Covid-19: Community Pharmacies

Steve Brine Excerpts

Thursday 11th March 2021 Westminster Hall

[Steve Brine (Winchester) (Con) [V]]

I am delighted that the Henley reveal is not on show today. It is always good to discuss community pharmacy in the House. In doing so, I declare my entry in the Register of Members’ Financial Interests and of course my experience as a former pharmacy Minister.

The Medicines and Medical Devices Act 2021 has received Royal Assent, which is a good thing, as it is an important piece of legislation. I remember its conception. The Minister is right to say, as she has done previously, that it has the patient at its heart, but the Bill, and certainly the discussion around it, has also advanced the idea of making what would be a pretty fundamental change to community pharmacies through a shift to what we call the hub and spoke model, which I want to touch on. The Minister is very familiar with the arguments. For those who are not, we are talking about a totally new way of working, whereby independent pharmacists have a hub pharmacy that dispenses medicines on a large scale for regular spoke pharmacies, which then supply them to the patient.

A consultation as far back as 2016 flew this flag, and it was confirmed in the long-term plan of January 2018. Fast-forward to life in the pandemic, and it is true that the combination of rising prescription volumes and reduced patient access to primary care services has put great pressure on community pharmacies to keep up the face-to-face contact that their customers want and need. Boy, have they done that. I am so glad that Ministers have consistently recognised the work of community pharmacists throughout, and I join colleagues in paying tribute to mine. They are a workforce who just get on with it.

Adding the rising volumes and access to primary care services to the Government’s requirement for greater value from pharmacy, it is clear why many people believe that a hub and spoke dispensing model is the way forward. On the flipside of the debate, many are understandably worried that centralised dispensing could drive down costs in pharmacy. Unless the pharmacy on the high street then acts as the spoke part by handling the prescription to the patient, we just end up with a bigger distance-selling pharmacy market and a lack of patient contact, which then puts opportunities for wider primary care contact out of reach. Put simply, the unintended consequence could be a total stitch-up that leaves community pharmacy not so much as “always the bridesmaid, never the bride”—as I have often heard—but more like “jilted at the altar,” and I do not want to see that happen. The truth is that, as with everything else, and especially the growth of distance-selling pharmacies, it is somewhere in between.

We can debate the pros and cons all we like, and I am really pleased that the Minister has committed to a full public consultation on hub and spoke, to ensure that we get the right model going forward, but let us be clear that it is already happening, with the technology embedded in the multiples and the large chains long ago. Can she give an indication of when she thinks it is likely that her Department will bring forward concrete proposals to consult on hub and spoke?

In closing, I return to an old theme of mine in respect of community pharmacy: whatever the future architecture of the NHS—obviously, the White Paper is being discussed—it must take its rightful place as part of pre-primary care, as I call it. That is why I have always been so positive about the potential that primary care networks have for this sector. PCNs are a great chance for community pharmacy, and the new integrated care systems set out in the White Paper are the chance to bake in primary care, in its widest sense, within the NHS family. Hub and spoke is a positive opportunity moment for community pharmacy post covid, but only if the income and the process of dispensing are replaced in a way that allows the sector finally to realise its potential as part of primary care.