Jennifer Richardson finds out how C+D’s 2009 MUR Champion of the Year made the service a success Justin Gilbody has turned MURs into a comprehensive health consultation, including blood pressure tests, weight management advice, BMI checks, stop smoking guidance, alcohol information and other lifestyle advice.
By overcoming initial resistance and getting GPs onside, he secured support to spend one day a week as a ‘surgery support pharmacist’, with half the funding coming from the PCT and half from the local surgery itself.
This role includes reviewing hospital discharge letters and auditing emergency medication and prescribing. From there, the GPs have given Mr Gilbody the freedom to enter recommendations from his MURs into the surgery system. And his MURs have contributed to reducing the surgery’s prescribing budget by up to £4,000 a month; saved it over 30 nurse and GP appointments a month; and earned it QoF points. “It’s quality clinical work, and it’s saving them money,” he says.
One patient who had been prescribed sumatriptan was still complaining of migraines. Through an MUR, Mr Gilbody discovered she was avoiding taking the tablets when she felt the onset of an attack early in the month, as she was worried she would not have sufficient tablets for a worse attack later in the month. His recommendations led to her prescription being increased.
Another patient was referred to hospital after Mr Gilbody became concerned about his breathing problems, and ended up having a heart valve replacement. He has also recommended warfarin initiation, carried out blood pressure checks to save nurse appointments, and a single pain relief discussion with one patient saved the surgery £114 a year.
Mr Gilbody was “very pleased” to win a C+D Award for work he is rightly proud of, though he was unable to attend the celebratory event last June due to the impending birth of his first child. He has had great feedback, he says, from the GPs and customers, following coverage of his win in the local media. The trophy is now proudly displayed in the dispensary. “I don’t brag about it,” he says, but he adds: “I do show the customers.”
But Mr Gilbody also insists that the award was a team effort. Having two ACTs allows him the time to carry out the MURs, he says, and the whole pharmacy team is primed to highlight MURs on each patient’s repeat prescription review date. “It’s my name on the award, but we won it,” Mr Gilbody says. “They all supported me. If you haven’t got that you’re fighting a losing battle.”
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Name
Justin Gilbody
Pharmacy
Co-operative Pharmacy, Tibshelf, Derbyshire
Award won
C+D MUR Champion of the Year 2009
Award entry
Developed MURs into a comprehensive consultation, working with the local surgery
Football team
Nottingham Forest “all the way! But I married into the world’s biggest Arsenal fans so they’re my second team, I’ve adopted them”
Last supper
American diner-style chain Damon’s Not-so-secret other life
Mr Gilbody is a one-man tribute act to Freddie Mercury, performing in venues around the UK (see and hear for yourself at www.akindamagic.co.uk) |
How Justin won the C+D MUR Champion of the Year Award 2009
Mr Gilbody has 10 commandments for building an award-winning service:
1. Aim high
Mr Gilbody was inspired by his MUR accreditation course to make his reviews as clinical as possible. “I have never been able to allow myself to claim £28 from the government just for asking, ‘Are you taking the medicines?’.”
2. Stick to your guns
Mr Gilbody says others, including a local PCT, tried to convince him to keep MURs simple. But he refused to downgrade his vision of what he wanted his service to be.
3. Get your local GPs onside
It’s been said before, but Mr Gilbody’s more than willing to say it again. He describes as “ridiculous” the attitude of doctors who believe they can’t learn anything from a pharmacist intervention. His response? “I didn’t get my degree off a Weetabix packet!”
4. Swallow your pride
Despite clearly not being afraid of confrontation, Mr Gilbody also knows when to go cap in hand and advises simply asking local GPs what they would like to get out of your service. “To overcome [GP resistance] I bent over backwards,” he says. “You have to run around after them because they have all the power.”
5. Become part of the community
Mr Gilbody had a headstart, having lived in his pharmacy’s area his whole life, but he has embraced community life and is a local councillor. Being part of the community helps create trust with patients, Mr Gilbody believes.
6. Put quality above quantity
Mr Gilbody says that targets can mean pharmacists are often torn “between doing professional MURs and being a number checker”. He says: “I do worry about numbers because I like to do my job properly, but I won’t do it at the expense of quality.”
7. Treat your patients, and your service, with respect
Mr Gilbody believes a pharmacist should not be interrupted while carrying out an MUR, in the same way a GP consultation would not be disturbed. “I’d never dream of interrupting a doctor,” says Mr Gilbody. “It’s not fair for the person you’re reviewing to be interrupted all the time.”
8. Give a little
Mr Gilbody spends some of his own time catching up on his MUR service, for which he is not paid. “There are personal benefits,” he says. “The job satisfaction pays for it.”
9. Believe in yourself
“I’m confident in everything I do,” says Mr Gilbody, “that’s the key. I see a lot of good pharmacists, locums, who’re good at what they do but they just lack confidence. It’s all about selling yourself.”
10. Appreciate what you’ve got
Despite his confidence and straight-talking approach, Mr Gilbody emphasises that he would not have had the success he has without support. He says: “I’m lucky that I’ve got good doctors, good staff, good customers and, if I need any help, I’ve got good people to call on above me.” |
