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Shared care

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


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