NHS England to spot check pharmacies' MUR payment claims

Pilot aims to tackle a lack in consistency in the way advanced services are monitored
Pilot aims to tackle a lack in consistency in the way advanced services are monitored

NHS England will "verify" certain contractors' claims for medicines use review (MUR) payments as part of a pilot, it has announced.

From October, the NHS Business Services Authority (NHS BSA) will ask selected pharmacy owners to submit the signed patient consent forms that correspond with their MUR payment claims.

NHS BSA said the six-month “proof of concept” pilot aims to “standardise” the current funding approach for advanced pharmacy services.

“A lack of consistency” across England in the monitoring of how advanced pharmacy services are delivered and claimed for prompted the need for a more “centralised approach” to pharmacy’s post-payment verification methods, it explained.

The pilot will begin with the MUR service, but “other advanced services will be included in due course”, NHS BSA confirmed.

"Outliers" will be sampled

Speaking to C+D this morning (September 29), Pharmaceutical Services Negotiating Committee (PSNC) director of NHS services Alastair Buxton said a "sample" of pharmacies will be selected to take part in the pilot via two approaches.

As well as picking pharmacies to ensure “good geographical coverage across England”, any contractors who are identified as an “outlier in terms of the number of MURs claimed for that month” will be contacted, Mr Buxton said.

“That is not making the assumption that claiming lots of MURs in any month is wrong, or evidence of fraud, but inevitably they are of higher risk of something having gone on, so [auditors] will always look at outliers,” he stressed.

Mr Buxton said if the six-month MUR pilot goes well, he expects the payment verification approach to be rolled out to the new medicine service and national flu service.

NHS BSA stressed that only pharmacy contractors contacted by the organisation need to submit their MUR patient consent forms.

It advised contractors to "review how they currently file signed patient consent forms", ready for the pilot.

16 Comments
Question: 
How do you think the MUR service could be improved?

Shenu Barclay, Locum pharmacist

The MUR SERVICE could be improved by targetting clients with long term conditions e.g.diabetes,hypertension,mental health conditions,parkinsons disease.A TOOLKIT should be published by NHS ENGLAND for  each ltc e.g.diabetes tookit(devon),parkinson toolkit recommended by parkinson society.ALL patients over 65 should be reviewable every 6 months and every time that a patient is discharged from hospital,he /she should be eligible for an MUR.

MS SHENU BARCLAY/LOCUM PHARMACIST/COVENTRY

Valentine Trodd, Community pharmacist

The MUR service could be improved by scrapping it.

Beta Blocker, Primary care pharmacist

MURs are a box ticking exercise... absolute waste of money for the taxpayer and money grabber for the pharmacy companies.

In the last year as a practice based pharmacist, I’ve only had 2 MUR intervention forms reach my desk. When I’m conducting my own med reviews with patients in practice, I’m intervening atleast 50% of the time... So how have I only received 2 interventions out of a possible 1200 from the 3 pharmacies located around my surgery? 

Jonny Johal, Pharmacy Area manager/ Operations Manager

Spot on. 

Shahil Patel, Superintendent Pharmacist

If you're a pharmacist at boots or llyods, just remeber they will happily put your registration on the ropes you're just a resource, i worked for a company that hired a manager who did textiles at university and she told me to do MUR'S on 18 year olds who have just brought OTC products at the counter. I kindly declined and told her to make fancy MUR consent forms with her skillset.

Jonny Johal, Pharmacy Area manager/ Operations Manager

Wow! They should scrutinise the conscent, content, talk to patients to confirm as well as looking at patients' surgery records.

Can I nominate a few pharmacies for this exercise? Please, please, please.

Valentine Trodd, Community pharmacist

That funny.... I went through this exact scenario almost 12 months ago - a 'probity' visit from the NHS where they verified the number of MURs claimed against signed consent forms. So what's new?

BTW, the visit was a complete sham... we routinely send out consent forms with delivery drivers for signing by patients, who we later call for a phone MUR. Any of these could have been submitted as a bogus MUR and the NHS would never know the difference.

Complete waste of all our time...

Fuzzy Wuzzy, Dispenser Manager/ Dispensing Assistant

What a load of nonsense...I reported 2 Lloyd’s pharmacy branches for excessive MURs, one did 160 and the other 140 in a MONTH! Reply I got back was we are behind on our visits but will try and inspect one of them. Add to this that isn’t there a data protection issue here also.  How will this ever work or prove anything.  Another waste of time and more work for over worked pharmacy staff

 

Ilove Pharmacy, Non Pharmacist Branch Manager

I trust Lloyds sacked the pharmacist just in time. Al these rogue pharmacists giving Boots, Lloyds and the rest a bad name. Making up MUR figures for no financial gain to themselves. Tut tut tut...

 

Meera Sharma, Community pharmacist

So, how do you pick outliers in multiples where every store is submitting the same numbers, as dictated by their managers?? If you're going to spot check this, please do some legwork and do what CQC do - observe both announced & unannounced visits. It will also highlight how unsafely some of the pharmacies are operated! 

Ilove Pharmacy, Non Pharmacist Branch Manager

Will Boots be part of the pilot ?

Shahil Patel, Superintendent Pharmacist

of course, such a credible company.

Marcus Jones, Student

Well the MURs i have seen, you could question whether the patient was ever there with the lack of notes, and just a signature.

Make them digital, digital signature, digital feedback, digital verification any notes have been reviewed by the GP. simple stuff in this day and age

Or better still have the patient complete the MUR initially digitally then if there is need they can see the pharmacist, think about all the savings. 

Wait actually, digitally, by pass the pharmacist and go direct to the GP, just saved £28 per MUR and would most likley get better results ;-)

Stuart Nicholls, Community pharmacist

What ever next! Who would risk crimonal charges and disqualifiction.

C A, Community pharmacist

Apparently a lot of Boots stores send out forms with their drivers, so in answer to your question...

Ilove Pharmacy, Non Pharmacist Branch Manager

Surely not. Boots are an incredible store and so consistent across the board. they all manage to hit 400(no more no less) MURs each year. It's just amazing is it not? As soon as they hit the magic 400 no more patients need or ask for reviews anymore.

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