BOOTS could face an investigation from the pharmacy watchdog over allegations that staff were put under pressure to milk NHS schemes to increase profits.
It follows reports that the UK’s biggest pharmacy chain has ordered some staff to carry out medicine-use reviews (MURs) for people who do not need them.
Now the General Pharmaceutical Council, the pharmacists’ regulator, is calling in evidence surrounding the allegations.
MURs are intended for patients who fall into key groups, including those recently discharged from hospital and those taking high-risk medicines.
The health service pays £28 for every MUR and the NHS caps the number of MURs per pharmacy at 400 per year, but critics suggest some pharmacies see this as a target to bump up profits.
Last week, the Guardian said it has seen a 2008 email from a senior manager at Boots which said: “I personally don’t want colleagues to feel ‘brow-beaten’ but we do need to deliver our targets of 400 MCUs (medicine check-ups - another name for MURs) per store this financial year for two reasons: Delivering 400 MCUs is a measure of Excellent Patient Care.
“The company can make £28 profit for each MCU, so each one we don’t deliver is a lost £28.”
One Boots pharmacist in the Midlands told the newspaper he was directed by his managers to carry out an MUR on a man with dementia, and on himself. Another Boots pharmacist in north-west England remembered a staff away day at which he and his colleagues were told: “400 MURs is an expectation now. We don’t need to tell you that.”
Boots pharmacists responding to a Pharmacists’ Defence Association (PDA) union survey also reported being “pressurised into conducting MURs whether or not patients are eligible to receive the service” and “Boots keeps asking me for more MURs.”
John Murphy, general secretary of the PDA, said they had been telling the regulator and large organisations, including Boots, for years about the malpractice but they had “turned a blind eye or pretended it is not happening.” He said: “Our pharmacist members are telling us they are being forced to treat MURs as a profit-making scheme for the company.
“Either they stick to their ethical standards and ensure that the right people get the service irrespective of their financial targets or they satisfy their employer by achieving their profit objectives and keep their job.”
The General Pharmaceutical Council (GPhC) confirmed it is liaising with the PDA to obtain the findings of their survey and any other relevant evidence they hold. It added: “Our standards are clear that pharmacy owners have a responsibility to enable their staff to make the care of patients their first priority and to raise concerns with the relevant authority about any issue that may affect patient care or public safety.”
Boots said they took the reports “very seriously.” A statement added: “If we find any issues of undue pressure from managers we always seek to rectify them and our continued focus is on ensuring our pharmacists are supported and equipped in their role to continue delivering the best care to patients and customers.” In 1,135 routine inspection visits by GPhC, only one pharmacy was found to require improvement on measures relating to incentives or targets. In that case immediate action was taken.