The UK Government has launched a consultation revisiting proposals to enable hub and spoke dispensing among separate pharmacy businesses.

The consultation, which opens today and runs for 12 weeks, seeks views on the Government’s plans to amend the Medicines Act 1968 and the Human Medicines Regulations 2012, expanding the definition of ‘retail sale’ as it applies to the dispensing of medicines from community pharmacies. 

The changes – which would apply throughout the UK – would mean that the hub and spoke model, which is currently only available to individual businesses and is largely used by chain pharmacies, would be open to independents, for example by ‘grouping together’ to split the cost of setting up a hub.

Two separate hub and spoke dispensing models stand to be introduced under the proposals: one whereby a patient’s prescription is assembled by the hub and sent back to the spoke to make the supply, and another in which the hub supplies the prescription directly to the patient. 

Accountability 

It is proposed that hub and spoke entities decide among themselves which business has “responsibility and accountability” for each step of the dispensing process.

Under the proposals, hubs will need to be registered pharmacies, in order to ensure they follow the same regulations as the spoke pharmacies. There is also a proposal to allow dispensing doctors to access hubs, though they will not be able to function as a hub.

The Government says the changes will be “enabling” for those pharmacies that wish to avail of it, and will be completely optional.

The consultation document notes that some medicines, such as controlled drugs or acute care medicines, are not appropriate for hub and spoke dispensing.

Other proposals included in the consultation include requiring pharmacies that use hub and spoke dispensing to display a “prominent notice” informing patients the model is being used and listing the name and address of the hub. 

The consultation seeks views on whether changes should also be made to allow the supply of medicines from the spoke back to the hub – a measure not covered by the proposed legislative changes at present. 

Claimed benefits

The Government claims the changes will have numerous benefits for pharmacies, patients and the NHS. It says the changes will free up time for spoke pharmacies, allowing pharmacists to focus more on clinical services and face-to-face patient care.

It is also claimed that the use of automation by hub pharmacies will make dispensing more efficient, and could drive down the number of dispensing errors, which “are already very rare”.   

The Government says that where the model is adopted, “it is expected that the responsibility for the majority of purchasing medicines will move to the hub, who will in turn need to charge the spoke for the services and costs of these medicines”.

Hubs that dispense a higher volume of medicines may be able to negotiate better prices with wholesalers, although there is also a chance that concentrating drugs purchasing in fewer businesses could lead to fewer suppliers in the market and thereby reduce competition and lead to higher prices, the Government acknowledged.

A previous attempt in 2016 to change the law to facilitate hub and spoke dispensing among separate entities was paused after numerous concerns were raised about the Government’s proposals at that point, such as around who might bear liability for errors and the ability of pharmacies to supply medicines in an emergency.