Hub and Spoke Gareth Jones Hub and Spoke What is in the DH Hub - - PowerPoint PPT Presentation

Hub and Spoke Gareth Jones

Hub and Spoke

• What is in the DH Hub and Spoke proposal?
• NPA Hub and Spoke T&F Group

DH proposal

• Amend s10(1) of the

Medicines Act 1968

• Enable inter-company

Hub and Spoke arrangements

• “create a level playing

field”

DH proposal

• Part of the DH narrative
• n efficiencies – referred

to repeatedly at recent Parliamentary meeting by the Minister and Chief Pharmaceutical Officer

DH proposal – “impact assessment”

• 45% of medicines will be

dispensed in hub and spoke arrangements within 3 years

• 10% reduction in

pharmacist labour costs in spokes

DH proposal – “impact assessment”

• For every job lost in

the spoke, 0.4WTE will be created in the hub

DH proposal – “impact assessment”

• Capital investment costs

excluded from the calculations

NPA Hub and Spoke T&F Group

• Manchester University literature review
• Over 400 members responded to survey
• Visit to an automated hub
• Interview 20 experts
• Legal opinion from a QC
• Members of group from NPA, PSNC and

PV

Benefits

• Capacity

– Some opportunity to support capacity release to deliver other services – No evidence that there are cash savings within pharmacies

More efficient?

• Can not reduce staffing in a typical

independent – you can redeploy capacity

• Reducing staff can be counterproductive

and potentially less safe

• Hub service fee
• Replication of process

– Accuracy check in spoke – FMD check in spoke

More efficient?

• Ineligible lines
• Barriers

– Lack of original pack dispensing – Low level of repeat dispensing

• Reduce stock levels?
• Resilience?
• Can MDS packs be done within inter-

company Hub and Spoke?

Safer?

• Misleading to portray this as a case of

humans versus machines

• Existing error rate is low
• FMD authentication process may deliver

the safety benefit without automated dispensing

• New opportunities for error

Impact on competition & procurement

• Risk of a duopoly due to barriers to entry

– DTP / restricted wholesaler schemes – Investment – Infrastructure

• Risk to short-liners

– Reducing amount of business open to short- liners, challenge to reach critical mass

• Risk to the tax-payer

Barriers

• EU Falsified Medicines Directive
• Accuracy check requirement
• DTP/limited wholesaler schemes
• Lack of competition between hubs

Enablers

• Original pack dispensing
• Electronic Repeat Dispensing
• New service commitment, eg, Pharmacy

First

• Public specification for hubs

Enablers

• Fair contractual arrangements
• GPhC recognition of the additional risks

involved within inter-company hub and spoke

Conclusion

• The inter-company hub and spoke idea is

integral to the Ridge/Cavendish view of the world

• DH document shows a complete lack of

understanding of the issues

• This politically driven proposal, as

currently framed, can not deliver the promised level playing field

Conclusion

• DH needs to go back to the drawing board
• Please respond to the consultation, which

closes on 17th May 2016