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Update: Profession responds to Boots MUR exposé

An investigation by The Guardian, published on April 13, has claimed that managers at Britain’s biggest pharmacy chain are directing their pharmacists to provide medicines use reviews to patients who didn’t need them, in order to claim public money from the NHS.

The full story can be read here.

'How Boots went rogue' – click here.

The company (April 14) issued a statement in response to the story:

“Our professional standard is clear: services must be for the benefit of patients not the attainment of numerical targets and are fundamental in helping customers make the most of their medicines in managing their conditions effectively. We have today reminded our pharmacists of our existing guidance (previously issued in 2014) as we fully support their professional judgment to assess the appropriateness of a clinical service and these services,” said Boots UK.

“Offering the best care to patients is at the heart of everything we do and this includes offering pharmacy services that are relevant to the changing needs of patients and healthcare systems. Our pharmacists are empowered to use their professional judgment to assess the appropriateness of a clinical service, and we make it clear to our colleagues that these services should not be undertaken inappropriately.”

The company defended the role of community pharmacy in offering services such as MURs and its own approach.

“Providing accessible healthcare through community pharmacies has always been integral to Boots mission. We believe community pharmacy today plays a vital role in supporting the UK health system and we actively support NHS initiatives such as medicines usage reviews."

The statement also said: “We don’t recognise the claims in today’s press, which are not representative of the 60,000 colleagues who work for Boots UK and our commitment to developing healthcare further. The health and wellbeing of all our colleagues is, and always has been, a priority for the business.

“Over the last ten years, our group has continued to significantly re-invest profit right across Boots UK. We are absolutely clear that the drive for strong financial performance has never been to the detriment of our constant priority on pharmacy, and delivering the best healthcare services in the communities we serve.”

Boots dispenses more than 220 million prescriptions every year in the UK, said the company. “We strongly believe that community pharmacy today, more than ever, plays a vital role in supporting the UK health system.”

Updated 3.10pm, April 14:

Society questions staffing levels in pharmacy

Reports in The Guardian regarding Boots will make difficult reading for many in the sector, said RPS English Board Chair, Sandra Gidley, in a statement.

“We can state unequivocally that the vast majority of pharmacists are doing everything they can to provide great patient care and are using precious NHS resources as effectively as possible.

“The medicines use review and new medicines service are important NHS services that can make a real difference to medicines use and patient outcomes. We are very disappointed to hear these reports of substantial commercial pressures which directly contradict both regulatory and professional standards. The RPS believes that as health professionals, individual pharmacists must have professional autonomy when providing patient care wherever they are working.

The Guardian article raises important questions about staffing levels in community pharmacy. The reports of unacceptable pressures that pharmacists are working in have been raised with us by individual members, in various settings and there is an urgent need to address the issue of target setting and unacceptable commercial pressures within large company settings.

“In an era of openness and transparency, it would be good for pharmacists, the NHS and the public to be aware of staffing levels in community pharmacies. We would encourage all employers to consider how this could happen.”

Updated April 16:

Rob Darracott, chief executive of Pharmacy Voice, said the story had already caused “significant harm” to the reputation of community pharmacy and the wider profession.

“MURs are an important service that is having a positive impact on some of our most vulnerable patients. It is also one of the clinical services where we must demonstrate success if we are to make the strongest possible case to deliver more advanced services in the future.

“Put simply, we do not have the time to turn inwardly when our window of opportunity to influence Government thinking on their damaging proposals is narrowing by the day. We should be under no illusions – stories like this undermine the case for the sector and, in the eyes of the public, damage the reputation of our profession.

“We all know what our community pharmacy teams can achieve when they are at their best: the stories being collected from the public as part of the campaign bear full testament to the life affirming, life changing and life-saving interventions being made every day.

“So, whether our best is providing a first-rate service to our patients or fighting off ill thought-out Government proposals, right now we can ill-afford to do anything less.”

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