KMICB - Shared Care Guidance

Shared Care 

A medicine is deemed suitable for shared care if it requires frequent monitoring which can be undertaken in the primary care setting but is such that overarching specialist involvement is retained. 

Shared care should only be implemented when it is in the best interests of the patient. Prescribing may be transferred to a primary care prescriber once the patient’s condition is stable or predictable, as outlined in the relevant Shared Care Protocol (SCP). The specialist retains ongoing responsibility for certain aspects of care, including: 

• initiation of treatment 
• on-going specialist monitoring and/or 
• assessment to enable effectiveness and/or
• reducing risk of toxicity 

A SCP is a formal agreement that outlines the responsibilities of specialists, primary care prescribers, and patients in the ongoing management of a medicine. It provides structured guidance on treatment initiation, prescribing, monitoring, communication, and review to ensure safe, effective, and coordinated care across healthcare settings. 

Treatment should be initiated by a specialist. Responsibility for prescribing should only be transferred to primary care when the patient’s condition is stable or predictable, as defined within the applicable SCP. 

When initiating a shared care request, the specialist must complete the Shared Care Request Letter (Appendix 1), include their contact details in Section 13 of the SCP and send the full version of the SCP to the GP.  

The GP must respond in writing for each individual case, using either Appendix 2 (acceptance) or Appendix 3 (decline). Until a written agreement is received confirming that the GP has accepted the shared care arrangement, the specialist remains responsible for prescribing. 

 Shared Care Medicines PIL V1 A5 leaflet

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