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GPs stop shared care due to growing legal fears

Shared care is em-erging as the main service GPs are threatening to stop providing free due to legal fears if practices are not commissioned under an enhanced service.

Failure of hospitals to provide proper support and lack of money from primary care organisations for the work is also leading GPs to withdraw, Pulse has learned.

A study of GPs in south Wales has found half are on the verge of stopping shared care monitoring of disease-modifying anti-rheumatic drugs (DMARDS) because of lack of support from hospitals.

GPs also said they feared their competence would be under greater scrutiny if they had lost out on a bid to do the work as an enhanced service.

Berkshire, Buckinghamshire and Devon LMCs are close to agreeing a local enhanced service deal to cover a range of new secondary care drugs, including DMARDS and Zolodex, after GPs had voiced concerns over shared care.

Jane Solomon, Berkshire and Buckinghamshire LMC director of liaison and development, said GPs had demanded a formal arrangement. 'We live in an increasingly litigious world,' she said. 'What GPs are concerned about is the sheer volume of new drugs coming from secondary care and that they were not getting any support.'

Essex LMC also reported at least one GP was telling patients he would not be continuing shared-care services.

Essex LMC chair Dr Brian Balmer said GPs feared they would be at greater risk of legal action if they had not been contracted to do the work.

'If it's being done elsewhere under a proper regulated service I think medicolegally you look wobbly,' he said. 'Zoladex has been included in minor surgery in at least two PCTs in my area while another is not paying for it at all.'

Dr Mayur Lakhani, RCGP clinical governance spokes-man, said GPs were 'laying themselves open' if they provided the service on an ad-hoc basis.

Dr Stephanie Bown of the Medical Protection Society said GPs would have to demonstrate they were trained and experienced in the work if they had not been commissioned to do it.

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