When clinical, and therefore prescribing, responsibility for a patient is transferred from hospital to GP, it is of the utmost importance that the GP has full confidence to prescribe the necessary drugs. It is, therefore, essential that a transfer involving drug therapies with which GPs would not normally be familiar should not take place without full local agreement and the dissemination of sufficient information to individual GPs.
When a consultant considers a patient's condition is stable, he may seek the agreement of the GP concerned to share care. In proposing a shared care arrangement, a consultant may advise the general practitioner which medicine to prescribe. Where a new, or rarely prescribed, medicine is being recommended, its dosage and administration must be specified by the consultant so that the GP is properly informed and can monitor treatment and adjust the dose if necessary. In addition, when a treatment is not licensed for a particular indication, then full justification for the use of the drug should be given by the consultant to the GP.
Walford D. Responsibility for prescribing between hospitals and GPs
NHS Executive Circular. EL (91) 127, November 1991
Transition of Commissioning Policies
On 1st July 2022 NHS Cheshire and Merseyside Integrated Care Board (ICB) became the new statutory body responsible for ensuring health care services are available to meet the reasonable needs of the people of Cheshire & Merseyside.
Until such time as a single suite of commissioning policies can be developed and adopted, NHS Cheshire and Merseyside will continue to adopt and operate the CCG policies it has inherited at Place/borough level, which means that there will be no immediate change in commissioning policy for local people resident in those Places/boroughs from what was in place prior to 1st July 2022.
Indications, dose adjustments and monitoring requirements for disease modifying drugs (DMDs) (licensed and unlicensed indications) included in this Framework are in line with national guidance published by the British Society for Rheumatology 2017.
Adapted for local use
St Helens and Knowsley Teaching Hospitals NHS Trust