Former pharmacy minister and chair of the health and social care committee (HSCC) Steve Brine has said he ‘doubts very much’ that changes to hub and spoke legislation is the answer to problems faced by independent community pharmacies.
At the Sigma Pharmaceuticals UK conference last weekend, Mr Brine described the government’s silence on hub and spoke dispensing as ‘a critical blockage’, leaving community pharmacies ‘stuck in limbo’ without clarity on the future of dispensing.
But in response to comments against hub and spoke dispensing from those present at the event, he suggested that the approach would most likely not solve the sector’s problems, stressing the importance of holding the government to account on its decisions.
The government committed to ‘pursue legislative change to allow all pharmacies to benefit from more efficient hub and spoke dispensing’ in 2019 as part of the community pharmacy contractual framework (CPCF).
A consultation on legislative changes to enable hub and spoke dispensing across different pharmacies was launched by the Department of Health and Social Care (DHSC) in March 2022.
Two hub and spoke dispensing models were proposed: 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.
The consultation closed in May 2022, and Mr Brine suggested to Sigma conference delegates that the government had ‘done all the work on the consultation’ and was now ‘sitting there and … kicking it around’ between DHSC and the Treasury.
He described the lack of progress on the issue as ‘a critical blockage’.
‘Until the government decide what it wants to do on hub and spoke, I think we've got a problem,’ Mr Brine said, suggesting that independent contractors were ‘stuck in limbo’ without clarity about what the role of dispensing would be in the future.
And he said that while he understood that community pharmacies are paid according to their dispensing volume, ‘until we clear those decks [of dispensing workload] it's going to be very hard for the community pharmacy on the high street to be those primary care centres I used to go on about while I was the minister’.
The NHS England long-term workforce plan is based on predictions that hub and spoke dispensing will increase 2% a year, freeing up capacity within community pharmacy to deliver more clinical services.
Mr Brine said that he hoped that the cross-party HSCC could ‘turn up the heat under their feet’ and push the government to give more clarity on the future of dispensing.
But one delegate present at the conference spoke out against the ‘mechanisation’ of hub and spoke dispensing, stressing the importance of an ‘intermediary’ in the system to ensure patient safety.
Mr Brine responded: ‘Nobody’s saying hub and spoke is the answer to your problems, I doubt very much it is.’
But he told contractors: ‘The fact is, is the government has set that hare running and done a big consultation on it and they're going to come forward with an answer to that consultation, which you're going to have to live with and they did it outside of talking to you.’
And he said that part of the reason why the upcoming HSCC pharmacy inquiry was taking place was ‘because we're going to pull them before us to try and answer’.