What is Shared Care?
There are some medications which need to be started by a specialist. If a specialist initiates a medication the responsibility of prescribing and monitoring remains with them unless as shared care agreement has been made. A patient should be stable for at least 3 months prior to this taking place.
A shared care agreement is a formal document which outlines the monitoring requirements and prescribing recommendations to allow these medications to be safely continued by the GP. The patient should also remain under the care of their specialist and have regular reviews- often around once a year providing nothing has changed.
Shared care agreements are voluntary and can be declined if the practice is not satisfied that it is safe or appropriate. The prescribing and associated monitoring is in addition to core GP services. This in turn has an impact on capacity within the surgery.
What is Right to Choose (RTC)?
When you are referred to a specialist on the NHS you have the legal right to choose the provider, as long they offer the appropriate service. This may include private clinics/ hospitals where funding has been commissioned by the NHS and is not restricted by geographical location.
There has recently been an increase in awareness around ADHD and other types of neurodivergence. More people (both adults and children) are coming forward with symptoms which warrant an assessment. This is has subsequently lead to the waiting times for assessments to increase. As a result we have had an increase in requests for referrals to RTC providers which may have shorter waiting lists.
Who do we accept shared care agreements with?
All doctors have a responsibility to ensure their prescriptions are safe and a patient has appropriate specialist follow up. To ensure this we will only consider local NHS providers for shared care agreements and not any Right to Choose or Private providers.
We appreciate that this can be frustrating for patients. This decision has been made to ensure safer prescribing of specialist medications and also to allow GP time to be spent on core services.
What does this mean for me?
You can choose whether to undertake a referral with a local NHS provider, NHS funded right to choose provider or a private provider with funding arranged by yourself.
If you choose to be seen via a private or Right to Choose provider and are prescribed a medication requiring shared care we will not be able to take on the prescribing. In these instances you can continue to source the medication from the provider.
The monitoring tests should also be completed by them, even if the location is far from home, which is an important consideration when choosing who you’d like to be referred to.
Can I be seen by a local specialist instead once I have a diagnosis?
If you would like us to consider taking on a shared care agreement we will need to refer you to a local specialist service. They often have long waiting lists to be seen even if you have a diagnosis from an alternate provider. Once the local NHS service has seen and assessed you, and they are happy you are stable on your medication we will be in a position consider a shared care agreement.