Medicines Use Reviews (MURs) have been around for years, but in Liverpool during the 2015/16 financial year, over £500,000 of potential MUR fees remained unclaimed. LPC Member Eric Goodwin, of Green Lane Pharmacy on Allerton Road shares his top tips for maximizing MUR’s below:

  • Read your Drug Tariff part V1C, approx p42, to ensure you and your staff know exactly how MURs are reimbursed.
  • Target patients who "wait" for their prescription to be dispensed, or tag patient's bags awaiting collection. Do not try to book patients on an appointment basis. BE SPONTANEOUS.
  • Have pre-prepared MUR consent form + MUR Meds questionnaire form + MUR Consultation form, stapled together. If your consultation room does not have a computer, print out from the PMR the patients med list, or jot down a list of the meds the patient takes and the dosage.
  • Opening conversation - "Do you mind sparing me a few minutes of your time to have a quick chat about your medicines"
  • Usher patient into Consultation Room, explain you are offering a free NHS service of a Medicines Use Review (don't call it an "MUR" because they don't know what one is!), which is an informal chat about your medicines to ensure youknow what they are all for, you're taking them at the best times of the day, and you're getting the best out of them. You can tailor the wording to what is comfortable to you, but KEEP IT SIMPLE!
  • Fill in their NAME ONLY on the "Consent" form (top copy of the 3 forms), and ask them to sign it "to give you permission to ask them the questions". Don't waste time filling in all other details, you can do that later fromcomputer records/printing out a bag label.
  • Turn over to the "Medicines Questionnaire" form and ask the questions listed in relation to their medicines in general, circling the answers given. You may want to "spot check" them on certain meds they take, to ensure they DO know what they are for, and pay particular attention to certain things like "statins best taken at night, and do you have annual blood tests", "any unexplained bruising with anticoagulants/anti platelets", "check inhaler technique", "do diabetics check their blood sugars", "do thyroid patients have annual blood tests", etc. Think on your feet, but REMEMBER this is simply a Medicines USE review, and NOT a full CLINICAL review, so keep it SIMPLE and within the parameters requested by the NHS. A bit of extra care and attention as with the above questions is acceptable to "show concern" for the patient's wellbeing, but don't get too involved. Don't forget to ask if they self-medicate with anything else and jot these on the form with the number taken.
  • Turn over to the "Consultation" form which corresponds to the NHS Data Collection Sheet reporting template, and all you need to do here is briefly check the 6 requirements in the bottom right column i.e. Diet & Nutrition - show some concern - "do you eat well and make sure you take in adequate fluids?", Smoking - Y or N, Physical Activity - advise to do as much as they are able - WALKING is the BEST exercise for the elderly, "to keep their legs nice and strong" (they like that one!), Alcohol - TACTFULLY make sure they don't drink to excess, Sex !!! - I'm not comfortable with this one, but if I know them I may make a light joke about what we're supposed to ask them, and you'll be surprised what sometimes comes back! - "lightens the moment", Weight Management - just make sure they are not losing weight, and they are comfortable with their overall condition.
  • TAKE THE OPPORTUNITY to tell them about other pharmacy services offered, and also EPS if they're not currently nominated, if you have the time.
  • Finally thank them for sparing you some of their valuable time, AND thank them for choosing to come to your Pharmacy with their prescriptions.
  • BINGO - done! Shouldn't take much more than 5-15 minutes depending upon the number of meds/the patient/amount of questions asked. Gets quicker with practice, which makes PERFECT!
  • Back to check your waiting scripts, and write up the MUR later, and enter FULLY in PMR if preferred. I simply tag patient note with "MUR - 30/01/2017" so that I know when a next one is due, and keep all my filled-out sheets (3 pages) in a file ready to populate the NHS "Data Collection Sheet"/template when convenient, and at the end of each quarter. Keep all MUR records for 2 years. Use the MUR tally sheet to see how you're getting on, making sure that 70% of your MURs are in the TARGET group of either RESPIRATORY/HIGH RISK MEDICINE (i.e. NSAID, anticoagulant, antiplatelet, or diuretic)/Post Hospital Discharge/CARDIO VASCULAR DISEASE.
  • SIMPLE - 400 allowed per year - equivalent to no more than 2 per day at £28 each - £11,200 per year PURE BOTTOM LINE NET PROFIT.