The New MUR Form

Advanced Services Pharmacies providing the MUR service must use one of the two official forms recognised by the Secretary of State for Health. The original version 1 MUR form was superseded by the new version 2 form in December 2007. The version 1 MUR form can still be used until 30th September 2008 and it can be downloaded from the publications database.

The new version 2 MUR form

During 2006/07 PSNC and the Department of Health conducted a review of the NHS MUR form. The aim of the review was to streamline the NHS MUR form in order to make it more user friendly for pharmacists, GPs and patients. The review was informed by feedback from pharmacists, GPs, LPCs, PCTs and other stakeholders. A stakeholder engagement event was held, followed by a consultation on the proposed new form and then a period of testing by practising pharmacists.

The new NHS MUR form (version 2) was published by the Department of Health in December 2007. At the same time new amendments to the Secretary of State Directions were issued. Pharmacy contractors in England could start to use the form from 14th December 2007. The original version 1 form can continue to be used by pharmacy contractors until 30th September 2008.

What changes have been made

The version 2 form has been reduced down to two A4 sheets and the key details required by the patient's GP/Practice are all present on the first page - the Overview page. Specific changes made to the MUR form, as a result of feedback provided by stakeholders include:

All medicines (including OTCs/herbals) are listed in a single medicines column; cells have been segmented to prompt recording of drug name, dosage form, strength and dose.
There are a reduced number of rows for detailing the patient’s medicines, but further copies of page 2 can be used for patients on more than 6 medicines (Sheet X or Y field included to allow for this eventuality). Likewise multiple copies of page 1 may be completed if more than four action points are identified.
‘Dosage regimen as patient takes it’ column reworded as ‘Does the patient use the medicine as prescribed?’. A Yes tick box is provided and a space to annotate how the patient takes the medicines if not as prescribed.
‘Patient’s knowledge of the medicine’s use’ column reworded as ‘Does the patient know why they are using the medicine?’ with Yes/No boxes provided. An additional column – ‘More information provided on use of medicine’ – with yes/no tick boxes is also provided.
‘Are side effects present?’ – reworded as ‘Are side effects reported by the patient?’
The ‘Action Plan’ and ‘Next steps’ section on the back page have been moved to the front page in order to improve ease of use by GPs. The sections have been reworded.
Clinical codes for MUR have been added to facilitate recording of the MUR on GP systems (information provided by NHS Connecting for Health).

Using the new form

The amendments to the Secretary of State Directions provide new flexibilities to pharmacists in the way the form is used. Alongside the amendment Directions the Department of Health has also published Guidance from the Secretary of State on the use of the form. The content of the guidance is described below.

Communicating with the patient

The pharmacy contractor will always provide a copy of the full MUR form to the patient, i.e. both pages of the version 2 form.

Communicating with the GP/Practice

Pharmacy contractors are required by the Secretary of State Directions to communicate with the patient's GP following an MUR. The amendments to the Secretary of State Directions provide new flexibilities in relation to communicating with GPs when using the new version 2 form:

a) When there are items within the Action Plan that need to be considered by the GP/Practice pharmacy contractors are required to send the Overview page of the form to the patient's GP within 7 days of conducting the MUR.

The pharmacist should make a professional judgement as to whether it is necessary to provide the GP/Practice with the Consultation record page of the form. If the Consultation record page is not sent to the patient's GP at the time of sending the Overview page, then the GP will be able to request a copy of it, from the pharmacy should they require this.

b) When there are no items within the Action Plan that need to be considered by the GP/Practice then a completed copy of the version 2 MUR form need not be sent to the GP. In this circumstance the pharmacy contractor should notify the patient's GP that an MUR has been undertaken, without any matters for consideration by the GP, within a month of the MUR being conducted. The notification should indicate that the GP can request copies of the completed MUR form(s) from the pharmacy. A template notification form can be found by clicking on the link below:

Template Notification Form (MS Word)

N.B. When copies of the old form (version 1) are being used, the original requirement to send a copy of the full form (i.e. all 4 pages) to the GP on all occasions still applies.

Format of triplicate MUR form pads

Feedback on the MUR form triplicate pads used by some pharmacists suggests that certain colours of paper prevent the forms being scanned into GP systems.

