Shared care is where medications are initiated and stabilized by a specialist and once the patient is settled on the drug, ongoing prescriptions are provided by primary care.
Shared care applies to specific medications. These medications can be found on this website. Common examples include medications for ADHD, disease-modifying drugs for rheumatological conditions (DMARDs) and lithium. The website makes it clear what is required of the specialist and what is required from general practice.
The following points should be noted regarding shared care:
- There is no requirement/obligation on the practice to agree to shared care.
- Even if shared care is initially agreed to, notice can be given at any time by the practice, and prescribing responsibility will be returned to the specialist.
- Shared care agreements will be not made with any private providers. We will not take over prescribing of any shared care drug if initiated or recommended by a private provider. Prescribing responsibility will remain with the private provider unless transfer to an NHS provider is completed. It is the responsibility of the private provider to make a direct referral to an appropriate NHS service if transfer of care is required. Requests for GPs to do this will be returned to the specialist.
- Where there is a Right to Choose provider involved, the shared care agreement may be accepted with some providers but not with others, at the discretion of the practice. This is due to the specific terms of the shared care agreement. Where a Right to Choose referral is made, it is the responsibility of the patient to check whether the practice will provisionally accept the terms of a shared care agreement. If not, the practice will not prescribe medication under any circumstances. Please note that point 2 still applies, so patients must ensure that their chosen provider will continue to supply medication in the event of cessation of shared care. Failure to do this means that the patient could be left without any medication. Please see website https://adhduk.co.uk/right-to-choose
- Any tests required to safely initiate or monitor medication prior to it being stabilized are the sole responsibility of the specialist (NHS, Right to Choose or private). We cannot accept delegation of this activity under any circumstances, including location or cost of the specialist service. Location of the specialist service should therefore be considered by the patient when making their choice of provider. Ongoing monitoring will only be undertaken according to the terms of a shared care agreement which has been accepted by the practice. Failure of the specialist or patient to comply with shared care monitoring will result in cessation of the shared care agreement and no further primary care supply of medications.