Urging the Govt to move forward with delayed hub and spoke legislation

Pharmacy hub and spoke providers joined together yesterday (19^th November) to highlight to MPs the importance of moving ahead quickly with elements of proposed hub and spoke legislation.

Representatives from Centred Solutions, HubRx and PillTime visited Westminster and spoke to more than 30 MPs about the urgent need to move ahead with Model One of Hub and Spoke legislation. The event was organised with the support of former pharmacist and Labour MP, Sadik Al-Hassan.

Currently hub and spoke is only an option for pharmacies that operate in the same legal entity. Legislation to make hub and spoke accessible for all pharmacies was due to be rolled out in January 2025 but it has been delayed.

Having witnessed the benefits of hub and spoke for community pharmacy, Centred Solutions, HubRx and PillTime are now calling for the Government to move ahead with Model One of hub and spoke legislation. This model would allow for dispensing across different legal entities with medicines returned from the hub ready to be dispensed in store to the patient. It will level the playing field for smaller and independent pharmacies, allowing them to use a hub and spoke model of their choice now to create capacity for clinical services.

All three companies said there had been a lot of interest and support from MPs who had visited the information session at the Houses of Parliament. A number of MPs signed a letter to Minister of State for Health and Social Care, Stephen Kinnock, saying that hub and spoke was the lifeline community pharmacy needed now to:

• Deliver more clinical services for patients.
• Release pressure elsewhere in the NHS.
• Secure the future of pharmacies.

Sadik Al-Hassan, MP for North Somerset and Officer for the Pharmacy APPG, said: “As a big proponent of pharmacy, it was great to see so many other Parliamentarians during our hub and spoke event who want to support community pharmacy and pharmacists after a decade of underfunding and marginalisation. Community pharmacies are a vital lifeline for our high streets and independents have always been at a disadvantage versus larger chains who can employ economies of scale. Model One of the proposed legislation would allow the benefits of big pharmacies for smaller ones to help them focus on the service provision our NHS needs during this difficult financial time.”

Todd Siegel, CEO of Centred Solutions, said: “We have already seen the massive difference hub and spoke can make. Our customer data shows 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 1.8 million additional appointments every year on current staffing levels. We know many pharmacies who want to urgently move to this dispensing model to ensure their readiness for the future, but they are unable to do so due to the delayed legislation. If Model One isn’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.”

Daniel Lee, CEO of HubRx, said: “Model One will provide much needed structural changes in community pharmacy, allowing pharmacies to offer more clinical services including Pharmacy First. This should be an easy decision to make for policy makers. It has cross-pharmacy support, no funding is needed, and the market is ready. The benefits will include the creation of much needed capacity in pharmacy and a more motivated workforce, while also helping to reduce primary care pressure. I have spoken with hundreds of pharmacists who are overwhelmed with the daily workload and pressure they face each day, struggling to cope as things are, never mind being able to offer more clinical services. Hub and spoke has transformed our own pharmacies, allowing us to increase our clinical services. Other independent pharmacies need this option now.”

Leighton Humphries, CEO at PillTime said: “The potential to ease the pressure around compliance aids and deliver reduced workload, increased efficiency, and lower costs were all identified as key hub and spoke benefits by respondents in a recent survey. The ongoing delay for hub and spoke legislation is putting patients at risk. Pharmacies are under immense pressure and we see vulnerable patients, like the elderly or those managing chronic illnesses, being the most affected with compliance aid services (like dossette boxes) being withdrawn or limited. Hub and spoke would allow pharmacies to outsource compliance aid dispensing effectively and safely, to ensure patients get the support they need. The delay in legislation is widening the gap between larger groups and smaller independent pharmacies who need the same access to hub and spoke to survive.”

All three companies agree that Model One of hub and spoke legislation needs to be in place by summer 2025 at the latest. More time, if required, can then be taken to review the second model of hub and spoke, where the hub sends the medication directly to the patient.