Shared Care Agreements
From 1st February 2025, Park Medical Group will resume accepting new Shared Care Agreements (SCAs) for a limited number of medications.
In October 2023, all Gosforth and Jesmond GP practices decided to stop accepting new SCAs. We made this decision due to concerns about capacity and patient safety.
After discussions with the North East and North Cumbria Integrated Care Board (NENC ICB), which commissions NHS services in our region, we can now adjust our approach.
What Are Shared Care Agreements?
Shared Care Agreements are arrangements in which a Specialist asks a general practitioner (GP) practice to prescribe and monitor specific medications. While the Specialist retains ultimate responsibility, the GP practice provides ongoing care under the agreement.
However, SCAs often involve significant additional work for GP practice teams. This work is not part of our core contracted services and can affect our ability to deliver essential patient care. In 2023, we reviewed our approach to SCAs due to these challenges.
Why the Change in Policy?
Following discussions with NENC ICB, additional funding has been made available. While this funding does not solve all challenges, it will help cover some of the extra work associated with SCAs and reduce the impact on our core services.
How Will the New Process for New Shared Care Requests Work?
The NHS provider requesting the Shared Care Agreement must write to request it formally.
An SCA will only transfer to us once it has been formally requested, reviewed, and accepted by us.
SCAs will be reviewed on a patient-by-patient basis. We cannot guarantee that all new SCAs will be accepted.
Which New SCAs Are Likely to Be Accepted?
We cannot return to accepting all new SCAs. For example, we cannot accept agreements involving controlled drugs or those requiring complex and frequent monitoring.
However, we will review SCAs for the following medication:
| Amiodarone | Azathoprine | Denosumab |
| Hydroxychloroquine | Leflunamide | Lithium |
| Melatonin | Methotrexate | Mycofenolate |
| Sulfasalazine | Valporate |
What SCAs Are Unlikely to be Accepted?
While we will review each SCA request individually, the following drugs are unlikely to be accepted.
| Apomorphine | Epoetin beta | Tocapone |
| Atomexetine | Guanfacine | Riluzole |
| Ciclosporin | Hydroxycarbamide | Sativex |
| Cinacalet | Ketamine | Sirolimus |
| Darbepoetin | Mercaptopurine | Tacrolimus |
| Darbepoetin | Midodrine | Vigabatrin |
What This Means for New SCAs
We will review new requests for SCAs on a patient-by-patient basis. For us to agree to it:
- There must be clear guidance and a comprehensive handover of care from your Specialist
- Your health must be stable.
- You must be able to attend the practice when required.
We regret that we cannot accept new SCAs for housebound patients.
If we are unable to accept a newly proposed SCA, your Specialist will continue to prescribe, monitor, and review your medication. These appointments will be at other NHS locations, not the practice.
What This Means for Existing SCAs
All existing Shared Care Agreements will continue. You do not need to take any action. Please attend the practice as usual for monitoring and reviews.
FAQs
Q: I am new to the practice and have an existing shared care agreement – what will happen?
A: This will be treated as a new shared care request and reviewed on an individual basis.
Q: I am being treated by a private provider and need regular blood monitoring. Will an SCA be accepted?
A: No. Private clinics should arrange their own monitoring. We cannot arrange, carry out, or communicate test results on behalf of private doctors. Private doctors are responsible for all monitoring, follow-up, and post-operative care, including providing painkillers and preventative medicine. We do not offer post-operative care on behalf of private providers.
Q: What if my Specialist refuses to arrange monitoring or prescribing?
A: Shared Care Agreements are discretionary and need to be accepted by the GP practice before they are considered valid. The specialist remains responsible for prescribing and monitoring specialist drugs.
Q: I’ve been discharged by my Specialist, but they say I still need monitoring.
A: If your Specialist has discharged you, no Share Care Agreement is possible. We cannot prescribe or monitor specialist medication to a patient who is not under the care of a specialist.
Q:I want to make a complaint.
A: We encourage anyone unhappy with their care at our practice to contact us before making a formal complaint.
Shared Care Agreements are discretionary and are reviewed on a patient-by-patient basis, as detailed in this policy.
Of course, all patients have the right to complain to us according to our standard procedure.