Shared Care

Our policy

Shared care is whereby responsibility for a patient's medication and ongoing monitoring is shared between a GP and consultant. In the first instance, it is expected that the consultant will assess a patient's suitability for the medication, perform any necessary investigations and appropriately counsel the patient fully on the medication, before prescribing the medication, and adjusting the dose until the patient is stable.

Once a stable dose is achieved, the consultant then writes to the GP to ask them to consider shared care. If the GP accepts, they then take over the prescribing and monitoring of the patient, notifying the consultant should any problems arise. The patient remains under the care of the consultant throughout the entirety of the shared care agreement. There must be a written agreement on the duties and responsibilities of each party. Shared care is designed to facilitate appropriate clinical oversight and to maintain patient safety.

GPs are under no professional or contractual obligation to enter into shared care arrangements with any provider whether NHS or private. Shared care is entirely voluntary for GPs and therefore we reserve the right to decline any request for shared care, without reason. We do not participate in shared care arrangements with any private provider in line with our local ICB stance.

At St Fillans we will participate in shared care agreements with providers whom patients have been referred to under the NHS Right to Choose route, where services are outsourced to somewhere else within NHS England with approved providers; you will receive care to NHS standards, and if required, you will receive an NHS prescription. This policy is in line with BMA guidance.

Learn more about the BMA Guiances on General practice responsibility in responding to private healthcare

Private providers are aware of the above. Some GP practices chose not to participate in any shared care agreements. If your private provider assures you that your GP will perform required investigations, and give medications as deemed necessary by that provider, they are providing you with false assurance and factually incorrect information.

In essence, should any tests or medications as part of the care given by a private provider, the private provider themselves can request tests or supply medication to the patient for the appropriate fee.

Everyone has a right to choose and pay for a private provider, however, it is not an NHS GP's responsibility to request tests or prescribe medications on behalf of that provider purely for the purposes of reducing the cost or waiting times to assessment and/or treatment. Consideration must always be given towards proper clinical oversight and patient safety.

As per the BMA, NHS guidance states that 'Private and NHS care should be kept as clearly separate as possible. The patient should bear the full costs of any private services. NHS resources should never be used to subsidise the use of private care. The arrangements put in place to deliver additional private care should be designed to ensure as clear a separation as possible of funding, legal status, liability and accountability between NHS care and any private care that a patient receives.' 

Learn more about the BMA NHS Guidance