Latest news that the new Pharmacy First scheme for England will launch on January 31, 2024 is a much needed boost and vote of confidence for community pharmacy. But with no formal announcement about hub and spoke plans and a serious funding shortfall that still needs addressing, are some pharmacies going to find themselves disadvantaged from the offset? Shelley Dyer, Centred Solutions Head of Marketing, explores what pharmacies could do.
The announcement from NHS England that the Pharmacy First scheme will officially launch in community pharmacies across England early next year is welcome news for the sector. It’s an initiative that pharmacies and the wider NHS have been crying out for. The scheme will ensure pharmacists and their teams can work at the top of their clinical licence while relieving pressure from their health care colleagues elsewhere in primary care.
In addition to this, the extended pharmacy contraception and hypertension case-finding services will relaunch in December. This means that within the next couple of months pharmacies will find themselves offering a wide range of patient facing services which they will receive much needed revenue for. The more services they deliver, the greater the profit for their business and the greater the future security of their business. But with pharmacies already stretched to breaking point, where exactly are they going to find the time to deliver these services?
When the Delivery Plan for Recovering Access to Primary Care was published in May 2023, hub and spoke was cited as a key way to free up pharmacy time to deliver the proposed Pharmacy First scheme:
“We also want to give community pharmacy contractors more choice about how the deploy staff and release pharmacist’s time for more patient-facing services.
“To support this…government will give pharmacists the flexibility to dispense medicines in their original packs and widen pharmacy hub-and-spoke arrangements, both of which aim to facilitate greater use of automation to increase efficiency, by progressing legislation following consultations.”
However, six months on and there has still been no formal response to the consultation into proposals to widen hub and spoke arrangements for all pharmacies. Nor has any date been set as to when to expect a response to the consultation. Yet despite this the government has decided to push the button on Pharmacy First without necessarily creating the capacity to deliver such a scheme.
The risk here is that many pharmacies will find themselves at a real disadvantage at the end of January. Independent stores or groups operating under different legal entities are being asked to deliver a whole new raft of services without access to the central fulfilment and automation that was meant to deliver efficiencies. What is even more concerning is the £2000 upfront fee for Pharmacy First will be “recovered” from contractors if they “have not delivered five clinical pathway consultations” within two months of the scheme launching. Additionally pharmacies will be expected to deliver a minimum number of consultations each month in order to claim the £1,000 fixed payment. Those not reaching the minimum consultation numbers, which increases gradually to 30 per month by October 2024, will simply receive the £15 service fee for each clinical pathway they complete.
Those pharmacies that are in a position to move forward with hub and spoke arrangements should absolutely be making this a priority to ensure they are in a strong position to deliver Pharmacy First when it launches. There are a range of scalable and modular hub and spoke solutions now available on the market that make hub and spoke an option for pharmacy groups of all sizes that operate within the same legal entity. Financing options are available meaning businesses can pay for the solution out of the efficiencies generated. This hub and spoke technology can save up to 4 hours and 27 minutes per day per store*. That time can be used to deliver Pharmacy First consultations worth up to £5,500 per month in terms of service fees on top of the £1,000 fixed monthly payment.
For those independent stores or groups with stores in different legal entities, hub and spoke remains off limits for now however the good news is that there are still a couple of options available that can help to make the dispensing process for original packs more efficient, releasing much needed capacity.
Firstly, a Tote2Spoke solution will allow pharmacies to work in partnership with a wholesaler or warehouse. They can batch pick medication on the pharmacy’s behalf and deliver it back to store in patient specific totes. The software can then be used to scan, label and sort medications from the tote into patient specific baskets with no need to unpack onto shelves. The same software will also guide pharmacies through the dispensing process in store for any exceptions not fulfilled by the wholesaler/warehouse. Medication can then be bagged.
There is also newer software coming to market which will allow pharmacies to simply automate their original pack dispensing process in store without being connected to a hub or wholesaler. The software works by allowing branches to process multiple patient orders at once rather than one at a time. Clinical and accuracy checks are done online at the start of the process, freeing up the pharmacist. The software then guides the dispensing staff to batch pick, batch sort, batch label and batch bag medication ready for collection creating much needed efficiencies.
There is no denying that Pharmacy First is a great step forward for English pharmacies. However it is really concerning that it is being launched ahead of any changes to the hub and spoke legislation. But the real thing for pharmacies to consider is that there is something they can all can do to increase capacity for their existing workforce to be able to deliver the scheme. The key lies in a level of automation for the original pack dispensing process which currently takes up a huge chunk of pharmacy time. Pharmacys need to start looking at automation for this process now in some guise if they want Pharmacy First to work for them.
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.