Shared Care Guidelines

RED AMBER GREEN

TRAFFIC LIGHT SYSTEM FOR NHS STOCKPORT

NHS Stockport supports the use of the Red Amber Green traffic light system proposed by the Greater Manchester Medicines Management Group. This system provides professional guidance on where prescribing responsibility should lie in respect of a small number of specialist medicines. It is designed to balance patient safety and clinical responsibility with the inconvenience for patients of having to get mediation from the hospital. Finance should never be the reason that shared care is used or refused.

RED drugs – prescribing should remain within secondary care (hospital) for these medicines.

AMBER drugs – prescribing should be initiated in secondary care (hospital) and may be passed to primary care after a formal request supported in most cases by means of a shared care guideline written to cover the indication specified in that guideline.

GREENdrugs – prescribing can be initiated in primary care. These drugs may include those which would not normally be started by a non-specialist GP without a specialist opinion having first been obtained.

The GMMMG updates the full Red Amber Green(RAG) list on a regular basis. For the latest version, follow the link below and click on the list for adults or children.

http://gmmmg.nhs.uk/html/rag.php

AMBER DRUGS AND SHARED CARE GUIDELINES (SCG)

Shared care is an agreement between the patient’s GP and Consultant to use a certain medicine, for a given condition, in a predefined manner, where an approved guideline, co-authored in primary and secondary care, is available.

Without a supporting guideline the full clinical responsibility lies with the person signing the prescription. Where is it not reasonable for the GP to take this responsibility alone but with the support of a consultant team it is safe to do so, a shared care guideline is devised. This document provides a clear framework as to what the GP will do and what the consultant will do to support the management of the patient. Thus the GP has a document that shows that although outside their normal area of competence there is a safe plan in place to allow them to take clinical responsibility and sign the prescription. There must always be a quick contact route back to the consultant should there be complications that the GP does not feel competent to manage.

Funding for participation in shared care is included within the £10 per head of population as part of the GP development scheme. As such GPs should never refuse shared care. If a GP feels unable to undertake shared care which is supported by an approved guideline they should contact the Medicines Optimisation office for a discussion on their reasons. If the reasons are deemed sound by the approvals panel the GP will be supported in refusing shared care. If they aren’t the GP should accept it.

Currently a few trusts use the GMMMG website to host their updated guidelines e.g. Pennine Care NHS Foundation Trust. The GMMMG website is also used to host those SCG which had been approved across Greater Manchester.

The following table contains the most recent Stockport approved guideline that is currently available and. If this guideline has not recently been reviewed, the requesting consultant must confirm that this is the guideline under which treatment is being shared and provide up to date contact numbers for any queries regarding treatment.

Please do not accept prescribing responsibility unless sent a reference to a current shared care guideline, or a copy of that guideline.

ALPHABETICAL LIST OF SHARED CARE GUIDELINES: