Shared Care Agreement FormShared Care Agreement • November 6th, 2013
This treatment has been accepted for shared care according to the agreed shared care protocol available on ADTC link on the NHS Fife intranet (www.fifeadtc.scot.nhs.uk). I am therefore requesting your agreement in the shared care of this patient.
Shared Care Agreement FormShared Care Agreement • November 6th, 2013
This treatment has been accepted for shared care according to the agreed shared care protocol available on ADTC link on the NHS Fife intranet (www.fifeadtc.scot.nhs.uk). I am therefore requesting your agreement in the shared care of this patient.
Request to Share Care and Agreement FormShared Care Agreement • June 1st, 2022
This Request to Share Care provides Key Primary Care Information on responsibilities and monitoring. The aim is to support the GP to agree to share care arrangements. Refer to Full Shared Care Protocol for further information (page 4 onwards).
Shared Care Agreement FormShared Care Agreement • November 6th, 2013
This treatment has been accepted for shared care according to the agreed shared care protocol available on ADTC link on the NHS Fife intranet (www.fifeadtc.scot.nhs.uk). I am therefore requesting your agreement in the shared care of this patient.
SHARED CARE AGREEMENTShared Care Agreement • February 17th, 2022
The Shared Care Agreement (SCA) is intended to facilitate the accessibility and safe prescribing of complex treatments across the secondary/primary care interface. It does not contain all of the relevant product information, which should be sought using the current British National Formulary and manufacturer’s Summary of Product Characteristics. The SCA must be used in conjunction with the NHS Lothian Procedure for the Shared Care of Medicines, available here.
Shared Care Agreement for Methadone Oral Solution 1mg/mlShared Care Agreement • October 4th, 2022
This shared care agreement is aimed at General Practitioners with a special interest (GPSI) in drug misuse within the Local Enhanced Service (LES) working alongside specialist services to manage the care of drug users.
Effective Shared Care Agreement for AmiodaroneShared Care Agreement • December 23rd, 2014
This shared care agreement outlines suggested ways in which the prescribing responsibilities can be shared between the specialist and GP. GPs are invited to participate. If the GP feels that undertaking the roles outlined in the shared care agreement is outside their area of expertise or have clinical concerns about the safe management of the drug in primary care, then he or she is under no obligation to do so. In such an event, clinical responsibility for the patient’s health remains with the specialist. If a specialist asks the GP to prescribe, the GP should reply to this request as soon as practicable. Sharing of care assumes communication between specialist, GP and patient.
SHARED CARE AGREEMENT Name of Medicine: Indication: Version: Approval Date: DD MM YYYY Review Date: DD MM YYYShared Care Agreement • July 19th, 2017
The Shared Care Agreement (SCA) is intended to facilitate the accessibity and safe prescribing of complex treatments across the secondary/primary care interface.It does not contain all of the relevant product information, which should be sought using the current Brisitsh National Formulary and Manufacturer’s Summary of Product Characteristics. The SCA must be used inconjuction with the NHS Fife Policy and Procedures for the Shared Care of Medicines, available at:-
Shared Care Agreement FormShared Care Agreement • November 6th, 2013
This treatment has been accepted for shared care according to the agreed shared care protocol available on ADTC link on the NHS Fife intranet (www.fifeadtc.scot.nhs.uk). I am therefore requesting your agreement in the shared care of this patient.
Effective Shared Care Agreement (ESCA)Shared Care Agreement • August 3rd, 2015
This shared care agreement outlines suggested ways in which the responsibilities for managing the prescribing of ibandronic acid 50 mg for the prevention of skeletal events in metastatic breast cancer can be shared between the specialist and general practitioner (GP). You are invited to participate however, if you do not feel confident to undertake this role, then you are under no obligation to do so. In such an event, the total clinical responsibility for the patient for the diagnosed condition remains with the specialist.
