Lo's Pharmacy, a Yorkshire-based pharmacy chain is adopting a new approach to hub and spoke in a first of a kind model to be used in the UK.
The pharmacy will centralise its repeat prescription dispensing service for original packs with the support of its medication wholesaler.
The independent group, which has 25 NHS community pharmacies across Yorkshire, will install Centred Solution's Automated FLOWRx Hub product at its central dispensing
facility in Wath-Upon-Dearne, South Yorkshire.
But unlike other FLOWRx customers, who pick packs from a robotic dispensing system or internal warehouse, Lo's Pharmacy will receive patient-specific flow totes
directly from their wholesaler which can then be processed by their hub.
This workflow has not been used anywhere else in the country until now and it is a revolutionary approach to hub and spoke dispensing, showing what can be achieved
when key players decide to collaborate. It further demonstrates that there are range of variations of hub and spoke models available and accessible to independent
and multiple community pharmacies across the UK.
Paydens Pharmacy Group, one of the first multiple pharmacies to adopt hub and spoke model last year, revealed that the move has resulted in significant time
savings in store.
Centralising dispensing of repeat prescriptions relieves pressure in pharmacy branches and releases time to deliver revenue generating services, the group said.
The group created a hub in Maidstone, Kent, to service its highest dispensing branches. The hub uses Centred Solution's FLOWRx Hub Auto to dispense their original
pack repeat prescriptions. The group put in the first FLOWRx Hub production line in spring 2022 and then added in a second line in the autumn as they increased
production and moved more stores to the hub and spoke model.
The innovative solution interfaces with EMIS PMR, Omnicell's Robotic Dispensing System and Universal Logistics Management software as well as Victoria OS ordering
software.
The hub operation runs during the day Monday to Friday and produces an average of 33,289 packs per week for just under 9,000 patients, leaving plenty of scope to
ramp up. The hub is currently dispensing 79.7% of repeat prescription original packs requested by the group's busiest stores.
The National Pharmacy Association (NPA) has called for immediate intervention by Health Secretary Neil Gray to compensate pharmacies left in financial
chaos due to flaws in Scotland's new pharmacy payment system.
Introduced last year, the system was designed to streamline payments to pharmacies, dispensing doctors, and medical appliance suppliers. However, the NPA, which
represents independent pharmacies across the UK, reported that many pharmacies were facing repeated shortfalls in expected funding under the system.
Some pharmacies have encountered discrepancies of tens of thousands pounds due to errors in the Data Capture Validation & Pricing process introduced by NHS National
Services Scotland.
In other cases, NHS Boards have clawed back money from pharmacies at short notice, following processing errors that had initially resulted in an overpayment.
HubRx has appointed Dr Sarah Passmore as superintendent pharmacist ahead of launching what the company called "the UK's first state-of-the-art automated pharmacy
hub".
Dr Passmore brings more than 20 years of pharmacy experience - having held key regulatory roles with Rowlands Pharmacy over a 11-year tenure, which also saw her
involved in a number of pharmacy automation projects.
Commenting on her appointment, Dr Passmore said: "As a pharmacist, who has spent more than 10 years working within community pharmacy, I'm excited by what a hub and
spoke model for prescription dispensing can bring.
"Pharmacists are highly trained in delivering clinical services to patients - and like me - it's often a part of their job that they thoroughly enjoy. The option of
using hub and spoke to support dispensing prescriptions will give community pharmacists the gift of more time that can be spent helping patients.
"I'm excited to join HubRx and for it to become the first state-of-the-art automated pharmacy hub designed for independent community pharmacists to launch in the UK."
Titan PMR has been accredited by the NHS to provide electronic prescription services (EPS) to dispensing doctors.
Over 1,000 of these doctors, who provide a vital service to almost 10 million people in rural communities, can now offer their patients the same level of benefits
and efficiencies that electronic prescriptions and Titan PMR have brought to pharmacies around the UK.
These features will also increase efficiency for dispensing doctors, who will reduce dispensing errors and improve organisation, increasing their capacity while
enjoying the ability to integrate with other technologies.
