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PSNC to discuss future of MURs in upcoming contract negotiations

PSNC: Contractors will be capped at 200 MURs until September
PSNC: Contractors will be capped at 200 MURs until September

Discussions around the future of the medicines use review (MUR) service will form part of upcoming contract negotiations, PSNC has said.

The number of MURs contractors can deliver will be capped at 200 from April 1 to September 30, as part of interim funding arrangements announced by the Pharmaceutical Services Negotiating Committee (PSNC) this afternoon (March 8). 

Explaining the cap, PSNC said: "Further discussions about the [MUR] service will form part of the wider [contract] negotiations."

PSNC hopes to begin these negotiations "in the next month", during which it has previously said it will propose a service-based contract, a move to a multi-year settlement and funding for the implementation of the EU scanning law – the Falsified Medicines Directive.

It "hopes that any substantive changes to the community pharmacy contractual framework will be agreed in time to be implemented from October", PSNC added.

Single activity fee may be adjusted

As part of the interim funding arrangements anounced today, funding for England’s pharmacies will remain at its current level of £2.592 billion.

The single activity fee "will be set to continue to deliver funding at this rate", the negotiator said.

However, the level is "still under discussion with the Department of Health and Social Care, and as such, may be adjusted later this year".

26 Comments
Question: 
Are you satisfied with the current MUR service?

How High?, Community pharmacist

Good. Get rid of MURs. Questionnable service delivered very poorly in order to hit the 400 and ensure maximum payment. Adds no value and rarely helps patients. Just causes stress and complaints from other patients waiting for scripts.

Leon The Apothecary, Student

I had an interesting thought to how you could make MURs less of a company-led industry. Make the MURs payable only to the Pharmacist who conducted them, rather than the company who owned the building where it was conducted and see how companies lose interest.

Locum Pharmacist, Locum pharmacist

They will just reduce our pay to compensate !

N O, Pharmaceutical Adviser

Going by your logic, this should apply to everything including dispensing and giving advice to patients. Don't you think?? The only solution could be to convert all pharmacies in to single pharmacist owned pharmacies. But then we should only talk which is possible and not what we dream of !!!

Barry Pharmacist, Community pharmacist

Are you satisfied with the current MUR service? Absolutely not. 

The way that community pharmacists have been treated to ensure that "tick box" MURs are done has been one of the more darker periods in the history of pharmacy.

Sue Per, Locum pharmacist

Time for a complete change to the contract. Scrap the NMS, as this is carried out by the doctors and is a duplication of the service.

Incorporate the fee for MUR's into the dispensing fee, with a cap on the total fee payable to a pharmacy, based one each pharmacist and assistant employed, at the rate of 40 hours for every 3600 items dispensed.Proof of pharmacist hours to be recorded in the same manner as RP records. maintained for six years, with such records to be declared, and made part of the routine inspection to the GPHC inspectors.

This will immediately remove the bullying and pressure to meet the targets, and will disincentivise manipulation of the contract to chase volumes.This will immediately bring an end to 7 day scripts for free MDS's, and may bring an end to the "freebies" such as collections and deliveries. Prescribing may chage from 28 day supply to 56 days, if appropriate.

This will restrict the amount of fee profit that can be extracted from pharmacist, and potentially lead to individually owned pharmacies, as such a funding model would not suit a multiple contractor.

All other services, which can be fed to consumers to be removed, or charged at a subsidised rate of £2.00. Services such as Minor Ailment, smoking cessation etc. This will deter abuse by the consumer, and making it a "targetable" service by the contractor difficult, and also reduce fraud.

Also promote and incentivise other screening and monitoring services, such as  blood pressure,  diabetes, asthma clinics, alongside flu vaccinaton services  

Ghengis Pharm, Locum pharmacist

"Incorporate the fee for MUR's into the dispensing fee, "

Err, isn't that where they took it from in the first place ?

 

 

 

Adam Hall, Community pharmacist

You are suggesting a cap on income for owners, in the hope there may be more individually owned pharmacies, which will be subject to the same cap on income. Communism reborn, methinks.

Sue Per, Locum pharmacist

Simply a fair income for the pharmacist depending on the fee income generated with his/her efforts, rather than a flat rate ir-respective of the volume of dispensing and other services provided. After all the contractors income is based on volume, therefore why should the fee earner not recieve a proportionate amount, based on that amount??. 

