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Rowlands to locums: MURs and NMS 'not optional extras'

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Rowlands: Locum pharmacists should know what is expected from them
Rowlands: Locum pharmacists should know what is expected from them

A letter sent to locum pharmacists working for Rowlands is intended to “reinforce the message” that performing some services is a requirement for working for the multiple, it has told C+D.

In a letter sent to locums working for Rowlands in the “Doncaster, Grimsby and Lincoln area” last week – and seen by C+D – locums are “reminded” that “it is a requirement of the company and a condition of booking that you recruit and perform medicines use reviews (MURs) and [the] new medicine service (NMS) when working as a locum for Rowlands pharmacy”.

The area manager who wrote the letter said they were “disappointed to hear that there are a number of locum pharmacists who are not delivering these services on a regular basis”.

A spokesperson for Rowlands told C+D on Friday (August 25) that while this particular letter was not issued nationally, “locums need to know what is expected from them”.

“The letter to locums was intended to reinforce the message that MURs and NMS [consultations] are not optional extras, rather they are core services we need to provide if we are to meet patient and commissioner expectations,” the spokesperson added.

Meeting targets

In the letter, the area manager said that every Rowlands branch in the area is set a "target" of completing 10 MURs a week and 15 NMS consultations a month. Locums in the area are “required” to complete two MURs and recruit an unspecified number of patients to the NMS every shift, to “help the branch and area achieve its goals”, the area manager added.

Rowlands told C+D that MUR and NMS targets vary across the country “according to patient need and demand”.

When C+D asked whether locums would face consequences for not meeting the required numbers, Rowlands said: “Targets set out what we think is reasonable and achievable. These are not ‘red lines’, but provide clarity to managers and locums about expected performance and delivery of important patient services.”

“Successfully delivering MURs and NMS is critical to the future of community pharmacy in England. It demonstrates our unique ability and potential to achieve improved patient outcomes," Rowlands said.

"If community pharmacy fails to meet the expectations of NHS England or commissioners, then they will look at alternative providers,” it stressed.

Rowlands said that the purpose of the letter was not only to set out requirements for locum bookings at the multiple, but "why that matters to patients and the NHS".

Read a copy of the letter sent to locums working for Rowlands here.

83 Comments
Question: 
Are you required to meet weekly or monthly MUR targets in your pharmacy?

Pharm No More, Community pharmacist

Would rather have my testicles forcibly removed with a plastic medicine spoon without anaesthetic than work at a rowlands anyway...

Justin Casey, Pharmaceutical Adviser

Collectively, as Pharmacists, we are the profession.  Everyone is aware that the benefit of MURs and NMSs to patients in their current format  is usually minimal.

  The GPhC is clearly in deriliction of its duties by its complicity in presiding over what amounts to serious prolonged corporate fraud against the NHS.  I would suggest that we, as a collective, bring a Civil case against the GPhC.

They are patently unfit to be the arbiter of their stated principles. Their hypocrisy is staggering.  They should be investigated, prosecuted, disbanded and replaced by a new agency that has integrity and credibility.

By allowing the status quo to remain we are as corrupted as the Regulator.  They allow the multiples to prop them up with bungs. We collect our wages.

We as pharmacists should stand for something more than the corporate bottom line.

If the profession is indeed in terminal decline I am afraid allowing a farcical and ineffective paid paper exercise to remain wont hold the tide back; Not in my name and not like this.

We need to make the profession and industry sustainable.  We need to work on how that may be achieved.  This should be an intrinsic function of our new Professional regulator.

JC

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 article says that Roland’s say "“required” to complete two MURs and recruit an unspecified number of patients to the NMS every shift," therefore taking away the professional judgment of the pharmacist in their course of work.

The GPHC needs to address this - Unacceptable - If they allow this then Pharmacy Management must also become criminally liable for mistake carried out under their management - They can not have it both ways!

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.

