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A specialist healthcare lawyer has commented on the “understandable distrust” that could arise between dispensing hubs and spoke pharmacies that take advantage of the new flexibilities that came into law at the start of this month. 

Speaking at the Pharmacy Show on Sunday October 12, Brabners LLP partner Richard Hough – who also practised as a pharmacist for 30 years – said that before taking the decision to outsource prescription assembly to a hub, a pharmacy will “want to make sure that the integrity of your patient base is secured” and that the hub will make no attempt to “solicit” their patients.  

He described this as a key component in “the establishment of trust – or perhaps, the overcoming of understandable distrust between the hub and the spoke”.  

“You can [prevent this] through legal means, you can put non-solicitation clauses in, you can put indemnities in, you can put damage clauses in,” he said. 

He warned that "if you get to that point, it's failed," and continued: “It’s a clause that should be in your contract – but ultimately, it’s there to ward people off.

“There has to be an establishment of trust between the hub and the spoke.”

Commenting on other tensions that might arise between the two parties, Mr Hough said the hub “will probably want a minimum dispensing volume as well”. 

He urged those considering entering into a hub and spoke arrangement to ask questions such as: “What happens if a spoke’s placed an order, it reaches the hub and then they cancel it for whatever reason? 

“There needs to be a mechanism to look at how the hub is remunerated in these circumstances.”

The pharmacy that signs up to become a spoke site is “going to lose a profit element it can probably not afford to lose,” he said – which means that any extra capacity created to deliver NHS and private services must result in a profit amount that compensates for this loss.  

“Securing” those services is “a really key point,” said Mr Hough.  

In his view, “the key issue” that will “determine the success of this model will be establishing the financial viability of the model, which is likely to be centred on the ability of the spoke to secure and provide additional services, whether that's private or NHS”.