To ensure fair competition and better functioning of hub and spoke dispensing, the National Pharmacy Association (NPA) wants the government’s competition watchdog to review the model.

It wants the Department of Health and Social Care (DHSC) to ask the Competition and Markets Authority (CMA) to look into the system so that there is ample choice in the medicines supply chain and independent pharmacies are not deprived.

NPA vice-chair, Nick Kaye, said: “If the government believes that hub-and-spoke dispensing is the future for pharmacy, it must do more to allow independents to engage with the model on a level playing field and to prevent unintended consequences. This includes ensuring that pharmacies that do not have access to hub services, or choose not to use hub services, are not disadvantaged.

The NPA said that hubs should compete in a competitive market on the basis of quality of service and price for the custom of pharmacies. It also suggested five tests for maintaining fair competition and choice in the model.

  1. Hubs must be registered pharmacies and meet all GPhC/PSNI standards
  2. Hubs must be prevented from using their trusted position in the supply process to try to circumvent the relationship between the spoke and the patient
  3. The current barriers to entry for a hub provider presented by the direct to pharmacy (DTP) and limited wholesaler schemes must be removed
  4. A common set of standards should set out the duties and accountabilities of a dispensing hub and professional metrics
  5. Any mechanism which is designed to prevent a pharmacy from easily switching hub provider should be prevented

Further, the Human Medicines Regulations 2012 should be updated to put an obligation on all manufacturers to supply the reasonable needs of all registered pharmacies.

Kaye added: “The government should also ensure that manufacturer-controlled supply restrictions, which stifle competition along the supply chain, are swept away.

“The CMA is an obvious place to start for scrutinising the matter and achieving a competitive environment that works for independents and the NHS.”

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