Policy on Non-Acceptance of Shared Care Agreements (SCA)
Purpose:
This policy outlines Marine Avenue Medical Centre's position on Shared Care Agreements and provides clear guidance to both clinicians and patients regarding the management and prescribing of medications or treatments initiated in secondary or private health care under a shared care arrangement. It aims to ensure safe, evidence-based, and appropriate care for all patients, in line with the competencies and responsibilities of the healthcare professionals within our practice.
Policy Statement:
Our practice does not enter into Shared Care Agreements for the ongoing management of specialist-initiated medications or treatments from private providers. While we are committed to providing high-quality care and collaborating with other healthcare providers, the responsibility for prescribing and monitoring certain medications must remain with the initiating specialist. This includes, but is not limited to, medications requiring specialist knowledge, regular monitoring, or high-risk management protocols.
Rationale:
Clinical Expertise, Workload and Resources:
· Shared care arrangements require significant clinical responsibility and specialist knowledge, which may fall outside the generalist scope of primary care.
Ensuring patient safety is paramount; as such, the practice may not have the infrastructure, resources, or expertise to comply with specialist-led protocols.
Clinical responsibility for monitoring and management should remain with the initiating specialist service where continuity, oversight, and expertise can be maintained.
Shared care often introduces legal and clinical accountability complexities for prescribers not directly involved in the treatment decision.
Primary care settings are not always equipped with the time, staffing, or infrastructure to safely manage complex medication regimens as outlined in SCAs.
Implications for Patients:
Patients will need to continue receiving prescriptions and monitoring from the initiating specialist, hospital team or private healthcare provider which will incur a cost.
We will provide general medical care and support as appropriate but will not assume responsibility for specialist-led treatments under a Shared Care Agreement.
Communication with Secondary Care:
This policy will be communicated to secondary care providers when an SCA request is received.
We will collaborate in providing relevant clinical information to support continuity of care.
Alternative Approach
Patients requiring ongoing treatment with specialist-initiated medication should remain under the care of the initiating specialist. Where long-term management is needed, the specialist should make appropriate arrangements for continued prescribing and monitoring or refer to services capable of accepting full clinical responsibility. Private healthcare providers are able to make referrals to NHS services without requiring GP input.
Exceptions:
The surgery has taken a firm stance on this matter and there will be no exceptions.
If an individual has chosen to take a private provider route to expediate waiting times, the expectation is that they continue on this route.
Review
This policy will be reviewed annually or sooner if clinical or legal guidance changes.
Date of Policy Implementation: 1st April 2025
Review Date: [1st April 2026]
Approved by: Marine Avenue Medical Centre Clinical Team