In Analysis

Follow this topic

Bookmark

Record learning outcomes

What should independent pharmacies do to free up their time so they can focus on delivering services? Kathy Oxtoby reports…

In October, regulations permitting hub and spoke dispensing between different retail pharmacy businesses came into effect. It has been almost a decade since draft legislation was proposed to enable hub and spoke dispensing between different retail pharmacy businesses.

Now, hub and spoke provisions in The Human Medicines (Amendments Relating to Hub and Spoke Dispensing etc.) Regulations 2025 and The National Health Service (Pharmaceutical and Local Pharmaceutical Services) (Miscellaneous Amendments) Regulations 2025 “have come into force, enabling all pharmacies to have hub and spoke arrangements”, says Community Pharmacy England (CPE).

“Hub and spoke dispensing within a single retail pharmacy business (intra-company hub and spoke dispensing) is already permitted and has been a feature of pharmacy practice for a number of years. This is not affected by the new HMR and PLPS regulations,” says CPE.

The advantages of automation

It “broadly supports the introduction of changes that allow hub and spoke dispensing to occur between different legal entities, as one of a number of ways for pharmacy owners to free up pharmacist time for the delivery of other clinical services”, says Gordon Hockey, director, legal at CPE.

He says the new hub and spoke regulations “level the playing field (at least legally) between companies that are big enough to operate their own hubs and independent pharmacies and small chains, where this is not a realistic option”.

Hub and spoke dispensing can also provide smaller pharmacies with the advantages of automation and can increase the number of prescriptions that smaller pharmacies are able to dispense, says Mr Hockey.

“Some independent pharmacies, but by no means all, will find hub and spoke to be a useful mechanism for releasing time for patient care,” says Gareth Jones, director of corporate affairs at the National Pharmacy Association (NPA). 

“However, this is certainly no silver bullet as far as pharmacy finances are concerned. The medium to long term business case only stacks up for local pharmacies if there is an ongoing pipeline of NHS investment in clinical services, to make productive use of the pharmacist time released.

“The NPA provides detailed guidance for those of our members wishing to engage with this long-anticipated opportunity.” 

He says: “We’ll keep an eye out for unintended consequences, because this is a substantial change in pharmacy practice that needs to operate safely and efficiently for patients and on a level playing field for contractors.”

Hub and spoke must ensure patients have timely access to a pharmacist

Amandeep Doll, the Royal Pharmaceutical Society’s (RPS) director for England, says: “We support the removal of barriers in legislation that prevent the use of hub and spoke dispensing models, provided patient safety, accountability and regulatory oversight are maintained.”

She says hub and spoke models “must ensure patients continue to have timely access to a pharmacist for advice and support”.

“We also believe transparency with patients is key – pharmacies should make it clear when hub and spoke dispensing is being used and which hub is involved.”

What’s needed are “clear standard operating procedures and policies for hubs and spokes”, she says. “Any implementation should enhance the role of community pharmacies in providing clinical care to patients.”

Harry McQuillan, chairman of Numark, says the introduction of legislation enabling hub and spoke dispensing between different retail pharmacy businesses marks “an important moment for community pharmacy”.

“In principle, Numark welcomes any change that can deliver greater flexibility, efficiency, and consistency of service for patients, and we must be clear that the benefit of this change will depend entirely on whether it is economically viable for all pharmacies, not just the large pharmacy groups.”

He says: “Our position remains that hub and spoke must work for the whole sector, including all sizes of independent pharmacy owners.

“Without an accompanying economic model that defines who benefits, how costs are shared or apportioned across differing legal entities, and what efficiencies are truly passed back to the spoke, this legislation risks widening the gap between large, vertically integrated operators and independent contractors.”

That said, for independent community pharmacies, “the case for adopting spoke and hub assembly lies in the ability to free up pharmacist and their support team’s time for patient-facing care”, he says.

“Delivery of clinical services becomes much easier when we improve workflow efficiency, dispensing accuracy, and manage stock more effectively through the technology deployed in centralised assembly.

“This development allows the pharmacist workforce to focus on the safety of supply, which will become an increasing element of their clinical practice as prescribing is embedded within the community setting,” he says.

It is also anticipated that various models of hub operation will develop and that one size will not fit all, he says. “Regional hubs, for example, would allow supply resilience to be built into the system and our recent experience during the covid-19 pandemic demonstrated that the current network of community pharmacy is extremely resilient and versatile. That factor cannot be lost as this model is considered.”

The case against is “equally significant”, says Professor McQuillan. “Independent pharmacies may not have access to affordable or interoperable hub options, commercial terms could be unfavourable or opaque, and regulatory and liability frameworks remain complex when using an external hub that is shared across differing legal entities.

“The very low generic medicines pricing in the UK and the subsequent low level of purchase margin left in the system right across the pharmaceutical supply chain, makes the economics precarious for all involved.”

Numark’s view is that “the concept can work and does in other European countries, and only where independent pharmacy owners are supported to participate on a level playing field”.

“That means clear economic modelling, transparent pricing structures, and fair access to hub providers,” says McQuillan.

He says ultimately, spoke and hub assembly “should be about improving patient care through smarter use of resources, and that element is often lost in this debate”. “Numark continues to urge policymakers to ensure that the independent sector and its millions of patients are not left forgotten as this new model evolves”.

And what of the alternatives? Instead of getting involved in hub and spoke, should pharmacies invest in a robot?

“It is not a matter of just buying a robot, it is a matter of buying the right robot for your needs,” says Cyrus Hodivala, managing director of Meditech UK and Ireland, a provider of integrated robotic solutions with more than 4,000 installations worldwide in 22 countries. He is also owner of Cristal Pharmacy, an independent pharmacy in North London.

“This robot needs to be sized correctly and allow for your future growth with real figures and real business modelling around it. The advantages of the right robot in the right environment can be huge and life changing for the pharmacy or group involved, especially when partnered with the right PMR software and a professionally thought-out workflow,” he says.

“Take away the mundane tasks of stock counting and put away and release the power of high-speed picking and dispensing with automated checking in line using the right software combination with your robot,” he says.

“This is when automation becomes hugely powerful. It gives pharmacy owners choices. Choices that have been sadly lacking from fully manual systems other than by adding more staff in order to get the job done. 'Automate, Innovate, Dominate' is the strap line for Meditech in the UK and one we believe in.”

Further information/resources

·     Community Pharmacy England: Briefing 020/25: Hub and Spoke dispensing between different retail pharmacy businesses. [https://cpe.org.uk/briefings/briefing-020-25-hub-and-spoke-dispensing-between-different-retail-pharmacy-businesses-2/]

·     General Pharmaceutical Council (GPhC) guidance on hub and spoke dispensing. [https://www.pharmacyregulation.org/about-us/news-and-updates/gphc-review-highlights-areas-improvement-hub-and-spoke-dispensing]