MURs: A SEC SHA perspective

1
MURs A SEC SHA perspective

• Linda Dodds
• Associate Director of Clinical Pharmacy, E SE
  England Specialist Pharmacy Services
• Teacher Practitioner, MSOP

2
Why am I up here?

• Co-ordinated a SEC SHA review of MURs in late
  2006
• Thanks to Susan Evans, Flick Johnson, Fay
  Boyett, Elmarie Venter, Barbara Parkinson, Claire
  Johnson, Jane Wicks, Abigail Barry

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Key Issues identified?

• Variable uptake
• Variable quality
• Variable PCT support
• Barriers to MUR delivery
• Role of HEIs

4
Recommendations?

• Monitoring of MUR quality is crucial
• Redesign the form
• Re-accreditation at regular intervals
• National guidance for domiciliary care home
  MURs, PCT commissioning of MURs (to integrate
  into care pathways)
• Relaunch of service

5
What has changed since 2006?

• PCTs! Now a commissioning not a development
  organisation
• MURs low on the agenda
• No champions for MURs
• Monitoring likely to be by non-pharmacists
• PBC How do MURs get integrated?
• Negative connotations likely for GPs involved

6
Patient-centred NHS

• Demonstrate clinical and cost effectiveness
• Choice of provider
• Care closer to home
• Medicines integral to all care pathways
• The opportunities are still there!

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Outcomes for patients?

• Increased individual support around medicine
  taking with practical advice
• Someone who can answer their questions about
  medicines fill information gaps
• Safety reassurance
• Value for taxpayers money
• Shouldnt this be happening anyway??

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GPsNew commissioners

• Added value to care they provide
• Highlight noncompliance
• Sort out unintentional noncompliance
• Reinforce lifestyle issues
• Provide medicines information
• Cost savings
• Reduce waste
• Highlight potential savings

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PCTs Commissioners, not pharmacists

• Clear quality outcomes
• Appropriate use of public funding
• Probity issues
• Need to be convinced of pharmacy added value
• Service addresses CCtH agenda etc
• Service integrated with other services currently
  in the usual pharmacy silo

10
Community Pharmacists?

• That service is useful and valued
• Feedback
• Support
• Part of a team approach to care
• Raised status
• Income

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Audit priorities?

• Patient safety
• Optimal use of medicines
• Identifying ADRs or noncompliance
• Patient satisfaction
• Financial outcomes
• Waste reduction
• Supporting cost-effective prescribing
• Probity