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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.

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.

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.

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."

Superdrug has announced a pay increase for newly qualified pharmacists, in a move that will see wages rise to £50,000 - ensuring that Superdrug Pharmacists continue to receive the strongest renumeration package on the high street today. Superdrug is also enhancing its patient experience and operational structure, with the introduction of a new role of Pharmacy Team Leader to selected pharmacy stores. Pharmacy Team Leaders will be dispenser trained and provide a clear line of accountability for day-to-day dispensary activity including adhering to legal and clinical frameworks whilst supporting, coaching, and developing a high-performing pharmacy team. The role also allows Superdrug to offer a clear line of progression for talented Pharmacy Dispensers and Technicians who want to do more in their career and recognises the valuable contribution Pharmacy Dispensers & Technicians play in community pharmacy. In addition, the appointment of two new Heads of Pharmacy Operations sees the high street retailer driving and improving Superdrug's pharmacy performance to offer the best possible care for patients. Craig Watt, Pharmacist and previously Area Manager, has been appointed to Head of Pharmacy Operations North and will be responsible for the operation of Superdrug's central distribution hub serving its e-pharmacy and Online Dr team.

A new report has suggested that adopting hub and spoke dispensing model could be a realistic and affordable option for many pharmacies across the UK, not just a select few. The report released by Centred Solutions highlighted several evidence-based benefits of this model, including a return on investment (ROI) within two years for an average pharmacy, debunking the skepticism that has long surrounded the model. Analysis by the software and technology company found that the ROI, from setting up a hub and all operational costs (excluding transport), can be achieved through either re-directing time saved into delivering services, improving resource efficiencies, or a combination of both. One of the key findings is the 81 per cent reduction in payroll costs per item-from 99p in a pharmacy to just 19p in a hub. The report also revealed that by shifting to a hub and spoke model, pharmacies could offload 50 per cent of total dispensing volumes (70-80 per cent of repeat dispensing) from their branches, creating much-needed capacity. The report also projected an average stock reduction of 50 per cent in the first year for pharmacy branches moving to this model of dispensing.

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."

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.

Two weeks prior to the closing of the hub and spoke consultation, issues around patient safety, costs and competition as well as practicalities such as what to do with uncollected medicines were discussed in a webinar on hub and spoke dispensing on Wednesday (May 26). The webinar was organised by Sigma Pharmaceuticals in association with the National Pharmacy Association (NPA). NPA director of corporate affairs Gareth Jones chaired the event and was joined by Sigma's Hatul Shah and Raj Haria as well as NPA vice chair Nick Kaye and NPA head of advice and support services Jasmine Shah. Kaye said: "There are still many 'unknown unknowns' with hub and spoke and the jury's still out on any potential benefits. I have lots of reservations about cost and it worries me how efficient this is for the business and the long term sustainability for the sector as a whole. Above all we need to think about the patient at the centre of all this and the potential confusion for them." Jasmine Shah felt patient safety was going to be the key in regards to whether the spoke and the hub would hold the ultimate responsibility and "who is going to take the accountability as far as patient care goes". She added: "It is most important that GPhC standards and NHS requirement are both met in identifying all the risks associated with the arrangement with hub and spoke and ensuring that (patient safety) measures are in place. Everything that needs to be looked at is by putting the patient at heart of the arrangement and seeing what is the safest way for them to receive care from both spoke and hub."

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.

A policy brief, developed by researchers from the University of Bath and University of Strathclyde with funding from Sigma Pharmaceuticals, has recommended the Department of Health and Social Care (DHSC) and NHS to increase community pharmacy funding to avoid damaging closures and diminution of quality. The report launched on Wednesday (12 June) at an event in the House of Commons, attended by Members of Parliament, senior policymakers and the pharmacy industry, analysed community pharmacy policies and spoke to stakeholders to explore their opinions of the future of community pharmacy. It was found that patients value their community pharmacies, but staff feel demotivated, insecure and undervalued. Stakeholders and policies suggested that in the future, medicines should be supplied by automated 'hub and spoke' dispensing, enabling community pharmacy staff to provide services that relieve pressure on GP surgeries, such as long-term conditions management, urgent care and public health.

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.

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.

