Group items tagged

Centred Solutions has been at the forefront of the pharmacy hub and spoke dispensing in England over the last few years. We have already demonstrated 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, the time has come to stop delaying and to now 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. We do however 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 now to create capacity for clinical services. We feel strongly about this issue and that's why we are working alongside HubRx and PillTime to raise awareness.

Pharmacy hub and spoke providers gathered at Westminster on Tuesday (November 19) to highlight to MPs the urgent need to implement Model One of Hub and Spoke legislation. This proposed model, aimed at making hub and spoke dispensing accessible to all pharmacies, was initially scheduled for rollout in January 2025, but has been delayed. Representatives from Centred Solutions, HubRx, and PillTime engaged with over 30 MPs at the event, which was organised with the support of former pharmacist and Labour MP Sadik Al-Hassan. They highlighted the significant benefits of hub and spoke for community pharmacies and stressed the need to extend its use across different legal entities. Sadik Al-Hassan, MP for North Somerset and officer for the Pharmacy APPG, expressed his support, saying, "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."

While responding to the consultation on hub and spoke dispensing, trade unions for pharmacists have emphasised that the patient safety and care must be the priority in hub and spoke dispensing. The Royal Pharmaceutical Society (RPS) has welcomed the opportunity provided by a change in legislation to enable community pharmacies to make use of hub and spoke dispensing but reaffirmed that patient care must be at the heart of future changes. With regards to patient safety, the Pharmaceutical Services Negotiating Committee (PSNC) considers that only Model 1 is appropriate, with manageable risks related to patient safety, and is a model that has the potential to allow the whole sector to benefit fairly. In its response to the consultation on Hub and Spoke dispensing, PSNC highlighted that Model 2 in the consultation, a hub direct to patient supply of dispensed medicines, raises patient safety issues and it cannot be supported. RPS President Professor Claire Anderson said: "In all models, patients need to continue to have access to a pharmacist at the time of supply of medicines so they have the opportunity to discuss, ask questions or raise concerns, and receive appropriate information with counselling and advice.

The Department of Health and Social Care (DHSC) has finally published its response to the 2022 consultation on hub and spoke dispensing. Considering the consultation evidence and further discussions, the government has expressed its intention to progress the proposals for enabling hub and spoke models across different legal entities as soon as possible. This will be achieved by using the enabling powers outlined in Part 2 of the Medicines and Medical Devices Act 2021 (MMDA) to amend the Medicines Act 1968 and the HMRs. Furthermore, the DHSC has decided to proceed with the implementation of the two models of hub and spoke dispensing that it consulted on. The government response to the consultation reads: "Having considered the responses, the government intend to proceed to implement the necessary changes to medicines legislation to remove the current restrictions that prevent the hub and spoke dispensing models from operating across different legal entities found in section 10 of the Medicines Act 1968.

The Royal Pharmaceutical Society (RPS) has expressed a neutral stance on assisted dying, while emphasising the importance of certain safeguards in any proposed legislation. In particular, they have urged the Bill Committee to include clauses addressing conscientious objection and criminal liability for health professionals involved. The Terminally Ill Adults (End of Life) Bill, which passed its second reading on 29 November 2024, would allow terminally ill adults to request assistance in ending their life, subject to safeguards and protections. The RPS has submitted a written response to a House of Commons committee examining the Bill, urging consideration of several key points. The RPS insisted that there should be "no obligation for any pharmacist to participate in any aspect of assisted dying if they feel this is against their personal beliefs." Instead, they proposed an "opt-in" model, allowing pharmacists and other healthcare professionals to choose to participate in aspects of assisted dying by completing the necessary training, rather than being required to "opt out." "This would help avoid the need for anyone ethically opposed to assisted dying to signpost to another health professional, as this can also pose an ethical dilemma." "This opt-in model would also help identify where it may be more difficult to access health professionals who are willing to support assisted dying, such as in a specific care setting or in remote regions," it explained.

Community pharmacy is stuck in a vicious circle. Pharmacies are closing at an alarming rate whilst the government is talking about moving care away from hospitals and into the community to focus on preventative care. While the government talks about this vision for the future, the stark reality is that pharmacies are already struggling to meet the current Pharmacy First thresholds. And now we discover that one of the key components that could create capacity in pharmacy to deliver more clinical services has been put on hold…indefinitely. The recently published Darzi review, which was commissioned after the new government came to power to assess the state of the NHS, praised the value of community pharmacies and preventative services. But it recognised the level of pharmacy closures across the country and warned pharmacy access could be 'at risk'. Community pharmacy is ideally placed to deliver the government's vision of preventative care in the community. But let's all be clear, moving preventative services into community pharmacies has, so far, been nowhere near as successful as it could have been due to the current climate pharmacies find themselves in. The Pharmacy First scheme is a testament to this. Just this week it was announced that consultation thresholds for the Pharmacy First scheme have been reduced from 30 consultations to 20. It's the second time in three months that the thresholds have been reduced and it follows an intervention from Community Pharmacy England who wanted to "save many pharmacies from missing out on a vital payment this month." In June alone, 3,269 participating pharmacies failed to meet the threshold - that's almost a third of all community pharmacies in England.

The Pharmacy Supervision Practice Group consisting of members from AIMp, APTUK, CCA, NPA, PDA, PFNI and RPS held its fourth workshop to continue discussions on the future modelling of pharmacy practice. The ideas around 'supervision' shared by the organisation earlier formed the basis of the discussion during the workshop and helped to expand understanding of where there was consensus and disagreement. Examples of ideas explored during the workshop include: the extent to which a pharmacist should supervise the medicines assembly process, the purpose and extent to which a pharmacist might be absent from the pharmacy and how this might affect patient safety as well as the nature of whether fixed rules versus a broad framework were preferable for future practice. Chair of the group, Dr Michael Twigg, Associate Professor of Primary Care Pharmacy, University of East Anglia, said "Once again the sector bodies have come together in a collaborative and positive manner to explore the concept of 'supervision' in the context of current and future community pharmacy practice. This session provided an opportunity to constructively challenge assumptions and viewpoints within the group with the aim of moving the discussion forward." As part of the session, the DHSC, GPhC and PSNI gave an overview of the difference between legislation, regulation and guidance which was helpful to inform the group's thinking. Each of the organisations have been asked to use the conversation to refine the ideas presented in advance of the next workshop.