A LOCUM, Community pharmacist

well non pharmacist area managers showing their true colours , i work , i do murs, nms, etc its the staff who dont work , they are professional skivers, most area managers are the same , what exactly do you do and where are you most of the day ? ? ps why dont area manager put away stock , hoover and dust shelves , we locums are more qualified than you?

Tom Kennedy, Pharmacy Area manager/ Operations Manager

The typical Locum Pharmacist chooses their career path because it is easy, no stress of management, no emails and conference calls demanding better results and no need to worry about organisation or ordering as they won't be back the next day to deal with it.  

I really don't see why there is so much uproar over one letter asking Locums to do a few MURs now and then, it's the very least they can do since they have so few other responsibilities.  Try being one of the poor pharmacy managers that gets bombarded with emails and calls all day, or sit through a performance review when you don't hit your targets.   

It's this younger generation of pharmacists causing all the problems, graduate from a course that's gone soft and come out thinking they're entitled to everything handed to them.  The job's easier today than it's ever been with these computers and robots doing all the work for us.  More letters like this is what we need, bring these jumped up little locums back into the real world where we actually have to do some work for our money!!!

#DealWithIt 

Underrated Professional, Locum pharmacist

Hi Tom,

If locum work is such a doddle why are you still a POOR PHARMACY MANAGER?

We continue to allow non-pharmacist business managers to pressurize us and the complain that we work are stressed. I choose to leave and enter a pharmacy sector where I felt valued and respected.

Make your choice to stay and don't complain.

 

 

 

Sassa Jones, Non Pharmacist Branch Manager

So more letters overriding the pharmacists professional judgment over patient safety and workload to fill your pockets.

Cant wait for new rules to come into force where pharmacy managers will be jointly liable / negligent where they have not adhered to the GPHC professional stands of allowing the staff to : “comply with their own professional and legal obligations and are empowered to exercise their professional judgement in the interests of patients and the public”

#DealWithIt #

GPHC Should this pharmacy be inspected for workplace breaches?

A LOCUM, Community pharmacist

what these comments have proven is the disgraceful way non pharmacist managers and area managers treat/perceive locum pharmacists , stirring up hatred which staff pick up upon and follow suit , shame on you 'managers' , only one word for you 'karma'

Jonny Johal, Pharmacy Area manager/ Operations Manager

... surprise, 'karma' is the exact same word I use everytime I got taken advantage of by locums. In the old days, I had to take it when locums agreed on a rate, and when they turned up, they want a higher rate, those who threaten 'no shows' and cancellations a few days before the shift because another pharmacy is offering more, or those who refuse any 'non-professional duties' like putting away goods etc etc ... I am glad those days are well and truly behind us. Karma.

Stephen Eggleston, Community pharmacist

Hi Jonny

I went through those times as well and I am glad they are behind us.

The sad thing in this thread is how devisive it has been. Pharmacy has always had a problem with working together, uniting against a common enemy

As far as I can see, the common enemy here is the funding cut

James Mac, Community pharmacist

"What that means for patients and the NHS"... why lie? It's just about making the £28 a time.

Amal England, Public Relations

I have seen managers do MURs for no real reason and/or with patients who do not really want one as they feeel they have the mental capcity to do what is agreed with their GP, but the manager says "it will only be a couple of minutes." Of course it will be a couple of minutes if the patient is doing whats right. I find that locums are more likely to push for MURs than the manager, because the locum wants to go into the "good books". In my opinion, the community MUR and NMS should be abolished and it should be part of the GP contract. The GP would then use their practice pharmacist to undertake these services.....and yes every practice should have a pharmacist....by law.

Stephen Eggleston, Community pharmacist

Interesting idea - take even more funding away from Pharmacy and give it to GPs - because I can assure you, they will want to be paid additional funds for taking on an additional task

mark straughton, Student

The biggest problem in all this (and I really want to know other peoples thoughts?) and the reason why community pharmacy is doomed is because there's too many locums/ pharmacists coming through; there will always be someone to do the jobs.

