PSNC chief questions evidence for centralised dispensing proposals

Chief executive says she has seen little evidence to support claims that widespread use of ‘hub and spoke’ model would be better for patients and save money.

Sue Sharpe chief executive of the Pharmaceutical Services Negotiating Committee

The head of England’s community pharmacy contract negotiating body has challenged the evidence behind a government proposal to encourage large-scale expansion of centralised dispensing in the country.

Sue Sharpe, chief executive of the Pharmaceutical Services Negotiating Committee (PSNC), warned that the impact of the proposal on patient choice and the wider NHS had yet to be assessed.

On 19 October 2015, the government announced a consultation on changing medicines legislation to permit all community pharmacies to operate under centralised dispensing, also known as the ‘hub-and-spoke’ model.

Keith Ridge, England’s chief pharmaceutical officer, told the Royal Pharmaceutical Society’s annual conference on 14 September 2015 that large centralised dispensing facilities could be capable of dealing with two thirds of dispensing volume in community pharmacy.

Speaking at the Local Pharmaceutical Committees’ (LPC) annual conference in Birmingham on 4 November 2015, Sharpe said she believed this assertion was “unevidenced”.

“There’s an implicit assumption…that [centralised dispensing] that would [offer] an acceptable level of care to patients and that it would be cheaper, and I have seen nothing to support either of those two assumptions,” she said.

“How do we know whether that meets the needs of patients? What does this service look like, where is patient choice, and where is patient-led NHS in all of that? So far as I know, it hasn’t been tested [and it] hasn’t been explored.”

Sharpe also asked how a ‘click and collect’ type of service would affect demand for GP consultations or other pressures on urgent care if implemented.

“Is it an attack on the network? Is it an attempt to destabilise the whole of the community pharmacy sector [and] reduce it to a mere distributor?” she added.

During the LPC event, Sharpe said she did not know whether a national minor ailment service would be negotiated for next year’s community pharmacy contract. Talks with NHS England to introduce a national scheme broke down in July 2015 at a late stage [PDF], the PSNC reported at the time.

Sharpe urged LPCs to continue to make the case to local commissioners to introduce minor ailment services in their areas.

NHS England had yet to respond to a request for comment at the time of publication. 

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Citation
The Pharmaceutical Journal, November 2015;Online:DOI:10.1211/PJ.2015.20200035