We have today updated the look and feel of our webblog. You should still be able to find items easily on the blog. This is in line with our aim to continue to provide constant design updates and enhancements to our site.

We are now running the latest version of wordpress on the site and we like the look and feel of the version 2.7.

If you have any queries, do not hesitate to contact us using the contact form on: http://www.medicines-use-review.co.uk/contactus.asp

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MUROnline

We have therefore decided to do away with our ‘Beta’ logo (below). The new logo has the ‘Beta’ word removed. We use this opportunity to wish you a happy new year.

old logo

new logo

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MUROnline

1. It is an endorsement of what we are trying to achieve
2. It represents another avenue for the MUR Evangelist to secure valuable and varied employment
3. If bookapharmacist.com is successful in its aims, this may drive up registration for MUR Evangelists and vice versa
4. MUR Evangelists are under no obligations to use the services offered by bookapharmacist.com
5. Duplication of works and contents: Bookapharmacist.com and MUROnline will work closely together on contents-related issues to avoid duplication of work. In most cases, this relationship will result in contents collaboration, which can only be a positive thing
6. Your information will only be shared between the organisations if you ask us to. Your privacy is guaranteed

We are excited about this development, we hope you are…


Merry Xmas and Happy New Year.


Webmaster
MUROnline

…and P.S. we are still very excited about what we aim to deliver!

INTERIM MANAGEMENT TEAM

The publication of the pharmacy white paper in England represents ‘one of the most significant opportunities ever for pharmacy to step into its rightful place as a clinical profession’(1,2). Paul Bennett, the chairman of the English Pharmacy Board writes ‘If we dither and get it wrong, we will only have ourselves to blame’(2).

The White Paper

Dawn Primarolo MP, Minister for State for Public Health says: ‘The white paper reflects the views, ideas and innovative working of pharmacists across the country and demonstrates our support and commitment to working with pharmacy and others to deliver a practical, achievable program for the future of NHS pharmaceutical services’. The document describe MURs as providing ‘the opportunity to improve people’s use of their medicines, reducing wastage, improving their health and reducing unnecessary hospital admissions. The government proposes two areas within the current structure of the service that should be addressed: (a) To make stronger provision for PCTs to prioritise MURs to meet their health priorities locally, including health improvement, and to monitor service delivery more effectively. and (b) The funding structure should better ensure that the service is delivering to those who might best benefit, and reward the health outcomes that are achieved.

At MUROnline, we see MUR as an opportunity to develop some of the key points highlighted in the white paper. Through MUR, pharmacists can help:

• Support the promotion of health and help more people take care of themselves.
• Provide specific support for people who are starting out on a new course of treatment for long-term conditions, such as high blood pressure or high cholesterol.
• Support the screening of patients at high risk of certain diseases.
• Support the broader ‘NHS journey of improvements and move from an NHS that has rightly focused on increasing the quantity of care to one that focuses on improving the quality of care’(3).

The Challenge

At MUROnline, we believe that number of quality MURs delivered in England and Wales still falls significantly short of the target. The current PSNC figures demonstrate that we are simply not delivering enough MURs in England and Wales (4). If the target of MURs per pharmacy is 400/year, then each pharmacy must be delivering an average of 30 MURs per month. Table 1 below shows the average number of MURs conducted per pharmacy claiming MUR payment and average number of MURs conducted per pharmacy in England (Source PSNC website(4)).

*Number of MURs per pharmacy claiming MUR payments
^Number of MURs per pharmacy in England

Table 1

In March 2008, only 16.84 MURs payments were made to pharmacies conducting MURs. More depressing however, to us at MUROnline, is the figure of 8.75 in the same month across all pharmacies in England. These figures imply that there are still pockets of pharmacies not conducting MURs. This is an unacceptable state of affairs to us at MUROnline. So what are we going to do about it?

