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Kings Fund director calls for MUR redesign


14 Dec 2016

The Kings Fund’s director of policy has called for medicines use reviews (MURs) to be revamped in a report commissioned by NHS England.

Richard Murray called for a redesign of MURS into full clinical reviews – including ongoing monitoring and follow-up of patients, consideration of prescription duration, and utilising independent prescribing as part of the care pathway – in the Community Pharmacy Clinical Services Review, published by NHS England today (December 14).

The independent review was commissioned by the chief pharmaceutical officer Dr Keith Ridge in April following the publication of the Five Year Forward View in 2014 and the General Practice Forward View earlier this year.

It also called for a closer working relationship between pharmacists and GPs, and for NHS England to set out how the national minor ailments scheme will be implemented

Evolving models of care

The report called for “renewed efforts to make the most of the existing clinical services that community pharmacy can provide and to do so at pace”.

This may require national action through the community pharmacy contract, the review said, as well as local efforts to integrate pharmacies into evolving models of care, it said.

Vanguard programmes should be used to “develop the evidence base” for community pharmacists, Murray said. This could include integrating them into long term condition management pathways, involving them in case finding programmes, and using new ways of contracting that mitigate any perceived conflicts of interest.

Minor ailments service

The report also called for NHS England to set out how it intends to deliver on its commitment to ensure that minor ailments services are commissioned across England by April 2018.

It stressed the need for community pharmacists and their teams to share information with clinical records held by other healthcare professionals, and said pharmacy technicians should be able to work under Patient Group Directions to improve better use of the skill mix within pharmacies.

The report recommended that a formal group be established, including representatives of community pharmacy, to have oversight of progress and recommend further action where needed.

A rapid review of the evidence for community pharmacy services, carried out by Professor David Wright, was published alongside the report.

“Welcome proposals”

Pharmacy bodies welcomed the contents of the report.

PSNC Chief Executive Sue Sharpe said: “This review includes some positive and welcome proposals for developing the community pharmacy service. We are ready and keen to work to implement these as soon as possible.

“The events of the last year have badly dented the confidence of pharmacy contractors, but energy in moving forwards will do a lot to restore it.”

Rob Darracott, Pharmacy Voice chief executive said: “This is definitely a report on which that partnership can be built”.

“The positive tone in this document is in stark contrast to the retrograde steps taken by the Department when it chose to reduce the NHS funding for community pharmacy services without a clear plan on how the network would adapt.

“We call on the Minister and NHS England, as they respond to this independent review, to match the ambition of the sector to transform both the role of community pharmacy and the effectiveness and efficiency of the wider primary care system in this country.”


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