CPPE section 2, brick wall

[joseph]

Am on my sixth attempt at section 2. section one is basic u just need a tagged BNF but section 2 is extremely annoying. I am particularly irritated by the ambigious wording of the questions, e.g can u do an mur on a child with X and Y conditions? well that depends on if the child is competent to understand the mur and give consent, but no accomodation has been made for this in the answers.

I need help with one particular question please?
if a pt only gives consent for MUR info to be shared with GP ONLY can we give completed mur action plan to (a) GP (b) pt (c) residental home matron (d) can u record MUR in u'r pharmacy PMR.

first of all, consent has to be give to share information with ''the person with whom the patient is registered for the provision of
General Medical Services'' i.e their GP but also the PCT and NHS business service authority. Therefore no consent to share info with PCT, GP and NHS-bsa EQUALS NO MUR. therefore are all the answers to this question false.
Then again the consent for PCT and NHS-bsa is for audit/monitoring and payment purposes so if u are willing to work for free does it mean u can share the info with the GP and pt only?
U can come at this from many angles so please let me know what the highly competent UK pharmacist community think about this question. would help if someone actually did this section and passed and then let the rest of us know how they managed this minor miracle.

p/s if i dont pass this section am going to get my accrediation with another organisation but i will continue to pay and attempt this CPPE section 2 until i get it right because they have peaked my curiousity to the extreme, then maybe i can answer my own question in the forum a few months or years down the line.lol

[ghajini]

Hi

I would answear true to information shared with gp, patient and record on the pmr but false to the other options. not sure if that is right. To pass section read the stuff in the drug traff under the mur section.

Am on my sixth attempt at section 2. section one is basic u just need a tagged BNF but section 2 is extremely annoying. I am particularly irritated by the ambigious wording of the questions, e.g can u do an mur on a child with X and Y conditions? well that depends on if the child is competent to understand the mur and give consent, but no accomodation has been made for this in the answers.

I need help with one particular question please?
if a pt only gives consent for MUR info to be shared with GP ONLY can we give completed mur action plan to (a) GP (b) pt (c) residental home matron (d) can u record MUR in u'r pharmacy PMR.

first of all, consent has to be give to share information with ''the person with whom the patient is registered for the provision of
General Medical Services'' i.e their GP but also the PCT and NHS business service authority. Therefore no consent to share info with PCT, GP and NHS-bsa EQUALS NO MUR. therefore are all the answers to this question false.
Then again the consent for PCT and NHS-bsa is for audit/monitoring and payment purposes so if u are willing to work for free does it mean u can share the info with the GP and pt only?
U can come at this from many angles so please let me know what the highly competent UK pharmacist community think about this question. would help if someone actually did this section and passed and then let the rest of us know how they managed this minor miracle.

p/s if i dont pass this section am going to get my accrediation with another organisation but i will continue to pay and attempt this CPPE section 2 until i get it right because they have peaked my curiousity to the extreme, then maybe i can answer my own question in the forum a few months or years down the line.lol

[Tony Schofield]

So who's work will this be when you submit your answer?

[joseph]

Thanks Ghajini for trying to help. Am glad I finally passed CPPE, and I would like to cheer up those struggling with section two, however certification exists for a reason i.e. to ensure you are competent to carryout an MUR. So am not going to spoon-feed you answers, am just going to help you with the questions which I think were poorly worded by CPPE thus penalising people who know the answer but fail because they cannot understand the ambiguity of the question/answers.

Your first sources of information should be the drug tariff and PSNC website MUR section. MUR · Pharmacy Contract & Services · PSNC. You can also ask fellow MUR cert pharmacists.


If you are asked if a person with medical condition X is eligible for a ‘regular’ MUR without being told the number of medications the pt is on then don’t worry about this and focus on the other criteria i.e. the 3month rule, 12month rule, recent medication changes etc

If you are asked if a child is eligible for MUR and nothing is stated about ability to give consent and to understand and thus benefit from the MUR consultation. Then assume that child is competent and focus on other criteria’s


Question regarding MUR consultation room; all the answers you need are in the DT and PSNC website

Pts on acute medication are ineligible for regular or targeted MUR but are eligible for prescription intervention. Some people argue that prescription intervention and MUR are the same service, however it is what triggers the MUR that is different, and others argue they are different services. Therefore this is another slightly ambiguous question. All you need to know is that pt on acute meds are ineligible for MUR, forget the definitions.

Regarding pt only giving consent to share information with GP. You can only give copy of completed action plan to GP and patient. You should also make a record of the MUR in your pharmacy records…………forget all the extra details of NHS-BSA and PCT which I eluded to when I started this post

Another ambiguous question, can you get MUR certified pharmacist to come over to your pharmacy to conduct MUR. The service spec state’s the pharmacist doesn’t only need to be certified but also needs to be registered with the local PCT i.e. send copy of his certificate to the PCT. This question again punishes those who know too much. So ignore the ambiguity and assume this certified pharmacist has already sent his copy to the PCT.