SHARED CARE AGREEMENTShared Care Agreement • January 31st, 2014
This shared care guideline has been produced to support the seamless transfer of prescribing and patient monitoring from secondary to primary care and provides an information resource to support clinicians providing care to the patient. It does not replace discussion about sharing care on an individual patient basis.
Riluzole (Rilutek®) Effective Shared Care Agreement For patients with amyotrophic lateral sclerosis (ALS) - a form of Motor Neurone Disease (MND)Shared Care Agreement • December 19th, 2013
MERCAPTOPURINE SHARED CARE AGREEMENT (SCA)Shared Care Agreement • January 21st, 2015
SPECIALIST RESPONSIBILITIES 1. Assess patient, confirm diagnosis and discuss benefits and risks of treatment with the patient.2. Perform pre-treatment assessments and on-going monitoring as detailed on page 2.3. Initiate, titrate and stabilise patient on treatment with oral mercaptopurine. Prescribers should familiarise themselves with the drug indication, dose, administration, contra-indications, cautions, side-effects, interactions and preparation by referring to the current version of the Summary of Product Characteristics (http://www.medicines.org.uk/emc/default.aspx) or the BNF/BNF for Children (http://www.medicinescomplete.com/mc/index.htm).4. Provide appropriate written information on mercaptopurine to the patient.5. Discuss proposed SCA with the patient and explain that their GP may or may not wish to participate. The patient has the choice to continue receiving treatment solely from the specialist if they wish.6. Send a letter to the patient’s GP to request participation in th
SHARED CARE AGREEMENT (SCA)Shared Care Agreement • April 11th, 2017
SPECIALIST RESPONSIBILITIES 1. Assess patient, confirm diagnosis, and discuss benefits and risks of treatment with the patient.2. Perform pre-treatment assessments and on-going monitoring as detailed on page 2.3. Initiate, titrate and stabilise patient on treatment with drug.4. To work within the current NICE technical appraisal guidance – ‘Human growth hormone (somatropin) in adults with growth hormone deficiency’.5. Prescribers should familiarise themselves with the drug indication, dose, administration, contra-indications, cautions, side- effects, interactions, and preparation, by referring to the current version of the Summary of Product Characteristics (SPC) or the BNF (requires login).6. Provide appropriate written information on the drug to the patient. Ensure appropriate injection techniques are taught to patient/parents as appropriate.7. Discuss proposed SCA with the patient and explain that their GP may or may not wish to participate. The patient has the choice to continue re
Shared Care Agreement: MycophenolicShared Care Agreement • April 12th, 2023
This Shared Care Protocol sets out details for the sharing of care for patients prescribed mycophenolic acid. This protocol is for use within Lincolnshire renal services, indications listed on page 3.
ContractShared Care Agreement • June 12th, 2018
SHARED CARE AGREEMENT Name of medicine Tacrolimus (Adoport®, Prograf® & Advagraf®) Indication Solid organ transplant adult patients Version: 2.1 Approval date: November 2016 Minor amendment: March 2018 Review date: November 2019
ContractShared Care Agreement • July 10th, 2017
SHARED CARE AGREEMENT Name of medicine guanfacine Indication for attention deficit hyperactivity disorder (ADHD) in children aged 6 to 18 years Version: 2.0 Approval date: May 2017 Review date: May 2020
Sharing of care assumes communication between the specialist, GP and patient, and other members of the care team including specialist nurses and pharmacists. The intention to share care will be explained to the patient by the specialist initiating...Shared Care Agreement • July 13th, 2021
This document does not replace the need to check the BNF and/or relevant SPC which should be read in conjunction with this document
ContractShared Care Agreement • July 10th, 2017
SHARED CARE AGREEMENT Name of medicine methylphenidate (Concerta XL® , Medikinet XL®, Equasym XL®) Indication for attention deficit hyperactivity disorder (ADHD) in children aged 6 to 18 years Version: 2.0 Approval date: May 2017 Review date: May 2020
Shared Care Agreement FormShared Care Agreement • November 6th, 2013
This treatment has been accepted for shared care according to the agreed shared care protocol available on ADTC link on the NHS Fife intranet (www.fifeadtc.scot.nhs.uk). I am therefore requesting your agreement in the shared care of this patient.
