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Hub and spoke will transform independent pharmacy

The model is the way forward for independents – and their local communities, says Daniel Lee...

Take a moment in your busy day and imagine this. A patient enters your pharmacy and the first thing you see is an open reception desk with clinical pharmacy support staff using iPads and screens to help customers choose from a range of products, delivered by a robot-operated chute from another part of the building.

To one side is an automatic body scanner that gives personalised health information. In front of you are two or three soundproof, purpose-built consultation rooms where after booking an appointment, patients can have a consultation with one of the pharmacists or technicians from a range of services.

Where are the pharmacists, normally seen the back of the shop, toiling away dispensing and checking prescriptions? They’re front of house now. They’re the clinical experts fully using their knowledge to help customers (and maximise their income).

They’ve just finished a diabetes clinic and now they’re about to see more customers for New Medicine Service reviews. Later they’ll deal with referrals from GPs and do some near patient testing to manage patients on oral anticoagulants. That leaves some time for private weight management and hair loss consultations.

The final task of the day is to take delivery of a batch of prescriptions dispensed by a state-of-the-art hub for independents.

Welcome to the future of community pharmacy. It’s closer than you might think. Next year, the government is likely to pass legislation allowing independents to use hub and spoke dispensing, already enjoyed by the big multiples. It’s set to help pharmacists break free from their traditional dispensing role and finally use all their hard-earned skills to grow their business.

Fresh from university, I joined my family’s independent pharmacy business more than 20 years ago but quickly became frustrated by the role. We had become individual purchasing managers for the NHS, addicted to our drug buying margin at the expense of our clinical service role. I felt trapped in the dispensary, professionally isolated and under constant pressure to deliver more for less.

Our owner-manager status also constrained our ability to adapt to the modern world. I watched as single-handed GPs took stock of their professional and business limitations and moved into partnerships based in shiny new multi-million-pound health centres.

I wondered why independent pharmacies couldn’t do the same without being swallowed up by a huge multiple. After just a few years I left community pharmacy and founded the UK’s first online pharmacy where I have spent most of my career since then re-engineering pharmacy processes to transform medicine supply in the UK.

A radical rethink of medication delivery has led to the hub and spoke model that is being developed to support the transformation of independent pharmacy.

A lot has changed over the past two decades, in many cases for the better - but there are the same recurring themes. If independents were in any doubt about the need to change direction, the NHS long term plan and community pharmacy contractual framework provide clarity. Independents can no longer depend solely on dispensing income.

The CPCF lays out how their clinical skills can be used – in urgent care, minor ailment consultations, new medicine reviews, health prevention and so on.

Hub and spoke for independents means seamless integration between PMR technology providers and a state-of-the-art automated pharmacy facility providing an outsourced assembling service at the highest levels of accuracy and low cost. Critically, it will pass on all purchase margin benefits to partner pharmacies.

It'll finally give independents the ability to reorganise their premises, clearing the huge amount of space currently taken up by inefficient dispensing areas and displays of toiletries, cosmetics and OTC items, and making way for a modern technology-supported clinical environment.

In this Covid-19 world, patients have quickly recognised community pharmacy’s place as a first port of call in primary care when many GP practices were struggling to stay open. Let’s give our communities the facilities they deserve and our profession the opportunity that goes with it.


Daniel Lee is the CEO of HubRx.




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