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Opinion: Hub and spoke is back on the agenda

There is to be another consultation on hub and spoke dispensing... probably because the first one didn’t give the Government the answer it wanted, says PM’s deputy editor Arthur Walsh 

Public consultations are wonderful things, aren’t they? They are a chance to scrutinise the Government’s plans and have meaningful input on the policies that shape our lives. That’s one way of looking at it. Another, more cynical view might be that they are an optical exercise allowing ministers to push through divisive policies that are going to get the rubber stamp no matter what. But we had a consultation, they can reply when this or that objection is raised. We listened!

Some pharmacists I speak with – weary veterans of the GPhC’s fees consultations – suspect the latter is nearer the truth. They are rolling their eyes at the prospect of another consultation on hub and spoke dispensing, a first try in 2016 having apparently failed to unearth sufficient enthusiasm for the model.

Pharmacy minister Jo Churchill made the announcement in the House of Commons at the end of January, saying: “To ensure that we get the right model to assist pharmacy going forward, we intend to be totally transparent.” 

This came in a debate on the Medicines and Medical Devices Bill, which is close to being signed into law and is seen as paving the way for future legislation allowing separate businesses to act as dispensing spokes of the same hub.

All this raises a number of questions. Can hub and spoke be made to work for independents? What has been done to address the concerns around efficiency that were raised by the likes of the NPA in 2016? Is it really the best way to free up pharmacists’ time and reorient the sector towards clinical services? Will it lead to more closures? And perhaps most importantly – if the Government and NHS are so keen on introducing it, does any of this even matter?

Seismic change

Shadow pharmacy minister Alex Norris, who spoke about this issue on PM’s Talking Pharmacy podcast last August, warned MPs that any plans for hub and spoke must be thought through carefully and have input from all stakeholders, describing it as a “seismic change for community pharmacy”.

Seismic indeed. Many worry that changing the legislation could force more pharmacies to close and that deprived areas could be hit the hardest. The NPA also says many of the assertions made for hub and spoke are overblown, with studies failing to bear out claims that automation results in improved patient safety. However, others argue that change is inevitable and only those businesses that adapt to new technologies and ways of working will survive.

Whatever your view of consultations, it would be wise to make your voice heard this time.

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