Shared Care for Patients and Carers

What is Shared Care?

  • Shared Care is a formal, optional agreement that allows GPs and pharmacists to safely prescribe and monitor specialist medicine.
  • Shared Care involves transferring care from a specialist to a GP/pharmacist. This is when it is in the patient’s best interest and clinically suitable to do so.
  • The patient remains under the care of the specialist and the GP/pharmacist, i.e., patient care is shared between the two clinicians. Shared care is a 3-way contract between patient, specialist, and GP.

Role and responsibility of the specialist

  • To diagnose the condition and start prescribing the medication.
  • Provide written and verbal information to the patient about the condition and medication.
  • Continue to prescribe and monitor the medication until the dose is stable.
  • Explain shared care to the patient, discuss concerns, and answer questions.
  • Request shared cared from the GP /pharmacist when the condition and medication are stable.
  • Continue to prescribe and monitor the medication while the GP decides about shared care.
  • Review the patient and medication at regular intervals to ensure safety and efficacy.
  • Provide advice to the GP/pharmacist if and when asked for.

Role and responsibility of the GP/Pharmacist

  • To review requests for shared care promptly. This is usually within 1-2 working days of receiving the shared care request.
  • To prescribe and monitor the medication as set out in the shared care agreement and specialist’s instructions, if shared care agreed.
  • To write to the specialist in a timely manner if shared care not agreed, providing reasons for rejecting shared care.
  • Ensure patient is given appointments for monitoring medication.
  • Report serious side effects from the medication or concerns with treatment to the specialist.

Role and responsibility of the Patient

  • To be aware of the conditions and requirements of shared care.
  • To take the medication as agreed with specialist and as set out in the shared care agreement.
  • Arrange and attend monitoring appointments with the specialist and GP/pharmacist. If unable to attend appointments the GP /pharmacist and/or specialist must be informed as soon as possible and another appointment should be made.
  • Order repeat prescriptions from the GP /pharmacist before medication has ran out.
  • Report any suspected side effects or problems to the GP/pharmacist or specialist.

Private healthcare providers

  • GPs are under no obligation to share care with private providers.
  • Private providers may write to the GP and request that the GP prescribe medication under shared care.
  • The GP will consider whether the patient has had an assessment equivalent to the NHS and weigh up other factors when deciding whether to agree to share care with a private provider.
  • If shared care with a private provider is agreed, the patient must to continue to see the private specialist at appropriate intervals.

What happens if a shared care agreement is declined?

  • Entering into a shared care agreement is entirely optional and we are not obligated to enter into a shared care agreement with your specialist. We carefully consider each shared care requests to ensure it aligns with our capacity, clinical expertise, and the best interests of our patients.
  • We will inform you and your specialist if we decline a request for shared care, stating our reasons for this. We will ask that your specialist continues to prescribe your medication and monitor your treatment.

Important information regarding ADHD shared care agreements

Non-urgent advice: ADHD update November 2024

As of the 12th of the November 2024, we are no longer accepting shared care agreements from any providers except

Nottinghamshire Neurodevelopmental Specialist Service (NeSS). This does not mean that you can’t get your prescription—responsibility to prescribe this lies with your specialist
ere has been a ongoing global shortage of ADHD medication for over a year and we no longer have the clinical capacity to fulfil shared care requirements as many patients require alternative formulation of their existing treatment or a new medication entirely .
You will need to inform you specialist that we, your GP practice, are currently not taking on any new shared care agreements for ADHD and you will need to continue obtaining prescriptions from them until we are in a position to accept shared care.
If we receive a shared care request from your specialist we will write to them explaining that we cannot accept at this time and request that they continue prescribing your medication for you.

Please note this does not apply to shared care agreements we receive from NeSS.
We will continue to honour all existing shared care agreements where the preparations are unchanged. If your preparation needs to be changed you will need to get an alternative prescription from your specialist. Your specialist needs to review you after this change and once you are stable we will return to taking on shared care. Your specialist will need to confirm in writing that you are stable on your new medication regimen.

We will continue to monitor the ADHD medication shortages and keep these changes under review.

If you have any questions or concerns in the meantime please contact the practice.