Lloydspharmacy investigating locum MUR pressures

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Lloyds will remind its teams to ensure all services are appropriate for the patient
Lloyds will remind its teams to ensure all services are appropriate for the patient

Lloydspharmacy is investigating pressures on locums to hit medicines use review (MUR) targets in one of its branches, the multiple has told C+D.

A locum – who wishes to remain anonymous – photographed the notice below in a Lloydspharmacy branch in south-east England last month.

Lloydspharmacy superintendent pharmacist Steve Howard told C+D the company is “investigating the matter internally”.

Mr Howard stressed that Lloydspharmacy does not set targets for locums and said the company has “addressed” instances where MURs were “delivered inappropriately”.

“While we encourage each of our stores to reach 400 MURs a year, we only do so when patients are eligible and when it’s deemed clinically appropriate by the pharmacist,” said Mr Howard.

“We will remind our teams of their responsibility to ensure that all services we provide are appropriate for the patient,” he added.

Mr Howard did not comment on the notice’s claim that each locum's MURs are “monitored”.

His statement comes a week after Rowlands confirmed that MUR targets are “not optional extras for locums.

77 Comments
Question: 
Are you under pressure to hit MUR targets?

Tim B, Locum pharmacist

Within 5 years pharmacists will be obsolete. Sorry, people but this is the reality. Replaced by robots and technicians. Perhaps Mr Eggleston will have changed his views by this point; or maybe have developed a robot able to perform an infinite number of bloody murs !

 

Roger Smith, Manager

We need to stop this malarkey now.

We need to petition and name and shame these companies. 

Marcus Jones, Student

Another Lloyds MUR Email

*Area manager of Lloyds last week wrote a letter to all local branches regarding the completion of MUR’s.

My friend who works in Lloyds as an employed pharmacist read out the email to me. This is what I was read.

“It has come to my attention that certain locums are telling staff that they are not accredited for MUR’s, saying they don’t have time to completed, and some even point blankly refusing to do them”

“If this happens in your store, please call me straight away and expect a phone call to that pharmacist”

My friend told me they expect those locums not doing MUR’s not to be asked to work at the store again.

Obviously the above is again putting locums and full-time pharmacist under duress to complete MUR’s even if in the pharmacist’s professional option is that it is not required or safe to do so with the current workload.

It goes without saying if they are not accredited to do them they cant anyway, of face being stuck off. As has has happened with others who have been put in this position.

If a pharmacist does not complete the MUR due to not having enough time the pharmacy, must decide what takes preference, core services or MUR’s, you can not always complete both in a safe and professional manner, with the time or resources available.

If you work for Lloyds could you please forward a copy of this email to C&D staff at: kristoffer.stewart@ubm.com

C&D – I would be great if you followed up with * Steve Howard for their comment on this letter.

The way things are, they have to change, we need to start protesting, setting up petitions and protecting our jobs, our livelihoods, our professional standards and the public from pressures to meet unattainable targets!

So much for Mr Steve Howard investgiting the issues, seems to have driven his managers to up thier game.

*This comment has been edited to comply with C+D's community principles*

Roger Smith, Manager

Another email right after Steve Howard  said he was looking into to it, *

C&D this whole MUR, and targets thing is getting out of hand maybe you should do a write covering Lloyds, Rowlands, Dudley Taylor, all those that have been mentioned.

Any comment from Steve Howard on this new email?

*This comment has been edited to comply with C+D's community principles*

Forget your GP the Robot will see you now, Locum pharmacist

Don't work for this unprofessional excuse for provision of healthcare.

jack The-Lad, Communications

What about criminal / corporate prosecution against the multiples ????????  We all know what they're guilty of , hiding behind the " we never forced the pharmacist to do that " ( as if ).

Sassa Jones, Non Pharmacist Branch Manager

Absolutely, if they contribute to the risk / mistakes happening through their policies and management they need to be in the firing line.

They can not take away control and your professionalism without inheriting the consequences of their actions.

So they either allow the pharmacist to use their professional judgment, provide suffecient staff and do not put them under duress or penalise them for not meeting these targets when its professional the right thing to do,

or they start taking responsibility for the mistakes that happen due to this.

