Shared care medicines

Shared care medicines are medicines where the responsibility of prescribing and monitoring is shared between your GP practice and your specialist.

Shared care medicines are medicines where the responsibility of prescribing and monitoring is shared between your GP practice and your specialist. In order to help with sharing these responsibilities, Shared Care Agreements are used.

What is a Shared Care Agreement?

A Shared Care Agreement is an agreement between you, your GP practice, and your hospital consultant or specialist care provider. It enables the care and treatment you receive for a specific health condition to be shared between the hospital/service provider and your GP practice.

There are two requirements for a Shared Care Agreement to be put in place:

  • It can only occur with your agreement
  • Your condition must be stable or as expected

Shared care is a formal patient-specific agreement that enables your GP to accept responsibility for the safe prescribing and monitoring of specialist medicines. A Shared Care Agreement contains information about your medicine, guidance on prescribing and monitoring and the responsibilities of your consultant/specialist provider, your GP practice and you.

The Shared Care Agreement means that when the hospital has started prescribing your medicine, it can be continued by your GP practice, so you won’t have to visit the hospital to collect your medicine.

Your specialist is responsible for obtaining agreement and consent from you for treatment and shared care. The specialist should inform you about your responsibilities when taking a drug prescribed under shared care.

How does shared care work?

  • The consultant is a specialist in the condition for which you are being treated and with your agreement, will start prescribing a medicine, making sure it is suitable for you.
  • The consultant will arrange for appropriate monitoring to be carried out, including blood tests.
  • If this monitoring is suitable to be carried out by your GP practice your consultant will discuss a Shared Care Agreement with you and will contact your GP practice.
  • If your GP practice agrees to the Shared Care Agreement, the GP practice will be able to prescribe the same medicine for you at the dose recommended by the consultant and ensure relevant on-going monitoring takes place.

What is the specialist’s role in shared care?

  • Confirm the diagnosis and start prescribing the medicine.
  • Provide the patient with written and spoken information about the medicine.
  • Prescribe and monitor the medicine until the dose is stable.
  • Explain shared care to the patient, answer any questions and discuss any concerns.
  • Write to the GP and request shared care when the condition and medicine are stable.
  • Prescribe and monitor the medicine while waiting for the GP to decide about shared care.
  • Provide advice to the GP if this is asked for.
  • Review the medicine at regular intervals to make sure it is still safe and effective.

What is the GP’s role in shared care?

  • To review specialist requests for shared care of medicines promptly.
  • The GP should inform the specialist within 14 days whether or not they are to accept shared care. If the GP does not agree to shared care, they should specify the reason(s).
  • If the GP declines shared care, then the specialist who started the treatment will be responsible for ongoing prescribing and monitoring.
  • If accepting shared care, the GP agrees to prescribe and monitor the medicine as set out in the specialist’s instructions and in the shared care agreement (if one is available).
  • If the GP agrees to shared care, they will report any serious side effects to the specialist and communicate with the specialist on how best to manage your condition and medication.

What is the patient’s role in shared care?

  • Take the medicine as agreed.
  • Request repeat prescriptions from the GP in enough time.
  • Attend follow up monitoring appointments with the GP and the specialist.
  • If not able to attend an appointment with the GP or the specialist, inform them as soon as possible and make another appointment.
  • Report suspected side effects to the specialist or GP.

Is shared care possible between a private healthcare provider and a GP?

  • Shared care with private healthcare providers is only possible when this service is being provided for the patient on behalf of the NHS.
  • If a patient is seeing a private specialist, and that service is not being provided on behalf of the NHS, shared care agreements and prescriptions from NHS GPs for medication recommended by the private specialist would not normally be possible. Please refer to NHS Mid and South Essex’s Defining the Boundaries between NHS and privately funded care policy.
  • If a patient would like to obtain the shared care medicine through the NHS, they should talk to their GP about having care for their condition transferred to the local NHS service. This would be classed as a new referral, and patients would join the end of any existing waiting list for that service.

If you would like more information about Share Care Agreements used in Mid and South Essex, please contact [email protected]