NPA hub and spoke roundtable shows risks remain – as parliament considers law change

23 Sep 2020

The National Pharmacy Association has published an account of an expert discussion on hub and spoke dispensing, held at the King’s Fund earlier this year.

Organised by the NPA and chaired by King’s Fund chief executive Richard Murray, the participants included representatives from community pharmacy, the pharmaceutical industry, wholesalers, the NHS, government and regulators.

The meeting concluded that hub and spoke has some potential to release capacity at pharmacies and improve patient safety, but that there are significant risks and barriers to overcome.  It was also a key theme that other capacity-releasing measures could achieve similar aims without the same risks.

All participants at the roundtable in February had access to a NPA report published that same month, which highlighted that large scale automated dispensing remains very limited globally, despite the technology being established for many years.

NPA chief executive, Mark Lyonette, said:

“This meeting was unique in terms of the broad range of stakeholders it brought together in one place to discuss this important issue. The NPA remains very sceptical about some of the grander claims made for hub and spoke dispensing. No studies of the impact on patient safety of the full end-to-end process have yet been conducted.But we see it as our duty to seek solutions that mitigate risk for our members and patients, to engage fully in debates about automation and service re-modelling and to ensure proper scrutiny of the assumptions on which claims for hub and spoke are built.”

King’s Fund chief executive, Richard Murray, said:

“I was pleased to be invited by the NPA to chair this event, as someone with an abiding interest in the success of community pharmacy. Hub and spoke is a contentious matter within the pharmacy sector, but this roundtable discussion was a serious, balanced exploration into safety, efficiency, regulation and feasibility.”

The write-up of this roundtable meeting (which took place on 25 February) was delayed by the onset of coronavirus and the need to reprioritise work streams.

Its publication this month coincides with ongoing consideration of the Medicines and Medical Devices Bill in parliament, which will pave the way for regulations to legalise ‘inter-company’ hub and spoke dispensing, where a pharmacy can outsource elements of its dispensing to a third party.