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HSCC chair ‘fearful’ of ‘disastrous’ government hub-and-spoke decision

Steve Brine has predicted that contractors “won’t like” the government’s response to its hub-and-spoke consultation.

Steve Brine, chair of the health and social care committee (HSCC), told delegates at the Sigma UK Community Pharmacy 2023 conference on Sunday (November 5) that he is “fearful” of the government’s response to its consultation on hub-and-spoke dispensing.


The consultation, launched in March 2022, asked the public for views on whether the government should change the law to allow all community pharmacies to use hub-and-spoke dispensing models.


Read more: Government ‘finalising’ hub-and-spoke consultation response


Currently, the law does not allow hub-and-spoke arrangements between different businesses – meaning this is not an option for independent pharmacies.


The consultation proposed two models of hub-and-spoke dispensing:


  • A ‘spoke-hub-spoke’ model where the patient presents their prescription to the spoke pharmacy and 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.
  • A ‘spoke-hub-patient’ model, which is the same as the above but the hub sends the medicines directly to the patient’s home rather than to the spoke pharmacy



“I don’t think it will be what you will like”



Speaking as part of a panel discussion at the conference, Mr Brine said that he believes that the government’s response was “going between” the Department of Health and Social Care (DH) and the Treasury.


He said that many people were “stuck in limbo” by the government’s long-awaited answer to the consultation.


But he added that he’s “not so bothered about when they come forward” with a response but rather is “fearful of what they're going to come forward with”.


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


He said that he wants the HSCC, as part of its pharmacy inquiry, to “inject” itself into the consultation process before the government produces a “disastrous answer”. 


“I don't think [it] will be what you will like and it certainly won't be what the contractors in my constituency will like,” he added, although he stressed that he doesn’t “think [the government has] decided” yet.



Preferred model?



Also speaking on the panel, Community Pharmacy England (CPE) chief executive Janet Morrison suggested that the government favours the hub-spoke-patient model over the spoke-hub-spoke model.


This, said Ms Morrison is “of course, not what we want”. 


Read more: ‘The DH’s hub-and-spoke dispensing consultation remains silent on key areas’


Dr Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies (AIMp) had earlier deprecated talk of hub-and-spoke as a solution to the problems faced by community pharmacy, calling the system “no panacea”.


She asked conference delegates, many of whom were contractors, whether they would willingly give prescriptions to hubs to dispense medication for them, as proposed by the spoke-hub-patient model.


Her question was met with a resounding chorus of opposition to that proposition.


Read more: Hub and spoke could pose long-term competition risks, watchdog warns


A DH spokesperson told C+D that it is committed to pursuing legislative changes to enable all community pharmacies to make use of hub-and-spoke arrangements.


They said that both the consultation response and the timetable for the implementation of the legislative changes are being finalised, but that it aims to publish the response as soon as possible. 


Read more: Big Debate #4 – Could a hub-and-spoke model ever truly work for independent pharmacies?


In a March 2022 analysis for C+D, pharmacy lawyer Noel Wardle noted that the consultation on hub-and-spoke was “silent” on a number of questions, including the prospect that supplies could be made directly to patients from unlisted pharmacies - as hubs will not be NHS pharmacies.


But some have argued that hub-and-spoke will help give pharmacists more time to provide clinical services.


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


Last month, EMIS Health clinical director Sima Jassal proposed that it could “free up a pharmacist’s time to deliver additional services - including clinical and accuracy checks within the patient medication record”.


Also in October, C+D reported that pharmacy minister Neil O’Brien had said that a government response to its hub-and-spoke consultation will be published “as soon as possible”.

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