Shared Care

When clinical and/or prescribing responsibility for a patient is transferred from specialists to the GP, the GP should have full confidence to prescribe the necessary medicines. Therefore it is essential that transfers of care involving medicines should not take place without the sharing of information with the individual GP and their mutual agreement to the transfer of care. These are not rigid guidelines, GPs and specialists may agree to work outside these guidelines if a discussion to agree this has taken place.

If you receive a request to prescribe in the absence of a shared care guideline, which you consider inappropriate please see Incident Reporting

AMBER Recommended requires specialist assessment and recommendation to GP to prescribe in Primary Care. 

AMBER Initiated requires specialist initiation of prescribing. Prescribing to be continued by the specialist until stabilisation of the dose and the patient's condition is achieved and the patient has been reviewed by the specialist.

AMBER Patient Retained requires specialist initiation of prescribing. Prescribing to be continued by specialist until stabilisation of the dose and the patient's condition is achieved and the patient had been reviewed by the specialist. Patient remains under the care of specialist (i.e. not discharged) as occasional specialist input may be required. 

PURPLE Medicines are considered suitable for Primary Care prescribing and/or management, following specialist initiation of therapy, with on-going communication between the Primary Care prescriber and specialist, within the framework of a Shared Care Agreement. 

Shared Care Protocols

Please note: during the current merger process of the Wirral and Pan Mersey formularies, the formulary will be reviewed on a chapter by chapter basis and the Pan Mersey APC categorisation adopted for each chapter reviewed. 

https://www.panmerseyapc.nhs.uk/shared-care/


For Cheshire & Wirral Partnership NHS Foundation Trust guidelines & policies relating to mental health, please visit: https://www.cwp.nhs.uk/about-us/policies-library/policies 

Drug Indication
Azathioprine Dermatology, Inflammatory Bowel Disease and Rheumatological conditions 
Ciclosporin Dermatology and Rheumatological conditions
Leflunomide Rheumatoid Arthritis and other Rheumatological conditions
Mercaptopurine Inflammatory Bowel Disease
Methotrexate Inflammatory Bowel Disease, Psoriasis and Dermatological conditions, and Rhematological conditions
Mycophenolate Rheumatological and Dermatological conditions
Sulfasalazine Rheumatological conditions and Inflammatory Bowel Disease
Lithium (under review) Bipolar Disorder or Depression

WUTH ADHD for Children

Atomoxetine

Dexamfetamine

Guanfacine

Lisdexamfetamine

Methylphenidate

 

CWP ADHD for Children

Atomoxetine (under review)

Lisdexamfetamine (under review)

Methylphenidate (under review)

ADHD in Children and Adolescents

 

Prescribing Support Statements

Hydroxychloroquine / GP letter (under review)
Melatonin for Children