Mur's - done at the counter!??!

[Tony Schofield]

I suppose that it depends on whether we judge everyone by the standards of the worst?

I choose not to as I personally know many many intelligent, articulate, and caring pharmacists who do an excellent job and whose patients value them immeasurably.

The glass is half full remember?

[GAZ]

I was locumming recently at a branch of BTC - a branch that I'd never been to before - the message passed on to me from the pharmacy manager was that I should try and do 5 MUR's on my day!!!!!!!!!!! 5!!!!!!!!!! Well, all started off ok and I had my first one done by 9.30am!! A general MUR "chat" with this gentleman provided valuable feedback to the pharmacy regarding the problems he was having "halving" his metoprolol 50mg (hopefully the pharmacy will action my recommendations to do this for him!??). I thought ok let's try towards this target of 5 - why not!! But then 10am arrived - scripts just kept coming in (one pharmacist= me & an understaffed dispensery (IMHO)) so any thought of conducting MUR's took a very distant back seat! So, in the end I did ONE MUR & I think I did a FANTASTIC SERVICE for BTC!!
I also noticed that on one day in this month they'd managed to do about 13 MUR's - I asked the staff how this was possible with only 1 pharmacist on duty? They told me that there was 2 pharmacist's on duty on that particular day & they we're mainly done OTC!! My question is, what are we as pharmacist's going to do about this? We can't allow this farce/fraud to happen...can we??!! I suspect not one of these patient's gave informed consent - BUT I wasn't there! If I do report my concerns, who do I report them to? I'm sure the branch manager/area manager just look at the numbers and would consider me as a locum to be better than a locum who did NONE BUT not as good as a locum who did 5!?

[Pharmanaut]

I was locumming recently at a branch of BTC - a branch that I'd never been to before - the message passed on to me from the pharmacy manager was that I should try and do 5 MUR's on my day!!!!!!!!!!! 5!!!!!!!!!! Well, all started off ok and I had my first one done by 9.30am!! A general MUR "chat" with this gentleman provided valuable feedback to the pharmacy regarding the problems he was having "halving" his metoprolol 50mg (hopefully the pharmacy will action my recommendations to do this for him!??). I thought ok let's try towards this target of 5 - why not!! But then 10am arrived - scripts just kept coming in (one pharmacist= me & an understaffed dispensery (IMHO)) so any thought of conducting MUR's took a very distant back seat! So, in the end I did ONE MUR & I think I did a FANTASTIC SERVICE for BTC!!
I also noticed that on one day in this month they'd managed to do about 13 MUR's - I asked the staff how this was possible with only 1 pharmacist on duty? They told me that there was 2 pharmacist's on duty on that particular day & they we're mainly done OTC!! My question is, what are we as pharmacist's going to do about this? We can't allow this farce/fraud to happen...can we??!! I suspect not one of these patient's gave informed consent - BUT I wasn't there! If I do report my concerns, who do I report them to? I'm sure the branch manager/area manager just look at the numbers and would consider me as a locum to be better than a locum who did NONE BUT not as good as a locum who did 5!?

If its as you say it is...
How pathetic can things get.
If you were signed in as responsible pharmacist tell the superintendent what you think!

[GAZ]

I wasn't the responsible pharmacist on the day in question - for what it's worth i am inclined to push my concerns towards him

[Pharmanaut]

I wasn't the responsible pharmacist on the day in question - for what it's worth i am inclined to push my concerns towards him

If you are willing to stick your head over the parapet....
Get on to the Superintendents office.

[imaginegenerous]

Recently heard reports of a locum in our area doing 20 ''MURs'' a day - not completing paperwork, going through the meds with patient representative if they are collecting the Px - completely unprofessional behaviour and apparently management know about it but aren't doing anything about it because it looks good on the figures...

[Ally]

Recently worked for a national chain been the second pharmacist. Caught the pharmacist doing inappropriate mure like people receiving medication for the first time and those with acute prescriptions. I think there should be a way to check up on the quality of murs. Not just the quantity

[GAZ]

The general feeling I get is that there are a small number (?) of pharmacists doing MUR's inappropriately, and not in line with contractual obligations eg in an approved consultation room (or other place, eg patient's home, with prior approval by PCT), with verbal/written consent from patient OR representative AND a clear guide as to the purpose of the "chat"! This bothers me!! It reflects badly on the pharmacy profession - patient's and gp's who only experience this tick box/numbers driven MUR/MCU would be well within their rights to question it's value or need! I did an MUR for a chap today - one of his meds was a statin - said he had no problems taking this (or any other medication) or with side-effects....job done - we're not looking for faults - just to reassure us, the patient & the NHS all is ok from our side - I WOULD NOT DREAM OF TELLING/ASKING/REMINDING THE GP IF THEY'RE MONITORING HIS CHOLESTEROL/TRIGLYCERIDES....WE HAVE TO ASSUME HE/SHE IS...THAT IS THEIR JOB!!!!! (I've had reports back of pharmacist's who send a copy of an mur to gp "telling" gp to regularly monitor patient's cholesterol, bp etc!!!!!!!!!) - Rant over for now!!
Enjoy the rest of the evening!

[Ally]

The debate rolls on.

Worked in Leeds recently where the local PCT has sent some questionaires for patients to do after they've had their MUR. Looking through im not to sure how well there gonna go down. Firstly it can be difficult to get a patient into an MUR in the first place, then to have a colleague spend 10 more minutes with them to answer more questions. As for the questions most look fairly basic like do you feel like you learnt anything about you meds? Was the pharmacist helpful etc But it goes into abit of detail like who identified the mur and why it was done, eg intervention, long term medication etc

Ive also been told of one national chain who opened up a new shop recently is telling all the pharmacist to do intervention murs since they dont have 3 months worth of records, so again a whole bunch of inappropriate Murs are been done simply to meet targets.

It seems like doing murs on a regular basis is not enough, pharmacists are pushed to meet the magic mark of 400 asap.

Would it be better to stop paying for Murs altogether? Yes we should be reimbursed for the services offered but more and more im believing its purely a money making scheme for the bosses, hence why all the rules are been bent.