Its quite simple if only the GPHC could get their head round this, as essentially tbe management are breaching the very rules they have set by operating in the way.

Things need to change!

I read below we can request an emergency meeting of the GHPC or RPS, I think its really needed before this gets out of hand, and both the patients and profession the suffer as a consequence.

Who would support that? I think we need just 30 people?

Alan WHITEMANN, Communications

Yes , the bosses need to be held accountable for their actions. *

*This comment has been edited to comply with C+D's community principles*

jack The-Lad, Communications

If you could get a petition going , I and many others would support that .

 

Locum Pharmacist, Locum pharmacist

Of course they don't set MUR targets! Do Boots? Superdrug? Rowlands? Well Pharmacy? What a ridiculous accusation against such a reputable company! Obviously all locum/employed pharmacists that have ever worked for these companies are highly mistaken.

Stephen Eggleston, Community pharmacist

Can I ask what the problem is? Is it not reasonable to ask any person that works for you to do their best to make your business successful? If a locum went against your buying protocol and ordered from a wholesaler that added unclaimable delivery charges, would you conyinue to use them? Similarly, you would want locums to be professional, courteous & pleasant to patients in order to encourage more patients to come to you and so develop your business. Why should MURs be classed any differently? It is one thing if you don't get the opportunity, due to lack of patients or too busy, but to not provide a legitimate service seems strange. MURs are not some new and foreign idea, they have been around for years. Everyone complains about falling rates - well, you can't expect contractors to maintain your rate if their income has been reduced. Clearly, this thread has attracted a lot of people discontented with their pharmacy lot - for them, I feel sad but if you don't like it, go and do something you feel is more worthy of your time and talent

Sassa Jones, Non Pharmacist Branch Manager

The Standards set by the GPHC below are clearly being breached within Pharmacies, with staff against their professional judgement put under duress to complete MUR's, in times of stress, busy period etc, at the risk to patient safety.

The pharmacist is stuck between a rock and a hard place due to the GPHC not upholding the standards and principles below and providing both employed and contacted pharmacists, protection from this. They are simply given the choice of dealing with and putting the general public at risk, or not working.

This is unacceptable.

As Mr Stephen Eggleston, Dudley Taylor has suggested “if you don't like it, go and do something you feel is more worthy of your time and talent”

This is the crux of the problem, and needs to be addressed urgently.

The principles:

Principle 1:

The governance arrangements safeguard the health, safety and wellbeing of patients and the public.

1.1 The risks associated with providing pharmacy services are identified and managed

1.2 The safety and quality of pharmacy services are reviewed and monitored

1.3 Pharmacy services are provided by staff with clearly defined roles and clear lines of accountability

1.4 Feedback and concerns about the pharmacy, services and staff can be raised by individuals and organisations, and these are taken into account and action taken where appropriate

 

Principle 2:

Staff are empowered and competent to safeguard the health, safety and wellbeing of patients and the public.

The staff you employ and the people you work with are key to the safe and effective practiceof pharmacy. Staff members, and anyone involved in providing pharmacy services, must becompetent and empowered to safeguard the health, safety and wellbeing of patients and thepublic in all that they do.

Standards

2.1 There are enough staff, suitably qualified and skilled, for the safe and effective provision of the pharmacy services provided

2.2 Staff have the appropriate skills, qualifications and competence for their role and the tasks they carry out, or are working under the supervision of another person while they are in training

2.3 Staff can comply with their own professional and legal obligations and are empowered to exercise their professional judgement in the interests of patients and the public

2.4 There is a culture of openness, honesty and learning

2.5 Staff are empowered to provide feedback and raise concerns about meeting these standards and other aspects of pharmacy services

2.6 Incentives or targets do not compromise the health, safety or wellbeing of patients and the public, or the professional judgement of staff.

Ilove Pharmacy, Non Pharmacist Branch Manager

We would Need to see a few patient deaths for something to be done. I can imagine a GPhC stooge appearing on Sky TV feigning shock and horror at the state of dispensaries up and down the country. Some unlucky pharmacist would likely end up in prison. Boots and the like  would use the opportunity to reiterate that patients are at gthe centre of everything they do. C&D as usual would report everything in robot fashion. No searching questions asking why this has occurred, just basic accounts as to how the pharmacist will be sacked before appearing at court.......

