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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?

Ilove Pharmacy, Non Pharmacist Branch Manager

Often locums have a more lucrative sideline which they eventually hope will result in them never having to work in pharmacy again. That sideline is usually more interesting and with less [email protected] to deal with such as obnoxious store managers or area managers with 'Napoleon' syndrome.

A LOCUM, Community pharmacist

and every employed pharmacist you have had in the last 37 years have been perfect of course ?

sanjai sankar, Locum pharmacist

What's interesting is that this article has generated more comments than all of the previous 5 C and D leading articles put together....This  clearly illustrates the strength of feelings about this issue which is well known but continues unabated....

Arun Bains, Community pharmacist

Does the C&D or the GPhC have any comment in this???

Ilove Pharmacy, Non Pharmacist Branch Manager

I doubt it. And if they do we know what it will likely be....

Valentine Trodd, Community pharmacist

Are you kidding?!

What's clear is that there's an asymmetry of motives and the nature of the communications very easily creates a pressurised, confusing  atmosphere to work in- this is the case everywhere. When on the one hand pharmacists are spending some of their time trying to buy in the best value generics to make the DT work and get value for money for the NHS the appearance of demands on their time which can be rationalised as a selfish managerial motive will only ever lead to the circular discussion community pharmacy has around this topic. There's maybe a bit of behavioural psych in relation to prospect theory etc involved here. To every individual feeling the pressure to do these services my sympathies flow, to every area manager who feels they're right in browbeating professionals unashamedly my blood curdles

S J- Locum, Locum pharmacist

*This comment has been deleted for breaching C+D's community principles*

Ilove Pharmacy, Non Pharmacist Branch Manager

I would suggest informing evey potential MUR client/patient that it will cost £28 to be charged to the NHS. Should be an interesting convo with some of them. Area managers will be proud that you engage your patients. :-)

Gemma Morris, Accuracy checking technician

...

Angela Channing, Community pharmacist

Had exactly the same thing myself last year, after the Guardian story.  He asked me, " so, is that what you get £28 for?"  I told him, if he didn't feel it was of any value to him, he didn't need to sign the form. .......  He signed the form, (after an explanation that it wasn't new money but money that was taken off us in the first place!)  He was ok about it !  Tut! Guardian readers!!  ;)

Ilove Pharmacy, Non Pharmacist Branch Manager

I would say this letter is a veiled threat. Any opinions on the matter Grace ? Or James for that matter?

Could one of you ask Rowlands what happens if a locum in their professional judgement decides that not up to 10 people required a MUR on a given day. And also the second scenario where some patients refuse to have an MUR again resulting in less than 10 per week. I'm sure your readership would appreciate your high level journalistic skills in this matter.

Dave Downham, Manager

Did you get turned down for a job with C&D or something? Journalists are supposed to be impartial; ranters, ravers and columnists should be the opinionated ones.

Leon The Apothecary, Student

I love having an opinion, it's true.

Ilove Pharmacy, Non Pharmacist Branch Manager

Seems a perfectly acceptable question if threats are issued that a minimum number of MURs must be completed and minimum NMS recruitments. What happens when these numbers are not met? Only Rowlands can answer. 

There is impartial and there is sitting back and watching a car crash and doing nothing about it. Have you never read a comments/opinions section in a  newspaper before.? I trust you're not related to anyone in the editorial team at C&D? or the publishers perhaps.

Jonny Johal, Pharmacy Area manager/ Operations Manager

Here are some basic background information on Rowlands for this discussion. The GPhC has 526 entries for "Rowlands Pharmacy", according to Companies House, reg. no. 2288928 L Rowland & Company (Retail) Ltd, tax year ending 2016 turnover £499.755 million, profit after tax £11.811 million, average profit per store is therefore £22,454; tax year ending 2017, turnover £503.826 million, profit after tax £5.079 million, average profit per store dropped to £9656.

A LOCUM, Community pharmacist

most businesses would then cut costs ,reduce staff , manager numbers ?

Jonny Johal, Pharmacy Area manager/ Operations Manager

... or review your business model, and find out what is causing the decline in profits (if it is real) at a time when turnover is up?

