NHS England may be thinking of decommissioning MURs and new medicine service, PSNC fears

Alastair Buxton, director of NHS services at the PSNC, told the HDA conference he has concerns that a review into clinical pharmacy could lead to services being cut.

Alastair Buxton, director of NHS services at the PSNC

The Pharmaceutical Services Negotiating Committee (PSNC) has expressed concerns that the findings of a review into clinical pharmacy services may be used to decommission the medicines use review (MUR) service.

Speaking at the Healthcare Distribution Association’s (HDA) annual conference on 16 June 2016 in London, Alastair Buxton, director of NHS services at the PSNC, said he was concerned about the “direction of travel” of the review. He said the PSNC, which negotiates the community pharmacy contract with the government, was worried that the review was about “getting rid” of MURs and the new medicine service (NMS).

After the conference, a PSNC spokesperson added that while this is their concern, “we don’t know if that is the government’s intention”.

The MUR service has had some bad press recently after
The Guardian

ran a story in April 2016 alleging that Boots was putting pressure on pharmacists to undertake unnecessary MURs.
The Pharmaceutical Journal also reported
on concerns about pressures placed on pharmacists to undertake MURs in 2013.

Gordon Hockey, a barrister who works for the PSNC, says the PSNC was worried the review was only looking at MURs, and not other locally commissioned services, such as emergency hormonal contraception services. “If you want to look at clinical services, you need to look at the full package. The PSNC has suspicions that the review will knock MURs,” says Hockey.

The independent review of community pharmacy services was commissioned by NHS England to make recommendations for future commissioning models for community pharmacy and the pharmacy workforce. It is being led by Richard Murray, director of policy for the King’s Fund, and is expected to be completed by October 2016.

When asked whether the review was looking into removing MURs or NMS services, Keith Ridge, chief pharmaceutical officer, said: “This review will provide one additional source of information on how clinical services provided by pharmacy teams could be redesigned to bring these teams even closer to patients and to the heart of the NHS. This work is one contribution to broader action to help modernise NHS pharmacy services, and to meet the changing shape and demands of healthcare.”

According to NHS England, the main areas for consideration in the review will be: meeting the changing healthcare needs of an ageing population; ensuring patients receive the best outcomes from medicines; and integrating community pharmacy into emerging new models of care as the NHS implements its ‘Five year forward view’. The review will also look closely at the barriers that prevent the best use of pharmacy team skills in the care of patients with acute and long-term conditions, it adds.

Speaking on the pharmacy cuts announced in December 2015, Buxton told the conference that pharmacy was “fantastically” efficient, although the Department of Health thought it could be more so.

He recognised that there were clusters of pharmacies, especially so after the deregulation of the market in 2005, but predicted that the government would defend itself by saying that another government was in power then.

Clusters of pharmacies in large population areas are hard to defend because they do exist, said Buxton, but clustering is not wrong since many community pharmacies deliver services based on patient needs.

Last updated
The Pharmaceutical Journal, PJ, July 2016, Vol 297, No 7891;297(7891):DOI:10.1211/PJ.2016.20201310

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