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NPA: Hub-and-spoke not necessarily safer or more cost effective

The review should give policymakers “pause for thought”, the NPA has said

There is limited international evidence to suggest that automatic dispensing hubs save money or improve patient safety, according to a study by the NPA.

Despite being established for “at least 15 years”, the use of hub-and-spoke dispensing “remains very limited globally”, the National Pharmacy Association (NPA) said on Tuesday (February 25).

A review published by the organisation, which looked at both the UK and international experience of hub-and-spoke dispensing, found no “demonstrable cost-benefit cases” for using the model.

The data and evidence “does not clearly establish either an economic case or a health outcomes case for large-scale automation”, NPA head of corporate affairs Gareth Jones commented.

While this does not mean hub-and-spoke is without a future, it should give policymakers “pause for thought”, he added.

“It raises serious questions about the underlying case for investing in models that allow hub and spoke to operate between different companies,” Mr Jones said.

It is currently illegal for different pharmacy businesses to share a dispensing hub, meaning independent pharmacies are not able to operate them, although the government has said it will seek to change this legislation.

The NPA has called for the feasibility, economic factors and patient safety benefits of large-scale automation to be examined more closely. Although automation may improve accuracy, new elements added as part of the process could “introduce new risks”, the organisation claimed.

More “rigorous independent research” is needed to establish the benefits of large-scale dispensing, the 99-page review concluded.

Does your pharmacy operate a hub-and-spoke model?

Leon The Apothecary, Student

The absence of data to review comes from that Hub and Spoke really being done on a large scale before, and seems to fail to account for several other concerning factors in a multiple, for example, the economic cost of people, the different skill sets required, and the difference between the two.

C A, Community pharmacist

It fails to take into account in small branches, staffing levels have been cut to the point where it's just -

Pharmacist/Manager/Clinical lead/Safeguarding lead/HR/Mentor/HLP Lead/Services Lead etc.


A Dispenser/OTC/HLP champion/MUR champion/NMS champion etc.

So having less staff would mean the branch closed.

ABC DEF, Primary care pharmacist

Do these pharmacy companies actually care about patient safety and treatment outcomes? NO! All they care about is money and targets and nothing else. End of. 

Leon The Apothecary, Student

Oh, and fulfilling their legal obligations to avoid fines.

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