DHSC gives green light to hub and spoke dispensing

UK legislation enabling hub and spoke dispensing will come into force on 1 January, 2025, the DHSC has announced in response to the 2022 consultation.

The model to be rolled out will comprise two options:

model 1 (spoke-hub-spoke): dispensary supplies the medicine to patient
model 2 (spoke-hub-patient): the hub supplies directly to the patient.

Under amended regulations, dispensing doctors will be able to act as a spoke. In its response, the Government urges dispensing doctors “to start exploring about how they might respond to the new flexibilities when they come into force.”

A concern to note is that model 2 is said to possibly undermine the provision of a full dispensing service in rural areas and the market entry arrangements. Addressing these concerns, the DHSC said: "In our opinion, it will be for each administration to determine how to implement the hub and spoke arrangements within the provision of their respective NHS pharmaceutical services."

Each devolved administration is also asked to consider reimbursement for NHS pharmaceutical services provided under hub and spoke models, including any consequential amendments to their NHS pharmaceutical legislative framework.

However, DHSC does voice the expectation that the spoke will be remunerated for the provision of the dispensing service, paying the hub for any activities carried out, including the cost of any medicines that the hub supplied. However, this will be a private arrangement between the hub and the spoke under the terms of those arrangements.

There is expected to be a process of engagement with the NHS national pharmaceutical services’ representative bodies to discuss any changes needed to NHS terms of service in each administration, in the light of the new models.

Among the logistical details currently finalised:

Schedule 3, 4 and 5 drugs can be included in hub and spoke model 1 and schedule 4 and 5 drugs can be included in hub and spoke model 2.
Spoke operators will need to display a notice to say the dispensing GPs operating as a spoke will need to display a notice stating its online presence and use of the hub and spoke model.

Discussions relating to the inclusion of schedule 2 drugs within either model of hub and spoke and schedule 3 drugs within model 2 are still being finalised.

Dispensary guidance news Political News