How FLOWRx Meets GPhC Hub and Spoke Recommendations

The General Pharmaceutical Council (GPhC) has just published a review exploring implementation and regulatory oversight of current hub and spoke dispensing models across registered pharmacies in Great Britain. It provides targeted recommendations to support pharmacy owners in meeting the GPhC standards for pharmacy premises in preparation for the anticipated expanded use of hub and spoke models across different legal entities. Our Sales and Marketing Director, Louise Laban, looks at how FLOWRx meets the recommendations.

Insights from Two Years of Pharmacy Inspections

The GPhC review looked at inspection data from the past two years alongside targeted data capture inspections in August 2025. Fifty-five inspection reports were reviewed including both hub and spoke premises with varying models of automation, manual processes and types of medication supply and services. The review provides generalised examples of good practice, recommendations and improvements across five key areas:

1. Governance and Risk

• Standard Operating Procedures (SOPs) for both the hub and the spoke should be easily available for staff and up to date: Centred Solutions always provide template SOPs as standard for both the hub and the spoke.
  
  
• Risk assessments should take place before hub and spoke models become operational and risk registers should remain in place: Centred Solutions’ customer solution team can support pharmacies with this as part of the training process.
  
  
• Best practice documentation should set out how to manage prescriptions from start to finish: At Centred Solutions a suite of online training and reference videos for both the hub and the spoke pharmacies is available online for all customers and can be reviewed by staff at any time.
  
  
• Clear records for checks should be made at various stages of the supply process: FLOWRx uses barcode and RFID checking technology to check right patient, right dose, right medication at each stage of the assembly process. This data is all captured within the software and can be checked at any time down to pack and patient level.
  
  
• If an error occurs, error reflection forms should be used so the root cause can be explored: As cited in the review, automation leads to lower error rates. We encourage all customers to log and share any errors, not only with staff in the hub and the spoke, but with the team at Centred Solutions too so causes are identified and learnings and improvements are made.
  
  
• The review suggests for all new spoke pharmacies, 100% of the prescriptions should be checked in the first week of integration with the hub and after the first week a representative sample of prescriptions could be checked: In terms of our FLOWRx solution, we would strongly disagree with this. While such checks may be necessary for an MDS hub, they are not appropriate for an original pack FLOWRx hub. When medications are returned to the spoke from a FLOWRx hub they are in a sealed and labelled bag and they have been checked by automation at each stage of the process to ensure right patient, right dose, right medication. FLOWRx captures who was responsible when the medication was picked, labelled and packed and captures all the data about that specific pack including EAN, GTIN, Batch, Serial Number and Expiry date, up to the point the medication bag is sealed. Opening that bag at the spoke to recheck items not only affects the integrity of the content but it can significantly increase the risk of human error and undermines the hub process. It is one of the reasons spoke pharmacies won’t open a bag to add any items that could not be fulfilled by the hub, these are processed and placed in a separate bag at the spoke pharmacy to protect the integrity of the hub order.
  
  
• There must be written agreements between hub pharmacies and spoke pharmacies detailing roles and responsibilities, as a result of the legislation: We have worked with pharmacy legal experts to produce template written agreements for each hub and spoke business model: IntraGroup, ManagedService and JointVenture Co-operative.
  
  
• A business continuity plan should be in place to ensure there is no interruption in a patient’s medication: All FLOWRx customers have a preventative maintenance plan to significantly reduce the risk of any downtime at the hub. In addition, our experienced field service team has SLAs in place to ensure a reactive service is provided to the hub within a set timeframe based on priority levels. Finally, because FLOWRx software links the hub and the spoke and provides full visibility, it means urgent prescriptions can be processed at the spoke with ease if required.

2. Legal and regulatory compliance

• There should be secure electronic transfer of patient data: FLOWRx software plugs straight into the pharmacy PMR so patient sensitive data is only transferred securely between our software and the PMR provider. This data is 128-bit encrypted and is never shared with any third parties.
  
  
• Hub pharmacies need to have a responsible pharmacist onsite: Centred Solutions’ stress this requirement to customers from the outset.

• Automation should flag anomalies and errors: FLOWRx has a “quarantine” process so any patient order at the hub which does not follow the “standard process” is flagged by the system and put into quarantine where a secondary check must be carried out by a pharmacist or checking technician before anything further can happen with that patient’s medication. Reasons for an order going into quarantine vary but can be a short expiry date on medication or the first time FLOWRx has seen that medication barcode.
  
  
• A robust process for checking all medicines are fit and safe for purpose and for actioning medication alerts and recalls, including who is responsible for these: FLOWRx allows you to set quarantine checks in the system for expiry dates and medication recalls. The system captures the medication batch number, EAN and GTIN records to a pack and patient level so it can quickly tell you which patient received any medication which has been recalled. In addition, Centred Solutions will always notify all customers of any medication recalls they are made aware of and remind customers to ensure that medication is flagged in the system to be placed into quarantine.
  
  
• A documented process should be in place for how changes to prescriptions are communicated: FLOWRx InStore is the only solution in the market today that gives spoke pharmacies complete visibility of what’s happening at the hub. It allows spoke pharmacy teams to easily track prescriptions through every stage of the hub process, recall prescriptions or specific items instantly, if changes need to be made or if it is needed locally.

4. Staffing

• Spoke teams should fully understand the hub process and have time for training: Our suite of online training and reference videos for both the hub and the spoke pharmacies can be reviewed by staff at any time. Equally FLOWRx InStore provides staff in the spoke pharmacy with full visibility, so they have the ability to reassure patients what is happening with their medication at any point.

5. Patient experience

• Gone are the times when patients have to wait days for their prescriptions to be delivered back to the spoke. All FLOWRx Hubs run a next day service from when the spoke places the order to when they receive it back completed, bagged and labelled meaning patient medications are ready for when the patients arrive to collect them.
  
  
• Patients need to be kept regularly informed of their choices when having their medicines dispensed via the hub and spoke model: All Centred Solutions customers receive a marketing toolkit to inform customers if their medications are processed at a hub, timelines and options to opt out.
  
  
• Only include the spoke address on medicine labels: All FLOWRx labelled medication only includes the address of the spoke pharmacy.

GPhC Inspection Reports Highlight FLOWRx’s High Standards

FLOWRx Hub and pharmacy spokes inspected by the GPhC previously have always met the standards required. Below is an example of the feedback given in the GPhC inspection reports:

Hub Pharmacy: “The assembly process relied on automation and barcode technology to track each step……To ensure only one person's medicines were placed in a basket, the system illuminated a light above the basket on a shelf, in which to place the stock. The system alerted team members if an intervention was required by a pharmacy trained team member through the use of an orange light above the basket. There was no way of operatives overwriting the need for an intervention as pharmacy professionals were required to log-in to complete these interventions.”

Spoke Pharmacy: “The pharmacy received a delivery of assembled bags of medicines from the hub pharmacy during the inspection and the team followed an organised and effective process for the receipt and reconciliation of these prescriptions.”

“This process was fairly new to the team and team members discussed the procedures and training they had undertaken ahead of completing the process. Team members spoke positively about the change and identified how it had supported the team in managing workload more effectively.”

FLOWRx: Setting the Standard for Hub and Spoke Pharmacy Models

FLOWRx not only meets but it exceeds the GPHC recommendations and is setting the bar for hub and spoke operations across the UK. Our growing base of customers is testament to this. If you are considering hub and spoke following the legislation change, make sure you take a look at our new report into the three business models now available.

Discover how FLOWRx can transform your hub and spoke operations. Book a demo to experience our technology first-hand.