Sassa Jones, Non Pharmacist Branch Manager

Honestly standards right now are a joke, one particular pharmacy chain, always has mistaken, missing items, unbalanced records for controlled drugs.

I reported one case as you are meant to, was never employed at that store again, so what do I do now, nothing, as I will risk my income if I follow the rules and standards laid down.

I honestly believe errors, mistakes and omissions should be highlighted to make sure they don’t happen again and staff learn, but the culture in these pharmacies is completely against this. Driven by the management.

Ilove Pharmacy, Non Pharmacist Branch Manager

As you've found, speaking out is akin to slitting your own throat. Be thankful, you could be make an honest dispensing error and have a jail term hanging over you. And not one organisation will support or speak up for you other than the PDA. Everyone(GPhC, RPS, NPA, LPC, C&D)will simply watch or in some cases assist in your 'hanging'.

Sassa Jones, Non Pharmacist Branch Manager

Criminal prosecution needs to stop, and as others have mentioned the Pharmacy’s need to be party to claims if their workplace standards are not up to scratch.

Maybe if Management faced criminal charge as well things would be different.

Its time for a big shake up and change, everyone I know is unhappy about the overbearing companies with their preference for targets over patient safety, customer care and quality service.

Ilove Pharmacy, Non Pharmacist Branch Manager

Sadly it literally takes people dying for these ridiculous organisations to wake up a la Grenfell. Till then they they just count their money. When the sh1t  hits the fans look for everyone to pass the buck or pretend they were totally unaware. Pharmacy pubblications may even claim they were pressuring the regulator for years to change. Multiples will go into PR overdrive to protect profits. Once everything quietens down and is no longer in the public domain and compo settled for the bereaved families  NMS and MUR bs will resume as before.

Sassa Jones, Non Pharmacist Branch Manager

Sir, reading your comments and understanding you are a Branch manager with Dudley Taylor, it does appear you have a very different view from those performing the day to day work.

It would seem from your comments that the Pharmacist should not apply their professional judgement and that you as branch manager should be able override this? Do you share in the risk? No – So you have no right to do so.

You suggest that rather than address the issues being raised, if people don’t like it they should find another job or profession.

Your comments are a disgrace to the profession and a fair example of middle management being stuck in the stone age and not able to cope with a changing work environment.

This is the entire problem, middle management like you who focus on profit and targets rather than a balance of making a profit, providing high quality services in a safe and responsible manner.

If this is representative of Dudley Taylor, its certainly not a pharmacy I would ever look to work with, maybe the GPHC should start with your pharmacy, and carry out a review of workplace pressures and professional standards.

Stephen Eggleston, Community pharmacist

Madam

1. I post as an individual, not as a spokesperson for my employer

2. If you read my post (and the original notice, for that matter) both refer to providing the services to eligible patients. There is NO MENTION of providing unnecessary MURs

3. AT NO POINT do I suggest that any Pharmacist does not have the opportunity to apply their professional judgement.

4. I am very aware of the mounting workload pharmacists face, and the professional & ethical challenges that follow. You will again note, had you read my comments, that I specifically mention that it may not be possible to provide services due to being too busy (with prescriptions)

5. My view IS that of someone doing the day-to-day work, as that is the capacity in which I am employed

6. At our last GPhC Inspection, the Inspector specifically asked if we felt pressured to provide MURs, to which I was honestly able to answer that I was fully aware of the financial benefit to the company but did not feel under pressure to provide the service inappropriately

7. Since you identify yourself as a Non-Pharmacist Manager, please do not presume to lecture me on when or if a pharmacists should exercise their professional judgement - I prefer to leave that to them as individuals

Jonny Johal, Pharmacy Area manager/ Operations Manager

Stephen, I am sure Sassa is not the only person who got that impression regarding your post. In this instance, she is right, you say you are posting your personal views, and it is those views which are pertinent in your self-seeked attention grabbing committee roles. As for my qualifications (since you mentioned Sassa's), I graduated in the same class as Michael Taylor.

