Shared Care Agreements (SCAs)

An SCA is an agreement between a hospital clinic and a GP practice to transfer some responsibility for a complex condition to the GP Practice. The condition usually involves treatment with drugs with a higher risk of dangerous side effects and the requirement of close blood or other biometric monitoring. These conditions and treatment are agreed upon between hospital clinics, health boards and GP Practices every year in the ‘GP Enhanced Services Programme: Disease modifying drugs’ service agreement. The current drugs that are resourced and funded are as follows:

Azathioprine

Ciclosporin

Hydroxychloroquine

Leflunomide

Methotrexate

Penicillamine

Sulfasalazine

Erythropoiesis stimulating drugs in chronic renal failure

Mercaptopurine in inflammatory bowel disease

Many SCAs for other conditions and medications exist despite not being included under the ‘GP Enhanced Services Programme: Disease modifying drugs’ service agreement. Unfortunately this leads to confusion and hospital clinics often understandably think that the existence of an SCA means that a GP practice is obligated to enter into it. The Almond Group Practice understands that it is more convenient for patients to receive their prescriptions and monitoring of conditions from their local GP practice and therefore we will continue our services for the above agreed drugs. However, we will not be entering into any SCAs outwith the above list. This policy is in line with our contract and has been agreed with the Local Medical Committee (LMC) and the GP Prescribing Committee (GPPC).