04 February 2008
To make MURs work, pharmacists need to embrace the ‘four Ps’ - profitability, political, patient and professional says Ajit Malhi, head of marketing services for AAH Pharmaceuticals.
The NPA has listed MURs at the top of its agenda for this year’s ‘Ask your pharmacist’ campaign. It has been joined by a high-profile PSNC initiative urging contractors and LPCs to promote MURs through an advertising, PR and poster campaign.
These are very welcome measures which should result in the general public knowing and asking more about MURs. But what else should pharmacists consider doing? MUR up-take is improving, but most pharmacies are still likely to fall short of the 400 consultations per annum target?
For MURs to be a success and deliver benefits to pharmacy, the government and ultimately our patients, pharmacists should consider four simple rules:
Profitability
The hard fact is if pharmacists hit the 400 MURs target, they add £10,800 to their bottom line.
After a couple of years with various Category M issues, many pharmacies are beginning to feel the pinch. However, MURs offer a very real opportunity to redirect back into pharmacy some of the profits that have been lost on generics.
At present, the reality is that many pharmacists are more likely to hit an average of 100 MURs a year. This is a fair distance from the set target, but it still represents a move in the right direction. In 2006/07, the average amount of MURs per pharmacist was 55 and in the year before it was as low as 15.
Getting the infrastructure in place is vital to gaining the maximum remuneration from MURs. Many pharmacists simply do not have or cannot find time to dedicate to this service. There needs to be a refreshed and renewed focus on profits; and time spent training staff to increase their responsibilities will ultimately afford more time for pharmacists to spend on local enhanced services.
Political
This would not be the first time that it has been said or penned that community pharmacy needs to engage with PCTs to provide local enhanced services, but in the case of MURs it has far wider and greater political implications.
If community pharmacy cannot collectively make MURs work it makes it infinitely harder to argue for additional services.
We all want to see community pharmacy providing chlamydia screening, minor ailments and obesity management, but our case will be strengthened considerably if we get MURs right. It is crucial that pharmacists make the most of the opportunities that come with this service if we want more to come our way. If GPs, PCTs and ultimately the government are of the opinion that MURs do not work in pharmacy, then they will conclude that additional, national commissioned services will not succeed either.
MURs should be a means to make local prescribing more efficient. They help identify whether or not patients are taking all of their monthly drugs or, indeed, if they still need those drugs.
If patients receive better advice and hence take the correct medication then they are a lot less likely to fall ill. In extreme cases, such as blindness in diabetics resulting from poor medicines compliance, the cost to the NHS is vastly increased. After all, it is reported that patient-returned medicines cost the NHS approximately £75 million per annum – that is £75 million which could be used to fund new national commissioned services.
Patient
There are many reasons why approximately half of the people on medication do not take them as prescribed. The task of pharmacy is to work closely with patients, help them understand their medication and involve them in managing their medicines better through the use of MURs.
In turn, it is anticipated that we will see an up-turn in compliant patients and thus a reduction in patient returns and wastage.
Many patients - in particular the elderly in domiciliary care - can become confused by medication instructions or may not even understand exactly why something has been prescribed. In the case of seasonally enhanced ailments such as asthma, it may be clear to the patient that one inhaler is used for an ‘instant’ result, however they may be unaware of the need for regular preventative treatment.
MURs offer community pharmacists a perfect platform to be seen by both the public and the Government as an easily accessible and trusted local health adviser and provider.
Professional
As a practicing pharmacist, fulfilling my locum duties on a Saturday, it gives me immense pleasure to end the day knowing that I have helped someone and administered some much needed medicines management advice.
Job satisfaction, in any line of work, improves morale and productivity: pharmacy is no exception.
Communication with patients is vital, equally so is the relationship building with GPs and PCTs to widen the healthcare community. This helps to raise the profile of community pharmacy and every pharmacy has a role to play if we are to reach our final goals.
There are still too many people who do not know enough about what a pharmacist can offer. If this target audience can benefit from MURs then they will pass on the good word to others. That in turn will open the door to other nationally commissioned enhanced services - which brings us back full circle to the first P, profitability.
For further press information, please contact:
Dean Enon
Gravitas Public Relations, 7 Imperial Square, Cheltenham, GLOS GL50 1QB
Tel: 01242 211000
