Legislative changes to allow independent pharmacies to operate a hub-and-spoke dispensing model were tabled as part of the Medicines and Medical Devices Bill, first presented to parliament in February 2020.

The bill – which is in its final stages of approval, before it becomes law – also includes proposals to allow large pharmacy chains with automated hubs to charge smaller chains and independent pharmacies “prescription assembly services”.

Recognising the potential impact on the sector of these legislative changes, pharmacy minister Jo Churchill said there will be a “full public consultation” on the implementation of the proposals.*

“The government will then report to parliament and include a summary of the concerns raised in the public consultation,” Ms Churchill said in a House of Commons debate on Wednesday (January 27).

“To ensure that we get the right model to assist pharmacy going forward, we intend to be totally transparent,” she stressed.

Earlier in the debate, shadow health minister Alex Norris stressed the importance of a “wide-ranging consultation with all manner of stakeholders” on something that will be a “seismic change for community pharmacy”.

“Free up pharmacists' time”

Legislative changes around hub-and-spoke dispensing were first mooted with the service-led pharmacy funding contract for England, announced in 2019.

An impact assessment published alongside the Medicines and Medical Devices Bill in 2020 said: “The government’s vision for community pharmacy is that it should provide expanded clinical services…helping to relieve pressures on other parts of the system.

“To achieve this, dispensing needs to become more efficient to free up pharmacists’ time for other activities. Permitting all pharmacies to access more efficient hub-and-spoke dispensing is part of the government’s strategy to support this transformation.”

While recognising the costs of setting up a hub-and-spoke dispensing model, changing business processes, IT and logistics and staffing the facilities, the government said benefits include “reduced staff time…potential for reduced rates of dispensing errors and potential for a calmer working environment at the spoke pharmacy”.

In its submission to ministers last year, the National Pharmacy Association (NPA) said that claims about the benefits of the hub-and-spoke model “are overblown” and that it could reduce “competition and choice in the pharmaceutical wholesale market without a level playing field”.

CCA hosts MPs to “help understanding”

The Company Chemists’ Association (CCA) – which represents the UK’s largest multiples and supermarket pharmacies – hosted a virtual event last October to “help parliamentarians understand more about the automation of medicines assembly, and the role of hub-and-spoke models”.

Attendees to the event – which included all-party pharmacy group (APPG) chair Jackie Doyle-Price, Department of Health and Social Care head of pharmacy Jeanette Howe and the NPA’s Neil Bhayani – discussed the issues that would need to be addressed before legislative changes were made.

These included: original pack dispensing; investment from the government to fund the widespread infrastructure; and fair community pharmacy funding to “improve the future viability of community pharmacies”.

*This article was updated on February 5 to clarify that the legislative changes around hub-and-spoke have not been removed from the Medicines and Medical Devices Bill.