Practice Policies: Update on Shared Care Agreements
From 1st October 2024, Dr Shantir Practice will no longer accept new Shared Care agreements.
We have made this difficult decision jointly with our neighbouring practices in Forest 8 and Walthamstow West Primary Care Networks.
We would like to explain to patients why we have had to make this decision.
What are Shared Care Agreements?
Shared Care is when a Specialist asks a GP practice to take on responsibility for prescribing and monitoring medications 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 ultimate responsibility for prescribing and monitoring remains with the Specialist.
Shared Care Agreements are not a ‘core’ part of our work in General Practice. By that, we mean they are not part of our NHS contract and not something we receive any additional support or resources to provide.
Background
We decided to review our Shared Care Agreement policy due to the growing number of requests we are receiving from an increasingly large number of providers.
These requests place an increasing amount of work on our Practice team, and at times, this additional workload is impacting our ability to deliver our core services to you, our patients.
We have raised this with local NHS commissioners, evidencing the increasing scale of the issue and expressed that the current situation is unsustainable. Our concern is that, without adequate resources to deal with this increasing demand, we can’t continue to assure ourselves that patients are safely monitored to the highest standards of care.
Our Decision
Our core duty is to ensure we deliver the core ‘work’ of General Practice, maintaining appropriate acute and chronic disease management for our patients. With no support available for us to take on this additional work, we have come to the difficult decision to suspend taking on new Shared Care Agreements from the 1st October, 2024.
This will become standard policy for Dr Shantir Practice and all our neighbouring practices in Forest 8 and Walthamstow West Primary Care Networks as well.
We will continue to engage with the Commissioners regarding our concerns. Whilst we do so, we will continue to honour agreements we have already signed up to.
What this may mean for patients
If there is already a Shared Care Agreement in place for your care, this will continue.
For patients with new treatment plans put in place by Specialists, responsibility for prescribing and monitoring your medication will remain solely with your Specialist. Rather than coming to the Practice for monitoring or reviews, you may be given an outpatient appointment at a hospital or other NHS location.
Examples of medication that may be affected:
| DMARD (commonly used for arthritis) | Immunosuppressants | ADHD medications | ‘High Risk’ medications |
|---|---|---|---|
| Methotrexate (oral / injection) | Tacrolimus (oral) | Methylphenidate | Amiodarone |
| Leflunomide | Sirolimus | Dexamfetamine | Dronedarone |
| Penicillamine | Mycophenolate | Lisdexamfetamine | Riluzole |
| Sulfasalazine | Ciclosporin (oral) | Atomoxetine | Lithium |
| Hydroxychloroquine | Guanfacine | Valproate (in people of child-bearing potential 12-55y | |
| Azathioprine | Midodrine | ||
| Mercaptopurine (6-MP) | Tolcapone | ||