Shared care agreements explained

Shared care moves routine prescribing from a specialist to your GP practice once you are stable. It is an arrangement the practice has to accept, which is why it is worth asking about early.

The short version

Shared care hands routine prescribing and monitoring to a GP practice once a patient is stable.
NHS West and North London ICB advises confirming whether your GP would accept the provider's notice for shared care.
A practice is not obliged to enter one.
One ICB states Right to Choose covers ongoing prescriptions where a practice declines, but NHS England's final ADHD Taskforce report says many shared care arrangements are no longer in place.

Shared care is the mechanism that turns a specialist diagnosis into a sustainable monthly arrangement. It is also the step where an otherwise successful journey most commonly stalls, and the warning signs are visible long before it matters.

What it is

Once a patient is stabilised on medication, the specialist who started the treatment can hand routine prescribing and monitoring to the patient's GP practice under a formal arrangement, with the specialist remaining available for review. That is shared care.

The practical effect is that prescriptions come from the practice rather than the specialist, which is usually simpler for everyone.

Why the word accept matters

NHS West and North London ICB describes the step you should take before choosing a provider: confirm whether your GP would accept the provider's notice for shared care should you be prescribed medication.

Accept, not receive. A practice is not obliged to enter a shared care agreement, and practices differ in whether they will. That is a decision for the practice, and it is not unusual for the answer to be no.

Asking before the referral costs one question. Finding out afterwards means renegotiating an arrangement at the point when you most need it to be settled.

What happens if the answer is no

One board has published a position on the cost. NHS South West London ICB states that Right to Choose covers ongoing prescriptions if a GP does not agree to take over prescribing through a shared care protocol. That is one integrated care board writing about its own area, it is a statement about who pays rather than a promise that a prescriber will be found, and no national rule was found that settles the point. Boards differ, so check what your own has published.

Treat that as the better case rather than the expected one. NHS England's final report of the independent ADHD Taskforce, published in November 2025, says shared care protocols for ADHD have been available for many years but these have become more problematic in recent years with many arrangements no longer in place. The same report carries a case study of a woman diagnosed through Right to Choose whose practice did not agree to shared care, which it says resulted in long delays in her getting access to ADHD medication.

For a wholly private assessment, NHS West and North London ICB raises ongoing responsibility for the costs of any medication and prescribing as a careful consideration, because the NHS may not pay for private prescription costs.

Questions to put to your practice

Does the practice enter shared care agreements for ADHD medication?
Does that depend on which provider the notice comes from?
What would the practice need from the specialist before agreeing?
Who reviews the medication once shared care is in place, and how often?

Questions people ask about this

Does my GP have to accept shared care for ADHD medication?

No. NHS West and North London ICB advises confirming whether your GP would accept the provider's notice for shared care should you be prescribed medication, and accept is the operative word: practices differ and some decline. NHS England's final ADHD Taskforce report of November 2025 says many shared care arrangements are no longer in place, so ask before the referral is sent rather than after a diagnosis.

What is a shared care agreement?

It is a formal arrangement under which a specialist hands routine prescribing and monitoring for a stabilised patient to their GP practice, while remaining available for review. It usually makes prescriptions simpler to obtain, and it depends on the practice agreeing to take it on.