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Government still mulling contested hub-and-spoke law change

Keith Ridge: Does not know if government will push ahead with original plans

England’s chief pharmaceutical officer Keith Ridge has confirmed to C+D that the government is still consulting stakeholders about its plans to expand the use of hub-and-spoke dispensing.

Speaking to C+D after his session on professional leadership at the Royal Pharmaceutical Society’s (RPS) annual conference last Monday (September 5), Dr Ridge said that a meeting was scheduled for later that week, where the government could gather “further stakeholder engagement” around its plans to allow independent pharmacies to legally operate automated dispensing hubs.

However, Dr Ridge was unsure whether this was a sign that the government will proceed with its original plans.

“Will the government push ahead with the legislation it proposed? The answer is I don’t know,” he said.

“It’s more [a case] of ‘let’s see what happens with the stakeholder engagement groups’,” he added.

In May, Dr Ridge was forced to backtrack on his “inadvertently misleading” statement implying that a 3% dispensing error rate in England could be reduced to “0.00001%”, if the country adopted the “large-scale automated dispensing facilities” that are used in Sweden.

Pharmacy bodies used a consultation earlier this year on the proposed hub-and-spoke changes to criticise the government’s “lack of clarity” around how the model could save money and improve patient safety.

Multiples unlikely to scrap model

When asked by C+D at the conference whether the hub-and-spoke proposals would have to be radically changed in order for the sector to embrace them, Dr Ridge said he could not envisage “large organisations that have already invested” in automated dispensing models “scrapping” them.

A C+D investigation in July revealed that both Boots and Lloydspharmacy told ministers last year it was “too early” to press ahead with plans to widen automated dispensing in community pharmacy, despite both companies operating their own versions of the hub-and-spoke model.

The week before Dr Ridge’s comments, Alliance Healthcare managing director Jeremy Main expressed his ongoing concerns with the hub-and-spoke model to C+D.

What do you think about the hub-and-spoke plans?

Dodo pharmacist, Community pharmacist

Any change in the law regarding hub and spoke dispensing across separate legal entities is not going to happen any time soon. There are multiple problems regarding data sharing, patient confidentiality, legal responsibility for errors, being able to supply a full range of products due to reduced wholesaler distribution and so on and so on. Look how long it has taken to change the law to decriminalise dispensing errors- still no end in sight. Regarding the multiples scrapping their hub and spoke sites, why would they ? They are not doing it between different legal entities. Ridge does not seem to have a clue what he is talking about, it is chalk and cheese.This just further illustrates how clueless Ridge is regarding community pharmacy. He thinks we can all operate the same as hospitals- his area of knowledge. The legal situation of hub and spoke for independant community pharmacies is vastly different to hospitals or multiples and infinitely more fraught with legal dangers. His position as Chief Pharmaceutical Officer gets more untenable every time he opens his mouth on the subject of community pharmacy. Does anyone have any ideas how we can get the ball rolling to remove him?

Ben Merriman, Community pharmacist

To be honest, I'm a litte surprised that we haven't heard anything from DH or GPhC since Dr Ridge's, erm, clarification relating to the his comments comparing the accuracy of an automated dispensary compared to a traditional one.  

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