Shared care is a term used within the NHS to describe the situation where a specialist doctor wishes to pass some of the patient’s care, such as prescription of medication, over to their general practitioner (GP). This is something that can be requested, but this may only be done if the GP agrees. In shared care arrangements, the prescribing Consultant or specialist team would still remain responsible for parts of the patient’s care. The presence of a specialist is also essential for the GP to be deemed to be operating under ‘shared care’. Shared care is not ‘shared’ unless it is shared by the GP with someone else. Without this, then GPs may be deemed to be operating outside of Good Medical Practice.
There are widespread issues within the NHS in getting ADHD assessments in a timely way. This results in patients opting to see private specialists and then hoping that their NHS GP will continue the prescription for any medication that is recommended. However, there can be problems when the specialist is no longer involved (which can happen for various reasons) and the GP is left with the responsibility of providing prescriptions, faced with a decision to either stop the treatment or continue without specialist input, both of which are clinically unsafe. We have more assurance from NHS providers that care will be continued, and this avoids us being put in an uncomfortable position where either: a private provider ceases to operate/stops follow up appointments under shared care OR a patient stops attending/funding follow up appointments with their private provider, all whilst leaving the clinical responsibility of prescriptions with the GP Surgery without specialist oversight.
Based on the above, going forward, we will not be signing any shared care agreements with private providers. While we sympathise with the patients, we have made this difficult but necessary decision for patient safety reasons.
We would also like to bring your attention to the following British Medical Association (BMA) guidance: https://www.bma.org.uk/advice-and-support/gp-practices/managing-workload/general-practice-responsibility-in-responding-to-private-healthcare
The BMA guidance is clear that ‘Shared Care with private providers is not recommended due to the general NHS constitution principle of keeping as clear a separation as possible between private and NHS care.’
We will be notifying patients at the point of seeking a private referral of the guidance, and making it clear that any treatment, tests or examinations requested by the private provider will need to remain the clinical responsibility of the private provider.
- We will honour the existing agreement between us and private clinics prior to 01.04.2025, provided there is a regular follow-up arrangement with the specialist.
- NHS and RIGHT TO CHOOSE NHS – we will honour shared care. ADHD and Autism (ASD) Assessment: Your Right to Choose Pathways.
- Any private providers outside of this – we will NOT be signing any shared care agreements. We will also not prescribe their medications whilst awaiting an NHS referral if at any point they wish to transfer to NHS care to get their medications. This would mean for the 1-2 year waiting time for NHS review, we will NOT be prescribing their medication for them until they have an NHS shared care agreement.
Woosehill Medical Centre
Last revised and updated on 21.07.2025