Finally, don’t call a sick pt to do an MUR over the phone even if you have PCT approval. It’s just common sense people

Don’t ask me for help with other sections, learn your BNF and clinical stuff. Good luck


I find that the MUR section of this forum will be infinitely more helpful to newly qualified pharmacists, if people who posted questions and then passed, came back and advised us how they overcame their problems rather than simply boasting that they have passed. So please people help improve the forum but don’t spoon-feed answers, just help with ambiguous questions, we need competent MUR pharmacists.

Remember me when your paid your MUR bonuses and don’t remember me when your boss is stressing you out with MUR targets. Lol

[johnep]

Agreed, too many come onto forum (often as first time poster) begging for help, but then do not share their experience. Why should we help you if you then refuse help to others?
johnep

[aseelupeelu]

Hi,

I just want to thank you for your recent post - it has helped a lot because I'm also struggling with section 2. I just have a few questions regarding your last post.

Firstly, regarding the first comment in the quote below - what if the question does not include a 3 month rule or medication change - what if you are just asked about a medical condition and whether they are eligible for a MUR?

Secondly, I struggled a lot with the question regarding consent. I'm wondering why you specifically say that it's okay to give a copy of the completed MUR to the patient and GP and no one else when it specifically says the following in the Drug Tariff "P provides information from the record mentioned in sub-paragraph (h) to the Primary Care Trust or the Secretary of State, on request, in the manner approved for this purpose, and for the purposes approved, by the Secretary of State" (section H is the following "P ensures that a written record of each MUR service consultation carried out by or on behalf of P is prepared by the registered pharmacist who carried out the consultation, on the approved form or in the approved manner and including the approved data (“approved” for these purposes means approved by the Secretary of State).

Finally, is there any specific reason to assume that the pharmacist called in to do the emergency MUR has already sent his copy of the MUR to the PCT? I would have thought doing so would be taking quite a big risk.

Sorry to bother you with all these questions - section 2 really is frustrating me.
Also I just want to congratulate you for passing your MUR - well donnnnnne =)

If you are asked if a person with medical condition X is eligible for a ‘regular’ MUR without being told the number of medications the pt is on then don’t worry about this and focus on the other criteria i.e. the 3month rule, 12month rule, recent medication changes etc

Regarding pt only giving consent to share information with GP. You can only give copy of completed action plan to GP and patient. You should also make a record of the MUR in your pharmacy records…………forget all the extra details of NHS-BSA and PCT which I eluded to when I started this post

Another ambiguous question, can you get MUR certified pharmacist to come over to your pharmacy to conduct MUR. The service spec state’s the pharmacist doesn’t only need to be certified but also needs to be registered with the local PCT i.e. send copy of his certificate to the PCT. This question again punishes those who know too much. So ignore the ambiguity and assume this certified pharmacist has already sent his copy to the PCT.

[joseph]

Hello aseelupeelu,

Regarding u'r first question. the question may list a medical condition and ask u pt is eligible for a 'regular' mur. With regular mur and targeted mur except high risk meds pt needs to be on more than one medication to be eligible. but as i have stressed in my article the wording of the questions by cppe is really frustrating and i can find no logic to some questions. But I have passed section two twice, once on my own and once for/with a friend. If you get a question just about medical condition X, just assume pt is on polypharmacy and consider the other criteria's; has the pt being attending your pharmacy for at least 3months, has it been 12 months since their last mur or have they been any recent medication changes that justifies an mur earlier than the 12month interval. am not sure what to do if no timeline is provided but if no timeline is provided then i would assume the pt has been attending my pharmacy for the last 3 months. just remember what answers you gave so you can change them at the next attempt if you fail.

I also struggled with the question regarding consent. true pt now has to sign consent to sharing of information with gp, pct, nhs-bsa. the PSNC website has got a template of such a document for pharmacist to print and use. the CPPE question makes no accomodation for this fact. having passed twice i can tell you that either this is not a significant question or the answer is to give copy of completed mur action plan to pt, gp and make a record of mur in your pharmacy records. I guess the key point here is the sharing of the information contained in the completed mur action plan as opposed to sharing the fact that you have done an mur with the pct and nhs-bsa

finally, the is absolutely no information about the emergency certified pharmacist being registered with the PCT in question. again having passed twice either this is not a significant question or the answer is TRUE, as in he IS eligible to do the mur. therefore i guess we are expected to assume that he did indeed register his mur accreditation with the pct.

I would like to expand on the points i made but am short on time (hence the poor grammer) and expect u'r eager for quick feedback. lets me know if u have any more problems

[aseelupeelu]

Thank you so much for replying. I appreciate it =) This thread has been of great help for me, so thank you for taking the time out to explain things.

I'm about to do section 2 of the MUR now, so fingers-crossed I pass this time.

[aseelupeelu]

Yayyy!! Ive passed section 2!! Thank you so much!

[joseph]

Well done. Good luck with the other sections