Sometimes the care of a patient is shared between two doctors (usually a GP and a specialist) and there is a formalised written ‘shared care agreement’. If a specialist asks a GP to enter into a ‘shared care agreement’, it is voluntary and at the discretion of the Practice. Often the GP will be asked to take over prescribing of a drug, and to monitor the patient by ensuring e.g. blood tests are done at regular intervals. It is usually the role of the specialist to review the patient periodically and advise regarding dose changes or adverse drug effects.
Most commonly the specialist in the ‘shared care agreement’ will be working within a team that is classified as an ‘NHS provider’ and has been approved by local commissioners. This means they will be following best practices and will be willing to adhere to locally agreed protocols.
Sometimes due to current long waiting times, patients may want to exercise their ‘right to choose’ and ask for a referral to an independent provider who holds an NHS contract. In some instances, these providers may only help a patient to obtain a diagnosis, but they will not offer follow up as described above in a ‘shared care agreement’. In these circumstances, the GP would not be able to safely prescribe or monitor medication for the diagnosed condition, and patients should be mindful of this when choosing a provider.