If we dither and get it wrong, we will only have ourselves to blame -

Paul Bennett, chairman of the English Pharmacy Board

MUROnline Response

The stated objective of MUROnline is to increase the number of quality MURs implemented by pharmacists in the United Kingdom. We aim to achieve this through the motivation and empowerment of our colleagues and by the collating and sharing of the evidence of the benefits of MURs. At MUROnline, we acknowledge a number of good quality works being produced by different organisations to drive the delivery of quality MURs. Notable amongst these are:

1. The PCPA-NPA MUR Support and evaluation program(5): The program has been designed to evaluate how effective MURs are at improving patients understanding of their medicines and subsequent compliance under prescribers’ direction. We await the outcome of this program with anticipation at MUROnline.
2. Pharmacy Magazine and Chemist & Druggist Magazine publish a range of tools on a regular basis to support the delivery of MUR. A set of notable resources includes a CPD module published in June of this year entitled: MURs-getting the essentials right(6) and MURZONE on the C&D website, with contributions from pharmacists(7).
3. There are other initiatives supported by the pharmaceutical industry. GSK Plus produced a document entitled: Communication Skills: effective patient communication skills for Pharmacists(8)
4. Local MUR initiatives. The Hampshire and Isle of Wight LPC has been very pro-active in promoting the values of MUR amongst its contractors. To support the evidence needed to justify the benefits of MUR, the LPC recently published the results of its asthma project. This provided evidence which demontrated the value of MUR in asthma patients(9)

At MUROnline, we have our own strategies for delivering quality MURs. We aim to deploy these strategies in Hampshire, Southampton City and Portsmouth City PCT regions.

Current Position

In April 2008, Hampshire LPC published a staggering figure of £2,500,000 in their monthly newsletter(figure 1). The amount represent the total amount of funding lost to pharmacies in Hampshire and Isle of Wight in 2007. From our viewpoint, this figure represent a significant amount of patients that were not helped to make the best use of their medication in 2007!

Figure 1: LPC News Newsletter April 2008 (10)

If we are still working on the general assumption that each pharmacy need to be achieving an average of 30 MURs/month, then in March 2008: Out of 9,570 possible MURs, only 2,738 was completed in Hampshire, Southampton City and Portsmouth City PCT regions. In percentage terms, this is only 29%!

We however believe that fundamentally, the pharmacist in charge must want to help his patient get the most out of his medication, otherwise, the whole notion that we are medicines experts will start to unravel.

MUROnline does not like this and we are determined to do something about it. Between now and December 2008, we will embark on a road to make significant positive impact on these figures. Our emphasis is on quality MURs and is in line with the theme of the latest Lord Darzi report on the vision for the NHS. We aim to do this with the help and support of all the stakeholders in the Hampshire, Southampton City and Portsmouth City PCT regions. Please watch this space.

Summary

We know at MUROnline, that there is a vast array of reasons why a single pharmacy may not be delivering quality MURs. There is no single solution to these barriers. We however believe that fundamentally, the pharmacist in charge must want to help his patient get the most out of his medication, otherwise, the whole notion that we are medicines experts will start to unravel. We have introduced the concept of an MUR Evangelist and we believe we can make significant contribution by motivating our colleagues to deliver quality MURs. We are going to aim to increase the percentage of quality MUR delivered across the stated PCT regions from 29% to over 50% by the end of this financial year. We can only achieve this if we get the full unequivocal support of all stakeholders. We will come knocking on your doors and we hope you will respond positively.

References

(1) Pharmacy In England: Building on Strengths - delivering the future DOH White Paper ISBN 9780101734127 -  Link

(2) Pharmacy Now: From the Chairman of the English Board: Board considers White Paper Issue 7 Summer 2008 - Link

(3) Lord Darzi of Denham: High Quality Care for All - NHS Next Stage Review Final Report: Full report (ISBN 978-0-10-174322-8) - Link

(4) PSNC MUR Statistics - Link

(5) PCPA NPA MUR Support and Evaluation Programme – Pilot sites chosen - Link

(6) MURs - Getting the Essentials Right: Contributing authors: Jennifer Archer MSc, HRD, FCIPD, FHEA, DipTM, consultant in education and development; Hassan Hajat, MRPharmS, MSc, senior commissioning manager and clinical adviser, Derbyshire County PCT: cpd module pharmacy magazine CPD1 June 2008.

