The Guardian’s investigation into medicines use reviews (MURs) – which alleged that managers at Boots routinely pressure pharmacists in its stores to conduct unnecessary MURs – not only sent ripples through the pharmacy sector, but also provoked a strong reaction from the public.

Members of the public were shocked by the allegations of extreme pressure faced by Boots pharmacists on a daily basis.

Aditya Chakrabortty, the Guardian’s senior economics commentator and the journalist behind the MUR investigation, spoke to C+D about the fallout following the revelations, and what inspired him to turn his attention towards pharmacy in the first place.

Why pharmacy?

As C+D readers are all too aware, pharmacy isn’t often featured in the national media. For example, Mr Chakrabortty says that junior doctors are often featured in the news, but pharmacists “often suffer neglect” when it comes to coverage in the nationals.

Yet this is "completely out of line with how important they are within our experience of healthcare," he says. "Pharmacists are so much a part of the patients’ experience and yet they don’t seem to get much representation with the national press," he adds.

Mr Chakrabortty explains the investigation was sparked by his interest in where, economically, “the public meets the private”, and emphasises that “there was little sense of axe-grinding” among pharmacists.

Outstanding reaction

The investigation drew on responses to a Pharmacists' Defence Association survey of more than 600 Boots pharmacists, but Mr Chakrabortty says the response he received was from far wider than the pharmacists in the survey. 

“The reaction has really been outstanding,” he says. “I think the letters editor said it was the biggest postbag of this kind that he’s ever seen. I’m still getting letters,” he adds.

He explains the letters he received from past or current Boots employees were not just about his investigation, but from pharmacists desperate to add their own experiences to the MUR pressures story.

"The people who came forward to speak to me and have written to me do so with a genuine concern for the standards of healthcare and for their patients. 

“It was really moving, the kind of care and attention they gave to their profession, that was easily one of the most important themes in the correspondence,” he says.

The week after the original MUR pressures investigation was published in the Guardian, the newspaper published letters from pharmacists, as "an acknowledgement of how much interest it provoked from people”, says Mr Chakrabortty.

"Struck a collective nerve"

The Guardian journalist was also shocked at the personal nature of some of the letters he received.

“There are people working in Boots who wrote to us about having suicidal feelings," he says. These are sentiments that were also expressed in responses to the C+D Salary Survey 2016.

Other pharmacists wrote to Mr Chakrabortty about the mental health problems they attributed to Boots, as well as pharmacists saying "their professional standing had been completely devalued as a result of this experience,” he says.

He explains the authors of the letters identified with ‘Tony’, the pharmacist in a follow-up piece published in the Guardian.

“It was almost as if we had really struck a collective nerve in this profession,” he tells C+D. "I don’t think anyone could have anticipated that when I started researching it."

The response

Mr Chakrabortty explains that one of the biggest themes that came out of his investigation was the sense that Boots employees had not been listened to “for some time”, by the people who pharmacists should expect to listen to them. “One of those was the General Pharmaceutical Council (GPhC),” he says.

However, he stresses that the GPhC approached him “immediately” after the piece was published, but he kept the identities of Tony and the other pharmacists he wrote about anonymous. 

He also emphasises that he went to Boots early on in his investigation and sought the multiple's response to each and every allegation.

“I’ve noticed a variety in the tone of how they have responded,” he says. “It would have been difficult for them to continue denying everything. They now seem to be recognising it. It's clear that there is a problem."

Next steps

Mr Chakrabortty stresses that – as many pharmacists will know – healthcare relies on people's trust. Not just between health professional and patient, but amongst the team you that work in.

His investigation has uncovered serious issues that he hopes that the profession can resolve. 

“Boots is one of the oldest companies in Britain and they work in one of the most important sectors. How much more important can it be?” Mr Chakrabortty questions.

“Before I started investigating Boots, I never really imagined that the people behind the counter are in the kind of situations they have described to me.

“I really hope for the sake of the patients and pharmacists and the healthcare system that we can repair that sense of trust," he says.

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