Announcement

Collapse
No announcement yet.

MURs: Solving the BIG problem!!!!

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • MURs: Solving the BIG problem!!!!

    ok so lets define the problem first:

    MURs are a great service for patients but the generous reimburment for an MUR (£27) leads to Undue pressure from store managers/area managers/superintendent pharmacists on store pharmacists (Locum or manager), to perform X number of MURs in a specific amount of time (e.g. 8 per week for managers or 2 per day for locums) to make up the maximum 400 per annum, this is done disregarding whether there is a need for an MUR or not. This is especially irritating when the person demanding is a non-pharmacist store manager, who doesnt know an iota about Pharmacuetical issues. Unfortunately, alot of pharmacists are succumed to fulfil these demands despite such practice being unethical and unprofessional.

    Solution:

    -Make the normal MUR GP/prescriber initiated
    -The system would work so that either the GP sees a need for an MUR for a patient or the patient can request an MUR
    -Patient can know of the service through advertising.
    -This would result in issuing of an MUR prescription, the patient then has the choice to go to any pharmacy they want to get the appropriate information,
    -The patient has the choice to go to whatever pharmacy they want, so they might be more likely to go to the pharmacy they most trust, this would provide incentive for better customer service for patients, so pharmacy contractors concentrate on this, e.g. providing extra staff, staff training
    -some sort of checking method to ensure GPs are issuing these Rxs.
    -Referal from a GP means bettering the perception of the pharmacists infront of the patient as GP normally refer to Hospital or specialists
    -the GP would be more willing to accept the feedback.
    -store managers would have no way to push pharmacists to do x MURs per week.
    -the pharmacy still retains the right to do intervention initiated MUR, which can only be judged by the pharmacist.
    -FINALLY, include a mini information Rx, where the pharmacy gets a small fee for counselling patients on certain medicines. e.g. use of inhaler etc...
    -the PCT should take this into account and maybe reflect this in an increase in the dispensing fee.


    NOW People, comments, criticisms, reflections, ideas, thought etc...what do YOU think???
    Last edited by SolomonQ; 21, July 2008, 07:42 PM. Reason: de-rantifying ranting
    We are the music makers, We are the dreamers of dreams and God damn we are that good

  • #2
    Re: MURs: Solving the BIG problem!!!!

    There would be no big problem over MURs if the pharmacist who carried out the service was re-imbursed for it. Apart from management bullying (there is no other word for it) and a little bit of personal gratification, there is no clear reason why any ,pharmacist should carry out this work in most companies.

    Pay the pharmacist a tenner a time and the numbers would go through the roof. The companies would actually make more money this way as well. Ten times £17 is a lot more profit than two time £27.

    So the REAL MUR problem is company management and their attitudes.

    Comment


    • #3
      Re: MURs: Solving the BIG problem!!!!

      Originally posted by SolomonQ View Post
      -Make the normal MUR GP/prescriber initiated
      -The system would work so that either the GP sees a need for an MUR for a patient or the patient can request an MUR
      -some sort of checking method to ensure GPs are issuing these Rxs.
      -Referal from a GP means bettering the perception of the pharmacists infront of the patient as GP normally refer to Hospital or specialists
      -the GP would be more willing to accept the feedback.
      I wonder how much the GP MUR referral fee would be? -- although I think I know which budget it would come out of.
      ....just my opinion

      Comment


      • #4
        Re: MURs: Solving the BIG problem!!!!

        So the REAL MUR problem is company management and their attitudes
        thats basicly the same as what ive identified as the BIG problem when i say:

        "Undue pressure from store managers/area managers/superintendent pharmacists on store pharmacists (Locum or manager), to perform X number of MURs in a specific amount of time "

        I wonder how much the GP MUR referral fee would be? -- although I think I know which budget it would come out of.
        yea that was one of the flaws i saw in this format, it gives extra work to the GP and to encourage referals would need some sort of incentive, even if this is provided from the pharmacy budget, most of the profession is employee anyway so not many pharmacist's would suffer, (sorry to those who own pharmacies this this case). store managers etc.... would have no reason to bully then.

        Also there might be no reason to take money from pharmacies as, the PCT could take some money from the GP contract equivalent to x times MURs per year and reimburse it similar to how pharmacies get paid for each MUR.
        We are the music makers, We are the dreamers of dreams and God damn we are that good

        Comment


        • #5
          Re: MURs: Solving the BIG problem!!!!

          best place to get MUR accreditation in w.mids???
          We are the music makers, We are the dreamers of dreams and God damn we are that good

          Comment


          • #6
            Re: MURs: Solving the BIG problem!!!!

            medway do a pretty easy distance learning course (must be pretty easy if I can pass it!)
            “It's not worth doing something unless you were doing something that someone, somewhere, would much rather you weren't doing.”

            Terry Pratchett

            Comment


            • #7
              Re: MURs: Solving the BIG problem!!!!

              MURs are a service paid for out of money that pharmacists (contractors) used to earn from dispensing profits under the old contract. It wasn't new money it was the same money paid in a different way and much of the development of pharmacy in the forseeable future will be the same thing. Particularly as the economy is slowing, unemployment rising and the money collected by government in taxation reduces. There will be less revenue to spend on new pharmacy services.

              However, traditionally, this purchase profit money was clawed back from pharmacists so we have to be grateful that it is there.

