Service income still too low to warrant hub and spoke, says CCA
The Company Chemists’ Association has warned not enough funding is being generated through service income in the five-year community pharmacy contractual framework to make hub and spoke a realistic proposition across the UK.
As the Government embarks on a consultation on proposals to enable the model to operate between separate pharmacy businesses through an amendment to the Medicines Act 1968 and the Human Medicines Regulations 2012, expanding the definition of ‘retail sale’ as it applies to the dispensing of medicines from pharmacies, questions remain about the viability of hub and spoke.
Two models are under consideration: one where a patient’s prescription is assembled by the hub and sent back to the spoke to make the supply and another where the hub supplies the prescription directly to the patient. If passed, hub and spoke, which is only available to individual businesses and is used by pharmacy chains, would be open to independents.
However, the CCA, noting that locally commissioned services make up less than one per cent of overall pharmacy funding, said its members believe the model will only deliver “capacity benefits if there is additional investment to either move the workload to a hub or fund additional activity in the spoke".
“We are very concerned that there simply is not enough service income within the current flat national funding envelope to warrant a network of hubs across the country,” the CCA said.
Its chief executive Malcolm Harrison said it was vital that any changes made as a result of the consultation “are based on robust data and the lived experience of pharmacy businesses".
“Having analysed the proposals and the accompanying impact assessment, I am concerned that the promises in the current five-year funding deal of improved capacity and cost-savings, are unlikely to be realised at all,” he said.
“I am very concerned by both the number and scale of the assumptions contained within the impact assessment, which are unlikely to come to fruition. The impact assessment also makes predictions on a yet unborn market, stretching 10 years into the future.
“Hub and spoke technologies do have the potential to enable new dispensing models in the future if new commissioning can support a change in operations. I would caution against firm predictions about likely benefits without stronger commitments to enablers of change.”
Mr Harrison also dismissed suggestions that hub and spoke is being driven by the CCA or any of its members given a belief in some quarters that any legal amendments to the model will only benefit large pharmacy businesses that use automated dispensing.
“We think it is worth clarifying that neither the CCA nor any of its members have ever called for this change,” he said. “This direction of travel by DHSC was initiated by parties from outside of the CCA and its membership.”