Maxine McCabe has made history as the first community pharmacist in the UK to be credentialed as a core advanced pharmacist by the Royal Pharmaceutical Society (RPS) in Scotland. Announcing McCabe's achieving, NHS Education for Scotland (NES) stated that this credential demonstrates her expertise across the four pillars of advanced practice: clinical, leadership and management, educating others and research. Maxine has worked in the community pharmacy sector since qualifying as a pharmacist in 2008, consistently showing a keen interest in developing the wider pharmacy team and enhancing clinical services for the local patient population. Throughout her career, she has managed various community pharmacies, including Boots and Parkhead Health Centre Pharmacy, where she played a crucial role in developing pharmacy practice and nurturing pharmacy support roles and trainee pharmacists. In 2023, Maxine took on a part-time role as a Senior Educator in the Prescribing & Clinical Skills teams at NHS Education for Scotland (NES). She continues to practice as a pharmacist, leading the Teach and Treat Training Hub at Burnside Pharmacy in Lanarkshire. McCabe expressed her excitement about the recognition, saying, "I am delighted to obtain my Advanced Practice credential and showcase that this is achievable in community pharmacy."

The Department of Health and Social Care (DHSC) has published its response to the 2016 hub and spoke consultation which has paved the way for a new discussion following engagement with community pharmacies and other stakeholders this year. The response showed that many respondents supported use of hub and spoke dispensing models in independent pharmacies, but expressed concerns about some practicalities related to it. Respondents raised concerns around "patient data, liability, implications for the supply chain, and risks to the existence of small community pharmacies." They also raised question about the speed of access to medicines in an emergency and security of data transfers between hubs and spokes, DHSC stated.

The Department of Health and Social Care (DHSC) has notified Community Pharmacy England (CPE) that they will no longer be able to implement the new hub and spoke models from 1 January 2025 as initially planned. The delay comes after the General Election, which put the progress of these amendments on hold. The DHSC is currently briefing new ministers across all policy areas, including hub and spoke dispensing between different pharmacy owners. As this process will take time, the implementation will not proceed as originally scheduled. CPE has stated that it does not yet have a clear timeline and will provide an update to the sector once more information becomes available. Malcolm Harrison, CEO of the Company Chemists' Association (CCA), expressed disappointment over the continued delays in fulfilling commitments made in the 2019 contractual framework agreement to support pharmacies.

Pharmacy hub and spoke specialists, Centred Solutions, has further strengthened its team with a key new appointment as the company expands its business. Ashley Kilgas, formerly sales director at Alliance Healthcare, has joined the company's executive team as chief commercial officer. An expert in sales leadership and customer relations with vast experience working in the healthcare and pharmacy sector, Kilgas will be tasked with building a high-performing commercial team to drive value for customers. Having worked closely with Centred Solutions on previous projects, Ashley already has an in-depth knowledge of the business. Expressing his excitement about his new role, Ashley said: "Centred Solutions is a pharmacy technology and automation company, with a tremendous amount of opportunity in front of it. There is currently nobody in the market with the same knowledge, expertise or product offering around hub and spoke. "While the company is still in its infancy, it is growing rapidly, and I am looking forward to working with the team to further strengthen and grow the business to support those working in pharmacy."

Pharmacy wholesaler PHOENIX UK is investing over £13 million to build a new state-of-the-art distribution hub in Wakefield. The 260,000 sq. ft facility is expected to be operational next year and will service community pharmacies, hospitals and dispensing doctors across the North East of England and Yorkshire. In a statement on Tuesday (July 5), PHOENIX UK said the completed hub will feature 22 dock level loading bays and seven access doors to enable the productive arrival and distribution of medical products. It will also be highly energy efficient, including the use of Solar PV on its roof. The car park will also offer 46 electric vehicle charging bays. Speaking at an official opening event held on 30 June to mark the expansion of the company's distribution capabilities, group managing director of PHOENIX Steve Anderson said: "Over the last few years, we have seen an outstanding growth in customer demand for our core services outpacing the market: Wakefield is a prime example of how we are committed to investing in the future by expanding our UK-wide operational capabilities to offer all our customers across the country the best possible service they need, want and deserve.

Sobha Sharma Kandel wants community pharmacy teams up and down the country to be super responsive to emerging needs of their patients - by always being pro-active rather than reactive. "We know that every patient benefits from our proactive approaches - listening, asking questions, providing information and making clinical interventions when appropriate. "At a time when general practice is overstretched, community pharmacy must be relied upon as the frontline of the NHS when it comes to providing diagnosis, treatment and continuous care in our communities to promote health and wellbeing of our patients." Sobha believes Covid-19 has helped shift public perception of community pharmacies from being a place where one goes to collect a prescription to a hub where one can access a range of healthcare advice and services. "We are way more than just a shop where you can collect your medicines," she said, giving examples of how her interventions have helped reduce medication errors, prevent harm and subsequently reduce cost of care. She once saved a baby from getting overdosed with omeprazole when they had issues with gastroesophageal reflux. On another occasion, she managed a lady's high blood pressure by finding equivalent medications to a combination dose prescribed by her doctor in another country.