BSW Area Prescribing Committee

Shared Care Agreements (SCAs)

SCAs outline ways in which the responsibilities for managing the prescribing of a medicine can be shared between the specialist and a primary care prescriber. Primary care prescribers are invited to participate.  If they are unable to undertake these roles, then they are under no obligation to do so.  In such an event, the total clinical responsibility for the patient for that diagnosed condition remains with the specialist.  

AMBER with SHARED CARE medicines require significant monitoring and to qualify must be designated so by the BSW APC.  Primary care prescribers are advised not to take on prescribing of these medicines unless they have been adequately informed in writing (by letter or via secure email) of their responsibilities with regards to monitoring, side effects and interactions and are happy to take on the prescribing responsibility.  A copy of the locally approved SCA should accompany the request. Primary care prescribers should reply to the request as soon as practicable if they are unable to support shared care (in writing or via secure email) and then arrange the transfer of care as necessary. This will ensure absolute clarity as to who is taking over the prescribing and any associated monitoring responsibilities.    

Sharing of care assumes communication between the specialist, primary care prescriber and patient. The intention to share care is usually explained to the patient by the prescriber initiating treatment. It is important that patients are consulted about treatment and are in agreement.  Where appropriate, patients should remain under regular follow-up in secondary care, where it is expected that the patient’s overall response to treatment and need for continued treatment will be monitored.  

The APC are working to review and align Traffic Light Statuses (TLS) and SCAs across BSW. Where differences in TLS and SCAs exist, clinicians should refer to the agreement for their locality.

A full list of SCAs agreed for BSW are listed below (A-Z) and are also available in the relevant drug entry or section on the formulary website

The formulary and APC websites remain under development. For further information or to report inaccuracies/feedback email

Acamprosate (RUH)
Alfacalcidol (RUH)
Aripiprazole (GWH)
Azathioprine/Mercaptopurine (GWH) for gastroenterology patients
BSW CCG Paediatric ADHD shared care
BSW Buccolam® (Oromucosal Buccal Midazolam) Shared Care Agreement
OFF-LABEL Co-enzyme Q10 (ubiquinone/ibidecarenone) for inborn errors of Q10 synthesis; Mitochondrial cytopathies - children
Colesevelam (RUH)
Colesevelam (SFT)
Nebulised Colistimethate (RUH)
BSW and AWP Shared Care Guideline for the Treatment of Alzheimer’s Disease (Donepezil, Rivastigmine, Galantamine and Memantine)
BSW Denosumab Shared Care Guideline for Osteoporosis
BSW Summary of Shared Care Guidelines and Monitoring of Disease Modifying Drugs (DMARDs) in Adults Feb 2021 Rheumatology, Dermatology, Gastroenterology and Neurology
Dronedarone (GWH)
Dronedarone (RUH)
Dronedarone (SFT)
Hydroxycarbamide (GWH)
Hydroxycarbamide (SFT)
Ibandronic acid for postmenopausal women with early breast cancer (RUH and GWH)
Lamotrigine (GWH)
Larvae therapy (RUH)
BSW Liothyronine Shared Care Agreement
BSW Lithium Shared Care Agreement
Methotrexate subcut Injection (GWH)
Methotrexate subcut Injection (RUH)
Methotrexate subcutaneous injection for adults in rheumatology (SFT) 2016
Oral Methotrexate (SFT)
BSW Epistatus® (Oromucosal Buccal Midazolam) for children over 10 years of age
BSW Epistatus® (Oromucosal Buccal Midazolam) for children under 10 years of age (unlicensed use)
BSW Rifaximin Shared Care Guideline for the reduction in recurrence of episodes of overt hepatic encephalopathy (HE)
Riluzole (SFT)
RUH Shared Care Guidelines: DOACS for the OFF-LABEL treatment of cancer associated thrombosis
RUH Shared Care Guidelines: LMWH for the OFF-LABEL treatment of cancer associated thrombosis
BSW SCA Sildenafil for Digital Ulceration and Severe Raynaud's (unlicensed indication)
BSW SCA Somatropin for Growth Hormone Deficiency in Adults
Testosterone Replacement in men (RUH)
BSW Testosterone in Women Shared Care Agreement
Valproate semisodium (GWH)