Shared Care Agreements – Our Practice Policy

What is a Shared Care Agreement?

A Shared Care Agreement (SCA) is a formal arrangement between an NHS specialist and a GP. It allows safe sharing of prescribing and monitoring responsibilities for specific conditions or medications.

For an SCA to be valid:

• The specialist must start treatment and stabilise the patient.
• The monitoring, review, and follow-up plan must be clearly defined.
• The GP must voluntarily agree to take on specified responsibilities.
• The specialist must remain actively involved, available for advice, and responsible for overall care.

Shared care is always voluntary for GPs. It is not automatic, and it will only be accepted when safe and appropriate.

When We Will Accept Shared Care

We will consider shared care agreements only if:

• The specialist is an NHS consultant who remains engaged in the patient’s ongoing care.
• There is a written, clear, and safe protocol defining responsibilities.
• The patient is stable on treatment before transfer.
• Monitoring, tests, and follow-up arrangements are robust and explicitly outlined.
• We have capacity and competence to manage the prescribing and monitoring safely.

When We Will Decline Shared Care

We will not enter into shared care agreements if:

1. No specialist follow-up or Advice & Guidance
   – If the provider discharges the patient after diagnosis/treatment initiation, refuses A&G queries, or fails to provide ongoing support.
2. Premature or arbitrary discharge
   – For example, automatic discharge after one year, regardless of ongoing need.
3. Lack of monitoring systems
   – If safe prescribing and monitoring (blood tests, side-effect reviews, escalation protocols) are not in place.
4. Unclear or missing agreement
   – If responsibilities are not clearly defined and accepted by both parties.
5. Private or “Right to Choose” providers
   – We will not normally accept shared care with private specialists or certain Right to Choose providers, especially when:
   • They do not remain responsible for follow-up.
   • Their monitoring protocols are inadequate.
   • Their assessments are not accepted by local NHS services.
   • They prescribe medicines that require specialist oversight (e.g. ADHD medications).
   • Their business or contract may cease, leaving unsafe gaps in care.
6. Safety or capacity concerns
   – Even with an agreement, we may decline if the arrangement is not safe or manageable.

What This Means for Patients

• If your treatment is initiated by a private or Right to Choose provider, that provider must continue prescribing and monitoring unless and until a safe NHS shared care agreement is established.
• You cannot assume your GP must take over prescribing — it is not automatic or guaranteed.
• If you wish for NHS support, you should request referral into an NHS specialist service. Only then can a formal shared care arrangement be considered.
• If you join our practice with an existing shared care agreement, we may review it and, where safe, continue prescribing on a temporary basis while local arrangements are established. If no safe transition is possible, prescribing will remain the responsibility of the original provider.

Our Commitment

• We will always review shared care requests carefully.
• We will explain clearly if and why we decline shared care.
• We will never leave patients without treatment — your initiating provider remains responsible until a safe transfer is agreed.
• Patient safety, fairness, and continuity of care are our highest priorities.