Yes- we can work to rule- eg, spend 30mins on each MUR, causing waiting times to slow down- but what's the point? The team will get annoyed, area managers will find out and the locum won't get booked again, because there will always be someone that'll do the locum and do what the company wants.

The same applies to rates- there'll be great locums out there on £23/hr who work well with the team, experienced, great with customers, do the services- but there'll come a locum that'll undercut the rate and do it for £21/hr so they can do the shift.

Of course locums will have their moments, i.e. summer time/ xmas time/ Eid etc when they can demand a higher rate and there's loads of work, but overall the trend is moving towards a decrease in wages....all due to the oversupply.

I agree there are benefits to more locums. There's been so many abysmal locums! I'm talking about the locums who turn up 30mins late to a shift and don't apologize, on their phone constantly, rude to customers, won't check any PCS unless patient comes to collect. The more locums will reduce this attitude and give them a kick up the bum. But it's the hardworking locums, who may find themselves working a shift with low staff and not have an opportunity to an MUR etc who will get punished and have shifts cancelled. Ironically, it's the 'good' locums who get left all the PCS to check, NMS to chase up because they do it and don't complain.

Let's not forget here it's not only locums- soon (if it isn't already happening) it'll move to resident pharmacists/managers. If a pharmcist manager is on say £45k, been at a branch for years, done a great jobs- know the customers, knows the company. There'll be another pharmacist at some point down the line who will do this jobs for £10k a year less. Money talks. And, I can't blame pharmacists for doing this- we all need to work. How can you blame a 23yo who's left uni and has a £50k debt to pay off? Talk of boycott/ work to rule etc, we're not considering the forces of economic supply and demand of a work force with a non-existent/powerless union.

I really can't see anyway out here??? Within the next 5/10 years locum rates will slip to £15/£16hr on average (like in N.Ireland) if you're lucky to get the shift, and regular pharmacist jobs will be around £25k-£30k a year. This is all assuming that remote supevision/ amazonisation of the pharmacy hasn't already happened, which will render the 'profession' extinct. In which case we'll count ourselves lucky to have a job as a 'pharmacist'

PS- I really hope I'm wrong and all this is a bad dream!!!!

 

 

PoPeYe- Popeys Car Wash, Locum pharmacist

I don't think that you're dreaming, forward thinker.

Boom Shakalaka, Locum pharmacist

Meh!

Shaun Steren, Pharmaceutical Adviser

This company is undergoing a huge turnover of staff at the moment and it is being reflected in the chaos you see at branch. There is a complete absence of leadership and the shop-floor staff that have remained feel utterly abandoned. I have never felt so sorry for pharmacy staff in my whole career. Staff with decades of outstanding service being treated like rubbish. Utterly shameful.

As locums what should we do? Very easy, do the MURs/NMS you are targeted to do and be as thorough as possible - IT IS NOT A LITTLE CHAT!!! I estimate that you will be out of the dispensary for a minimum of two hours a day following this strategy. Any script queues will be dealt with at a SAFE PACE with the time that is left. The waiting times will fit around this working pattern and the work that is left over will carry over to the next day. Answering of phones and counter service etc remains secondary to this (assuming like most pharmacies you have lost your shop hours and had your dispensary hours cut). 

Be as sympathetic and understanding as possible with the staff of this company, they are going through a terrible period right now and have been treated in the most shameful of ways. 

Locum Pharmacist, Locum pharmacist

Do you find patients waiting for their prescriptions are always very polite, patient and considerate of others? Or when they come to collect their medication and find it's not ready or we don't have everything in stock they are always so understanding?Or when Rowlands staff give their standard 10-15 minutes waiting time and the medication isn't ready patients are fine with it?

I sympathize with the staff but as pharmacists we need to take a practical and realistic approach. Let's not forget that dispensing errors have not been decriminalized and even before the funding cuts locums have been working under terrible conditions. Did we receive any sympathy? The GPhC does not take into account a challenging work environment or our goodwill based on previous fitness to practice cases and we cannot gamble with our livelihoods.

