Shared Care Agreements (SCA) are vital in ensuring that patients receive seamless and coherent healthcare services, especially when their treatment involves multiple health professionals or cross-sectoral health services. 

Shared care agreements are typically used for chronic or complex conditions requiring ongoing safety tests, blood work, or dose control - this could be for cases of Rheumatology & Immunology; ADHD, Mental Health Conditions, Specialized Physical Health.

You would think Primary and Secondary care should be working together yet some GP surgeries or rather, 'specific' Doctors do not want to work with the wider NHS trusts, at detriment to a patient.  Some GPs in practice refuse to or 'choose' to acknowledge expertise knowledge from specialists in the wider trust (which not only is disruptive, but can be a danger to patients).  They can even ignore prior diagnosed medical conditions within wider NHS trusts due to various reasons (again, a potential danger to patients) - this is detrimental to your health/continuity of care and could ensue legal action for some complainants.  At times, there can be even deplorable, unscrupulous reasons for GPs not to 'share care' or refer for secondary care in general - I have witnessed this deplorable behaviour 1st hand, which is why I have started this petition.

Unfortunately, Local Medical Committees (LMC) are also in the way of ensuring smooth pathway between primary and secondary care.  Always a recurring focal point for them, again, from July 26, Aug 26, Sept 26, LMC (Local Medical Committees), who act in Doctors' interests only, are asking GP practices to refuse all new SCA, trying to cite there are 'not the GP resources/capacity' for them.  They rightly state that it is voluntary to enter a SCA and yes, true, no legal obligation to enter - but their reasons against SCA fundamentally lack sufficient merit.  I will explain:

Key Factors GPs Consider when looking at a SCA:

Your GP will evaluate several factors before deciding whether to sign a shared care agreement: 

• Stabilisation: You must have completed your titration period and reached a stable dose (typically for at least 3 months) managed by your specialist;
  
  
• Specialist Credibility: The specialist or clinic (NHS, Right to Choose, or private) must be GMC-registered and follow official guidelines like NICE. 
• Capacity & Competency: GPs can decline if they feel the ongoing monitoring burden (such as blood pressure, pulse, or blood test checks) exceeds their practice resources;
• Practice Policy: GP surgeries publish a specific local policy or stance regarding shared care on their website (often under "medications" or "policies").  Check this or if you like, speak to Practice Management to get a copy of these policies.  Check the exact wording.  'Reasons' cited for refusal such as 'unable to accept shared care prescribing arrangements due to a responsibility to ensure the quality and continuity of care, which cannot be guaranteed', are not valid reasons - some GP surgeries with longstanding Doctors, Partners, offer pre-bookable appointments in advance with the same Doctor.  Moreover, that actual 'precise wording of quality', warrants concerns over overall 'competence', 'responsibility' at that surgery in general, in terms of patient safety and overall well-being) Doctors WILL be competent, more senior specifically, experienced).  Some surgeries, which cite 'a lack of guarantee', actually pride themselves on 'seeing the same Doctor' (continuity of care)/expertise, as a selling point so quite a contradiction really.

How to help yourself:

1) Check SCA policies online or if you like, speak to Practice Management to get a copy of these policies/medications and specific wordings;

2) As a patient, look online to see your GP surgery patient size list - this will give you reassurance that your surgery can cope (they must be able to if they have a list that size) thus counter-attacking the claim by LMCs/surgeries of a 'lack of resources';

3)  Check all longstanding Doctors at your practice online/via PM -  remember, other Doctors will also attend the surgery at times from elsewhere on the PCN - bringing vital knowledge.

4) Educate yourself on the financials - this is where:

• 'pharmanalyser.co.uk' comes in handy online;
• (NHS) regulations require individual general practice (GP) surgeries to publish the mean annual net earnings of their Doctors (available online). 

GP SURGERY Annual Income - (NHS PAYMENTS MADE TO GP SURGERIES)

If you wish to check how much annual income your GP surgery receives from the NHS; there is an excellent online website called 'pharmanalyser.co.uk' - Google it.  It is a NHS Pharmacy & GP Practice Analytics Platform.  Type in your GP surgery name and it will reveal key information.

• It tells you the total annual payments received from the NHS, amongst other information;
• It tells you whether there has been an increase or decrease from the prior year in monies received;
• It gives you a breakdown of what specific payments were made for;
• It also worryingly reveals that certain surgeries 'hide' some financial information (income) from public scrutiny on this website (such as income for premises expenses, seniority etc).  This is dubious. 

Some surgeries/LMCs state a 'lack of resources for SCA', yet the capacity and surgery financials demonstrate otherwise.  The total amount received from NHS gives you an indicator of the income received - in other words 'inadequate resources' (as cited by the LMC/surgery) is not an issue for a surgery nor legitimate reason for refusing shared care agreements. 

In addition, I would ask you to look up the number of Doctors at the surgery online; staffing; net annual earnings of the GPs at your surgery on their surgery website, as surgeries have to display this.  In the UK, National Health Service (NHS) regulations require individual general practice (GP) surgeries to publish the mean annual net earnings of their Doctors.  If the surgery is a top heavy partnership, profit share will be distributed amongst partners - the surgery acts more like a business.  It is in their interests to 'retain as much' for themselves - this doesn't work in your favour as a patient needing genuine care.

Combining both sources of this financial information, readibly available, If you do the maths, you will see, sufficient ample 'financial' resources for Shared Care Agreements, therefore the LMC has no business interfering in pathways between primary and secondary care - the LMC represents Doctors' interests only.

Benefits of SCA for patients -

 1) less travel (closer to home)

2) local doctors are easier to get appointments with than busy specialists

3) cost savings - you save money on fuel and time off work

4)  safety - specialists and local Doctors stay in touch - teamwork can ensure mistakes are prevented

Everyone should work together!

Research indicates that clear, structured shared care agreements improve patient satisfaction and show collaboration; they:

• reduce unnecessary hospital admissions, saving the wider NHS trust costs;
• ensure patients who have complex health issues, (maybe preventing them from attending to further away hospitals travel wise) have less distance to go; 
• ensure that those who lack transport, on reduced income, can instead visit their GP locally;
• allow patients who fear hospitals, to feel more comfortable at their local surgery

Standardized agreements act as a roadmap for healthcare professionals, providing transparent communication channels and established protocols for patient referrals and care transitions.

We urge healthcare policymakers and leaders to recognize the importance of standardized shared care agreements and take necessary actions to implement them across all healthcare settings.  By establishing a comprehensive framework, we can streamline care coordination, minimize errors, and ensure that patients receive high-quality, continuous care.

Let us push for this much-needed change and create a healthcare environment where patients’ needs are consistently prioritized. 

Sign and share this petition to advocate for the implementation of standardised shared care agreements in our healthcare system. Together, we can make a significant impact on the quality of patient care.