All Polices

Shared Care Agreements with Private Providers

Shared Care Agreements are written agreements between specialist services and general practitioners and allow care, specifically prescribing, to be safely shared between them.

BMA guidance, Advice & Support, “shared care” with private providers:

Sometimes the care of a patient is shared between two doctors, usually a GP and a specialist, and there is a formalised written ‘shared care agreement’ setting out the position of each, to   which both parties have willingly agreed. Where these arrangements are in place, GP providers can arrange the prescriptions and appropriate investigations, and the results are fully dealt with by clinicians with the necessary competence under the shared care arrangement. There is NHS guidance available about this.

Share Care is not recommended with private providers due to the NHS constitution principle of keeping a clear separation between private and NHS care.  Shared Care is currently set up as an NHS service, and entering into a shared care arrangement may have implications around governance and quality assurance as well as promoting health inequalities.  Shared care may be appropriate where contracted private providers are providing commissioned NHS services and where appropriate shared care arrangements are in place.

All shared care arrangements are voluntary, so even where agreements are in place, practices can decline shared care requests on clinical and capacity grounds.  The responsibility for the patients care and ongoing prescribing then remains the responsibility of the private provider.

As a practice we are following the BMA guidance, around private ADHD shared care agreements.  Presently we are not commissioned for most private ADHD services and therefore, not required to sign up for all private shared care agreements offering ADHD care.

We understand that this is frustrating, but until we are authorised by the Integrated Care Board Contracting Team, Coventry & Warwickshire who have reviewed the providers NHS contract there are limited prescribing ADHD providers we can refer to.

Privacy notice for sharing your data outside the practice

As a result of improvements in information technology and appropriate information governance standards, it is becoming possible to share your GP records across Coventry & Warwickshire Health & Social Care electronically using the practice clinical system. We will only share this information with your explicit consent, when seeing a health worker so that you are able to allow doctors, nurses and other health and social care services in other health organisations to view the information held on your GP records. Therefore, enabling health organisations to provide an appropriate health service required to meet the patients’ needs.

The following are examples of the types of organisations that we are likely to share information with:

  • NHS and specialist hospitals, Trusts
  • Independent Contractors such as dentists, opticians, pharmacists
  • Private and Voluntary Sector Providers
  • Ambulance Trusts
  • Clinical Commissioning Groups and Primary Care Networks
  • Social Care Services and Local Authorities

Any patient can choose to withdraw their consent to their data being used in this way. When the Surgery is about to participate in any new data-sharing scheme we will make patients aware by displaying prominent notices in the Surgery and on our website. These schemes are only for direct care so you (or your carer) will be present when the information is accessed and will be asked for consent again, before your records are opened.

A patient can object to their personal information being shared with other health care providers and can withhold consent but if this limits the treatment that you can receive then the doctor will explain this to you at the time.

NHS Hospital Contract

A new NHS Hospital Contract came into force on 1st April 2017 which all NHS Organisations have signed.

What this means to you:

MEDICATION – The hospital attended is to supply medication with an adequate supply for the patients immediate clinical need until the GP receives the relevant clinic letter and can prescribe.  We appreciate this change is frustrating but in line with this contractual obligation the GP surgery will not be able to issue you with consultant recommended medication even if you have a hospital prescription.  You would need to obtain from the hospital attended or contact the consultant or a member of their team.  Upon notification from the consultant the GP surgery may automatically add the medication change to your repeat list on the computer system.  You will then be able to order your repeat medicaiton without an appointment.
SICK NOTES – Under Section 11, the contract sets out new requirements to reduce inappropriate bureaucratic workload shift onto GP Practices.  NHS Trust Hospitals are now contracted to supply patients with the appropriate certification following discharge from an inpatient stay, day cases or following an outpatient appointment.  The length of the note given to a patient  should be provided for as long as required to anticipate the patients date of recovery or follow up.
RESULTS AND MEDICAL RELATED PROBLEMS – Results of investigations requested by hospital clinicians are to be communicated by hospital directly to patients.
Your consultant and their team are responsible for answering any concerns or queries you may have relating to your care under the hospital service, not the GP.  By this change of contractual responsibilities it is hoped nationally that this will reduce millions of GP appointments wasted nationally, responding to patients queries relating to hospital care and/or test results directly arranged by their hospital consultant.
For medically related problems, the hospital is to refer onto other necessary departments i.e. if seen in the Pain Management Clinic for knee pain they can then refer you to the Orthopaedic Department if necessary regarding that knee.  GPs will only have to provide a referral when the reason is not medically related to the original referral.
NON ATTENDANCE – If a patient does not attend a hospital appointment it is the hospital, not the GP, will liaise directly with the patient therefore the GP does not have to produce another referral (re-refer).
CLINIC LETTERS – Hospital clinic letters should be sent to the GP within 10 days.