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GPs exposed to legal risk through 'informal' shared care agreements

GPs have been urged to go through their records and ensure all patients on shared care have written agreements in place, after rising numbers of 'informal' requests to share responsibility for prescribing specialist drugs.

LMC leaders in Devon have issued the warning after several legal cases in their area in the past year went against GPs because they did not have the relevant skills to manage the agreements.

Devon LMC recommends that GPs should resist pressure from consultants to take on shared prescribing responsibility, as it can result in harm to patients.

Its June newsletter says: 'For each patient accepted, you should have a signed declaration from the consultant that the hospital has completed all of the initial work in starting the drug and there are clear instructions for drug monitoring.'

‘We are increasingly alarmed that these agreements are not being signed and sent to practices, and that many GPs are taking over shared care prescribing on the basis of informal requests in out-patient letters.' 

The LMC has recommended that local GPs should search their records to identify patients on shared care and ensure that this is being done on the basis of a written agreement with a named consultant.

Dr Andy Sant, executive vice-chair of the LMC, told Pulse: `There have been two to three adverse events in the last year or so, and GPs were left in the wrong medico-legally because they didn't have the relevant skills and knowledge.'

Dr Sant said that GPs should `understand that the risks rest solely with them' and should only prescribe shared care drugs when they felt they had the skills and knowledge to do so safely.

He said the LMC would be raising the issue of informal requests for shared care with local providers.

Dr Nick Clements, head of medical services at the Medical Protection Society, saidwhen sharing care doctors must be `fully competent to exercise their share of the clinical responsibility'.

He said: `The decision about who should take responsibility for continuing care or treatment should be based on the patient's best interests.'

GMC guidance on shared care can be found here [gated download] http://www.gmc-uk.org/guidance/ethical_guidance/prescriptions_faqs.asp#12

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