Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, whether he has made an assessment of the extent of regional variations in access to (a) shared care agreements and (b) prescribed treatments; and what steps he is taking to help ensure consistency of access to these in all integrated care boards.

Shared care arrangements between a general practitioner (GP) and a specialist are voluntary and are not part of the GP Contract. GPs do not receive additional funding for participating in shared care arrangements and may decline on clinical or capacity grounds.

Guidance issued by the General Medical Council supports GPs in deciding whether to accept shared care responsibilities, ensuring that any prescriptions or referrals are clinically appropriate. Where a GP does not enter into a shared care arrangement, responsibility for ongoing treatment, including prescribing, remains with the specialist clinician.

Integrated care boards (ICBs), including the NHS Surrey Heartlands ICB, are responsible for arranging health services in line with local population needs and relevant guidance. ICBs follow NHS England’s guidance on shared care protocols, including the Responsibility for Prescribing Between Primary and Secondary/Tertiary Care framework. Within the NHS Surrey Heartlands ICB this framework is overseen by the Surrey Heartlands Medicines Optimisation Group. Implementation may vary between GPs due to factors such as clinical capacity, digital infrastructure, and local agreements. Regarding funding, the ICB’s approach is consistent with national policy expectations that integrated care systems should ensure equitable access to medicines and safe, sustainable shared care arrangements.

Whilst a specific assessment has not been undertaken, to support consistency of access, the Department’s Fit for the Future: 10-Year Health Plan for England, published on 3 July 2025, sets out plans for a Single National Formulary (SNF) for medicines. The SNF will replace the current system of local formularies, with a national oversight board sequencing products based on clinical and cost-effectiveness, supported by the National Institute for Health and Care Excellence. This approach is intended to drive rapid and equitable adoption of the most clinically and cost-effective medicines across England.