Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that patients receiving (a) ADHD and (b) autism treatment through the Right to Choose pathway receive safe and uninterrupted care when GPs are unable to accept shared care arrangements.

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 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 are not contractually obliged to enter into shared care agreements, and GPs may decline such requests on clinical or capacity grounds. 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.

On initiating a treatment, the specialist clinician must follow GMC guidance that if continuation of the treatment is dependent on shared care, then an agreement with the GP must be in place before the treatment is started. If a shared care agreement is not in place, the responsibility for ongoing prescribing remains with the specialist clinician, and this applies to both NHS and private medical care.

It is the responsibility of integrated care boards in England to make available appropriate provision to meet the health and care needs of their local population, including providing access to attention deficit hyperactivity disorder and autism services and support, in line with relevant National Institute for Health and Care Excellence guidelines.