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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.

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.

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 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.