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Hub and spoke: NPA says DH’s £4k set-up cost per pharmacy is ‘very low estimate’

The DH’s estimate for hub-and-spoke implementation costs for each pharmacy “appears to be a very first glance” due to the “likely costs” adopting this model could incur, a National Pharmacy Association (NPA) director has told C+D. 

The Department of Health and Social Care (DH) has estimated that it will cost an average of £4,000 per pharmacy to complete the preparatory work necessary to operate within a hub-and-spoke dispensing model.

This takes into consideration “investment in IT systems, training, and process redesign”, the DH wrote in a document assessing the potential impact of two different proposed community pharmacy hub-and-spoke models (see below) published earlier this week (March 16).


Read more: Average hub-and-spoke set-up cost £4,000 per pharmacy, DH estimates


The NPA’s director of corporate affairs Gareth Jones told C+D that pharmacies that become a “spoke” will “require significant process re-engineering, re-deploying staff and changing the way medicines move through the pharmacy”.

“What’s more, to take full advantage [of the dispensing model] in terms of providing more pharmacy services also implies investment in premises including consultation rooms,” Mr Jones added.

Just last month, he told C+D that the “vast majority” of independent pharmacies are “still sceptical” about the hub-and-spoke model.


The two proposed 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.


PSNC “carefully considering” proposals


The DH committed to removing the barriers currently preventing all community pharmacies from benefiting from the hub-and-spoke models as part of the five-year funding settlement for England, in part to free up pharmacists’ time to offer more clinical services.

Last week (March 16), it launched a consultation on whether it should change the law to allow all community pharmacies to use hub-and-spoke dispensing models.


Read more: DH launches long-awaited pharmacy hub-and-spoke dispensing consultation


Currently, only pharmacies that are part of the same business can use the model, which the DH wants to change because this would “level the playing field between large chains and smaller pharmacies”, it said in a consultation document.

The Pharmaceutical Services Negotiating Committee (PSNC) told C+D that it will respond to the DH’s consultation in due course.

PSNC legal director Gordon Hockey added that the negotiator will be “carefully considering the proposals set out to make sure the models taken forward will allow the whole sector to benefit fairly”.

Pharmacists have until June 8 to respond to the DH’s consultation on the hub-and-spoke dispensing models.


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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