Government backs two new models of hub-and-spoke dispensing

The Department of Health and Social Care has said it will implement both models between pharmacies that are not within the same legal entity.
Woman collecting prescription bag from pharmacist

The government has said it will change legislation to allow two new models of cross-entity hub-and-spoke dispensing in the UK.

In an announcement, published on 13 May 2024, the Department of Health and Social Care (DHSC) confirmed it would implement both models for hub-and-spoke dispensing between two pharmacies that are not within the same legal entity, which was set out in a consultation in March 2022.

Model one allows the patient to present a prescription to a spoke pharmacy, which sends it to the hub pharmacy for dispensing. The medicine is then sent back to the spoke pharmacy, which supplies it to the patient.

In model two, the patient supplies the prescription to the spoke pharmacy, which is sent to the hub for dispensing. The hub then supplies the medicine directly to the patient, instead of via the spoke pharmacy.

Hub-and-spoke dispensing is currently only allowed within the same pharmacy. The DHSC’s announcement said that several changes will be made to both the Human Medicines Regulations 2012 (HMRs) and the Medicines Act 1968 to allow for the change.

The legal changes will include a requirement for written arrangements between any hub and spoke, “which must include a comprehensive statement in relation to their responsibilities and details of which party will be named on the medicine label”, the DHSC announcement said.

The label can feature either the hub or spoke’s details, but it cannot be both.

There will also be a requirement that the spoke must “conspicuously display” a notice about hub-and-spoke models, if it is using them. If an online pharmacy is using a hub-and-spoke model, its website will also have to display the same information “conspicuously”, the DHSC said.

An expansion to hub-and-spoke dispensing was first proposed in 2016, but was shelved following concerns around safety of the model and how pharmacy organisations would comply with the Falsified Medicines Directive.

In January 2018, NHS England revisited the model as part of its ‘NHS long-term plan’, published in January 2019, with firm proposals put out for consultation in March 2022.

The DHSC said 131 responses to the 2022 consultation were received, from 71 individuals and 60 organisations, including pharmacy businesses, membership organisations and national community pharmacy representative bodies.

More than half of respondents (53%)supported the proposal that legislative barriers to expanding hub-and-spoke dispensing should be removed and just under half of (47%) respondents disagreed with the proposal.

The DHSC added that although this was a small split in favour of the proposals, 71% of organisations that responded were in favour of expanding hub-and-spoke dispensing, with 29% of individuals in favour.

“The supportive organisations included 7 national associations, 5 large pharmacy chains (with over 1,000 employees each), 8 smaller pharmacy chains, other providers and organisations representing community pharmacy policy and practice in Wales, Scotland and Northern Ireland,” it said.

Commenting on the proposed changes, Malcolm Harrison, chief executive of the Company Chemists’ Association, said: “The changes should allow new business models, without increasing the burden on existing processes or adding confusion to patients.

“However, given the huge upfront capital investment and ongoing operating costs of hub-and-spoke dispensing models, and the financial strain all pharmacy businesses are currently facing, we think it is unlikely the sector will be able to benefit from these changes,” he added.

“We support the [DHSC’s] intention to release clinical capacity in community pharmacy. Unfortunately, however, the proposed changes will not release any capacity unless the government’s funding for medicines supply is increased,” he added.

Andrea Leadsom, the pharmacy minister, said: ““These proposals will level the playing field and enable our hard-working community pharmacies to benefit from centralised dispensing.

“It will also free up highly skilled pharmacists from back office duties to deliver patient-facing services, including Pharmacy First and contraception consultations, supply medicines and provide advice.”

Last updated
The Pharmaceutical Journal, PJ, May 2024, Vol 312, No 7985;312(7985)::DOI:10.1211/PJ.2024.1.314104

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