(7) MURZone -  Link  (http://www.chemistanddruggist.co.uk/murzone)

(8) GSK Communication Skills (ref PLS/CDR/05/17633/1-FP - CD Rom). Obtain a free copy from GSK on Freephone: 0800 221441 or email: customercontactuk@gsk.com

(9) Community Pharmacy Asthma Medicines Use Review Project - Outcome Report: Authors: Dr Jane Portlock, University of Portsmouth; Michael Holden, Chief Officer, Hampshire & IOW LPC, Shailesh Patel, Brand Manager, GSK UK Ltd. - request a copy via the Hampshire and IOW LPC website - Link

(10) LPC Newsletter April 2008 - Link

The presentation to the Southampton Branch of the Royal Pharmaceutical Society by Kazeem Olalekan on the 28th of February 2008 entitled the MUR Evangelist - a unique presentation by pharmacists for pharmacists was well received. Thanks to all for your constructive feedback.

[ Click here to view the presentation's feedback ]

The presentation stimulated the appetite of a great deal of the attendee and yearned to know more about MUROnline. They want to know how we plan to achieve the motivation of pharmacists. Troy Blake, a pharmacist from Southampton wrote: ‘I feel I know what an evangelist is but not what it would entail in practice - unsure - sounds exciting’.

It is exciting and we are certainly excited about this. The website is not done yet and we are still working on the content (hence the BETA release). The principle underpinning this project is this: As a group of pharmacists, we understand that the take-up of MUR could and should have been better, but there were valid issues around the implementation that probably alienated a significant majority of our colleagues. We also understand that the only people that will enable the patients to get the best value from the service are the pharmacists. So how does one re-motivate the pharmacist?

Presentations like this one is one way. We are very pleased that it is acting as a trigger for those who are not already accredited and a way to re-energise those who are already delivering the service. We have some interesting ideas about how to implement good MURs and we will share these. However, we also know that there are tons of very good practices out there. By being part of the MUROnline family, we encourage you to share these good practices with your colleagues; after all that is an integral part of the evangelist’s role. You are able to do this by submitting articles on the website.  Furthermore, we aim to make this the number 1 repository for anything relating to MUR. So on the website you might find clinical and practice information at your fingertip to aid the MUR process. Some of the contents may only be available to registered users of our site. MUR Online is the home of the MUR Evangelist and all the things you can do on the website will be at no financial cost to you. All we are truly interested in is a group of pharmacists delivering good quality MURs that will benefit their patients. Moreover, if you register in the BETA period, you can help shape the site’s contents. We want to achieve 100% service delivery across England and Wales in a fun way and taking advantage of Information Technology.

What is in it for me?

We have pondered over this a lot and we think we may be able to provide you with some answers. The overriding benefit is the satisfaction in knowing that you are doing all you can for your patients. We understand that you may want to be rewarded for your efforts. As a regular user of our site, you are demonstrating your passion for the service and we have devised a number of strategies to support you. Whatever your motivation, be it professional recognition or some other remuneration, then we might have something in it for you.

Now, just close you eyes and take a deep breath.  Think about the possibilities for our patients and our beloved profession. Make your mind up positively about MUR. Open your eyes and consider joining this innovation! Register as an MUR Evangelist today.

[ Related Content: Which User are you? Explaining the User Levels on MUROnline ]

In April 2007(1), the P3 Magazine published a survey conducted by TNS Healthcare of 100 pharmacies entitled ‘Why are some pharmacies not doing MURs?’. One of the key findings is that large pharmacies chains are more likely to conduct MURs because they promote the services effectively on their websites and in-store. The article suggested that this is the area where independent pharmacies may want to close the gap.

We hope that the BETA and subsequent launch of the full version of MUROnline and the accompanying promotion, will go a long way in making people aware of this innovative new service, which is now being provided routinely by their local community pharmacy.

