AUR vs MUR

AUR vs MUR

The following table outlines the key differences between an Appliance Use Review (AUR) and a Medicines Use Review (MUR):

  MUR AUR
Criteria and limits Can only be carried out by a pharmacist. Can be carried out by a pharmacist or a specialist nurse.
Yearly limit of 400 MURs per pharmacy. The number of AURs carried out should not exceed more than 1 per 35 specified appliances dispensed.
Application requirements The pharmacist must satisfactorily complete a competency assessment undertaken by a Higher Education Institution. The pharmacist (or specialist nurse) must submit to their local NHS England team documentary evidence of their qualifications and provide details of their competency in respect of the use of the specified appliances.
Before beginning to conduct MURs, the local NHS England team should be notified of the intent to do so. Before beginning to conduct AURs, both the local NHS England team and the NHS BSA should be notified of the intent to do so.
The pharmacy must have a consultation area clearly signed as an area for confidential consultations, which allows the patient and pharmacist to sit down together and have a conversation without being overheard. If the AUR is carried out at the pharmacy, the consultation area must satisfy the same criteria as the MUR consultation area. The community pharmacy contractor must also, having regard to the nature of appliances and the underlying purpose of the AUR, consider whether the consultation area is suitable for a consultation to determine how a patient uses an appliance and the extent of the patient’s knowledge about it. For example, this may include assessing the need for visual privacy during an AUR consultation.
Requirements For patients who have used the pharmacy for the previous three months (not applicable for Prescription Intervention MURs), 70% of MURs carried out, should be for patients belonging to one or more of four specified national target groups (people taking high risk medicines; those recently discharged from hospital with changes made to their medicines whilst in hospital; those with respiratory disease; and those at risk of or diagnosed with cardiovascular disease and regularly being prescribed at least four medicines). For patients  who are using a ‘specified appliance’.
A patient eligible for an MUR and the New Medicine Service (NMS) will not be able to access both services at the same time. The pharmacist should use their judgment to determine which service would be most beneficial for the patient.

The patient will not normally be eligible for an MUR within six months of completing NMS, unless in the reasonable opinion of the pharmacist, the patient would benefit from an MUR during that period.

Can be conducted on a patient who is taking part, or has taken part in the New Medicine Service (NMS).
Written consent must be obtained from the patient. Written consent must be obtained from the patient.
If an MUR is carried out other than in the consultation area in the pharmacy, the pharmacy must first obtain consent from the local NHS England team. The AUR service can be provided in the patient’s home or at the pharmacy. Consent from the local NHS England team is not required for the off-site AURs, but the original notification must indicate where they are to be undertaken (i.e. in patient’s homes and / or at the pharmacy).
An MUR can be carried out over the telephone if consent is granted by the local NHS England team. An AUR can only be carried out in person.
Notification that an MUR was undertaken must be sent to the GP if an issue is identified during the MUR where the pharmacist believes the GP should be informed. In this circumstance, the pharmacist must complete a copy of the nationally approved MUR feedback form and send it to the GP practice.  An overall report of MURs carried out, is also sent to the local NHS England team quarterly. Notification that an AUR was undertaken must be sent to the GP along with other information the pharmacist or specialist nurse feels is necessary. This information should also be copied to any nurse and providing relevant care to the patient, if it is known that there is such a nurse.
Funding £28 per MUR.

£28 per AUR conducted on pharmacy premises and £54 per AUR conducted at the patient’s home. If more than one off-site AUR is conducted in the same location within a 24hr period, then £54 is paid for the first AUR and £28 for each subsequent AUR in this location.

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