The fact of the matter is if we are running behind with the essential services then things like MURs/NMS will not and cannot be a priority. 

Garry Barrett,

I don't really see the issue... these services are essential for a pharmacy and I don't see why locums should be exempt; not pulling their weight means even more work the the regular pharmacist.

The good locums do contribute in this way, I find.

Re: the fees - don't forget this money was taken from the global sum and only earned back then the service is delivered in full.  It is not extra money.  I find that this fact is often forgotten (or ignored) by the press very frustrating

sanjai sankar, Locum pharmacist

No one is saying locums should be exempt   But it's more challenging coming into a new branch, with new staff, new computer-systems, different procedures and just fit in seamlessly and start reeling off MURs....The resident pharmacist surely is in a better position to conduct these services as they may already know the customers who maybe more comfortable in their presence....

A LOCUM, Community pharmacist

i have found its regular pharmacist and staff not pulling their weight , not locums , this is so obvious as this article would never have been raised if the former did their murs/nms ?

Ilove Pharmacy, Non Pharmacist Branch Manager

So it's about grasping back money then. What if a patient does not want a MUR or the feels there is no bebefit for a particular patient. Do you feel they must still perform one for the money?

Gerry Diamond, Primary care pharmacist

If I were a community pharmacy locum I would just take the employer at their word and say to staff. I'm off to do an MUR for whatever reason not worry about the queue and say I'm going to be ten minutes, so let customers to call back later or we can deliver it tomorrow. You need to manage your time and managers cant have it all their own way, dispensing, checking or murs/nms.

Locum Pharmacist, Locum pharmacist

Good idea! Next time I'll try for a 15 minute MUR... it's always nice to have a little break lol.

Freelance Chemist, Pre-reg Pharmacist

The shoe shop chemist and the owl pharmacy have been telling their pharmacists/locums/staff to tell the GPhC inspector if asked that their is no targets set for MURS etc

Ilove Pharmacy, Non Pharmacist Branch Manager

Independents too. Pharmacist/locums are btw a rock and a hard place. Lie to the inspector and keep having silly targets foisted on you or tell the truth and initiate an investigation that leads to your won sacking and possible removal from the register. You decide.....

A LOCUM, Community pharmacist

in summary , Rowlands are blaming locums for lack of store murs/nms which their managers have NOT done , they darnt upset their employed pharmacists so bash the locum who on the one day turns up has to do a weeks work in that day which has been meticulously planned/left for them by the store, i've heard the phrase 'just a locum' many times but the phrase 'nursing home to check in corner' , nomad trays to check on bench', 'delivery driver here in 5 minutes' ring in my ears constantly , once all done and recovered from my STEMI , day is  finished , then store and employed pharmacist can play happy families , next day, with little to do,good job done by everyone lol ! 

Jonny Johal, Pharmacy Area manager/ Operations Manager

... locums are locums for a reason. There are only a few locums I use regularly, there are so many whom I used once and never see again. I can write a book about locums and the issues they left behind, after 37 years in the business. 

P K, Locum pharmacist

 

I find your comments very depressing and insulting.  'Locums' are not all the same so please don't generalise.  I choose to locum - after 30+ years, most of them in pharmacy manager positions, I decided to take things a bit easier and do part-time locum work.  Needless to say, it is not easy and there are pharmacies I am happy to go back to regularly and others I avoid - for many reasons.  Maybe one day I should write an article on the trials of being a locum and the standards of management, dispensing and customer service we come across.  Fortunately, I see some very good examples to balance off the poorer ones so the future may not be as bleak as some predict.

BTW I do MURs and NMSs when possible and enjoy doing them because I try to ensure that every one is patient focussed.  

 

Duncan Walsh, Locum pharmacist

not all locums have that attitude

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