The Pharmaceutical Services Negotiating Committee (PSNC) has produced a series of promotion materials to support the promotion of service across LPCs. Click here to download the materials.

ref:

(1) Why are some pharmacies not doing MURs?: Exclusive Survey: Louise Tamblin from TNS: P3 Magazine, April 2007, p22.

So you have decided to visit us on MUROnline at www.medicines-use-review.co.uk. You are exploring the site and you are wondering ‘why should I register?’.

Well, we will try and explain:

There are four registration levels you should be aware of. You will have to decide which one you are. We will use the ‘home’ analogy to illustrate the user levels.

MUROnline (at www.medicines-use-review.co.uk) is the home of the MUR Evangelist. If you want a room in that house, you must first register and then request to be an MUR Evangelist by agreeing with the 4-point pledge. This is the highest user level. Once your details have been verified, you can pretty much use all the facilities available on the website. As of the BETA release, you can start to submit articles relating to your experiences of MUR. You may sign your articles anonymously or with your full name. You may also want to restrict who can view your articles to validated users only.  Moreover you can start to use your evangelist or ‘EV’ code. Use this to inform employers that you have signed up to this unique family of pro-active pharmacists. Ask them to go to www.murevangelist.co.uk to find out more about you. You can ask us to include as much or as little information about yourself on these pages. Also as an MUR Evangelist, you are automatically registered to receive pharmacy bookings from employers (Findapharmacist facility). What we do is provide a facility whereby the employer can contact you. The employer requests the services of an MUR Evangelist online and we simply forward that request to you either by e-mail or by you logging on to a special area of the website. It is entirely up to you to follow up the request. If you like the job being offered, just contact the employer directly. Do this as soon as you can, as the job is open to all the rest of the evangelists in the house. The jobs are offered on a first come, first served basis. That’s not all, we hope to build a network of online resources, some only available to MUR Evangelists and/or other users.

Now, lets just say you are a visitor. You walk past the home of the MUR Evangelist and you think: ‘I like the design of the house’ or maybe you think ‘I’ll like a room in the house one day’ or you think ‘I wonder what they are excited about in that house’. That’s OK. The MUR Evangelists have nothing to hide. We invite you to come in and have a look. You can have a look in a number of ways. This brings us to the other user levels on MUR Online. When you first register on MUROnline, you are designated a Registered User. This allows you limited access to some of the resources on our website. As we build more of these resources, we will determine which resources you can access. Being a Registered user is like being invited into the grounds on which the home is built. You enjoy the landscaped garden, enjoy the superb architecture of the building and we may even put up a show in the garden to tantalise your taste buds. Unfortunately, however, you cannot come in! We need to know who you are before you can come in. This is not because we are some secret cult…Oh no! This is just simple courtesy. If you want to be allowed in (and most people are allowed in), we need to be able to validate your identity. If we are able to do this, then your user level will be upgraded to a Validated User. As a Validated User you are privy to our discussions on MUROnline. The only major restrictions is that you are not allowed to submit articles and you are not contacted through the ‘findapharmacist’ facility. You may however, use a lot of the other features of the website. You may be a validated user if you are a pharmacy student (at University), a pre-registration pharmacist, a doctor, a booker for a pharmacy chain or independent. Lay members of the public may choose to be validated users of our site but we attach a strong caveat to this. Information encountered on the site are for qualified professional users only and must not be a substitute for professional judgement. Always contact your local pharmacist or doctor for professional advice. Now if you are a Pharmacist but not an MUR Evangelist then you will be designated a Pharmacist provided we can verify your identity. We like to know who you are. You may not want to be an MUR Evangelist because you do not work in community pharmacy but just want to keep up with what the MUR Evangelists are talking about. You may even have important information you wish to communicate to the MUR Evangelists to enable them give better advice to their customers e.g. PCT Pharmacist describing local prescribing trends and recommendations or an hospital pharmacist describing the common problems to be aware of etc.

Now you see. There is space for everyone. In summary, there are 4 user levels on MUROnline and they are:

1. MUR Evangelist
2. Pharmacist
3. Validated User; and
4. Registered User.

Which user are you?

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MUROnline