MDS has become an area of pharmacy that many pharmacists love to hate, especially with the manual nature of preparing blister packs or nomad trays. For many, it represents hours of repetitive back-room work, soaking up the skills and time that could otherwise be devoted to patient-facing services. It is no wonder that 74% of MDS services in community pharmacy are already operating at full capacity, with teams spending on average 29 hours a week on this alone.
Yet despite the frustration, demand for MDS is undeniable. Patients rely on it heavily for safety, adherence and independence – and carers and families depend on it to make complex medication regimes more manageable. With an ageing population, growing levels of polypharmacy, and more people living independently for longer, this demand is only likely to increase.
Across Europe, MDS is widely used and valued, integrated into healthcare systems as a standard solution. It is vital the UK does not remain an outlier by denying patients the support they want and need.
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This is where a Hub and Spoke model can be transformational, opening the door for independents and small chains to partner with third-party hubs that can shoulder the burden of MDS preparation.
At a time when the industry has never felt more pressure, no longer does a pharmacist have to choose between continuing a service that bleeds time and money, or withdrawing a service that patients depend on. Outsourcing through hub and spoke offers a third path – one that is safe, scalable, and sustainable.
Over the last decade, some of the larger brands have signalled a retreat from MDS, but for a community pharmacy, it is often a cornerstone of local trust. Walking away from MDS would mean walking away from a group of patients who need support the most. It would also leave independents vulnerable to being seen as outdated, less safe, or unwilling to adapt to patient needs. For independents, the ability to continue offering MDS – without carrying its operational burden – could prove a vital differentiator.
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That is why automated medication pouching could become a game changer for smaller organisations, especially when partnering with larger hubs. The use of technology reduces the risk of manual error dramatically, with accuracy levels of 99.99% compared with error rates as high as 1 in 50 with manual trays.
That is a reputational game-changer in a world where families entrust us with their most vulnerable patients. At the same time, developing relationships with hubs can also massively shift the commercial model.
For example, a pharmacy with 300 MDS patients could generate more than £32,000 annually through modest patient charging at £8.90 per month – and that’s before you factor in the labour hours released to focus on Pharmacy First, vaccinations, medicines reviews, and care home services.
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Beyond the numbers, hub and spoke also offers something less tangible but equally important: resilience. Freeing up staff from repetitive tasks reduces stress and burnout, improves retention, and creates capacity for the work that inspires professionals to enter the sector in the first place. It also strengthens succession planning, with pharmacies then able to demonstrate efficient, profitable, and scalable operating models - that will inevitably be more attractive to buyers or family successors.
As an industry, we need to pause and recognise how monumental this legislation is. For independents, it is a once-in-a-generation opportunity.
That means the practical next step might not be a wholesale overnight transformation, but it is certainly something that needs to be piloted and tested straight away. Because it’s only with proper evidence that we discover what works – and what doesn’t – in real-world practice.
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Staff hours saved, errors reduced, and patient satisfaction levels can all be tracked in a controlled way - that allows for enhanced patient care, an opportunity to expand clinical offers or new clinics, and gives teams breathing space to thrive.
The introduction of hub and spoke is more than just a technical change in legislation though. It is a chance to reimagine one of pharmacy’s most persistent pain points. MDS has too often been pharmacy’s quiet contradiction: an essential patient service delivered at great personal and financial cost. But now it can become a driver of safety, efficiency, and growth.
The question is not whether MDS can be outsourced - that has already been answered. The real question is whether community pharmacies will act now, harnessing hub and spoke to turn a long-standing burden into a breakthrough.
Sophie Bartlett is commercial director at PillTime