A number of issues are creeping up on pharmacy, but dispensing hubs are not necessarily the answer, says pharmacist Noel Wicks

Comments from the English chief pharmaceutical officer at the recent Royal Pharmaceutical Society conference have certainly stimulated some debate. I can imagine that there was a pretty stunned silence in the audience when Keith Ridge declared that centralised dispensing hubs could fulfil twothirds of the country’s prescriptions. This was a pretty brave statement to make to a room filled with pharmacists, and I’m sure it didn’t remain silent for very long.

However, as Mr Ridge pointed out, centralised hubs are already with us. So, what could this mean for pharmacy? I can imagine one of two thoughts going through most people’s heads at the mention of a hub-based future. On the one hand, you could have some of the mundane, repetitive dispensing done off site, freeing up time to care.

On the other, you have the removal of the bedrock of community pharmacy and what such a change might mean for the future. It’s easy to see how such a topic might polarise people and, at the very least, prove for some interesting conversations over drinks.

This does all bring to the fore a number of issues that have been quietly creeping up on pharmacy. These include the advancement of robotics in pharmacy, the potential need to scan medicines to prevent counterfeits and improve safety, the increasing script workload of an ageing population and the pressure on NHS spending. These are all interesting issues in themselves but, when combined, it’s easy to see why centralised hubs might seem like a panacea for a wide variety of current and future problems.

In my experience, panaceas often fall foul when it comes to the real world. It brings to mind a recent decision by Morrisons to return to some manned express checkouts in their stores. There were probably a variety of reasons for this U-turn, but foremost came their customers’ desire to interact with a human being.

While the benefits of self-service tills seemed like a bit of a no-brainer, the reality wasn’t quite as simple as that. I have the same feelings about large-scale hub models. Undoubtedly, they have the potential to streamline some of the more uncomplicated and predictable work, such as repeat prescriptions. The trouble with uncomplicated and predictable is that it’s so difficult to know in advance which prescriptions fit that description.

My fear is that, like the Morrisons example, we underestimate the dynamics of the systems we are trying to automate. The downside could be that we end up still having to run a back-up system in the pharmacy to unpick work done by the hub or chase the things that can’t be done by the hub.

There is no doubt that hubs are here to stay, but I am not sure they should be held up as answers to any of the issues facing pharmacy that I posed earlier. Hubs may provide a temporary “sticking plaster” to some of pharmacy’s problems, but the real solutions will only come with some pretty radical changes across the entire system. 

Noel Wicks is an independent pharmacist.

Hubs may provide a temporary ‘sticking plaster’ to some of pharmacy’s problems, but the real solutions will only come with radical changes across the entire system