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NPA: Do not worship ‘false gods’ of hub-and-spoke

Ian Strachan: Where is evidence that centralised dispensing will make things better?

It is “highly questionable” whether central dispensing hubs will generate any savings, says NPA chair Ian Strachan

Community pharmacy must not put itself at risk by “worshipping at the feet of false gods” such as hub-and-spoke dispensing, the National Pharmacy Association (NPA) has said.

It is “highly questionable” whether the hub-and-spoke model will generate savings, NPA chair Ian Strachan said at the organisation’s triennial chairman’s dinner at the Apothecaries’ Hall in London on Monday (November 23).

England’s chief pharmaceutical officer Keith Ridge suggested in September that hubs could deal with two thirds of the country’s prescriptions, but Mr Strachan warned the “general rollout” of this model could bring “serious risks to the pharmacy network and therefore ultimately patients”.

Mr Strachan stressed the value of the existing community pharmacy model, which offers “convenient, face-to-face advice”. “Where is the evidence that centralised dispensing will make things better, not worse?” he asked.

Instead of focusing on hub-and-spoke dispensing, the NHS should invest in pharmacy services, Mr Strachan argued. “Quality and productivity gains cannot be achieved by cuts,” he said.

“On the contrary, the NHS should now be investing in services that have the potential to achieve cost savings elsewhere in the system, as well as delivering improved patient care.”

Mr Strachan called for the commissioning of a common ailments service in England, which he described as a “no-brainer”, and a greater role for pharmacists in managing long-term conditions. To perform these services, pharmacists should have “greater freedom” to use skills such as prescribing, he added.

Earlier this month, Pharmaceutical Services Negotiating Committee (PSNC) chief executive Sue Sharpe branded increasing the use of dispensing hubs as "madness".

Do you think the hub and spoke model could benefit pharmacy?

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Graham Phillips, Superintendent Pharmacist

Hello Benjamin "naturally cause efficiency savings" - please explain the financial modelling you've done in support of that assertion. Whenever I've looked at this I cannot find the significant savings but maybe you know somethign I don't?  I'd be delighted to have your insights. After 30y in practice and having built up a small group of pharmacies I'm clearly missing something here




Leon The Apothecary, Student

Hub and Spoke can naturally cause efficiency savings just through simple logic. I find Ian Strachan's comment that it cannot highly questionable. He labels them as cuts, where it's more of a logistical issue.

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