21Shared Care Agreement & GP Liaison

Purpose

Getting a shared care agreement written, signed and accepted by the GP - or establishing that it has been rejected.

Procedure

1. Record on the tab whether a shared care agreement needs writing.
2. The clinician writes the agreement in Signwell. Doctors and nurses each write their own; admin does not draft them.
3. Record the clinician and mark the SCA completed.
4. Before handover, confirm the patient's obs are current - send obs reminders and track expiry (16). If the patient does not send obs in, medication is discontinued.
5. Send the SCA to the GP and record the date sent.
6. Wait 2 weeks. If nothing comes back, chase the GP and record the date last chased.
7. If still nothing, send a hard copy by post.
8. If there is still no response, imply rejection: send a letter to the GP confirming that as no response has been received, rejection is assumed and the service retains prescribing. Mark the status rejected.
9. Rejected patients continue to be prescribed for by the service and move to 22.

Fields recorded

Does SCA need writing · SCA status (completed / rejected) · written on Signwell · clinician · date of last appointment · obs reminder sent · reminder expiry · discontinuation if obs not received · date sent to GP · date last chased with GP · hard copy posted · date prescription sent · tracking number

Notes

• Implied rejection is a formal step, not an assumption held internally - the GP is written to and told.
• Writing the agreement is a clinical task. Admin owns the sending, chasing and status tracking that follows.

Open points

• Whether an explicit or implied rejection triggers a funding review with the ICB.

Flowchart