There was a positive buzz around last month’s Royal Pharmaceutical Society conference, with many innovative practitioners displaying their brave ‘can do’ approaches to community practice, and an apparent acceptance among top-level speakers that pharmacy’s time is genuinely and finally about to come.

The most outspoken of the four chief pharmacists sharing the podium for a panel session was undoubtedly England’s Dr Keith Ridge. He hinted heavily at a technology-rich, dispensing-lite future for community pharmacy in which two-thirds of prescriptions could be assembled at dispensing hubs (see news page 4).

While most pharmacists would be delighted with less involvement in dispensing, not all would like the entire dispensing process removed from their premises. Good arguments can be made for these hub operations, particularly for repeat items, and the multiples already make use of them to a greater or lesser extent. Dr Ridge wants legislation changed so that independents can use third-party dispensing hubs, which would level the playing field to some extent.

Even though dispensing has increasingly become a technical, rather than a professional, process, many pharmacists would still prefer to retain a degree of control over the operation. Not only are they liable, as the responsible pharmacist, for its outcome, they are also financially dependent on its efficiency.

And let’s not underestimate the scope of medicines optimisation work that goes on in every community pharmacy. Selecting a particular tablet colour, brand, packaging, print font size on the label, popping tablets out of their blister foil, selecting a non-CRC cap, or setting up an inhaler for its first use, are all important parts of medicines optimisation that simply wouldn’t be done at a dispensing hub.

Community pharmacy looks set to become increasingly multi-faceted, driven by local commissioning, various roles such as practice-based pharmacists, and the increasing use of technology. So while some contractors may see dispensing hubs as a genuine step forward for their practice, particularly if they can set up their own with local colleagues to agreed protocols, others may prefer to keep closer control of what remains their fundamental raison d’être. But beware: patient choice is a good thing, but confusion around who dispenses their prescriptions and why is definitely not.

Dr Ridge’s suggestion that the profession could make more use of click-and-collect dispensing may be a step too far for many independents. The real danger is that pharmacists innovate themselves out of their long-standing and important supply role before they have a firm foothold in a new service provision role.