What is Shared Care?
At our practice, we are committed to providing safe, high-quality care for all our patients. A shared care agreement is a formal, patient-specific arrangement where your GP and a specialist share responsibility for prescribing and monitoring your treatment. It may take time for a shared care agreement to be reviewed and accepted.
Understanding Your GP’s Responsibilities
Shared care agreements are always voluntary. GPs are not obliged to accept them and, when they do, they must be confident it is safe and appropriate to do so. This is because:
- Legal responsibility: Once a GP signs a prescription, they become legally responsible for that prescribing decision and must be able to explain and justify their actions
- Clinical competence: GPs must only prescribe within their own level of competence and expertise
- Monitoring requirements: GPs must ensure they have the resources and capacity to fulfil all monitoring requirements safely
- Ongoing specialist support: Effective shared care requires continued specialist involvement, not just initial diagnosis
Examples of Shared Care Medications
Shared care is typically used for specialist medicines that require ongoing monitoring, such as:
- ADHD medications
- Specialist medications for long term conditions (e.g., methotrexate)
- Certain mental health medications
- Gender care
NHS Shared Care vs Private Prescribing
We accept shared care agreements with NHS specialists when:
- A formal shared care protocol exists for the medication
- The specialist remains available for ongoing support and advice
- Clear monitoring arrangements are in place
- The medication is appropriate for primary care management
- The condition is stable or predictable
Private Healthcare Providers
We do sometimes accept private providers shared care agreements but these need to be checked very carefully. This is because private providers do not always offer the ongoing specialist care that shared care requires. GPs have a responsibility to verify that providers are properly qualified, regulated, and working to NHS standards.
Shared care between a private consultant and an NHS GP is generally not supported. If private care is interrupted (e.g., patient unable to continue funding), the GP would be left without a specialist partner, posing risks to patient safety).
Your Responsibilities in Shared Care
If your GP agrees to shared care, you have important responsibilities:
- Take the medicine as agreed
- Request repeat prescriptions from your GP in good time
- Attend all follow-up monitoring appointments with both your GP and specialist
- Inform us if you cannot attend an appointment and arrange another as soon as possible
- Report any suspected side effects to your specialist or GP
Planning Ahead
We strongly encourage you to discuss any planned private or Right to Choose referrals with your GP in advance so you are fully aware of any potential limitations on shared care arrangements. Where appropriate, we can offer referral to the equivalent NHS pathway instead. We appreciate that there may be long waiting lists to access NHS specialist services, and we will do our best to support you during this time.
What Happens if your GP Declines Shared Care?
If your GP does not feel able to accept clinical responsibility for prescribing (for example, if the medication is outside their area of expertise or requires monitoring beyond the practice’s capacity), then:
- The specialist who started the treatment remains responsible for ongoing prescribing and monitoring
- You will need to continue obtaining prescriptions directly from your specialist
- Your GP may be able to refer you to an equivalent NHS specialist service