After a full year of testing, including six months of compliance testing at a practice in Cumbria, the new accreditation for Titan also has potential to help the
NHS fulfil its target of all prescriptions being issued electronically.
Currently written paper prescriptions from dispensing doctors account for around seven per cent of the total prescriptions in England - around 6.5 million each month.
"Until now dispensing doctor surgeries have basically been in the digital dark ages when it comes to dispensing medicines," said Tariq Muhammad, a tech entrepreneur
and CEO of Bristol-based Invatech Health, which developed Titan PMR.
The recent announcement that Royal Mail will be partnering with distance selling pharmacy (DSP) giant pharmacy2U highlights how standards of regulatory
enforcement are being ignored to accommodate the DSP model.
The brunt of these double standards hinges around the levelling down of temperature enforcement standards by the Medicines and Healthcare products Regulatory
Agency (MHRA) which demands mapping must be audited from the point of dispensing to the patient.
The MHRA has a well recognised duty to ensure medicines reach patients in a safe condition. The current anomaly appears to turn a blind eye to this step in the
supply chain at the point the wholesaler releases goods to the pharmacy hub.
Equally the training on delivering medicines safely and effectively direct to patients should apply fully to all hubs including DSPs. Why is it that DSPs are being
treated differently to bricks and mortar pharmacies? It's essentially the same patients receiving the same medicines from the same wholesalers.
A further regulatory disparity exists around how parcels must be "tracked and signed for" to be reasonably certain medicines are delivered into the hand of the
intended recipient, as per existing regulations.
Clearly an untracked, unsigned package cannot be guaranteed to finish in the hands of the intended recipient.
There is a very real possibility that such omission could lead to community pharmacy closures which will, in turn, lead to unemployment and a reduction in the
care services. At a time when integrated care systems have just gone live, the removal of vital support services leading to further inequalities is the wrong
message for both providers and patients alike.
Omnicell Limited, a wholly owned subsidiary of Omnicell - an American healthcare technology company, has signed an agreement with the shareholders of Hub and Spoke Innovations Limited to acquire Hub and Spoke Innovations.
Hub and Spoke Innovations Limited is distributor of the Pharmaself24 prescription collection kiosk in Great Britain.
The move will complement Omnicell's total solution technology portfolio for retail pharmacy in the UK, including a pack-pick dispensing robot, automated MDS filling
machine and eMAR solution, thereby helping pharmacies to improve workflows and offer a 24/7 access to medications and patient care.
It will also help community pharmacies achieve their goals, as they increasingly look at ways to make their businesses more efficient and free up staff to offer more pharmaceutical care and services to patients.
In short, the deal would enable Omnicell to offer a wider range of digital technologies to streamline retail pharmacy operations, allowing pharmacists to spend more time with patients and focus on value-added, revenue-generating healthcare services, such as vaccinations.
Titan PMR, a pioneer of cutting pharmacy technology has set up additional new team of 12 staff to cater for a deluge of independent pharmacists investing in
new businesses.
The company is utilising the opportunity that is underway as large chains look to sell off or close their community pharmacies, offering an opportunity for
pharmacists looking to provide efficient dispensing and additional services.
In January this year Lloyds Pharmacy, which was bought by a private equity firm in 2022, announced plans to close all its 237 branches inside Sainsbury's stores over
the course of 2023. Currently, more than 5,500 of around 14,000 registered pharmacy premises across the UK are owned by corporates and supermarkets.
Titan PMR - an innovative, cloud-based system which manages end-to-end pharmacy workflow - has become the preferred software platform especially amongst first time
buyers who are keen to offer new services to patients. The new team at the Bristol-based company, hired to support this sector, sees its total workforce growing to
more than 50 staff.
Atorvastatin was the most dispensed drug in England in 2021/22 with 53.4 million items, revealed the annual Prescription Cost Analysis (PCA) published by
NHS Business Services Authority.
According to the official statistics, Apixaban (an anticoagulant) was the drug with the highest cost of £401 million.
