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Midlands pharmacists secure £250,000 for domiciliary MURs

Nick Hunter: Pharmacists will work with GPs to target domiciliary MURs to patients with complex conditions

Pharmacists will receive £56 on top of their standard MUR fee to conduct 10 reviews in patients' homes by the end of the year, says Nottinghamshire LPC chief officer Nick Hunter


Pharmacists in the Midlands have secured almost £250,000 to provide domiciliary MURs until the end of the year, C+D has learned.

Nottinghamshire and Derbyshire local professional network (LPN) received £140,000 from Health Education England and NHS England area teams on Friday (February 20) for local pharmacists to extend a domiciliary MUR service beyond March, Nottinghamshire LPC chief officer Nick Hunter told C+D.

The LPN had already received more than £100,000 in December to run the service until March 31 – a sum that equated to around 2,000 MURs, Mr Hunter said. He estimated the fresh injection of cash would pay for a further 2,500 MURs to be conducted before the end of the year.

Pharmacists are paid £56 per patient plus the standard MUR fee of £28 – a rate that Mr Hunter deemed “fair” for the intervention, which involves pharmacists visiting the homes of patients on multiple medicines to provide “detailed” MURs that last up to an hour.


The MURs could be more thorough than those in a pharmacy, as pharmacists would be able to examine a patient’s medicine cupboards, Mr Hunter said. Pharmacists could follow up with patients over the phone or with a second home visit, he explained.


Each pharmacy will have an initial quota of 10 MURs, although they can potentially deliver more if others do not reach this limit.


Practical considerations


Mr Hunter said there were practical elements that needed to be considered before the service could get fully up and running. Two hundred pharmacies had expressed an interest since the service was announced in December, but the time taken to check that each pharmacist did not have a criminal record meant only 30 were already ready to take part, Mr Hunter said.

Because of travel costs and the need to hire locum cover, Mr Hunter also suggested pharmacists should conduct multiple MURs in one day to ensure they were “commercially viable”.

But he stressed the initiative was worthwhile for pharmacists. The scheme came off the back of a “very successful” pilot last year, when pharmacies in the area successfully conducted 36 domiciliary MURs, Mr Hunter said.

The service was also a chance to improve relationships with GPs, who would work with pharmacists to select suitable patients for the visits and prioritise those with complex long-term conditions, he added.

“GPs used to call on patients for home visits a lot more frequently. [Now] If a patient gets a visit it’s possibly just a carer, who will have no pharmaceutical or medical training. These patients need some high-level input,” he added.


Last year, C+D reported that PSNC walked out of contract negotiations over suggestions that pharmacists provided domiciliary MURs without extra funding.



What would be the benefits of commissioning domiciliary MURs nationally?


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Dilip Shah, Community pharmacist

Well done and I am confident that more commissioning services like this will be forthcoming in the near future as we are seeing more integrated services between NHS and Social Services. This will enable to reduce the cost to the NHS on the long run and better patient care.

Tariq Atchia, Pharmacy Area manager/ Operations Manager

News of a service with fair remuneration is very welcome. Now it's time for the pressure to build towards the commissioning of a fairly funded national service which will help those hard to reach patients in their own homes. One would have to say that this scheme does favour pharmacies that already have two pharmacists in branch, and small and mid sized multiples with many pharmacies in the same area that can utilise scale and stack patient visits on top of each other using the same mobile pharmacist.

Ahmad d Atchia, Locum pharmacist

You are absolutely right Tariq. As you suggested there should further support to role out the service nationwide. In turn this will address partly the issue of supposedly overproduction of qualified Pharmacists.

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