10.3.2024 Danny McNally
Centred Solutions has been at the forefront of pharmacy hub and spoke dispensing in England over the last few years. We have already driven significant change in the market, demonstrating that hub and spoke dispensing is a realistic model of dispensing for pharmacy groups of all sizes. We’ve seen the massive difference that hub and spoke can make to community pharmacy. With pharmacies struggling to survive, Director of Sales and Marketing Louise Laban argues the time has come to stop delaying and to push ahead with model one of hub and spoke dispensing.
In our experience, there is no risk with moving ahead with model one of hub and spoke legislation which would allow medicines to be returned from the hub to the pharmacy ready to be dispensed to the patient. However, we understand the need for more policy discussion around the second model of hub and spoke, where the hub sends the medication directly to the patient. This should not delay the implementation of model one. This model would immediately level the playing field for smaller and independent pharmacies, allowing them to use a hub-and-spoke model of their choice to create capacity for clinical services.
Creating Capacity for Services
1,400 pharmacies have closed their doors since 2017, resulting in higher dispensing volumes and increased pressure for the pharmacies that remain. Workforce shortages and spiralling staffing costs, not helped by last week’s announcement to increase Employer’s National Insurance contributions and the national living wage, means that pharmacies are simply unable to take on additional resources to deal with the increased dispensing volumes. Tasked with delivering high volumes of dispensing on a skeleton workforce, the pharmacies that remain open are struggling to achieve NHS clinical service targets. Designed to take pressure off GPs and support patients, Pharmacy First thresholds have had to be reduced until March next year.
The Need for Hub & Spoke Pharmacy Solutions
Our data clearly illustrates that moving to hub and spoke takes an average of 80% of original pack repeat dispensing volumes out of pharmacy stores. This frees up over four hours of pharmacist’s time per day to deliver patient-facing services. Of the 10,000 pharmacies remaining open in England, that’s 70,000 additional appointments per day or 1.8 million every year on current staffing levels.
Even with an improved funding model, community pharmacies will still need to create capacity in-store to deliver more services in line with the Government’s current vision to shift more care into the community and provide more preventative care closer to home.
With many pharmacies struggling to achieve minimum thresholds, an estimated £250m will be left unclaimed from Pharmacy First. This could be used to fund 16.5m million pharmacy consultations if the capacity can be created. Each consultation could release a single GP appointment, allowing them to treat more serious illnesses in the community, reducing further appointments and hospital admissions.
We see time and again that community pharmacies who have already been in a position to move to a hub and spoke model of dispensing, have been able to not just maintain but actually grow their dispensing volumes while at the same time delivering more services.
The need to move ahead with Hub & Spoke
Unfortunately, hub and spoke is only an option currently for pharmacies or groups within the same legal entity. The legislation to allow dispensing between different legal entities was due to be rolled out in January next year. But at the end of September, it was announced that this was being delayed indefinitely so the new Government could be briefed on the proposed changes. It then emerged that the Government would 'continue to discuss' issues raised around the second model of hub and spoke which is the proposed hub-to-patient model. Community Pharmacy England (CPE) has suggested briefing new ministers before changes are implemented 'could take some time'.
These discussions should not delay the first model of hub and spoke being rolled out. All pharmacies could benefit from a hub and spoke model of dispensing which allows for the spoke to send orders to the hub and then for these orders to be returned back to the spoke to be dispensed to patients. We are working with many pharmacies who want to urgently move to this dispensing model to ensure their readiness for the future. They are now unable to do so due to the decision to delay.
If these changes aren’t put in place soon there is a real risk that many more pharmacies will have to close their doors as the current way of working is simply not sustainable. Moving ahead with model one of hub and spoke would immediately allow all pharmacies to put in place this model of dispensing with a range of options they can pursue. This includes creating their own hub for companies with shared ownership or with different legal entities, creating co-operative hubs with shared ownership for likeminded pharmacies as well as outsourcing to a third party hub provider. The playing field needs to be levelled so every pharmacy has the choice and the opportunity to secure their future.
Pharmacy Hub & Spoke Solution for Repeat Prescription Dispensing
Our award-winning FLOWRx range offers everything you need to enhance dispensing pharmacy workflows with our hub and spoke and Tote2Spoke™ solutions. Whether you're looking to set up your own hub, implement Tote2Spoke™ with a wholesaler, or boost the efficiency of a single store, we provide comprehensive support from picking and packing to labelling and checking.
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