems.

Practices were also told they would have to buy the technology exclusively from providers on the Better Purchasing Framework (BPf), developed by NHS England to provide recommended suppliers and ‘assure value for money’. Currently, there are 19 accredited suppliers listed in the framework.

But last month GP leaders warned that the new cloud-based telephony systems will cost ‘cash-strapped’ GP practices up to £10,000 extra per year.

And now the BMA has sent a letter to NHS England highlighting worries about the procurement process. In particular, it says, suppliers on the BPf do not appear to be ‘financially competitive’ and that practices are being forced to buy from companies they may have had no previous relationship with or even knowledge of.

The letter from GP Committee England’s deputy chair, Dr David Wrigley, to NHS England’s national director for primary care, Dr Amanda Doyle, acknowledges that cloud-based telephony has benefits for both patients and practices but warns against rushing its roll-out. It asks for an ‘immediate pause’ of the project ‘to take stock of where we are and how we proceed from here’.

Dr Wrigley goes on to explain that despite the BMA being repeatedly assured that costs would not increase for practices having to switch from their current provider to a supplier on the BPf, ‘this could not be further from the truth for colleagues across the country ‘ who have gone from paying ‘reasonable sums’ for services to seeing costs ‘skyrocket’.

He said: ‘We have seen invoices from current telephony providers as well as the payments required for future contracts with different companies and they show exponential increases – some by an incredible 470%.

‘Though figures vary between practices, some members have seen increases of as much as £3,200 per year – from £800 to £4,000 – with all these costs expected to be covered by the practice and no additional funding provided to cover them.

‘At a time of significant pressure on GP finances this is the last thing GP partners wish to see, particularly on a contractual issue mandated by the 2023/24 imposition.’

Dr Wrigley added: ‘Commercial suppliers who are on the BPf do not appear to be offering financially competitive services, with practices held hostage by additional costs along with further contractual stipulations over which they have very little say. Practices are also rightly concerned about this business-critical service being provided by companies that they have had no relationship or knowledge of in the past’. 

The letter, obtained by our sister publication Pulse but seen by Management in Practice, also pointed out that the complexity of new agreements with suppliers was adding to the problem.

‘Practices are presented with dense legal contracts that require time and money (via legal fees) to properly analyse and risk leaving GP partners liable if they do not fully vet new contracts,’ Dr Wrigley wrote.

‘ICBs have been given very little help or guidance to support practices and this has led to huge frustration from colleagues trying to engage with the system.’

He said that his own practice was given just 48 hours’ notice to review a complex 149-page contract with ‘many unanswered questions remaining’ and that he did not feel able to sign the contract ‘given those cost and time pressures’.

The letter asked for an urgent meeting with NHS England to discuss ‘how best to resolve this serious situation’.

‘We believe an immediate pause of this project is now required to take stock of where we are and how we proceed from here,’ Dr Wrigley concluded.

NHS England has been approached for comment.

Earlier this month, NHS England said more than eight in 10 GP practices now ‘have digital telephony in place’.

A version of this story first appeared on our sister publication Pulse