Sassa Jones, Non Pharmacist Branch Manager

Sir, your comments appear to come from acting as a manager within the profession, how are we to know whether these are only your views, your employers or what you apply to your staff.

Given you are a manager one can only assume this is what you apply in your place of work.

Please note you have responded to a long thread explaining the additional pressures put on pharmacist’s duress, and stress to meet targets. Not once have people said flat out they won’t do them.

So your comments can only be applied to the entire thread and discussions, in the context of this thread, (no one has said they wont do MURs) I think you owe everyone an apology for your comment.

“for them, I feel sad but if you don't like it, go and do something you feel is more worthy of your time and talent”

In any context this is wholly unprofessional and a disgrace.  

On a personal note its very clear what you mean, no matter how you try to hide, so don’t you lecture anyone! You have no right after your comments!

Marcus Jones, Student

Well said, we can all read what he has written, his views are very clear despite any attempted backtracking on his comments.

His comments are not justified in any way, and i also call for an apology. 

Stephen Eggleston, Community pharmacist

I think you confuse "clarification" with "back-tracking"

Marcus Jones, Student

Jsut read your own comment, you started off with the following comment, i might add to concerned pharmacists long explainations about being under unfair presure at work. 

"Can I ask what the problem is?"

Honeslty you have no professionalism, you appear to be toltally ignorant to all the comments on this article. 

Your reaction says it all we can see through you.

You cant take these comments back!

Ilove Pharmacy, Non Pharmacist Branch Manager

GPhC will do sweet FA.

Jonny Johal, Pharmacy Area manager/ Operations Manager

Mr Eggleston, your implied thread here is if locums do not generate income for the contractor through MURs, they should leave the profession. Considering not a single pharmacist (including locums) had been disciplined by the GPhC for not doing MURs - implying everyone who needs a MUR was given an MUR, nor has any patients, in my experience, claimed to have suffered as a result of a lack of MURs and no patient had ever asked me for a MUR but there are plenty who refused ... your intervention totally missed the point, we are not talking about (your words) 'business development' here (although it is important), it is professionalism which is under discussion. Are those pharmacists who only do MURs when they see a need unprofessional or people like yourself who conflate renumeration with patient needs and 'professionalism'? I don't think it is them who should "go and do something they feel is more worthy of their time and talent", I would recommend, for your own sense of integrity and for the good of pharmacy in general, a period of reflection and introspection. Please don't ruin pharmacy for the rest of us.

If I may say so, you are a disgrace to our profession, sir.

Stephen Eggleston, Community pharmacist

Dear Jonny

I implied nothing

I stated that I would expect any locum to contribute to the profitability of the business eg by following buying protocols, providing services (I mention MURs but could have picked any other - 'flu vaccines, perhaps). Personally, I only carry out MURs when they are needed but one cannot tell the "value" of an MUR before you undertake it - only on reflection. However, the service spec does not say "only be paid for those which identify an issue".

I am happy to provide services but every service provided is done so at a cost and as such needs to be paid for. If you feel being paid for your expertise is "unprofessional" or "disgraceful", I would respectfully suggest you raise it at your next appraisal. Please share the outcome

Jonny Johal, Pharmacy Area manager/ Operations Manager

Hahaha Stephen, there is no need to backtrack, we all know what was meant.

Marcus Jones, Student

Is this guy a joke? 

Hes offended nearly every pharmacist here, with his comments and wants to continue arguing with people

I don’t need to say any more than repeat his comments:

"Everyone complains about falling rates - well, you can't expect contractors to maintain your rate if their income has been reduced. Clearly, this thread has attracted a lot of people discontented with their pharmacy lot - for them, I feel sad but if you don't like it, go and do something you feel is more worthy of your time and talent"

You cant take these comments back!

Ilove Pharmacy, Non Pharmacist Branch Manager

Eggleston sums up exactly why community pharmacy is DEAD. I only wish the general public could read these threads. I would love to see how the MUR?NMS conversations would work out.

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