New law strengthens punishment for assaulting health sector workers

New law strengthens punishment for assaulting health sector workers

July 27 2018 A new law will increase the possible sentencing of someone who commits common...

Home Office gives go ahead to allow cannabis-derived medicinal products on prescription

Home Office gives go ahead to allow cannabis-derived medicinal products on prescription

July 27 2018 Certain cannabis-derived products will be reclassified as Class 2 medicinal...

Review on prescribed medicines sets out scope and terms of reference

Review on prescribed medicines sets out scope and terms of reference

July 24 2018 A review of prescribed medicines looking at the evidence of dependence and...

AMs recommend that pharmacists have access to palliative care data in Wales

AMs recommend that pharmacists have access to palliative care data in Wales

July 18 2018 Community pharmacists should be among those health professionals who are alerted to...

APTUK questions claims about pharmacy technicians’ desire to supervise medicines supplies

APTUK questions claims about pharmacy technicians’ desire to supervise medicines supplies

July 18 2018 The Association of Pharmacy Technicians UK is questioning a survey on pharmacy...

  • New law strengthens punishment for assaulting health sector workers

    New law strengthens punishment for assaulting health sector workers

    Friday, 27 July 2018 16:08
  • Home Office gives go ahead to allow cannabis-derived medicinal products on prescription

    Home Office gives go ahead to allow cannabis-derived medicinal products on prescription

    Friday, 27 July 2018 15:58
  • Review on prescribed medicines sets out scope and terms of reference

    Review on prescribed medicines sets out scope and terms of reference

    Tuesday, 24 July 2018 12:30
  • AMs recommend that pharmacists have access to palliative care data in Wales

    AMs recommend that pharmacists have access to palliative care data in Wales

    Wednesday, 18 July 2018 17:41
  • APTUK questions claims about pharmacy technicians’ desire to supervise medicines supplies

    APTUK questions claims about pharmacy technicians’ desire to supervise medicines supplies

    Wednesday, 18 July 2018 17:17

Umesh Modi is a chartered accountant, and Pamini Jatheeskumar is a chartered certified accountant at Silver Levene...
  Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead...
Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead pharmacist, Health and Wellbeing Directorate, Public Health England
More inWhite Papers  

pills bottleMay 25 2016

Department of Health proposals to increase the extent of hub and spoke dispensing may not achieve the desired levels of benefit, pharmacy organisations are warning.

Responses to the consultation on amending legislation to allow all community pharmacies to engage in centralised dispensing services, have challenged the Department over its lack of detail. The responses have been published now that the consultation period has closed.

Pharmacy Voice, the body representing pharmacy owner organisations, has criticised the short time frame for the consultation, and has called on the Department “to publish the evidence used to justify their proposals around hub and spoke dispensing.” It has said that the consultation does not shed any further light on what basis the Department believes the proposed changes to the Human Medicines Regulations 2012 will make the dispensing process more efficient or how it will lower operating cost.

Rob Darracott, Chief Executive of Pharmacy Voice, said: “Importantly, there is still no consistency in the terminology being used to describe what the Government is trying to achieve, and there is no indication of how the consequent complex legal and professional issues will be resolved. The opportunity for constructive, informed policy engagement has been constrained by the rushed and poorly timed consultation.”

Currently, The Human Medicines Regulations 2012 mean that a pharmacy business may operate a hub and spoke system among its own pharmacies, but not offer the centralised dispensing service to other companies. The consultation had asked about amending the regulations to allow pharmacy companies to operate hub dispensing services for unconnected spoke pharmacies.

Numark, the pharmacy symbol group, has said that that “it is right to ‘level the playing field’ to enable all pharmacies, and not simply those in the same retail pharmacy business, to make use of hub and spoke dispensing.” However, the business case for hub and spoke needs further examination, it said.

There is also a need to recognise that “there are significant differences in the process depending upon whether the hub and spoke are under common ownership or not. To suggest, as the document does, that ‘large scale “hub’ pharmacies have the capability to ‘increase efficiency and lower operating costs significantly’, is a significant over-statement given the limited amount we know about its use in practice.

“Numark believes that the Department should be very clear at the outset – as should our members - what is the rationale for hub and spoke; the creation of ‘headroom’ or an attempt to take direct costs out of the system?”

PSNC has raised its concerns saying that amending the Medicines Act 1968 or Human Medicines Regulations 2012 may not change NHS provisions, but “would provide an entirely new legislative framework for the retail supply of medicines on which there has been no consultation.”

Among the other points included in it its response to the consultation, are:

  • the impossibility of creating a level playing field when independents must use and share patient lists with third party hubs;
  • the proposed unrestricted wholesale dealing between relevant clinical settings is arguably contrary to European legislation;
  • professional and legal issues and a change in legislative emphasis from pharmacies to pharmacists have not been considered and could lead to patient safety issues;
  • ‘hub and spoke’ dispensing may be unable to comply with the Falsified Medicines Directive;
  • the alleged safety arguments are not evidenced, and sharing the dispensing process between two legal entities could lead to quite the opposite effect.

The Healthcare Distribution Association, representing pharmaceutical wholesalers, has also said that there should be a level playing field to allow independent pharmacies to access the same technology as vertically integrated chains.

However, it has raised “fundamental concerns regarding the Government’s proposals which do not recognise that hub and spoke technology is at a very early stage and the consequences of its introduction are not fully understood. Therefore, estimates that 45% of medicines will be dispensed through hub and spoke appear on the high side.”

In addition, “removing the current legislative impediment could open medicines distribution to new providers who might not be required to match the same high quality and safety standards, mandated by [UK medicines regulator] the MHRA, and provided by HDA member companies through their commitment to the MHRA-endorsed HDA Gold Standard of Good Distribution Practice.

“Although these new providers would be subject to General Pharmaceutical Council pharmacy regulations, the distribution standards are not compatible with those currently in place for wholesale distribution.”

It says that:

  • the MHRA should be responsible for inspecting hubs and hub-to-spoke transportation to ensure they comply with wholesaling levels of European Union regulations for Good Distribution Practice (GDP);
  • pharmacy regulations for the appropriate storage and transportation of medicines should be reviewed to take into account the changes in pharmacy storage and transportation models prompted by hub and spoke.

Links:

Pharmacy Voice response

Numark

PSNC response

HDA UK response

Legal & Policy News

July 31 2018 General practices employing pharmacists are citing improved capacity to see patients and workload changes as the main benefits of the scheme.
July 25 2018 Switching to sulfonylureas in type 2 diabetes has been linked with an increased risk of complications compared with staying on metformin, a BMJ study has concluded. However, the study has...