Shared Care Agreements (SCA) with Private Providers
Shared care agreements (SCA) are often reserved for complicated specialist medications which GP’s wouldn’t usually prescribe themselves. Shared care agreements make it clear what the GP and the specialist have to do in order for the prescription to be supplied by the GP safely. This is a complicated and time consuming process for the practice and within the NHS practices receive funding for this work. As a result many practices are unable to engage in these shared care agreements with private healthcare providers. A common example that we encounter privately is with medications for ADHD – given the NHS waits for assessment are many years in length.
We recognise the challenges patients face under very long NHS waiting lists and have always tried to accommodate such requests when we are able to do so. We do not get any funding for this additional workload but at present are still trying to accommodate such requests where possible. Patients should note however that each request will be assessed by the practice and prescribing GP and a decision on whether to engage in a shared care agreement on a case by case basis.
We do however set a number of conditions that need to be met in order to agree to safely share care with private healthcare providers:
· The medication must be one the GP is competent to prescribe safely.
· The medication would have to be available on the NHS in similar circumstances.
· The private healthcare provider would have to agree to share care using the NHS Lothian shared care agreement.
· The private specialist has to follow up the patient as would happen within the NHS.
· The patient would likewise have to agree to continue seeing the specialist in order for the prescription to be continued. If a patient decided to stop seeing the specialist we would not be able to continue prescribing the medication.
We need to be satisfied that the private specialist is suitably qualified and experienced. This can be difficult but in general there is rarely an issue with any major private healthcare provider. If we cannot be certain the private specialist is suitably qualified we cannot agree to a SCA with that provider. For example, an ADHD diagnosis must be carried out by a fully qualified psychiatrist and evidenced in their documentation to us. The practice needs to have capacity to do this work. As above this is not work GP’s are required to do, and are not paid to do. We try and support our patients as best we can but with all the pressures in GP there may come a time when we cannot take on any more of these SCA if the work involved got so much that it was affecting core NHS work.
Organising Investigations Requested by Private Providers
Often, patients require monitoring in the form of blood tests, blood pressure monitoring and ECG while receiving treatment from their private provider. Unfortunately, our clinicians are only indemnified to undertake NHS work and the practice does not have additional indemnity cover to provide non-NHS Blood tests. In addition to this, it is important to understand that the clinician requesting the blood test (or any other investigation) is clinically responsible for any results received. Investigations should therefore be organised by your private provider and the results interpreted by them