Shared Care Prescribing Policy

This document is based on Principles for Shared Care Prescribing as per the BMA which was updated on 28^th April 2025. See link: Prescribing in general practice.

Shared Care Prescribing refers to medication which is initiated by a specialist and ongoing prescribing and monitoring is shared with a GP practice, usually accompanied by guidance or a shared care agreement.

The GMC has guidance on shared care prescribing which requires a clinician to be informed about the side effects of the medication and undertake the required monitoring.

The following principles should apply to all shared care prescribing.

1. Shared care prescribing is non-core voluntary activity that can be declined by the GP practice for any of the reasons stated below:

   This includes:
   – Inadequate capacity within the practice
   – Inadequate competency about the specialist medication, despite training
   – Lack of assurance to provide the ongoing specialist support required for shared care.

   The practice will ensure any refusal is consistent and framed by a set of principles so it is not discriminatory to specific patient groups or individual patients.

2. The GP practice is satisfied with the quality assurance and clinical governance of the specialist provider

4. If ongoing medical monitoring is required, responsibility for this should be clear within associated guidance in the form of a shared care agreement

5. The appropriate stabilisation period has occurred before prescribing is handed over to the GP practice and it is clear that should the patient require specialist support that the patient will be consulted and re-referred to a Specialist.

   a. The duration is determined by the shared care agreement (often 3 months).

5. There is enduring specialist input
   For example:
   – Ongoing out-patient follow-up
   – A mechanism which allows timely advice from the specialist, which could be converted into an out-patient review.

Roles and Responsibilities of parties involved

1. Specialist Responsibilities:
   • Initiate treatment and stabilise the patient on the medication.
   • Provide the GP with comprehensive information about the patient’s condition, treatment plan, and any monitoring requirements.
   • Ensure the patient understands the shared care arrangement and consents to it.
   • Remain available for consultation and advice as needed.
2. GP Responsibilities:
   • Assess whether they have the necessary expertise and resources to take on shared care responsibilities.
   • Prescribe the medication as per the specialist’s guidance once the patient is stabilized.
   • Monitor the patient’s progress and report any concerns to the specialist.
   • Ensure the patient understands their treatment and any necessary follow-up.
3. Patient Responsibilities:
   • Attend all appointments and follow the treatment plan as advised.
   • Report any side effects or concerns to their GP or specialist promptly.
   • Understand the shared care arrangement and their role within it.

Communication

• A formal written agreement/protocol should be established, detailing the responsibilities of each party.
• Regular communication between the GP and specialist is essential to ensure continuity of care.
• Any changes in the patient’s condition or treatment plan should be communicated promptly.

Review

This document will be reviewed on an annual basis or amended based on BMA changes.