Our practice is no longer able to accept new shared care prescribing arrangements for specialist mental health medications, including ADHD medications, whether these have been initiated through NHS secondary care services or through the NHS Right to Choose pathway.
This has been a difficult decision. However, after careful consideration and repeated difficulties in obtaining timely specialist support and collaboration, we have concluded that these arrangements are no longer sustainable or in the best interests of patient safety.
Many mental health and ADHD medications require specialist knowledge, regular review, ongoing monitoring, and access to specialist advice. Shared care is intended to be a collaborative arrangement in which responsibility for the patient’s care is shared between the specialist clinician and the GP, with clearly defined roles and responsibilities.
In practice, we have experienced persistent difficulties in obtaining appropriate specialist support, particularly when patients are discharged from specialist services or when advice is required regarding medication changes, monitoring, or ongoing management. This can result in the GP being left with sole responsibility for prescribing complex specialist medication without the necessary specialist oversight. We do not believe this reflects the principles of safe shared care or provides the level of support that patients deserve.
For these reasons, we believe that the safest and most appropriate approach is for the initiating specialist service to retain responsibility for prescribing, monitoring, and reviewing specialist mental health and ADHD medications throughout the course of treatment. This ensures that patients continue to receive care from clinicians with the appropriate expertise and access to specialist services when required.
We appreciate that this decision may be disappointing for some patients.
It has not been taken lightly and reflects our responsibility to ensure that prescribing remains safe, clinically appropriate, and supported by effective specialist collaboration.
We remain committed to working with specialist services to provide the best possible care for our patients within our respective clinical responsibilities.