Shared Care Prescribing: Our Policy & Patient Safety

Introduction

Shared Care is a formal agreement where a specialist and a GP share the responsibility for a patient's treatment. This usually involves the specialist initiating and stabilizing a high-risk medication, and the GP taking over the monthly prescribing once the patient is on a stable dose.

Our Approach to Patient Safety

At College Green Medical Practice, our priority is ensuring that every prescription we issue is safe and appropriately monitored. We follow the clinical guidance set by the Birmingham and Solihull (BSOL) Integrated Care Board.

We only enter into Shared Care Agreements (SCA) with providers who follow the established BSOL local pathways. This ensures that the specialist provider offers the same level of robust, long-term physical monitoring and emergency support that our local NHS secondary care services provide.

Frequently Asked Questions

Why won’t the practice accept Shared Care from my 'Right to Choose' (RTC) provider?

While "Right to Choose" allows patients to be assessed by various NHS-commissioned providers, the ongoing Shared Care arrangement is a voluntary agreement. Many RTC providers are based outside our region and do not provide the specific level of ongoing physical monitoring (e.g., blood pressure, heart rate, and weight checks) or the "wrap-around" crisis support required by our local clinical governance.

Does this mean my treatment has to stop?

No. If the practice is unable to accept a Shared Care Agreement, the clinical and contractual responsibility for your care remains with the specialist provider who started the treatment.

The specialist provider is responsible for issuing your prescriptions. If they are an NHS-commissioned (RTC) provider, they should provide these prescriptions via the NHS. You should not be asked to pay privately for medication that was initiated under an NHS pathway.

Why are ADHD medications treated differently?

ADHD medications are "Controlled Drugs." They require specialist knowledge to monitor for potential side effects on the heart and mental health. Our GPs are generalists; we must be certain that the specialist oversight is seamless and meets local safety standards before we can take over the legal responsibility of signing those prescriptions.

What about Gender Dysphoria and Hormone Therapy?

We recognize the importance of timely care for gender dysphoria. Our policy aligns with national NHS England guidance:

• Bridging Prescriptions: GPs do not have the specialist expertise to safely initiate "bridging" hormone therapy. We will, however, refer you to the appropriate NHS Gender Dysphoria Clinics (GDC).
• Shared Care: Once a formal Shared Care Agreement is received from an NHS Gender Dysphoria Clinic, we can prescribe and monitor treatment in line with their specialist guidance.

What should I do if my Shared Care request is declined?

If we cannot accept an agreement from your provider, you have two options:

1. Request prescriptions from your provider: Ask your specialist provider to continue issuing your prescriptions directly.
2. Local NHS Referral: We can refer you to the local BSOL NHS specialist services, though we acknowledge that waiting lists for these services are currently significant.