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MUR counter fraud service assessment exercise (updated)
See update at end of this article
PSNC has been contacted by a number of Local Pharmaceutical Committees and pharmacies following receipt of letters from Primary Care Trusts requesting that copies of all MUR forms for June 2009 be sent to the PCT.
These letters have been prompted by the NHS counter fraud and security management service (CFSMS), which wrote to Directors of Finance, asking them to make a request for forms for the purpose of post payment verification, and once the forms are received, the CFSMS will request a sample of the forms from the PCT so that they can write to patients to ask about their experiences of the MUR service.
This has raised two questions. First, is there a requirement in the Terms of Service to require copying and secure despatch of the forms to the PCT; and secondly, because these forms contain sensitive personal information, would the pharmacist be breaching confidentiality by sending copies of the whole of the MUR form.
The Terms of Service require a pharmacist to allow a person authorised in writing by the PCT to enter and inspect the pharmacy and to allow access to information required to confirm compliance with the Terms of Service. This does not therefore require pharmacists to produce copies of MUR forms and to send them to the PCT, but a person authorised in writing by the PCT could visit the pharmacy and ask to see relevant documentation.
There is a need to protect patient’s confidential information and monitoring by PCTs should ensure that there is the minimum disclosure necessary for the purpose of the monitoring – that is why in the NHS Primary Care Commissioning documents - ‘Community Pharmacy Assurance Framework’, anonymised copies of documents are favoured for most monitoring undertaken. One of the problems of the CFSMS proposal, is that for all 149,000 MURs conducted in June 2009, copies of complete MUR forms will be sent to PCTs as a result of which a sample will be selected for verification.
The MUR service is provided under arrangements set out in the Secretary of State Directions, and it is not clear that the pharmacist will be authorised under these arrangements, to furnish non-anonymised copies for the CFSMS exercise.
The Department of Health has been asked to advise on the extent to which the Secretary of State Directions may allow pharmacists to disclose complete copies for post payment verification purposes. PSNC is also due to meet the CFSMS as a matter of urgency to discuss the exercise.
Pharmacists should be aware that they may be challenged by patients if they do disclose information as part of the CFSMS fraud assessment exercise. We therefore advise pharmacists who are concerned about the risk of inappropriate disclosure of confidential information to await further guidance before voluntarily supplying copies of MUR forms to the PCT.
UPDATE
PSNC has met the NHS Counter Fraud Service to discuss the concerns about the MUR fraud assessment exercise. NHS Counter Fraud has written to Primary Care Trusts to ask that they defer any further action, pending receipt of legal advice, therefore pharmacy contractors should not send MUR forms to their PCT until further guidance has been issued.
PSNC remains committed to supporting fraud minimisation measures, but the methods used must be proportionate and protect confidential information from inappropriate disclosure.
Posted 19 October 2009