|
Mouse mat sent to all pharmacists and GPs in
Hampshire and the Isle of Wight
|
Promoting MURs in the media
Last month the Pharmaceutical Services Negotiating Committee
ran media training seminars in Preston and London on how to promote
MURs. The courses were attended by 30 LPC members, who gained
an
understanding of how the media works, what makes the news and
how they can raise the profile of pharmacy services with the local
media, GPs, PCTs and the public. |
Research published this week shows that uptake
of medicines use reviews in the first year of the new community pharmacy contract was slow (p218).
However, there are more recent signs of growth in the number of contractors
claiming payment for
MURs and the number of MURs performed in each pharmacy
(PJ, 17 February, p180). Several initiatives around the country aim to
support delivery of this advanced service.
Mike Holden, chief officer of Hampshire and Isle of Wight Local Pharmaceutical
Committee, explains that the LPC has had a proactive MUR strategy since
the new contract was implemented. The most recent phase of the strategy
includes a newsletter, focused entirely on the MUR service, which was
launched in January. The newsletter will be published monthly and contains
links to MUR resources, updated data on MUR activity within the LPC,
details of planned public relations activities and workshops, and a section
for readers to share ideas and best practice.
The LPC has also commissioned two pharmacists to offer part-time support
to pharmacies who want to develop their MUR service. The pharmacists
started work last month and will provide direct support via local pharmacy
group workshops, small group sessions and one-to-one coaching. A survey
conducted by the LPC in January highlighted three main problem areas
where support is needed: promoting the service to patients, both within
the pharmacy and more widely, engaging and integrating with GP patient
care and involving the whole pharmacy team.
The LPC has also produced a number of MUR resources, which are available
on its website. These include documents to
help pharmacists brief GPs and market their service to patients, tips
on how to plan time for MURs and how to recruit patients, as well as
posters, leaflets and support packs.
Mr Holden says that the LPC’s latest MUR activity data show that
the strategy has been successful. “Back in April 2006, only 54
per cent of pharmacies across Hampshire and Isle of Wight were performing
MURs. By November, this number had risen to 73 per cent,” he explains.
The number of MURs performed per pharmacy per month also increased over
this time, from five to 10. “Although the number per active pharmacy
is still below the national average we have got more [pharmacists] doing
it. We concentrated on getting more people on board rather than on the
numbers because the numbers game is relatively easy. It is getting the
mindset right to deliver MURs in the first place that is the hard bit,
as well as getting the engagement with GPs and the team involvement,” he
argues.
Mentoring scheme
Within Surrey PCT, an MUR mentoring scheme for community pharmacists
aims to help improve pharmacists’ confidence in performing MURs,
increase patients’ enthusiasm to attend, increase GPs’ confidence
in the value of MURs, increase the number of MURs conducted, and support
and encourage communication between pharmacists and other health care
professionals, particularly GPs.
There are currently over 20 pharmacists undertaking the scheme, each
of whom is assigned a PCT pharmacist who acts as their mentor. The programme
includes an accompanied visit to a GP surgery and ongoing telephone support.
“The key issue is that the mentoring has improved the confidence
of pharmacists to do MURs and also the quality (via qualitative feedback
from GPs),” explains
Fiona Harris, locality chief pharmacist and associate director of public
health at Surrey PCT. “We ran a pilot in one practice where the
MURs are done before the medication review by the GP, which has received
positive feedback from the practice.” However, she warns that,
to take MURs forward, the profession needs to get the support not only
from the medical and nursing professions but also from patients. “They
are often not sure what is the purpose of an MUR,” she says. Practical resource
Devon LPC, in conjunction with Hampshire and Isle of Wight LPC, is
currently developing a practical MUR resource that will focus on 16 therapeutic
areas. The idea came about following several successful disease-based
MUR workshops held throughout Devon. Emma Mortimer, who is working
on the new MUR resource as a project pharmacist for Devon LPC, explains
that one A4 page will be dedicated to each therapeutic area in the
form of a crib sheet. It will incorporate triggers for an MUR, concordance
hints and advice on conducting MURs as well as signposting information.
The resource is expected to be ready by the end of next month.
Ms Mortimer also works as a community pharmacist in a busy health centre
pharmacy and currently conducts about eight MURs a week. “This
gives me a realistic target of reaching the 400 and also means that I
am not bombarding GPs with the dreaded MUR paperwork.” She relies
on a second pharmacist to cover for two days a week.
MUR form consultation
The Pharmaceutical Services Negotiating Committee
is currently seeking pharmacists’ views on a modified
MUR form (PJ, 27 January, p97), which has been reduced to
two A4 pages.
The deadline
for
comments is 28 February 2007 |
Ms Mortimer admits
that, at first, she found the paperwork a barrier to successful implementation. “I
think this is also a barrier for GPs and tends to give them a more negative
view of the service,” she
says. She now has an agreement with her local surgeries that she only
sends the action plan, which she clearly marks to show whether it is
for information only or whether action is required by the GP. “This
has been favoured by the GPs and from the feedback I have had, they are
following actions much more readily now.” She is looking forward
to using the new MUR form when it becomes available (see Panel right).
Recruiting patients was also an issue but initial problems have been
resolved by getting all staff involved in the process. “Once staff
were confident about the service, what they needed to say and which patients
to ask, it turns out that they are much better at recruiting than I am,” she
admits.
“It has taken a while but I feel like MURs are starting to become an established
service, and it can be possible in a busy pharmacy. I am looking forward
to inviting back all my MUR patients in 12 months,” she says. |
The
Pharmaceutical Journal