              I don't think involving GPs in the MUR decision is a good idea as it is meant to be a pharmacy intervention. I do think GPs should, through PBC, be prepared to pay pharmacists for medication reviews but a MUR isn't a full blown review. It is a means by which the government can ensure that the billions of pounds worth of medicines purchased for patients through pharmacies is well spent and that patients are taking them properly.

              The BIG problem, and I agree with Solomon here, is that big companies see MURs purely as profit opportunities and pressurise their staff to achieve target MURs regardless of the appropriateness.

              I am aware of MURs being done for the same patient monthly by different pharmacies. A prosecution or two for fraud would not be amiss here!

              However, I believe it is time that employee pharmacists made a stand and refused to do inappropriate work thereby challenging their superiors to dismiss them. Constructive dismissal and bullying don't go down well with employment tribunals!

              However, I appreciate that individual pharmacists have an awful lot to lose in such circumstances and I can't expect them to make themselves unemployed in the name of such a principle. They still need to eat!

              I hope the PDA are planning a test case or two where an individual pharmacist would be supported through the process. I am a contractor pharmacist and would happily contribute to such a fund to support a test case.

              I believe that the best way to avoid these situations, and there will be more as white paper initiatives become real services (imagine being bullied to do cardio vascular risk assessments?) is for the PDA to be involved in service design at the very beginning of the process. Big companies accept many service opportunities without giving pharmacists proper back up. (I am thinking particularly of supervised methadone in very busy pharmacies). It is time that this issue was addressed. Then pharmacists can look forward to new services as professionally rewarding activities as opposed to increased burdens leading to more misery at work. They will then see the responsible pharmacist concept as a welcome development as opposed to a real threat.
              http://uk.youtube.com/watch?v=Hmbyj0XFUhA

              Comment


              • #8
                Re: MURs: Solving the BIG problem!!!!

                Originally posted by Tony Schofield View Post
                The BIG problem, and I agree with Solomon here,
                Will wonders never cease ;-)

                is that big companies see MURs purely as profit opportunities and pressurise their staff to achieve target MURs regardless of the appropriateness.
                snip...
                A prosecution or two for fraud would not be amiss here!
                Yeah so a pharmacist pressurised into meeting MUR targets ends up putting through one they haven't actually completed (just prepopulated the form). Methinks the blame will be placed entirely on the pharmacist involved and none will attach to those those exerting the pressure.

                Jeff

                Comment


                • #9
                  Re: MURs: Solving the BIG problem!!!!

                  The circumstance you describe is indeed the fault of the pharmacist.
                  http://uk.youtube.com/watch?v=Hmbyj0XFUhA

                  Comment


                  • #10
                    Re: MURs: Solving the BIG problem!!!!

                    Originally posted by Tony Schofield View Post
                    The circumstance you describe is indeed the fault of the pharmacist.
                    Only the pharmacist?
                    To make an individual the scapegoat of a system that applies too much pressure turns a blind eye to a significant part of the causative process.

                    Jeff

                    Comment


                    • #11
                      Re: MURs: Solving the BIG problem!!!!

                      I hear what you are saying Jeff but if more pharmacists behaved as autonomous professionals and asserted themselves in these situations we wouldn't have a problem. Coming here (and elsewhere) and complaining highlights the problem but does nothing about addressing it other than raising expectations which inevitably will be crushed. I can't understand why so many "autonomous professionals" put up so little opposition to being treated like numbers. Until they start to behave in a manner that demonstrates they are individuals with individual judgment and as long as they cry imploringly for someone else (PDA, RPSGB, GPhC, Government, Batman and Robin.........) to stand up for them this situation will perpetuate itself.
                      http://uk.youtube.com/watch?v=Hmbyj0XFUhA

                      Comment


                      • #12
                        Re: MURs: Solving the BIG problem!!!!

                        the case with all struggles is that the first few people leading the struggle are always likely to be martyrs, and no one in this case is willing to be martyrs. If experiences well positioned pharmacists who can afford to stand up to their employers dont do this, then who will.
                        We are the music makers, We are the dreamers of dreams and God damn we are that good

                        Comment


                        • #13
                          Re: MURs: Solving the BIG problem!!!!

                          skin conditions clinic......would that work? alot of people put off going to doctors as skin conditions not seen as serious especially if no urticaria/irritation present, quickly poping into a pharmacy would entice more people to get these seen by a HCP, could be an extension of the mole checking services already being offered.
                          We are the music makers, We are the dreamers of dreams and God damn we are that good

                          Comment


                          • #14
                            Re: MURs: Solving the BIG problem!!!!

                            Now you are talking Solly. Be careful not to exceed your competency(bad for legal bills!) and you could be onto a winner.

                            I am serious. However, understand that the public may well take a while to come round to it. A bit like opening a new pharmacy, the public don't flock in on day one until they have a reason to then as reputations improve so does the business.

                            Why don't you put together a proposal and sell a franchise to Lloyds or some other big company?
                            http://uk.youtube.com/watch?v=Hmbyj0XFUhA

                            Comment


                            • #15
                              Re: MURs: Solving the BIG problem!!!!

                              I understand about franchises in the normal business sense, but what do you mean by franchise in this case, Mr T?
                              We are the music makers, We are the dreamers of dreams and God damn we are that good

                              Comment

                              Working...
                              X