The medicines listed below are designated within the Trust formulary as requiring Specialist initiation, and subsequent prescribing in accordance with an ESCA – Effective Shared Care Agreement. These drugs are coded within the Formulary as amber.
Specialist initiation might be required because of complex assessment and diagnostic criteria for the disease being treated, or the medication used might be unfamiliar to GPs. As the prescriber of a medication legally assumes responsibility for the drug additional prescribing support might be required for continued prescribing.
An Effective Shared Care Agreement can assist in the seamless transfer of patient treatment from secondary care to general practice, as it provides information on the drug, together with guidance on the prescribing and monitoring responsibilities.
The timing of the transfer of prescribing responsibility for each medication is described in its specific ESCA, but, as a principle, prescribing should be retained by the specialist until the dose is stable between hospital visits.
ESCAs in place within the trust and agreed with our local CCGs are shown below. Additional ESCAs may be found on Telford & Wrekin CCG and Shropshire CCG websites. (The patient’s CCG is determined by the CCG for the patient’s GP practice).
Copies of the agreement should be printed for each party – Specialist and GP – to agree, sign and retain.