Shared Care is when a Specialist asks a GP Practice to take on responsibility for prescribing and monitoring medications, which are usually only issued by Specialists. This might happen if you have been referred for a specific issue and a Specialist has made a diagnosis and put a treatment plan in place.

These agreements require all parties to accept shared care, and the specialist remains responsible for prescribing and monitoring.

A specialist has seen me and has advised that my GP will prescribe the medication. When can I expect my prescription?

Your specialist will commence your medication until it is stable. At this point, your specialist will write to us for consideration in taking over the prescribing. This process can take up to 2 weeks (once we have received the paperwork from the clinic). In the meantime, your specialist can continue your prescriptions.

Patient Responsibilities whilst under a Shared Care Agreement 

It is essential to understand your role in the Shared Care Process. Most Shared Care Drugs must be closely monitored, so you will be called in for regular blood tests, Blood Pressure checks, and BMI checks (depending on the medication requirements).

It is imperative that you comply with these requests and keep up to date with your monitoring. Failure to do so will affect the Practice's ability to prescribe the medication safely and may mean that we have to return your care to your specialist.

I am under a Private consultant; can my GP take over prescribing and monitoring?

If specialist care is accessed privately, the private clinician is responsible for providing prescriptions. If medication is intended to be prescribed long-term, a private specialist may request that a GP take it over. GPs are not obligated to prescribe a drug that another clinician started. A GP must be satisfied that any prescription is safe, appropriate, and in line with NHS guidelines and prescribing competencies.

Medications started privately will only be continued to be prescribed by a GP if they are:

a) in line with NHS treatment guidelines

b) align with the local prescribing policy

c) are deemed to be safe and appropriate for the patient being treated

d) might usually be prescribed by a GP (i.e. not a specialist medication)

Some specialist medications (e.g. stimulants for ADHD, immunosuppressants, and hormones used in gender affirming treatment) require a “shared care agreement”. This allows GPs to prescribe specialist medications under the oversight of a specialist, who continues to review the patient’s treatment. Although there are established local shared care agreements with NHS specialists, these are not in place for private prescribers, so we do not accept shared care agreements with private specialists. This means that any medication requiring a shared care agreement that a private clinician initiates will need to be prescribed directly by that clinician.

If I pay for my own Private prescription, can I have my blood tests done at the Practice?

Unfortunately, no. This is because our clinical staff are only indemnified to undertake NHS work; we do not have additional cover to provide non-NHS Blood tests.

Could the Doctor not just request the tests on the NHS?

The clinician requesting pathology remains clinically responsible for any results received. Patients under NHS Shared Care Agreements are jointly monitored by the GP under the direction of a specialist, whereas Private Medications are not. GPs are not indemnified for monitoring non-NHS medications.  

General practice responsibility in responding to private healthcare  (BMA)

Understanding Shared Care – NHS, Right to Choose and Private Providers  (Wessex LMCs)

Duty of care when test results and drugs are ordered by secondary care (BMA)

Good Medical Practice (General Medical Council - UK)

Discharge Standards (NHS England)