Additionally the use of different colours for the ‘GP copy' by different providers of the triplicate pads reduces the ability of GP Practice staff to recognise the forms; there have been instances of the forms being mixed up with MAR chart re-order sheets.

Feedback suggests that a white copy of the form sent to GP Practices reduces scanning difficulties, as would the use of black ink when pharmacists complete the forms.

Where can I get the new version of the NHS MUR form?

The new version of the MUR form can be downloaded using the links below. A photocopy template was printed in the January 2008 edition of PSNC Community Pharmacy News.

New version 2 MUR form (PDF format)

New version 2 MUR form (Microsoft Word format)

A number of organisations have produced pads of self-carbonating MUR forms including:

National Pharmacy Association (call 01727 800401)

AAH Pharmaceuticals (call 02476 432000)

UniChem (customers should refer to their your portfolio 2 catalogue or call 020 8974 4035)

RX Systems have announced that their next release of the ProScript program will contain the new MUR form. EPS customers will be able to use it as soon as Connecting for Health signs off the new release.

Resources to help in raising awareness of the new form

It is important that pharmacy contractors, pharmacists and GPs are made aware of the availalbility of the new form.

A leaflet for pharmacists has been written which explains the main changes described above. This is available in PDF format and Microsoft Word format (which can be copied into local LPC newsletters etc.):

Pharmacist briefing leaflet (PDF format)

Pharmacist briefing leaflet (Microsoft Word format)

Additionally a briefing sheet for GPs and Practice Managers has also been written:

GP and Practice Manager briefing sheet (PDF format)

GP and Practice Manager briefing sheet (Microsoft Word format)

PSNC has written to all PCTs in England to highlight the publication of the new form:

Letter to PCTs (PDF format)

Frequently asked questions

How do I obtain a supply of triplicate MUR forms?

Triplicate pads of MUR forms can be obtained from the NPA, wholesalers and some buying groups.

Is there a way of filling in MUR forms electronically?

Yes. A number of options exist, including a Microsoft Word template and modules integrated within PMR systems. Click here for more information.

How long do I have to keep a copy of the MUR form?

The Secretary of State Directions for the Advanced services state that the pharmacist should keep a copy of the record for such a period as the PCT may reasonably require; within ‘Information for PCTs on Implementing the New Community Pharmacy Contractual Framework’, published by the Department of Health, it is suggested that a minimum of two years should be sufficient.

On the MUR form, what is the patient’s NHS code/number?

This is the unique NHS number that appears on the patient’s NHS medical card. If the patient does not know their NHS number/code then leave this part of the form blank. Patient’s NHS numbers are included in ETP prescription messages.

My PCT wants to add extra parts to the MUR form, can they do this?

No. The MUR form has been agreed with the Department of Health and approved by the Secretary of State. Although it might seem helpful to adapt the form for different requirements this would lead to huge number of different forms in circulation, leading to the associated difficulties for pharmacists who have to complete the forms, and patients and GPs who receive the forms. This potential inconsistency and confusion is avoided by the use of a nationally agreed and approved form.

Who do I give copies of the new form to when I complete a review?

Copies should be given to the patient and where appropriate the GP (see below).

Do I have to send copies of all MUR forms to the GP?

An element of autonomy has been given to pharmacists to decide whether or not all pages of the new version 2 MUR form should be sent to the GP. If there are no actions for the GP to follow up on then there is not an automatic requirement for a copy of the version 2 form to be sent to the GP.

If actions have been identified for the GP to consider, and the pharmacist is using the new form, then a copy of the Overview page should be sent to the GP; a professional judgement should be made on whether a copy of the Consultation record page needs to be sent.

N.B. When copies of the old form (version 1) are being used, the original requirement to send a copy of the full form (i.e. all 4 pages) to the GP on all occasions still applies.

Can I still use the old, version 1, forms?

The older forms may still be used until 30th September 2008, after which time it will be necessary to use the new version 2 form.

Will the pharmacy system suppliers update their integrated MUR forms within PMR systems?

The pharmacy software suppliers have indicated their intention to update their PMR systems to include the new form as quickly as possible. PSNC sent the companies a copy of the new form in August 2007 so they could start to prepare their software for the launch of the new form.

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