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DH launches long-awaited pharmacy hub-and-spoke dispensing consultation

The Department of Health and Social Care (DH) is asking for views on whether it should change the law to allow all community pharmacies to use hub-and-spoke dispensing models.

Currently, the law does not allow hub-and-spoke arrangements between different businesses, which the DH is committed to change as it would “level the playing field between large chains and smaller pharmacies”, it said in a consultation document published today (March 16).


Read more: ‘Pharmacy's hub-and-spoke model: we must consider the profound business impact’


The changes proposed in the consultation – which will close on June 8 – would apply across the UK, the DH specified.

Pharmacists can respond to the consultation here.


Changing the law and consulting on proposals


In November last year, the DH published the results of an eight-week consultation it ran in 2016 on proposed changes to medicines legislation, which included questions on the pharmacy hub-and-spoke model.

However, the latest consultation will seek views on more that just removing the restrictions that are preventing hub-and-spoke models from being used by all pharmacies, the DH said.

Respondents will also be asked to share their views on policy proposals that have been put forward to “reflect the nature of the change and to ensure that patient safety is maintained”, it said.


Patient safety at heart of proposals


The DH’s policy proposals have patient safety “at the forefront”, it said.

“We have explored different options in terms of how to ensure the proposals do not adversely affect patient safety, what needs to be in the legislation that give effect to these, and what should be addressed through professional standards to assure this,” the DH wrote.


Read more: NPA: ‘Vast majority’ of independents ‘still sceptical’ about hub and spoke


The proposals should not “stifle innovation”, it acknowledged, and it believes its vision offers the flexibility required for local implementation.  

Some of the proposals include:

  • Amending section 10 of the Medicines Act 1968 – which at present only allows the hub-and-spoke model between businesses owned by the same company
  • Allowing dispensing doctors to access the dispensing hub
  • Requiring that the hub is a registered pharmacy
  • Amendments to the Human Medicines Regulations 2012 and the Medicines Act 1968 – which would allow for two different hub-and-spoke models (see below)

The two hub-and-spoke dispensing models

First model: Patient presents prescription to the spoke pharmacy. The pharmacy sends it to the hub, which prepares and assembles the medicines. These are sent back to the spoke, which supplies them to the patient.

Second model: Same as above but the hub sends the medicines directly to the patient’s home rather than to the retail pharmacy.”


The consultation also asks whether there are “further hub-and-spoke models which should be considered” and whether pharmacies should "display a prominent notice to inform patients that hub and spoke dispensing is being used”.


Read more: Numark CEO: Hub-and-spoke ‘very successful’ for Rowlands but independents should find ‘different solution’


The National Pharmacy Association (NPA) vice chair Nick Kaye said the NPA will “carefully scrutinise the proposals to determine whether they have gone far enough to address our concerns”.

“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,” Mr Kaye added.

Could a hub-and-spoke model ever truly work for independent pharmacies? Catch up with C+D's fourth Big Debate on the C+D Community.


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