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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."

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.

Speaking at the SIGMA Conference 2023, Dr Leyla Hannbeck, CEO of the Association of Independent Multiple Pharmacies (AIMp), spoke about the increasing number of prescriptions, lack of funding and other existing challenges. Leyla explained how the pharmacy sector is facing immense challenges which are disrupting the delivery of services as well as impacting its growth. She further spoke about the hub and spoke model, and how it is unable to solve the issues. "Community pharmacies are clogged with prescription volume, and this is preventing them from supporting the wider NHS as well as offering services," she said. She said that the prescription volumes have rocketed, while the number of pharmacies in England has declined from 11, 522 in the year 2021-22 to 11, 414 in 2022-23. When it comes to Company Chemists' Association (CCA) pharmacies, there has been a loss of 1055 branches from 2022 to 2023.

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.

Bristol-based Titan PMR, a technology firm specialising in PMR systems for community pharmacies, is set to roll out an innovative platform named 'Titanverse,' that it claims will redefine pharmacy management, offering comprehensive solutions extending beyond prescription management. This new platform takes a versatile approach, efficiently managing all facets of pharmacy operations, from high-level management down to daily tasks, according to top company officials. "Our aim is to reshape pharmacies into genuine health hubs, providing advanced services and harnessing state-of-the-art technologies," said Tariq Muhammad, CEO of Titan PMR. "Titanverse, our latest offering, is positioned to ignite this transformation, revolutionising clinical services in the same way its predecessor revolutionised dispensing. With Titanverse, we have the vehicle to drive this vision forward, placing pharmacies at the forefront of primary care in the future." Titanverse adopts a Teams approach, catering to pharmacies with multiple locations or specific focuses. It furnishes real-time analytics and employs a color-coded rating system for swift performance evaluation. Moreover, the platform eases operations by enabling task delegation, encompassing clinical checks and dispensing, all while backing private services with adaptable templates and workflows.