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Amendments that would change hub-and-spoke legislation to allow cross-entity provision will not come into force in January 2025 as originally proposed, Community Pharmacy England (CPE) has said.
The amendments — originally announced in May 2024 following a consultation held between March and June 2022 — will allow for hub-and-spoke dispensing across different legal entities.
Currently, hub-and-spoke dispensing is only allowed between pharmacy locations belonging to the same owner or legal entity; for example, between branches of the same pharmacy company.
In a report on the consultation outcome, published in May 2024, the Department of Health and Social Care (DHSC) said the amended legislation allowing hub and spokes to be built across different legal entities would level the playing field in community pharmacy, “enabling spokes to provide more patient-facing services, relieving pressure on the wider NHS”.
In a statement published on 27 September 2024, CPE said: “[The] DHSC has informed us that … they are briefing new ministers across all policy areas, including hub-and-spoke dispensing between different pharmacy owners. As this will take time, they are now not in a position to implement these proposals from 1 January 2025, as previously intended.”
“We do not have further clarity on the timescales but we will update the sector once we have more information,” the statement added.
The proposed changed to legislation would allow for two cross-entity hub-and-spoke models. In both models, the patient presents their prescription to a spoke pharmacy and the prescription is assembled at a hub pharmacy.
In model one, the assembled medicine would be sent back from the hub to the spoke for the patient to collect. In model two, the patient would receive their prescription from the hub.
Commenting on the delay, Malcolm Harrison, chief executive of the Company Chemists’ Association (CCA), said: “It’s disappointing that commitments made to support pharmacies in the 2019 contractual framework agreement are the subject of further delays.
“As part of the 2019 five-year deal, community pharmacy has had to make substantial efficiency savings. In exchange, the Department for Health and NHS England committed to enable more efficient operating models with changes to supervision and hub and spoke laws.
“It is also still the case that if pharmacies are to be able to benefit from hub-and-spoke arrangements, new clinical services must be commissioned. The costs of establishing and maintaining hub operations are significant, and with little to no profit available in dispensing NHS medicines, it is hard to see how new facilities could be established, or pharmacies could afford to procure assembly services from them.”
Gareth Jones, head of corporate affairs at the National Pharmacy Association, said: “It’s better to get this complicated matter right than it is to push through change without a full understanding of the issues, which are highly consequential for independent pharmacies.
“Above all, we need to be very careful not to write community pharmacies out of the equation by careless application of a direct to patients model of dispensing.
“A new and significantly improved community pharmacy funding settlement would be needed to make sense of hub and spoke in the medium term.”
The Department of Health and Social Care said that a timeline for introduction of the hub-and-spoke changes would be published at a later date.
