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: www.cwp.nhs.uk/resources/policies 

Drug Indication
Atomoxetine ADHD in Children and Adolescents
Azathioprine Dermatology, Inflammatory Bowel Disease and Rheumatological conditions
Ciclosporin Dermatology and Rheumatological conditions
Colistimethate (nebulised) Bronchiectasis
Hydroxychloroquine Rheumatoid Arthritis and other Rheumatological conditions
Leflunomide Rheumatoid Arthritis and other Rheumatological conditions
Lisdexamfetamine ADHD in Children and Adolescents
Melatonin Sleep Disorders in Children and Adolescents
Mercaptopurine Inflammatory Bowel Disease 
Mesalazine and Other Aminosalicylates Inflammatory Bowel Disease (Adults)
Methotrexate Inflammatory Bowel Disease, Psoriasis and Dermatological conditions, and Rhematological conditions
Methylphenidate ADHD in Children and Adolescents
Metolazone Chronic Kidney Disease (Adults)
Metolazone Refractory Heart Failure (Adults)
Mycophenolate Rheumatological and Dermatological conditions
Penicillamine Rheumatological conditions
Riluzole Amyotrophic Lateral Sclerosis (ALS)
Rivastigmine Parkinson's Disease
Sulfasalazine Rheumatological conditions and Inflammatory Bowel Disease

 

Prescribing Support Statements
Apomorphine Injection
Dementia
Gonadorelin Analogues
Glyceryl Trinitrate Transdermal Patch for Children
Mepacrine
Nitrazepam for the Treatment of Epilepsy in Children