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CCA boss: Hub and spoke ‘one way’ to help solve pharmacy workforce crisis

Implementing hub-and-spoke dispensing models may prove “one way to release capacity” for pharmacists by helping to relieve some of the workforce pressures the sector currently faces, Company Chemists' Association CEO Malcolm Harrison has said.

Mr Harrison made his comments during a panel session on hub-and-spoke dispensing at the Pharmacy Show in Birmingham on Sunday (October 16).

Introducing this kind of dispensing more widely would help release pharmacists’ time to “do other, more clinical, work” – as it is understood that NHS England and the government wish for pharmacies to deliver more clinical services, he told delegates.

“It would take away some of the operational challenges they face on the dispensing side of things,” he added.

In light of the current workforce pressures in community pharmacy, the wider implementation of hub-and-spoke dispensing models needs to be driven forward, as “there’s got to be some benefit” from it, Mr Harrison added.

The last few months have seen the sector embroiled in a debate around the cause of workforce issues in community pharmacy and whether these are due to a shortage of pharmacists or rather a lack of pharmacists willing to work in the sector in its current state.

Read more: PSNC CEO: Government must stop recruiting ‘clinical’ pharmacists into PCNs

If pharmacies are to offer more clinical services, more capacity needs to be created for pharmacists, Mr Harrison argued.

“Unless there is a pharmacist tree somewhere and we can find more pharmacists, we’re going to need to do things differently to release the clinical capacity for pharmacists,” he told delegates.

“Hub-and-spoke is one solution and I think it’s important that [it] is explored. I think it’s important that we give it a go.”


“Just enabling the legislation is one thing”


In March, the Department of Health and Social Care (DH) launched a consultation that proposed making legislative changes across the UK to allow the operation of hub-and-spoke dispensing across different legal entities, setting out two proposed models for this.

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.

However, Mr Harrison warned Pharmacy Show delegates that while there are “significant benefits” to be found from “automated supply”, hub-and-spoke dispensing is not without “risks”.

There are “huge risks” involved with set-up fees, production costs, “the robotics on the logistics side of things”, and software and integration, he said.

“What you need is certainty to be able to invest,” he added. “Will it work at a local level? That is something that the market will need to decide once the legislation has changed.”

But besides enabling the legislation, “we need a contractual framework, and we need the NHS to commission for workforces to be freed up in the spoke pharmacies, so that they can then utilise the workforce”, Mr Harrison added.


Hub and spoke will allow teams “to breathe”


Mayank Patel, the managing director and superintendent pharmacist at Pearl Chemist Group – who also sat on the Pharmacy Show panel – told delegates that “our workforce is very stressed. Our pharmacists are really tired, they’re stressed and they’re burnt out”.

Dispensing medicines via a hub-and-spoke model “allows them to breathe”, he added.

“By taking that work away from them and letting them walk up to patients and be more patient-centric, they’re actually in the better place. And we can then provide services to the patient, for the patient.”

Read more: Phoenix UK and Peak Pharmacy invest millions in hub-and-spoke models

In July, the Competition and Markets Authority acknowledged “potential longer-term competition risks” that could materialise in its response to the DH’s impact assessment of its two proposed hub-and-spoke dispensing models.

Meanwhile, in June, the Pharmaceutical Services Negotiating Committee (PSNC) suggested that the DH’s hub-and-spoke dispensing proposals offer “virtually no financial efficiencies” for pharmacies.


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