Just when will pharmacy hub and spoke launch?

It’s been almost 18 months since the consultation into the expansion of a pharmacy hub and spoke model closed. Despite this extensive timeframe there has been no formal response to the consultation nor has there been any indication of when to expect one. Earlier this month the Chair of the Health and Social Care Select Committee, Steve Brine MP, indicated that the matter was now bouncing around between the Department of Health and Social Care and the Treasury. Sales and Marketing Director, Louise Laban, takes a look at where we are now and what pharmacies can do.

The consultation into hub and spoke launched back in March 2022 and concluded three months later. It asked the public for views on whether the Government should change the law to allow all community pharmacies to use hub and spoke dispensing models. The current law does not allow for hub and spoke between separate business entities.

Hub and Spoke Dispensing Models

The consultation proposed two models. In one model the patient presents their prescription to the spoke who sends it to the hub for assembly before sending it back to the spoke to then dispense to the patient (spoke-hub-spoke). The second model proposed that the patient presents their prescription to the spoke who send it to the hub who sends it directly to the patient’s home address (spoke-hub-patient).

Speaking at the Sigma Conference in November, Health and Social Care Select Committee Chair, Steve Brine MP, and Chief Executive of Community Pharmacy England, Janet Morrison, appeared to indicate that the government favours the more controversial spoke-hub-patient model although they stressed no decisions had been taken yet with discussions still ongoing between the Department of Health (DoH) and the Treasury. Steve Brine MP went on to say that he wants his committee, as part of its imminent pharmacy inquiry, to “inject” itself into the consultation process before the Government produces as “disastrous answer”.

Previous Concerns With the Hub & Spoke Consultation 

When the consultation launched last year we had real concerns around some of the statements made in the impact statement published alongside the consultation document. We challenged those statements hard in our consultation response as we believed that it hadn’t taken into account just how much technology had moved on since the very first consultation into hub and spoke several years ago. By its own admittance the impact assessment had focused on purely large scale hubs that had been in operation for some time as well as responses and figures from the original 2016 consultation. It did not look at other hub solutions that have come to market since 2016 which are much more scalable, affordable as well as being accessible for the majority of pharmacies.

Perhaps most concerning were the figures and formulas used as a baseline throughout the assessment. This included statements claiming a pharmacy business processing less than hundreds of thousands of items per week, may lack the volume to invest in their own hub. This was not an accurate reflection of the current market. We were and still are working with several hubs that process significantly fewer items (some less than 5,000) who are now seeing efficiencies in terms of costs, staff satisfaction and the ability to provide more revenue generating services without increasing staffing levels.

It's therefore reassuring that the team at the DoH who are leading on the consultation have been in contact with us directly to find out more about how the technology market for hub and spoke has moved on and what solutions are in operation today. We had a really interesting discussion with the team where we were able to provide valuable insight on the topic and we have since provided a range of evidence to show just how accessible hub and spoke really is for all pharmacies and the benefits it can provide when done effectively. All community pharmacy hubs we work with operate a successful spoke-hub-spoke model ensuring the pharmacy and patient relationship is maintained at branch level and we pointed this out to the team. We’re hoping to take the team to one of our customer sites so they can see first-hand how it works.

Ongoing Struggles For Pharmacies 

While it is reassuring that discussions are still ongoing and no final decision has been made, this is no consolation to pharmacy businesses who are, as Steve Brine MP pointed out, currently stuck in limbo waiting for an announcement. Despite this they will still be expected to roll out the new contraception service in December and the Pharmacy First Scheme on January 31 next year. It’s no secret that pharmacies are already stretched to breaking point and my concern is that simply adding more services on top of their existing workloads means they are being set up to fail.

Pharmacies are not currently in a position to take on existing work until changes are made to the medication dispensing workflow to free up much-needed capacity for existing staff to deliver these new services. Hub and Spoke is part of that solution alongside a fair funding deal. We’ve seen for ourselves how much time our customers save when they have moved to hub and spoke. An average pharmacy can save up to 4 hours and 27 minutes per day[1] by moving to this model.

Hub and Spoke Support Fom Centred Solutions 

While we are in this state of flux, my advice to pharmacies would be to start looking at a hub and spoke model for your business now if you haven’t already done so. All the evidence suggests that the model will happen in one guise or another and it is better to be prepared and ready for it rather than finding yourself on the back foot. By looking at such a model now you are also putting yourself in a great position to deliver the range of new services that are rapidly approaching.

At Centred Solutions, we offer a range of pharmacy automation software to support your pharmacy. Whether you are a standalone pharmacy that could benefit from your own mini hub or you need support managing patient medication from a wholesaler or warehouse, we have the solution for you. 

Contact us today to arrange a demonstration of any of our products.

[1] : Based on average prescription no. per day in average pharmacy in England of 248 prescription items with each prescription taking an average of 126 seconds to dispense (SOURCE: https://uk.gophr.com/pharmacy-deserts-landing-page) and based on 70% of prescriptions being original pack medication and 70% of those being able to be processed with automation.