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Contractors have two weeks to change MUR SOPs as patient groups narrow

PSNC: It was announced in July that MUR target patient groups would change
PSNC: It was announced in July that MUR target patient groups would change

Pharmacy owners now have two weeks to update their standard operating procedures (SOPs), after which 70% of MURs must involve high-risk or hospital discharge patients.

Contractors in England are required to change their SOPs for medicines use reviews (MURs) as of October 1, to reflect a reduction in the patient groups who can be targeted for the service, the Pharmaceutical Services Negotiating Committee (PSNC) announced on Friday (September 13).

Of the patients who can receive an MUR, 70% must now fall into one of two categories: those on “high-risk” medicines; and those recently discharged who had changes made to their medicines while they were in hospital, PSNC said.

PSNC announced in July that there would be a reduction in the maximum number of MURs pharmacies can provide, before the service is completely phased out in 2021. The negotiator said at the time that discussions about changing patient target groups were ongoing.

Target groups revoked on October 1 are: patients with respiratory diseases; patients at risk of or diagnosed with cardiovascular disease and patients regularly prescribed at least four medicines.

“Pharmacies won’t meet MUR targets”

Farhat Ahmed, superintendent pharmacist at Washwood Heath Pharmacy in Birmingham, claimed the announcement – which came 18 days before the changes are due to be implemented – has not given contractors enough notice to prepare.

She is also concerned that narrowing the criteria from four patient groups* to two will mean pharmacies will not be able to provide the 250 MURs allowed by March 2020.

Pharmacies will not see many patients being referred from hospital – one of the two remaining patient groups – Ms Ahmed claimed.

PSNC “might as well have just shot MURs out of the water” when they first announced the contract, she said.

PSNC: “Pharmacies can reach their MUR targets”

In response to these claims, PSNC said there are “sufficient numbers” of patients in the new target groups for pharmacies to reach their MUR targets.

“The PSNC committee analysed the number of patients who fit into the different target groups and has determined that there are sufficient numbers for pharmacies to reach their MUR targets,” it told C+D.

*This article was updated on September 17 to clarify there were previously four target patient groups for MURs

Will the change affect the number of MURs you are able to complete by March?

Benie I, Locum pharmacist

I thought MUR figures were not targets ? Or has this now been changed by Boots/PSNC ?

Not-So-Lucky Ex-Locum, Superintendent Pharmacist

The truth will out!!

There has been a scheme in my area where hospitals can send discharge information via pharmaoutcomes. Very handy for tray patients and patients who have had new medication started.

Has been running for around 6 months and guess how many referrals I've had? You've guessed it, 0.

I agree with a previous comment that respiratory MURs are the most beneficial but I don't think it will be a problem hitting the "target" number though given the reduction in numbers we can provide. I'm sure most pharmacies can find 250 patients across 2019/20 and 100 across 2020/21 who are on a high risk medicine. Just targeting patients on a diuretic will probably be enough.

I'm sure many people who work for multiples are glad to see the back of MURs but for the smaller chains/independants it's another 11k per year lost, and I can't see where it is being made up.

Independent Dave, Community pharmacist

Lost for words 

Jenny Etches, Community pharmacist

Sadly my most useful MURs tend to be respiratory ones - big changes in adherence for many patients Given the push to publicise the need to educate patients about asthma control I’m annoyed at this change as I can’t see how we can reach our target, which isn’t a target, of course. 

SP Ph, Community pharmacist

Hospital discharged patients hardly ever come to a Pharmacy. They are always sent home with 1 or 2 weeks worth of blister packs and many end up back in to hospital even before the surgery issues a new script for continuation of the treatment. All we ever get is either a fax of the discharge summary or the patient's representative coming with the copy asking for further supplies.

So that leaves us with one category split in to 4 further sub-categories (if Iam right) i.e Diuretics, anti-coag, anti-platelet and NSAID. 

Now in the rush to get 200 by October, many might hae already got these done either under this category or part of Cardiovascular category.

So, 70% of 50, in best case scenario, is 35 patients. From here start calculatiing upwards for anyone who has not done the 200 by October, pathetic.

The whole reason given behind doing away with the MURs was unnecessary TARGETS set by contractors. So, now by saying ""pharmacies to reach their MUR targets""", the PSNC itself has broken the rule.

Our situation is like a poor hungry dog in the hands of an Evil Owner. First the size of the Bone/ Stick was cut short to the bare minimum. Then they started throwing it as farr as possible for the dog to get exhausted to even reach the target to feed itself. Now, they have started throwing it up Coconut tree in Caribbean sort of Country and say FETCH.

Please PSNC, you have already sold our souls. There is nothing left with us to give these thrill seakers any more fun. So, instead of playing with further just pull the plug/ bring the axe down in one stroke, don't just inflict more pain and misery.

anti-depressed Pharmacist, Manager

Also there is a good chance they are prescribed a new medicine after they come out of hospital so you will be doing an NMS instead. These are the people negotiating our contracts...

Farhat Ahmed, Locum pharmacist

“The PSNC committee analysed the number of patients who fit into the different target groups and has determined that there are sufficient numbers for pharmacies to reach their MUR targets. Did PSNC provide the figures I would love to see the figures for MURS on recently discharged patients, I certainly do not do many of these, how many do other contractors do? Would love to see the analysis from the PSNC, I presume they must have made it available to C&D, could you please publicise it, I am always happy to see the figures that help reach the end conclusion.


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