Shared Care Prescribing Policy
Shared Care Prescribing allows NHS specialists and GPs to collaborate in managing and monitoring specialist medications. This arrangement ensures that responsibilities for prescribing are clearly defined and governed by local policies, maintaining patient safety and high standards of care.
NHS Shared Care
Under NHS shared care agreements, GPs may work with NHS specialists to prescribe medications this includes NHS commissioned Right to Choose Providers. These agreements are supported by local policies, which ensure that:
- Patients are started and stabilised on their medication by the specialist.
- Ongoing specialist reviews are conducted at the hospital.
- GPs can seek advice and support from specialists as required.
Conditions commonly managed under shared care include rheumatoid arthritis, ADHD, Parkinson’s disease, inflammatory eye disease, IBD, and gender dysphoria.
Private Providers
In recent years, more patients have sought private treatment and asked GPs to prescribe medications recommended by private specialists under NHS prescriptions. This differs significantly from NHS shared care agreements.
Due to safety concerns and sustainability issues, our practice will no longer issue new prescriptions for specialist medications initiated by private providers. Instead, patients must obtain these prescriptions directly from their private specialist.
ADHD Medication Management Following Transfer from CAMHS
Following discharge from Child and Adolescent Mental Health Services (CAMHS) and while awaiting assessment or ongoing care from the Adult ADHD Service, the arrangements for the management of ADHD medication are as follows.
Patients are discharged from CAMHS upon reaching 18 years of age. Due to current waiting times, there may be a period of up to 12 months before an appointment is available with the Adult ADHD Service. During this transition period, patients may require continued access to their existing ADHD medication.
Where clinically appropriate, the GP practice will continue to prescribe the patient’s established ADHD medication in accordance with the treatment plan previously recommended by the specialist service. This is intended to minimise disruption to treatment during the transition between services.
Continued prescribing is subject to the patient remaining up to date with the practice’s required medication monitoring. Monitoring must be completed every six months and includes assessment of blood pressure, heart rate, height and weight.
The GP practice is able to continue an established medication regimen but is not able to independently make changes to specialist ADHD treatment. Where there is a change in symptoms, concerns regarding treatment effectiveness, adverse effects, or difficulties relating to the prescribed medication, advice may need to be sought from the relevant ADHD specialist service. The timescale for receiving specialist advice may vary depending on the service’s response time.
Patients who require further information or clarification regarding the management of their ADHD medication during this transition period should contact the practice.
Patient Safety
Private healthcare providers may not adhere to the same safety standards as NHS services. Without access to ongoing specialist input, GPs face significant risks when prescribing and are not insured for these scenarios. Ensuring patient safety is our top priority, and we must adhere to robust governance protocols.
Resource Limitations
GPs are not funded to perform non-NHS work. Supporting private prescriptions diverts resources from NHS patients and exacerbates health inequalities. At a time of increasing demands on primary care, this is not sustainable.
Additional Information
This decision aligns with British Medical Association (BMA) guidance, which prioritises patient safety and equitable resource allocation.
We understand this may be disappointing, but it ensures safe and sustainable care for all our patients. For further guidance, please contact your private specialist or discuss a referral to an NHS service.