Whilst many pharmacists agree that MURs are a good development for the profession, sadly, the obsession of some large organisations to treat MURs as a vital income generator has led to many pharmacists being harassed to deliver rigid targets regardless of their achievability.
Since the last article on MURs in the Winter 2009 edition of Insight, the PDA has helped hundreds of its members to deal with unreasonable pressure from managers to perform MURs.
The PDA is aware of some tragic cases where pharmacists have buckled under relentless pressure from managers to meet targets and have even gone as far as resorting to falsifying company records to keep disciplinary action at bay. Such activity cannot be condoned and is soon exposed through company audits, which ironically have been tightened due to a rise in such cases. It is the view of the PDA that some companies may believe that the financial rewards generated from their pharmacist workforce being “encouraged” to produce large numbers of MURs are probably deemed by them to outweigh the “collateral damage” caused by some of their more vulnerable employees being disciplined and dismissed when they succumb to the pressures they are under and resort to ‘out of character’ behaviour.
However, pharmacists should be encouraged by a number of successful experiences that PDA members have had in tackling undue pressure from company managers. Employment legislation and company policies can give significant protection from bullying behaviour and this coupled with robust PDA Union representation has dealt a wakeup call to arrogant and bullying managers.
In order to help other pharmacists realise they have the power to stand up to their employer, we have detailed how some of our members have made their working lives a lot easier.
Area manager receives a gross misconduct verdict for aggressive behaviour
John was subjected to increasingly threatening emails about his MUR performance over a period of six months. John’s area manager refused to believe that he was doing all he could to deliver the MUR target; visits and communications from the area manager became increasingly aggressive.
After contacting the PDA for advice, John was advised to keep a diary about his treatment and archive the emails he was sent. John was determined to try and deal with the pressure he was facing with as little fuss as possible and forwarded some of the worst emails to a senior pharmacist in his employer’s organisation in the hope that this would mean the area manager would stop bullying him. Unfortunately this inflamed the situation and the area manager angrily remonstrated with John at his next visit for going over his head. The bullying got worse after this and John agreed with his PDA case manager that the only option was to submit a formal grievance direct to the pharmacy superintendent.
As part of the support provided to members, John was helped to construct and articulate his grievance by an experienced advisor who also provided personal representation at the meetings. The pharmacy superintendent was provided with an extensive dossier of information and John gave a full account of what had been happening. John had followed the PDA’s advice very closely, the evidence that was presented was overwhelming and after a number of witnesses were interviewed, the pharmacy superintendent upheld every point of John’s grievance and agreed that the behaviour of the area manager was unacceptable and the emails he sent were threatening and aggressive.
John was then asked what he wanted as an outcome to his grievance and decided that due to the behaviour of the area manager which appeared incapable of being rectified, he no longer wished to work for him. As a result of the grievance, the area manager was disciplined for gross misconduct and issued with a severe sanction, including having John’s store being removed from his area.
Non-Pharmacist store manager is demoted
Another pharmacist had severe problems with her store manager pressurising her to complete MURs. This non-pharmacist store manager even waited outside the consultation room and harassed the pharmacist in front of patients to see if an MUR had been completed so that he could enter better figures onto his area manager’s report. The manager’s behaviour gradually got worse and culminated in some very offensive comments being made to the pharmacist after the manager lost his temper with the pharmacist for not meeting the MUR target.
Like in John’s case the pharmacist was given extensive support to raise a grievance and was represented by a PDA union official at the meeting to discuss her concerns.
As a direct result of the PDA’s intervention, the non-pharmacist store manager was disciplined for gross misconduct and removed from his managerial position. Both of these examples show that by using established employment processes along with support from the PDA, pharmacists can protect themselves from the bullying behaviour that seems prevalent in some organisations.
Advice On How To Handle Pressure On Mur Delivery
Pharmacists can help protect themselves from being disciplined for MUR performance by following some simple steps and by seeking advice from the PDA at an early stage.
- Don’t agree to a target that you know to be unachievable. Target setting should be a two-way process and the objectives agreed should be realistic and attainable within the resources you have.
- Always contemplate the professional and patient interest considerations – you should only be undertaking an MUR when it is in the patient’s interest to undertake one. This, and not employer business-driven targets, should define whether an MUR is to be undertaken or not.
- Never agree to a rolling target where the next day’s target increases if the current day’s target for whatever reason cannot be met.
- If you are unable to reach a target without extra support, resources or training being provided by the company, it is essential that this is documented at an early stage and that this is communicated to your line manager.
- When circumstances outside your control prevent you from reaching a target, make a note of these for discussion at review time.
- If you experience bullying, harassment or generally unacceptable behaviour at work from your line manager, then keep a diary of events and retain copies of emails or other correspondence that will help you prove this if needed at a later stage.
- If matters start to get out of hand then make contact with the PDA for advice as soon as possible.
Developments at Co-op
Some pharmacists employed by the Co-operative pharmacy have found themselves invited to disciplinary meetings for failing to meet the company target of two MURs per day. Some documents seen by the PDA confirm that any shortfall in the MUR target on one day has to be made up on subsequent days. This approach clearly has the potential to place enormous pressure on pharmacists when workload or lack of suitable patients makes two MURs per day an impossible goal to reach, let alone three or more on subsequent days.
As part of its support to members, experienced PDA representatives have been supporting members who have been called to disciplinary meetings established by Co-op. Ahead of these meetings, they made contact with the HR advisors supporting the disciplining managers in order to request information needed for the members to defend themselves.
The PDA is pleased to note that in every case where members have come to us for advice about being disciplined by the Co-op for failing to meet MUR targets, the meetings have subsequently been cancelled and the allegations dropped after our intervention.