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CCA boss questions DH’s ‘assumptions’ about hub-and-spoke model

The Company Chemists' Association (CCA) CEO Malcolm Harrison has raised concerns over “both the number and scale of the assumptions” in the government’s impact assessment on hub-and-spoke dispensing.

The Department of Health and Social Care’s (DH) “promises” regarding “improved capacity and cost-savings” are “unlikely to be realised at all” within the five-year rolling funding deal for community pharmacies in England, Mr Harrison said today (April 5).

The CCA examined the DH's proposals and accompanying impact assessment on allowing all pharmacies to operate under a hub-and-spoke dispensing model, which were set out in a document released last month (March 16).

While the CCA welcomes “the long-awaited release” of the DH’s consultation on hub-and-spoke dispensing – which set out two proposed models that could be rolled out – it sought to debunk some of the government’s “claims”.

C+D has approached the DH for comment.


Who does the DH think will benefit from the models?


The DH estimated that up to 4,122 pharmacies could benefit from the legislative changes it is consulting on. It also believes that implementing hub-and-spoke dispensing could shave off “40% to 50%” of the time it takes to dispense medication, C+D reported last month.

However, the CCA disputed the DH’s belief that the proposed models would bring benefits and increase capacity within pharmacies.

On the contrary, it said, hub-and-spoke dispensing “only delivers capacity benefits if there is additional investment to either move the workload to a hub, or fund additional activity in the spoke”, according to the “experience of CCA members”.


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


Mr Harrison also specified that neither the CCA nor its members have called for this legislative change.

This “direction of travel” was “initiated by parties from outside of the CCA and its membership”, he said. 

“Over the last decade,” the CCA wrote, “local services have been systematically scaled back in response to government challenges”. 

Pharmacies’ reduced service income under the current “flat national funding envelope” means that “a network of hubs across the country” is not “warrant[ed]”, it said.


 CCA calls for “evidence-led” approach


The DH’s impact assessment on hub and spoke “makes predictions on a yet unborn market, stretching 10 years into the future”, Mr Harrison said.

Although hub-and-spoke does have “potential to enable new dispensing models in the future”, that cannot happen without “new commissioning [to] support a change in operations”.


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


As such, he cautioned against “firm predictions about likely benefits without stronger commitments to enablers of change”.

It is also vital that policy changes following the hub-and-spoke consultation should be “evidence-led” and “based on robust data and the lived experience of pharmacy businesses”, Mr Harrison stated.

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


DH working to ensure model serves patients and pharmacists 


Responding to the CCA's comments, a DH spokesperson told C+D it is "working to ensure this model works in the interests of patients and pharmacists, allowing pharmacists to undertake broader, more clinical roles". 

“We want community pharmacies to play a bigger role in the delivery of health and care, and the government committed to holding a full public consultation on the possible extension of hub and spoke dispensing", they added.  


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