In my election statement I called for the new medicine service (NMS) and medicines use reviews (MURs) to become universal components of more clinically orientated community pharmacy service. Despite the adverse publicity and claims of their use to achieve targets for remuneration, my stance is not that they need to be abandoned but they are re-engineered to take account of the changing situation in primary care. Issues include: pharmacists workload; the impact of the Health and Social Care Act 2012; other pharmacists, including pharmacists in GP surgeries, care homes and a part of hospital outreach; access to the patient record; and current NHS funding and need to make large savings.
There needs to be an acknowledgement of the enormous clinical input pharmacists already have on a day-to-day basis ensuring that patients get the correct, appropriate medicines, whether they are on prescription or being purchased. For MURs and NMS to become universal, for many pharmacies, this will require two pharmacists.
The Health and Social Care Act put GPs in the driving seat. However, the consequence for most GPs is that they cannot manage an overwhelming workload. Any service that creates work for them will not be considered favourably. The NMS and MURs must save GPs’ time and pharmacists must have the autonomy to resolve many of the issues that arise.
The services offered in the community pharmacy must be as a part of an overall system of review agreed with the GP surgery. It is no good developing these services in isolation without the GP being a partner in the programme. Soon many GP surgeries will have their own pharmacy team and the MURs and NMS must work in collaboration with them. Both will have access to the same patient record, which will help make the recommendations more relevant.
For any new service to be developed it must save money for the NHS. There is the potential to save huge amounts on the medicines bill, the GPs’ time and increase the efficiency of the whole medicines pathway. The NMS and MURs must not only demonstrate huge savings but help make the case for employing two pharmacists.
Ross Ferguson in pharmacy Practice recently stated: ‘What we need is robust and determined professional leadership to tackle this serious issue head on and we need it now’. The Royal Pharmaceutical Society needs to lead and the Pharmaceutical Services Negotiating Committee needs to negotiate a clinical future.
English Pharmacy Board
Royal Pharmaceutical Society