The UK Government has launched a consultation that will consider whether it should change the law to allow all community pharmacies to use hub-and-spoke dispensing models.
The 12-week consultation, which opens today (16 March), is seeking views on the Government’s plans to amend the Medicines Act 1968 and the Human Medicines Regulations 2012, which would allow the operation of hub and spoke dispensing models across different pharmacies.
As it stands, pharmacies can only use hub and spoke models if the spoke pharmacy forms part of the same retail business as the hub pharmacy. This means that chain pharmacies are the main properties using the hub and spoke model.
However, the proposals would mean that hub and spoke dispensing could happen across separate businesses, which Department of Health and Social Care (DHSC) has claimed will ‘level the playing field’ between larger chains and smaller pharmacies.
Under the proposals, hubs will need to be registered pharmacies to ensure that spoke and hubs operate within the same regulatory framework which promotes patient safety. There is also a proposal to allow dispensing doctors to access hubs, though they will not be able to function as a hub.
Benefits of hub and spoke
DHSC said that changes to this law would mean independents could ‘group together’ to split the cost of setting up a hub, and free up time by being able to outsource elements of the dispensing process to other pharmacies, meaning they could concentrate on more ‘clinically focused tasks’.
The DHSC added that the model may help with cost-saving, as ‘hub pharmacies with a higher volume of dispensing may be able to negotiate better deals with suppliers’.
These savings would then be ‘passed onto spoke pharmacies’ and ‘the spokes may also experience a cost-saving,’ the DHSC said.
Two hub and spoke models proposed
The government has proposed two separate hub and spoke dispensing models: one whereby a patient’s prescription is assembled by the hub and sent back to the spoke to make the supply, and another in which the hub supplies the prescription directly to the patient.
It is proposed that hub and spoke entities decide among themselves which business has ‘responsibility and accountability’ for each step of the dispensing process.
Nick Kaye, vice-chair on the National Pharmacy Association (NPA), welcomed key points in the consultation, in particular the fact that hubs will need to be a registered pharmacy.
‘[This] is something that we have long called for in the interests of patient safety and professional accountability,’ Mr Kaye explained.
However, Mr Kaye called for greater investment in services in order to produce ‘real value’.
‘Hub and spoke only adds real value when there is investment in services at the spoke, taking advantage of time freed up by the hub operation. Without a step change in investment by the NHS, this whole project is an empty shell', he said.
He added: ‘The consultation acknowledges the potential competition issues that go to the heart of whether hub and spoke can deliver a level playing field, as the Government promises.
‘This includes those pharmacies that cannot access it due to logistical reasons, for example, pharmacies in remote rural areas of the country,’ he explained.
In 2016, the Government looked into changing the law to facilitate hub and spoke dispensing among separate pharmacies, however this was paused after concerns were raised around safety.
Pharmacists who wish to respond must do so by 8 June.