SHARED CARE AGREEMENT Name of medicine lisdexamfetamine Indication For attention deficit hyperactivity disorder (ADHD) in adults Version: 2.0 Approval date: October 2016 Review date: October 2019Shared Care Agreement • February 13th, 2017
This Shared Care Agreement should be used for patients under the care of adult psychiatry services. The Shared Care Agreement lisdexamfetamine for attention deficit hyperactivity disorder (ADHD) in children 6 years and over should be used for patients under the care of NHS Lothian Child and Adolescent Mental Health Services.
SHARED CARE AGREEMENT – FRAMEWORKShared Care Agreement • July 11th, 2019
Shared Care: IntroductionShared Care Agreement • July 19th, 2022
The NHS England guidance and Welsh Ministerial circular published in 2018 (Responsibility for prescribing between Primary & Secondary/Tertiary Care for England and the All Wales Communication Standards between Primary and Secondary care HC/2018/014) and the basic premise that:
ContractShared Care Agreement • March 5th, 2018
SHARED CARE AGREEMENT Name of medicine dornase alfa Indication management of cystic fibrosis patients with a forced vital capacity (FVC) of greater than 40% of predicted and over 5 years of age to improve pulmonary function Version: 2.0 Approval date: November 2017 Review date: November 2020
ContractShared Care Agreement • July 13th, 2016
SHARED CARE AGREEMENT Name of medicine Ketamine Indication Complex Pain in Palliative Care Patients Version: 1.0 Approval date: June 2016 Review date: June 2019
Shared Care Agreement Signature Sheet Valproic acid (Depakote)Shared Care Agreement • October 12th, 2020
This page is to be completed by the consultant psychiatrist initiating the therapy. A copy of both completed forms should be retained by the GP and a copy should be returned to the consultant (preferably by email) for uploading in the patients records on Rio.
SHARED CARE AGREEMENT (SCA)Shared Care Agreement • July 18th, 2017
SPECIALIST RESPONSIBILITIES 1. Assess patient, confirm diagnosis and discuss benefits and risks of treatment with the patient.2. Perform pre-treatment assessments and on-going monitoring as detailed on page 2.3. Initiate, titrate and stabilise the patient on treatment with drug. Prescribers should familiarise themselves with the drug indication, dose, administration, contra-indications, cautions, side-effects, interactions and preparation by referring to the current version of the Summary of Product Characteristics or the BNF/BNF for Children (requires login).4. Provide appropriate written information on drug to the patient.5. Discuss proposed SCA with the patient and explain that their GP may or may not wish to participate. The patient has the choice to continue receiving treatment solely from the specialist if they wish.6. Send a letter to the patient’s GP to request participation in the SCA, along with the current SCA and the clinic letter (containing full details of the prescribing
SHARED CARE AGREEMENT (SCA)Shared Care Agreement • September 18th, 2017
SPECIALIST RESPONSIBILITIES 1. Assess patient, confirm diagnosis, discuss with the patient options for treatment and the suitability of leflunomide, including the potential benefits and side-effects of treatment.2. Perform pre-treatment assessments and on-going monitoring as detailed on page 2.3. Initiate, titrate and stabilise patient on leflunomide treatment. Prescribers should familiarise themselves with the drug indication, dose, administration, contra-indications, cautions, side-effects, interactions, and preparation, by referring to the current version of the Summary of product Characteristics or the BNF (requires login).4. Provide appropriate written information on the drug to the patient. Advise on need for effective contraception.5. Discuss proposed SCA with the patient and explain that their GP may or may not wish to participate. The patient has the choice to continue receiving treatment solely from the specialist if they wish.6. Review results of safety monitoring and reques
Shared Care Agreement FormShared Care Agreement • November 6th, 2013
This treatment has been accepted for shared care according to the agreed shared care protocol available on ADTC link on the NHS Fife intranet (www.fifeadtc.scot.nhs.uk). I am therefore requesting your agreement in the shared care of this patient.
Shared Care Agreement for Dalteparin injections for the treatment and prophylaxis of venous thromboembolism (VTE) in certain groups of patients under the care of East Cheshire NHS Trust.Shared Care Agreement • November 4th, 2021
Criteria for shared care Prescribing responsibility will only be transferred when:• Treatment is for a specified indication and duration (if applicable)• Treatment has been initiated and established by the secondary care specialist• The patient’s initial reaction to and progress on the drug is satisfactory• The patient’s general physical, mental and social circumstances are such that he/she would benefit from shared care arrangements Patients will be excluded from shared care if the following apply:• Unstable disease state• Patient does not meet criteria for shared care Patients should be referred back to the specialist as per the agreed treatment plan in the following situations:• The clinical situation deteriorates such that the shared care criterion of stability is not achieved• The clinical situation requires a major change in therapy LMWHs are considered to be safer than warfarin and other oral anticoagulants for the treatment and prophylaxis of venous thromboembolism (VTE) in cer
ContractShared Care Agreement • November 1st, 2019
SHARED CARE AGREEMENT Name of medicine Lisdexamfetamine (CNS Stimulant)single use not in combination Indication For Children (aged 6 years and over) and Adolescents withAttention Deficit Hyperactivity Disorder (ADHD) Version: 1 Approval date: August 2019 Review date: August 2021
Shared Care Agreement for Methadone Oral Solution 1mg/mlShared Care Agreement • June 1st, 2020
This shared care agreement is aimed at General Practitioners with a special interest (GPSI) in drug misuse within the Local Enhanced Service (LES) working alongside specialist services to manage the care of drug users. The shared care is between
Shared Care Agreement: Mycophenolate MofetilShared Care Agreement • April 12th, 2023
This Shared Care Protocol sets out details for the sharing of care for patients prescribed mycophenolate mofetil. This protocol is for use within Lincolnshire renal services, indications listed on page 3.
Shared Care Agreement Apomorphine For use in Parkinson’s DiseaseShared Care Agreement • October 6th, 2016
This shared care agreement outlines suggested ways in which the prescribing responsibilities can be shared between the specialist and GP. GPs are invited to participate. If the GP feels that undertaking the roles outlined in the shared care agreement is outside their area of expertise or have clinical concerns about the safe management of the drug in primary care, then he or she is under no obligation to do so. In such an event, clinical responsibility for the patient’s health remains with the specialist. If a specialist asks the GP to prescribe, the GP should reply to this request as soon as practicable.
Powys Shared Care Agreement: December 2014Shared Care Agreement • March 25th, 2022
🟋PLEASE CHECK ( POWYS FORMULARY WEBSITE ADDRESS)FOR THE LATEST VERSION OF THIS PROTOCOL🟋 General guidance This agreement outlines shared care arrangements for patients taking dexamfetamine or lisdexamfetamine dimesylate (lisdexamfetamine) for the treatment of Attention Deficit / Hyperactivity Disorder (ADHD).This Protocol does NOT cover the use of:1. lisdexamfetamine at doses above the maximum recommended in ADHD.2. Dexamfetamine at doses above the maximum recommended in ADHD. This Protocol should be read in conjunction with:⮚ The Shared Care Agreement Form (see below).⮚ NICE CG72 (September 2008, last modified March 2013 http://www.nice.org.uk/Guidance/CG72). Attention deficit hyperactivity disorder: Diagnosis and management of ADHD in children, young people and adults. Note: NICE CG72 incorporates recommendations from NICE TA98 and TA102.⮚ The Summary of Product Characteristics (Data Sheet) for Elvanse® see: http://www.medicines.org.uk/ 1. Licensedindication Dexamfetamine and lisde
