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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."

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.

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.

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.

Talk of hub and spoke models has been rumbling on for as long as I can remember. The topic has once again hit the headlines as the government announced a fresh consultation for its proposed changes, calling on all interested parties to submit their views by 8th June. The argument for hub and spoke is to allow independents to have the same level playing field as the larger groups who have been operating this model for some time. The government also sees significant efficiency gains in centralisation, arguing this will free pharmacists time away from dispensing to focus on clinical services. The latest consultation advocates two models being created. In the first model, the dispensed medication is sent back to the spoke. In the second model, the completed medication can be sent out directly to the patient. The latter is a new concept which could open up new opportunities in how services are delivered. Pharmacies could effectively outsource the entire dispensing and delivery to housebound patients and care homes allowing pharmacies to take on new business without having to worry about logistics and geography.

The Company Chemists' Association (CCA) has called for an evidence-based approach to hub and spoke dispensing proposals, stating that it is vital to back the changes based on robust data and lived experience of pharmacy businesses. Community pharmacy contractors need to to respond to a Department of Health and Social Care initiated consultation on the hub-and-spoke dispensing models by June 8. Malcolm Harrison, CEO of the CCA, said: "I am very concerned by both the number and scale of the assumptions contained within the impact assessment, which are unlikely to come to fruition. "The impact Assessment also makes predictions on a yet un-born market, stretching 10 years into the future. Hub and spoke technologies do have the potential to enable new dispensing models in the future if new commissioning can support a change in operations. I would caution against firm predictions about likely benefits without stronger commitments to enablers of change."

The Competition and Market Authority (CMA) has suggested regulatory levers to curb "potential competition risk" from hub and spoke dispensing. In its response to the hub and spoke dispensing consultation, led by the Department for Health and Social Care (DHSC) last week, the competition watchdog said that a pro-active approach to monitoring the effect of hub and spoke dispensing and subsequent early consideration of any competition concerns was likely to be more effective and potentially less costly than any "ex-post enforcement any ex-post enforcement or unpicking of subsequently embedded competition issues". The competition watchdog has made a few suggestions to identify and remove the barriers to competition that might emerge with the new business models entering the market. It has asked the department to enable a "more level playing field". "Smaller independent pharmacies should, have improved access to automation and new dispensing models," it said.

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."

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.

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.

The Royal Pharmaceutical Society (RPS) has called its member to to express their views and fill out the Department of Health and Social Care's hub and spoke survey on the proposed model of dispensing. The Society has urged its members to fill out the survey before May 20. RPS president Claire Anderson said: "It is vital that RPS members have their say on issue that impact you in your roles. Currently only single legal entities can make use of this model of dispensing. "Our survey, which opened today, seeks your views and comments and will help to inform the RPS submission to this consultation." The consultation on the proposals to enable all community pharmacies to access hub and spoke dispensing published by the Department of Health and Social Care (DHSC) will run for three months and will close on June 8, 2022.

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.