GP Interface with Hospitals and Shared Care
There are times when the hospital might ask your GP to undertake something on their behalf. This can range from tests or investigations, to prescribing.
GPs are independent practitioners, and as such they are responsible for the resutls of any rests they request, or medication that they prescribe. This means that in order to undertake tests, a GP must be confident as to how and with what urgency the result would need to be actioned. This means for prescriptions that they need to be confident of the risks and benefits of prescribing a particular drug for a condition, and feel safe to manage and monitor the prescribing.
Therefore if your GP does not feel that the test or prescription requested from them is within the normal scope of their practice or competence, they can reasonable refuse to undertake the test or prescribe.
Shared Care
Shared care is a term that describes a process by which medications are prescribed or monitored. Medications that can or should be managed under a Shared Care agreement are defined on a regional basis by the North East and North Cumbria Medicines Sub committee of the Integrated Care Board.
For the purposes of Shared Care Drugs may be classified as Green/Amber/Red/Black.
Green Drugs: are medications that sit within the scope of your GP, to initiate, increase and safely monitor within primary care.
Amber Drugs: are started by a specialist and the dose stabilised. Once the medication is on a stable dose and working well, it can be handed over, with agreement, to your GP to prescribe with support. This means that if any issues arose, such as abnormal results in the monitoring, or your condition became unstable again, we would have a quick and direct route to access reliable support.
Red Drugs: are started and continued by a specialist even when the dose is stable they continue under specialist provision.
Black Drugs: are not approved for prescribing within the North East and North Cumbria.
Private Providers and Shared Care
Pressures in the NHS have increasingly seen our patients seeking private care for help with their helath issues. There are ever growing numbers of private providers across all specialities. As a practice we have no way of quality assuring their diagnostic processes, their treatment plans and recommendations, or their care.
Where a private provider recommends a treatment that falls within our competence and confidence to prescribe, and where the reason for prescribing is felt to be safe and appropriate, we would typically adopt this advice and incorporate it into your care.
Where private providers start patients on drugs that are classed as Amber, Red or Black we do not feel that it would be within the scope of our practice to take on the risks of either monitoring or prescribing. This is on the basis that we cannot reasonably assure ourselves as to the level of ongoing support available to us in the eventuality that there are abnormalities on your monitoring, or there is an issue with side effects or the stability of your condition.
Where you have asked us to refer you for private care, where relevant we would always seek to counsel you beforehand, of the risk that we may not be able to prescribe. Where we have been unable to accept a shared care request from a private provider, we would always seek to offer you an NHS referral in order to give you the option of continuing your care via that route.