Shared Care with Private Providers

1. Policy Statement

Wickham Surgery is committed to providing high-quality care to all patients within the framework of NHS services and ensuring the safe and effective management of prescribed treatments. This policy specifically addresses shared care agreements for medications initiated by a private provider which are considered specialist and not within the scope of normal primary care prescribing.

2. Scope

This policy applies to all clinical and administrative staff at Wickham Surgery and affects all patients registered with the practice who seek or receive private specialist healthcare services.

3. Definition of Shared Care

Shared care involves the joint participation of healthcare professionals in the delivery of patient care, where clinical responsibility is shared between a specialist and the patient’s GP. It typically includes shared responsibilities for prescribing, monitoring, and managing treatment, particularly for specialist medications that fall outside the formulary of primary care.

4. Policy Objectives

• To ensure the safety and quality of care for all patients.
• To maintain compliance with NHS guidelines and ensure clinical responsibility remains appropriately managed.
• To clarify Wickham Surgery’s position on shared care for specialist medications initiated by private providers.

5. Policy Principles

5.1 No Shared Care Agreements for Specialist Medications from Private Providers

Wickham Surgery will not enter into shared care agreements with private healthcare providers for the prescribing or monitoring of specialist medications that fall outside the scope of normal primary care prescribing. This includes:

• Specialist Medications: Medications that require initiation, titration, or close monitoring by a specialist under specific clinical guidelines that are in the amber section of the local prescribing formulary. Examples include biologics, disease-modifying antirheumatic drugs (DMARDs), or medications used in the treatment of ADHD.
• Monitoring Requirements: Treatments with complex monitoring protocols (e.g., regular blood tests, imaging, or specialist assessments) that are not routinely supported in primary care.
• Unfamiliar Medications or Protocols: Medications for which Wickham Surgery lacks the clinical training, resources, or protocols to safely manage and monitor.

5.2 Reasons for Policy

• Clinical Governance: Private providers may follow guidelines or protocols that differ from NHS standards and Patients having been initiated on treatment may chose not to continue paying for ongoing specialist checks.
• Primary Care Scope: Specialist medications require expertise and monitoring that fall outside the scope of normal GP prescribing and management.
• Resource Allocation: Wickham Surgery must allocate its resources to prioritize NHS patients and services.
• Medicolegal Considerations: Assumption of responsibility for treatments initiated privately could expose the surgery to unacceptable medicolegal risks.

5.3 Patient Options

Patients receiving private care for specialist medications can:

• Continue their treatment, prescribing, and monitoring with the private provider.
• Transition back to NHS care through referral to an NHS specialist who can initiate treatment and establish shared care arrangements under NHS-approved protocols.

6. Responsibilities

• GPs and Clinical Staff: Ensure compliance with this policy and provide clear explanations to patients about the surgery’s stance on shared care for specialist medications initiated by private providers.
• Administrative Staff: Assist patients by providing information on NHS services or facilitating referrals to NHS specialists for ongoing care.

7. Communication with Patients

Patients seeking or receiving private care for specialist medications will be informed of this policy at the earliest opportunity. Staff should:

• Clearly explain the limitations of primary care prescribing and monitoring for specialist medications.
• Provide information about NHS pathways for specialist treatments.
• Offer appropriate referrals to NHS services if patients wish to transition their care.

8. Exceptions

This policy does not apply to NHS-funded shared care agreements with NHS specialists or hospital services, which are managed under established shared care protocols.

9. Review and Monitoring

This policy will be reviewed annually, or earlier if significant changes in NHS guidelines or local commissioning arrangements occur.

10. Approval

This policy has been approved by the GP partners of Wickham Surgery.

Effective Date: 27th March 2025