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‘Long overdue’ or too costly? Sector split over hub and spoke announcement

The pharmacy negotiator has said it is “already working” with the government on hub and spoke implementation, while membership bodies have warned that the reforms will offer little benefit to the sector without “huge” investment.

Yesterday’s publication of the government’s response to its consultation on hub-and-spoke dispensing comes nearly two years after it closed submissions on its proposals.

Two models of hub-and-spoke dispensing will be permissible in community pharmacies from next year, once the Medicines Act 1968 is amended to permit hub-and-spoke dispensing across different legal entities.

Read more: ‘Level playing field’: Hub and spoke possible for all pharmacies from January

The legislative change – which has proved controversial for many years - has been closely watched by community pharmacy and the reactions to the announcement show a mixed response from the sector.

 

‘Long overdue’ reform

 

Community Pharmacy England’s (CPE) legal director Gordon Hockey said that hub and spoke reform was “long overdue”. 

Hockey added that CPE is “already working” with the Department of Health and Social Care (DH) “to consider the implications of these changes for NHS dispensing in England”.

“Much still needs to be done to develop a model that works for community pharmacy,” he said.

 

“Huge upfront capital investment”

 

Company Chemists’ Association (CCA) chief executive Malcolm Harrison said yesterday (May 13) that the organisation was “pleased” the DH had taken forward the proposals and responded to “feedback” from pharmacies, adding that it supports the “intention” to free up time for clinical work.

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

But Harrison warned that the community pharmacy sector would be “unlikely…to benefit from these changes” owing to the “financial strain” faced by the sector and the “huge upfront capital investment” needed to launch a hub as well as “ongoing operating costs”.

“The proposed changes will not release any capacity unless the government’s funding for medicines supply is increased,” he said.

 

Don’t cut the spoke out

 

National Pharmacy Association (NPA) chief executive Paul Rees implored the government to promote competition between hub pharmacies so that “independents have a choice of hub”.

Rees said yesterday that intercompany hub-and-spoke models “must not be allowed to cut the spoke pharmacy out of dispensing medicine”.

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

Nevertheless, Rees said that hub and spoke could be “a positive development” for the sector, noting its potential to make dispensing “efficient” and to provide pharmacists with more time to “deliver more clinical services”.

But Rees said that “new NHS funding for clinical services is required to make the business case stack up for the spoke pharmacies”.

 

Level regulatory playing field?

 

Healthcare Distribution Association (HDA) executive director Martin Sawer expressed concern that the legislation may not maintain a “level playing field” in the regulation of large medicines warehouses and hub pharmacies for the “last mile transportation of many medicines”.

“We will be reviewing the contents of the announcement to make sure [the maintenance of parity in regulation] is still possible under the proposals,” Sawer said yesterday (May 13).

 

“Act now”

 

Meanwhile, a spokesperson for hub and spoke service provider Centred Solutions also welcomed the government’s decision. 

Centred Solutions sales and marketing director Louise Laban said yesterday that pharmacies should “act now and start looking at your options”.

Read more: Could a hub-and-spoke model ever truly work for independent pharmacies?

Currently, hub-and-spoke dispensing is only permitted between pharmacies within the same legal entity – meaning smaller independent pharmacies have been excluded from the model. 

 

But from January 1 2025, all pharmacies will be able to supply medicines using one of two hub-and-spoke models, subject to parliamentary approval, the DH announced yesterday.

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