Quite simply pay a proportionate amount for comissioned services such as MUR, NMS, FLU jabs, EHC..... and a fee propotionate based on the volume of dispensing, and counter sales, particulary [P] meds

N O, Pharmaceutical Adviser

Many valid points from employee/ locum pharmacists who have suffered target pressure or bullying to do the MURs.

But let's see 2 scenarios:

1. MURs/ NMSs scrapped and no other service(s) to replace. Leads to almost £20k/year lost in revenue for a pharmacy. Will then lead to staff cuts and Pharmacist wage cuts. This will lead to all employee/ locum pharmacists moaning about unsafe place to work and disgusting pay.

2. MURs are replaced with Clinical MURs with more work but same pay. Pharmacy owners will still be happy for not losing the extra income. But then, all employee/ locum pharmacists will up their voice against the target pressure/ bullying. But at least in this scenario there may be less chance of pay cut compared to scenario 1.

Now, I leave it to the knowledgeable colleagues to choose from the above, trust me there won't be any other option unlike BREXIT !!

Benie I, Locum pharmacist

@NO, I'm not sure veiled threats will restore respectablity to the sector.

anti-depressed Pharmacist, Manager

If they cut anymore staff the customers will become the employees.

"This will lead to all employee/ locum pharmacists moaning about unsafe place to work and disgusting pay"

So there will be no change is what you are basically saying.

Sue Per, Locum pharmacist

At the rate of £19.00 p/h, for Locums, with all the bullying and hassasing thrown in for free and for all the accontability and with little pay differential between the so called "Technicians" some of whom can barely comunicate in the langauge earning some £14.00 p/h, and in some cases with £10.00 travel, it is not a difficult decision. Quit or lump it and slave away, to the delight and glory of the mercenary contractors.

I say, i am out!! until the volume led is scrapped.

 

Community Pharmacist, Community pharmacist

Don't work for £19 per hour....min should be £25 plus other services ...stick together and boycott poor employers who cream off the profit and pay peanuts
 

Chris Pillman, Community pharmacist

So much bullying from the large multiples, I've seen it first hand from Boots, Lloyds and Rowlands. Even in the receiving end of it a couple of times! These companies are a disgrace to the profession and humiliating to pharmacists 

Aldosterone antagonist, Locum pharmacist

Definetly, I have been a victim myself where one of the regional managers happened to visit the store and told me to do MURs and wanted me to text him the MUR count and EPS nominations done for the day. The cheek of it!

I had no dispensers that afternoon and only one counter assistant....

Sue Per, Locum pharmacist

You could have shut up shop, and if more of us did the same, we could bring these slave masters to their knees.An uphill task with a useless GPHC, who is well intentioned to prescribe professional rules, but not prepared to enforce them, particularly R.P. Regulations. 

Community Pharmacist, Community pharmacist

Come on PDA ....Never mind a 'conference/jolly'  in Cardiff  using our fees....Take on the big boys like you did with Boots...Pharmacists need you now!!!

David Moore, Locum pharmacist

Let's go the whole hog. Continue with MURs, but scrap the payments to the pharmacy companies.

Tired Manager, Community pharmacist

Champagne corks popping in every employee pharmacists household tonight. Might vote Tory at the next election if these get scrapped.... funding used to implement national Emergency Contraception/Stop Smoking/Minor Ailment Schemes with no upper limits that can be rebranded as targets. Rocket Science it is not!

C A, Community pharmacist

A national Minor Ailment Scheme doesn't fit with the NHS's new self care agenda, so good luck with that.

Sue Per, Locum pharmacist

Will certainly be rejoicing with a case of champagne, if the gangmasters are brought down to their knees, and the GPHC is disbanded, and/or merged or replaced another regulator, with sharp fangs to take over the responsibility.The current regulator is beyond a joke!!!, and some other kangaroo court would probably comand more respect and credibility than this one.

anti-depressed Pharmacist, Manager

Lets see how many pharmacies will "Make the care of patients your first concern" and still carry out 400 MURs  :)

Benie I, Locum pharmacist

I think suddenly the the 'patients will be the centre of all we do' just 200 times in 2019/20.

Adam Hall, Community pharmacist

Hang on - everyone is complaining about the unpaid stuff we do and yet, here you are suggesting we do more unpaid stuff. Show me a GP who does unpaid services and I'll show you naivety personified, who will soon learn the error of their ways!

Community Pharmacist, Community pharmacist

Glad someone else is awake Adam...

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