The statistics revealed that the cost of prescription items dispensed in the community in England was £9.69 billion, a 0.87 per cent increase of £83.7 million
from £9.61 billion in 2020/21.
"The number of prescription items dispensed in the community in England was 1.14 billion, a 2.58 per cent increase of 28.7 million items from 1.11 billion in
2020/21."
FreeStyle Libre 2 Sensor kit (a glucose monitoring system) was the presentation with the largest absolute increase in cost between 2020/21 and 2021/22 of £69.8
million, from £2.84 million to £72.6 million.
Community pharmacies are located within the very hotspots of peoples' communities, yet a staggering 720 individual businesses have stopped trading since 2015.
It has been called a "national disgrace and a betrayal to the elderly and the vulnerable" by sector leaders.
The funding crisis has been compounded by a gruelling 18-24 months post-Covid, both have which have placed immense pressure on the retail pharmacy sector.
The population is aging and with this comes patients living with a range of long-term health conditions. Medication regimes are becoming ever more complex and as a
result, maintaining prescription and medication adherence services is challenging to say the least.
Yet the public feel great warmth towards their local pharmacy businesses, and this positive attitude only increased during the pandemic. In fact, in a recent report
launched by Omnicell on the Changing Role of the Pharmacist, a survey of public opinion found that a third (32 per cent) said they perception of their local
pharmacy had changed for the better since the start of the pandemic and nearly half (44 per cent) said they are more familiar with their local pharmacy services
since the start of COVID.
This has meant that the role of the pharmacist has also changed and evolved; in part due to a national need and drive for more patients to be seen and supported
clinically by pharmacists.
This change of service provider role has slowly been developing over the last couple of years. Pharmacists are currently carrying out 65 million consultations
a year - a staggering rise of 44 per cent in the last 24 months alone.
With the government gearing up and pushing community pharmacies in England to adopt the hub and spoke dispensing model, stakeholders of the sector and industry
leaders analyse the pros and cons related to the new concept.
The model rose to prominence in 2015 in community pharmacy and the medicine supply chain in the UK, and has undergone a few consultations and reviews at the
professional and governmental level since then.
From a broader perspective, the industry agrees that the model will bring in efficiency to the system, much needed amid community pharmacy's flat funding settlement in England, at the same time highlighting some real challenges.
The National Pharmacy Association (NPA) has so far released three reports on this matter and a review of the challenges and enablers of the hub and spoke in the UK in 2016. Besides, a review of international evidence and the report of a roundtable meeting was brought together in the supply chain with government
and regulators in early 2020.
Online pharmacy PillTime has taken a step to boost its prescription growth by implementing new Patient Medication Record (PMR) system Titan in its
state-of-the-art premises.
PillTime moved to new, expanded 26,000sqft premises in Cribbs Causeway on the edge of Bristol earlier this year, where it has also installed state-of-the-art
robotics in a bid to significantly enhance future productivity and capacity.
Teething problems over Easter weekend saw PillTime struggling to seamlessly integrate all the new systems and processes while physically moving premises which
affected service delivery and customer support.
However, CEO Leighton Humphreys was supported by Tariq Muhammad, CEO of Invatech Health, who is a former community pharmacist and has worked with independent
pharmacies around the UK as well as larger online businesses, to integrate Titan into their workflows.
Alongside integration work, Muhammad and his team supported PillTime with necessary design, governance and pharmacy expertise as the company struggled to meet its
usual high standards for dispensing medicines to patients.
Digital transformation is sweeping across the healthcare landscape. Fuelled by ambitious government policy, exciting innovation and huge injections of funding,
it's hard for anyone in the sector not to catch a dose of digitisation fever.
But digitisation is not a universal tonic, and it certainly isn't always a 'good thing'. In fact, there's a real danger to digitising healthcare. Such a fundamental
change to the very nature of care delivery is an inevitably high-risk process: sometimes things or people get forgotten, vital processes stall, or new systems fail
to replicate the strengths of those they replace. Take, for instance, the digitisation of pharmacies.
