Essex LPC - The Voice of Local Community Pharmacy

Medicines Use Reviews (MURs) are the only Advanced Service currently available under the New Pharmacy Contract.

They are also a tremendous opportunity to demonstrate the value that pharmacy can add to the NHS.

Its importance is shown by the recent increase in numbers allowed (400) and remuneration provided (£25 per MUR). The extra numbers are only available to those who have started doing MURs before October 1^st 2006.

The committee have identified this work stream as a priority, being particularly concerned to ensure that mechanisms are developed to support and empower contractors to undertake MURs. The committee objective will be to achieve full uptake of MURs across all contractors in Essex for the current financial year.

Information can also be obtained by contacting Sailesh Dawda who is the LPC workstream lead.

Below you will find further information to help achieve the goal of all pharmacies undertaking 400 quality MURs.

TOP TIPS:

These attachments provide advice from PSNC, Tendring PCT and Graham Fletcher.

Preparation

Preparation is the key to most successful projects.

Accreditation

Pharmacists can achieve accreditation through a number of sources. Those known are listed here.

http://www.psnc.org.uk/index.php?type=more_news&id=1468

The premises need to meet certain standards.

The pharmacist can then register the pharmacy's compliance using Form PREM1.

Alternatively or in addition the pharmacist can apply to carry our MUR's away from the pharmacy. For this to happen the agreement of the PCT is required. Each PCT will have its own system. Initial application can be through using Form PREM2 or any equivalent produced by the PCT.

Choosing your Target Audience

There are a number of sources that can be used to choose patients who you believe will be suitable for a MUR.

1. PCT guidance

2. Disease prevalence rate statistics

3. Your specialism

PCT Guidance

Each PCT has produced guidance as to which areas pharmacists should consider when targeting potential patients. The attachment covers Essex prior to restructuring and will be updated if changes are made.

Some PCT's are promoting MUR's for discharge patients. An example of such a referral form.

Disease Prevalence Rates

These are now available using QOF data locally and nationally. Contact your local surgery or PCT to source local data. National data for 2004/2005 is available here.

Your specialism

Many pharmacists have or are looking to have areas of specialised interest and MURs could provide you with an excellent opportunity to use this expertise as well as build up an evidence portfolio. There is now a website for pharmacists with a special interest. Click HERE to access.

Communication with your Local Surgery

Helping your local GPs and their staff understand how MUR's work and the benefits it brings to patients is very important. The same is true for other professionals who could potentially signpost suitable patients to you. Here are some ideas to help you "sell" MUR's. If your suggestion of helping them with their medication review process meets favour you can offer them a template letter which lets the GP signpost patients to their local pharmacy.

Communication with Patient

Helping your relevant patients understand the benefits of undergoing an MUR will lead to a greater uptake. A leaflet has been produced which is available from the Department of Health publications orderline (tel: 08701 555 455, publication reference no. 270570). You may also wish to inform your relevant patients about the service you can provide. Here is such a letter which can be adapted according to our individual needs e.g. you may wish to target specific disease states and mention relevant benefits in the letter.

Planned or intervention

Determining when you will carry out MURs is an individual choice and can reflect how confident you are. Who to target has been discussed earlier and this will mainly apply to planned MURs. However some pharmacists having produced a list of suitable patients engage them on a visit and carry out the MUR at this time. Here is a list of ideas to consider when choosing suitable times and starting points to carry out the MURs.

ACTION

The Interview

This is the key event that should elicit the information you will need to ensure the patient gets the best benefit from the service. Here are a set of ideas to help you achieve the best results.

Recording

The MUR has to be recorded on specific forms and copies given to the patient and GP together with a copy being retained in the pharmacy Form 1. Much of this form can be completed prior to the MUR interview Form 2. Language is also important as the form needs to be understood by the patient and the GP. Seek advice from the surgeries as to what will work for them. Do the same for patients. The current forms are not user friendly and are undergoing a revision. Communication with the surgery can help this. For example, sometimes there will be no recommendations for the surgery and they do not welcome receiving blank forms daily. At some point the form will need to be sent to them. Discussion can produce a solution e.g. batch them and submit monthly.

Examples

It is hoped to set up a section on the website where examples of MURs can be displayed

I have produced a template which can be used. Please send any good examples to me and I will share it here.

I am also looking to produce a PowerPoint presentation which all can use to sell the service to other professionals, patient groups etc. I can only achieve this if I receive enough information so please use the template.

Review

A good practice to be recommended is to seek feedback. This can come from patients, GPs and staff.

Discussing it with peers can also prove very helpful.

Claims

Guidance on the submission of claims is included below.

To visit the MUR Overview page click here.