Numark has reignited the hub and spoke debate, saying it could create the capacity for independent pharmacists to provide more professional services and improve patient outcomes.

Speaking this week at the group’s overseas conference in Cape Town, managing director John D’Arcy accepted that it is an emotive subject but it was important to debate the issue.

“We could have ducked it but that would not be good leadership, nor would it be good for independent pharmacy. Trust me, hub and spoke is coming. We ignore it at our peril. Let’s have the debate.”

A combination of rising prescription volumes and outdated supervision requirements is making pharmacy’s practice model unworkable, he said. Money is tight in the NHS and the Government is looking to make efficiencies and also wants greater value from pharmacy.

“Pharmacy urgently needs to wrap a value proposition around supply that focuses on patient outcomes and delivers value for money for the NHS. However, it is critically important that pharmacy retains the supply function because that provides the nexus to the patient through which pharmacists can add value.”

There is no doubt that the Government sees hub and spoke as a way of creating efficiencies and cost savings, Mr D’Arcy told delegates. However, he emphasised that face-to-face contact between patient and pharmacist is the best solution, which is why it is key that pharmacists are the ‘spokes’ in such a system.

“The NHS has a problem with access and most patients want direct contact with a pharmacist, especially as they get older.”

Hub and spoke could provide the headroom for pharmacists to provide more services, for instance by taking care of repeat prescriptions in the hub, delivered back to pharmacies [in the spokes] for supply to patients, he said. However, it should not be used only as a means of driving cost out of the system.

“Hub and spoke is not like distance selling because patients need the interaction with pharmacists.” If it becomes the norm in any way, Numark will be there with a solution for its members, he said.