Over recent years, the public's use of online-only pharmacies have boomed: in March it was reported that the number of items dispensed from distance-selling
pharmacies in England, UK quadrupled between 2016 and 2021.
These online providers offer an attractively convenient way for patients to receive their medicines; replacing a trip to a high street pharmacy with a package
delivered straight to their door. On the surface, this digital solution seems perfect not only for young patients with busy schedules, but also for older patients
or for those with restricted mobility who may struggle with in-person collection.
From July 2022, Manage Your Services (MYS) portal will be the only route available for pharmacy contactors to submit all new prescription returns/referred
back items and disallowed items, reminded the Pharmaceutical Services Negotiating Committee (PSNC).
Contractors will be able to view and submit the required information for all these items only through the MYS portal.
The NHS Business Services Authority (NHSBSA) will send out a notification email from July (for the dispensing month of June) to the pharmacy NHSmail account if any
new referred back or disallowed items have been generated for the contractor to complete on their MYS account.
"Contractors can view any referred back items for completion by checking the 'Unpaid items' tab on MYS landing page," PSNC.
"It is important to note that prescription returns/referred back items via MYS are only held in the system for a period of 18 months from the date they are first
sent to the pharmacy for action; if contractors have not completed and returned any outstanding referred backs before this deadline has passed, the referred back
items will be deleted from system."
Jhoots Group, a West Midlands based independent community pharmacy chain, has unveiled plans to expand its digital services after securing a funding worth
£8.23m from HSBC bank.
The new money will allow the groups branches to offer a digital platform for customers to request prescriptions online, enabling the implementation of a hub and
spoke dispensing system to automate prescription deliveries.
The innovation aims to reduce the burden of manual processes on pharmacists, allowing staff to use their time efficiently and support the NHS by offering vaccines
and minor ailment medicine services.
San Jhooty, chief operating officer at Jhoots Group, said: "When faced with the unprecedented challenges of the pandemic, primary and community services came
together to support the community and each other.
Errors of any kind in medical settings can have dire consequences for patients and healthcare systems. Unfortunately, negligence, misdiagnosis, and
medication errors aren't uncommon in the UK.
In this article, we discuss the nature of medication errors in the NHS, outline potential causes, and delve into how and why technology could be turning the tide
on the issue.
Prevalence and consequences of medication errors
Medication errors are incidents involved with the administering, prescribing, dispensing or monitoring of medicine to patients. It can happen at many different
steps in the healthcare process and by any medical professional in the system. Many cases are avoidable.
According to analysis from BMJ, there are an estimated 237 million medication errors made in England every year. The majority of these are minor errors, but 1 in 4
cases has the potential to cause moderate to serious harm to patients.
Not only do these errors cost the NHS significantly, at almost £100 million every year, but there is a shocking cost to public health. Lives are being lost because
of medication errors which is unforgivable and tragic for the families involved.
Drains on NHS resources have widespread impacts on public health and the operations of healthcare organisations up and down the country. Individual errors and
mistakes may seem inconsequential (in minor cases), but they all add up in the big picture to a significant concern for policymakers.
The Serious Shortage Protocol (SSP), for Estradot 50mcg patches will expire at 23.59pm on Friday 24 February 2023.
Department of Health and Social Care (DHSC) has confirmed that sufficient stock of Estradot 50mcg patches are now available to meet normal demand.
"After 24th February, any prescriptions for Estradot 50mcg patches must be dispensed in accordance with the prescription, and SSP048 will no longer be valid for
use," said DHSC.
Top tips for SSP claims by PSNC:
Where available, use the claim amend facility on the PMR system to rectify any incorrect EPS claims already submitted this month.
For any supplies made in accordance with SSPs, check that the correct number of patient charges are collected and declared on the end of month FP34C submission.
NHSBSA advise that contractors must follow the specific endorsement guidance issued with each SSP and endorsements should be clear and unambiguous - NHSBSA
processing staff must be able to determine what has been supplied. NHSBSA have published information on common SSP endorsing errors they see when processing claims.