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Independents concerned by government's dispensing hub plans

Mike Hewitson: Department of Health should test if independents want this

NPA board member Mike Hewitson says he has not heard "any clarion calls" from contractors to use a hub-and-spoke model


Independent pharmacies are concerned that Department of Health (DH) proposals to allow them to legally operate a hub-and-spoke dispensing model could hamper patient care.

C+D revealed last week (October 10) that the DH is “looking into” relaxing the law prohibiting companies from operating the model unless they own both the dispensing hub and the pharmacy. This would allow all pharmacies – rather than “just the large multiples” – to use it, the DH said.

But contractors warned that hub-and-spoke dispensing would “change pharmacy beyond all recognition” by reducing interaction between patients and pharmacists.

National Pharmacy Association (NPA) board member Mike Hewitson told C+D that independents he had spoken to had little appetite for the model.

“I don’t hear any clarion calls. [The DH should] test that this is something [independents] want, rather than just doing something it wants,” he said.

Bal Singh, head pharmacist at Khaira Pharmacy in West Bromwich, predicted that the model would “massively” reduce the quality of care pharmacies offer by moving core processes “off site”.

“Most independents are near a surgery for a reason: they can be flexible in [a way] that multiples can’t. [The hub-and-spoke model] takes away one of their massive unique selling points, for what? Saving a few pennies?” he said.

Others voiced concerns that, by driving down the cost of dispensing, the model could result in the DH paying contractors less for supplying medicines.

Former NPA chief executive Mike Holden told C+D that this would “claw back” any cost savings a hub made, while community pharmacist Clive Hodgson said pharmacists would be left to “scratch some form of living” by delivering clinical services.

Level the playing field

But Royal Pharmaceutical Society president Ash Soni said it would be “inexplicable” if the DH did not allow independents to “play on the same playing field” as multiples.

He stressed that the government must be “really clear” that independents could own their hub. “We mustn’t be forced into a position where we use hubs owned by another organisation [and they decide to] chop the spokes off,” he said.

Locum Ross Ferguson was one of the readers who welcomed the news. He told C+D that hub-and-spoke dispensing could be the sector’s “salvation”.

“If we continue to grimly hold on to the dispensing process then we are doomed to count ourselves out of existence,” he said.


What are your views on the benefits of using a hub-and-spoke dispensing model?

We want to hear your views, but please express them in the spirit of a constructive, professional debate. For more information about what this means, please click here to see our community principles and information


Michael Stewart, Community pharmacist

I have spoken to many independent contractors who have tried to implement a hub and spoke model but have been stymied by this law. Usually the situation is that they own both hub and spoke but they are trading as different limited companies and so cannot use the model. Bizarrely, if the 'spoke' was not a pharmacy (e.g. a post office/convenience store) it could be designated as a 'collection point' under HMR2012. Anecdotally, Hub and spoke is a useful model for managing care home services or prescription collection/delivery from a central location, I'm sure there are other uses. For me it is remote supervision that we should be very wary of - not hub and spoke models. Personally I would support a change to the law to level the playing field.

Mark Galloway, Pharmacy

Of course the drive for this from some quarters will be the need to QIPP the global sum!

Kirit Shah, Community pharmacist

Thec NHS has a £20 billion shortfall in funding every year and will look for any savings which can be made without a reduction in the service to the patient!

Yuna Mason, Sales

Anyone think the multiples might be pushing for this? So that they can sell their own existing automated solutions to independents? Would the change allow Walgreens Boots Alliance to use their automated dispensing facility for their Alphega pharmacies or can they do that already?

S Morein, Pharmacy Area manager/ Operations Manager

It is a meaningless argument whether contractors want "hub and spoke". If it is cost effective and delivers a better patient experience then it should happen. Contractors with their luddite, self serving attitude to modernisation sound like horse and carriage manufacturers of the early 20th Century decrying the modernisation of the motor car. Either the profession grabs the opportunity of change or it will cease to exist.

Stephen Eggleston, Community pharmacist

Whether driven by contractors or DoH, I suspect (fear?) H&S will be the model if the future

Mark Galloway, Pharmacy

From where I am sitting it is happening already, driven by some contractors themselves.

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