Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether his Department is taking steps to expand the number of organisations under the Right to Choose pathway that are able to have their ADHD prescriptions fulfilled by the NHS.

Shared care within the National Health Service refers to an arrangement whereby a specialist doctor formally transfers responsibility for all or some aspects of their patient’s care, such as the prescription of medication, over to the patient’s general practitioner (GP).

The General Medical Council (GMC), which regulates and sets standards for doctors in the United Kingdom, has made it clear that GPs cannot be compelled to enter into a shared care agreement. Shared care is not part of the GP Contract and as such, participation is voluntary. GPs may decline such requests on clinical or capacity grounds. A GP who has previously agreed to a shared care agreement but who can no longer support it must provide a clear rationale for their decision. Both the GP and the specialist clinician share responsibility for ensuring continuity of care for the patient.

The GMC has also issued guidance to help GPs decide whether to accept shared care responsibilities. In deciding whether to enter into a shared care agreement, a GP will need to consider a number of factors to determine whether it is within their sphere of competence, and therefore safe and suitable for their patient’s needs. This includes being satisfied that any prescriptions or referrals for treatment are clinically appropriate.

If a shared care agreement is not in place, the responsibility for ongoing prescribing remains with the specialist clinician, which applies to both NHS and private medical care.