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 he or she is 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 by letter 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 (where available) should accompany this letter outlining responsibilities.  Primary care prescribers should then inform secondary care of their intentions as soon as possible by letter, 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 with it.  Patients should remain under regular follow-up in secondary care, where it is expected that the patients 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 BSWare listed below (A-Z) and 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)
BSW CCG Paediatric ADHD shared care
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)
Denosumab (GWH)
Denosumab (RUH)
Denosumab (SFT)
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)
Drug and Alcohol Service (RUH)
Growth Hormone deficiency in Adults (Somatropin) (RUH)
Hydroxycarbamide (GWH)
Hydroxycarbamide (SFT)
Ibandronic acid (RUH)
Lamotrigine (GWH)
Lanreotide (RUH)
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
NHS BSW CCG Midodrine (licensed) and/or Fludrocortisone (off-label) for Orthostatic Hypotension in Adults
Naltrexone for Alcohol (GWH)
Naltrexone for Alcohol signature sheet (GWH)
Naltrexone for Opiates (GWH)
Naltrexone for Opiates signature sheet (GWH)
Octreotide (RUH)
Oral Methotrexate (SFT)
Oromucosal Midazolam - over 10s (GWH)
Oromucosal Midazolam - Over 10's (RUH)
Oromucosal Midazolam - over 10's (SFT)
Oromucosal Midazolam - under 10s (GWH)
Oromucosal Midazolam - under 10's (RUH)
Oromucosal Midazolam - under 10's (SFT)
Paediatric Oncology PIL (SFT)
Perampanel (RUH)
Renavit (RUH)
Rifaximin (RUH)
Rifaximin (GWH)
Rifaximin (SFT)
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
Sevelamer (RUH)
BSW SCA Sildenafil for Digital Ulceration and Severe Raynaud's (unlicensed indication)
Testosterone Replacement in men (RUH)
Ulipristal (RUH)
Valproate semisodium (GWH)