Andy Burrells, Community pharmacist

This is assuming the return is accurate and in line with current tax guidelines

Jonny Johal, Pharmacy Area manager/ Operations Manager

I find the section on directors' renumeration and deferred tax arrangement very interesting.

https://beta.companieshouse.gov.uk/company/02288928/filing-history

A LOCUM, Community pharmacist

Worked in one store where the staff identified mur/nms patients, pre-printed consent forms, ,stuck reminder stickers on bags  , asked patients in advance and whilst waiting , well organised effort and worked well, then go to another store staff uninterested, ripped of stickers and consent forms and bin them without even asking patients, Rowlands need to look at their staff, treat locums better and you never know ?

Jonny Johal, Pharmacy Area manager/ Operations Manager

We have a case of a pharmacist-in-charge, but by name only, blaming the staff for a lack of performance. I came across locums like this before.

sanjai sankar, Locum pharmacist

You also have the opposite situation. A pharmacist, often a locum who has to take on RP responsibilities but has no say about procedures or different ways of working. They must follow the owners way or else it's the boot....if any errors or targets not met occur  due to pressure,the staff and owner often collude against the locum...I've witnessed this first hand....you're   argument needs to be more balanced....

Locum Pharmacist, Locum pharmacist

Very true. I remember once a newly recruited trainee healthcare assistant took the side of the locum instead of the dispenser in a dispute. When I was working there the dispenser told her in no uncertain terms that that was backstabbing behaviour- the locum is just there for a day whilst they are permanent and need to back each other up no matter what. It happens often in pharmacies where the loudest tend to bully the other staff members into agreeing with them.

sanjai sankar, Locum pharmacist

Precisely....I have experienced situations where a non-pharmacist store manager for a large mulltiple took a dislike to me over a minor incident. After my shift, she got  the resident pharmacist (who was not even present during the incident) to shamelessly issue "negative"feedback to my agency over a range of points including my presentation....(suit and tie wasnt sufficient for them)...She, the instore pharmacist was not even present , but the bully of a store manager still coerced her to back stab a member of her own profession....This is what some locums have to face during their shifts and have absolutely no one to turn to for advice or support....

 

A LOCUM, Community pharmacist

i find pharmacist area managers attitudes different to non pharmacist area managers, i see plenty 'staff lack of performance' in all areas not just wrt murs/nms 

Jonny Johal, Pharmacy Area manager/ Operations Manager

Within a group, everyone work under the same contract, some stores perform better than others, the difference is often down to the person in charge - I am talking about leadership skills.

As for locums, I have been exploited by many, and there is a sub-group whom I would classify as 'looking for the job which has no work content', and nothing is ever their fault. I would be a rich man if I get a penny every time a locum said to me "I am just the locum".

A LOCUM, Community pharmacist

in an oversaturated market , dont book the 'sub group', simples , when the' leader' leaves the store or has a day off , very ofter locums single handed have to run a store, no help around everyone 'busy'doing nothing 

Tohidul Islam, Locum pharmacist

So, Rowlands have now decided that becuase their business is so poorley run that the only option left is to bully locums into doing MURs and NMSs thier managers obviusly aren't doing. If they were you wouldn't need to send out such a threatening letter. After speaking to a few Rowlaands managers its clear that the area managers at Rowlands really don't have a clue how to manage the business and lets not even talk about their people skills if this letter is anything to go by. 

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

I'm starting to think maybe we should lobby the government to hand over the MUR and NMS service to other providrs who will do a better job by ensuring patients actually get real benefit from the service as opposed to pharmacists doing one half heartedly just to hit a target since we have this drama every few months where one company or another seems to think its ok to threaten pharmacists when ever they need a bit more money in their account and force  them to carry out unnecessary 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.

Yes that only happens when you do a MUR/NMS whenre there is a real clinical need not when the area manager needs to hit his/her target so he/she can get a bonus at the end of the year and the company can make a few thousand more per branch. 

So in conclusion don't push pharmacists to do unncessary MUR/NMS or what ever service it is the you are offering. We as the RP will decide what the patients need not  the area manager or someone in senior maangement sitting behind a cosy desk who has never stepped foot in a pharmacy. No pharmacist I know has any probem with providing services and running a group with 3500 pharmacists I can say i know and have spoken to more pharmacists than most area managers. If you want to improve your busniess start by improving your realtionship with your staff. Your job as an area mamanger is to look afer your staff and your staffs job is to look after their customers. When you look after your customers they will come back to you. If you treart your staff badly then don't think for a minute that they are giving their best because they're not. Treating a pharmacists that runs your branch badly is like treating a chef, thats makes the food in your restaurant, badly. We all know how that one ends.  

Adam Smith, Senior Management

Very well said indeed! Common sense for a change. What would my customer benefit from, it's that simple. 

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