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ADHD/Autism/Gender Dysphoria Shared Care Agreements with private providers

ADHD/Autism/Gender Dysphoria Shared Care Agreements with private providers (Effective from 1 March 2025)

Sometimes the care of a patient is shared between two doctors, usually a GP and a specialist, and there is a formalised written ‘shared care agreement’ setting out the position of each, to which both parties have willingly agreed. Where these arrangements are in place, GP providers can arrange the prescriptions and appropriate investigations, and the results are fully dealt with by clinicians with the necessary competence under the shared care arrangement. There is NHS guidance available about this.

Shared Care with private providers is not recommended due to the general NHS constitution principle of keeping as clear a separation as possible between private and NHS care. Shared Care is currently set up as an NHS service, and entering into a shared care arrangement may have implications around governance and quality assurance as well as promoting health inequalities. A private patient seeking access to shared care should therefore have their care completely transferred to the NHS. Shared care may be appropriate where private providers are providing commissioned NHS services and where appropriate shared care arrangements are in place.

All shared care arrangements are voluntary, so even where agreements are in place, practices can decline shared care requests on clinical and capacity grounds. The responsibility for the patient’s care and ongoing prescribing then remains the responsibility of the private provider.

If you are under the care of a private specialist, we will not be able to enter into a shared care agreement. You can ask us to refer you to an in-person NHS mental health team, but while waiting to see them, you will need to obtain your treatment from your private specialist directly.

The above statement also applies to Third party providers working under right to choose.

We will not carry out tests that private providers want you to have, any tests that private providers need to be done must be completed by them. The Right to Choose providers are also commissioned to do things like physical checks and blood tests and therefore this is also something that they should provide. If they are an online/remote provider, you will need to discuss this fully with them on how to proceed.

If you have started treatment with a private provider, you will either need to:

    • approach the Practice to request a referral to an NHS specialist
    • or continue to receive your treatment directly from your private provider indefinitely

Please note that there may be a significant delay in having your diagnosis reviewed by the NHS team and them agreeing to participate in a shared care agreement. During this time, you will need to continue to receive your treatment directly from your private provider. The Practice is not able or obliged in any way to provide a “bridging” prescription.

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ADHD/Autism/Gender Dysphoria Shared Care Agreements with private providers

(Effective from 1 March 2025)

Sometimes the care of a patient is shared between two doctors, usually a GP and a specialist, and there is a formalised written ‘shared care agreement’ setting out the position of each, to which both parties have willingly agreed. Where these arrangements are in place, GP providers can arrange the prescriptions and appropriate investigations, and the results are fully dealt with by clinicians with the necessary competence under the shared care arrangement. There is NHS guidance available about this.

Shared Care with private providers is not recommended due to the general NHS constitution principle of keeping as clear a separation as possible between private and NHS care. Shared Care is currently set up as an NHS service, and entering into a shared care arrangement may have implications around governance and quality assurance as well as promoting health inequalities. A private patient seeking access to shared care should therefore have their care completely transferred to the NHS. Shared care may be appropriate where private providers are providing commissioned NHS services and where appropriate shared care arrangements are in place.

All shared care arrangements are voluntary, so even where agreements are in place, practices can decline shared care requests on clinical and capacity grounds. The responsibility for the patient’s care and ongoing prescribing then remains the responsibility of the private provider.

If you are under the care of a private specialist, we will not be able to enter into a shared care agreement. You can ask us to refer you to an in-person NHS mental health team, but while waiting to see them, you will need to obtain your treatment from your private specialist directly.

The above statement also applies to Third party providers working under right to choose.

We will not carry out tests that private providers want you to have, any tests that private providers need to be done must be completed by them. The Right to Choose providers are also commissioned to do things like physical checks and blood tests and therefore this is also something that they should provide. If they are an online/remote provider, you will need to discuss this fully with them on how to proceed.

If you have started treatment with a private provider, you will either need to:

    • approach the Practice to request a referral to an NHS specialist
    • or continue to receive your treatment directly from your private provider indefinitely

Please note that there may be a significant delay in having your diagnosis reviewed by the NHS team and them agreeing to participate in a shared care agreement. During this time, you will need to continue to receive your treatment directly from your private provider. The Practice is not able or obliged in any way to provide a “bridging” prescription.

Our New Phone System goes Live

**Patient Notice**

On Wednesday 23 October we will be going live with our new phone system. Our new phone system has extra features such as:

    • Patient call back: If we are experiencing a high volume of calls, you may be offered a call back. The system holds your position in the queue and you receive a call back from the practice when you are next in line.
    • Computer system integration: If your telephone number is linked to your practice electronic records, this will help the system to link to your medical notes when you call the practice.

Once implemented further features can be added/removed to enable a smoother service for our patients.

We kindly request your patience at this time 🙏🏻
Thank you

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Mental Health Crisis

There is now a simpler way for people to find the right support in a mental health crisis. If you, or someone you know, is experiencing a mental health crisis, you can now call NHS 111 and select option 2 for 24/7 access to crisis mental health support. We’re here for you 24/7

Click below ⇓ to go to our Mental Health Crisis page for more information:

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PPG Minutes: 18 June 2024

Attendees: Dr Brown, Louise Armstrong, Debbie Bailey (South Durham Health Federation), CC (Age UK) John Kelly, (Social Prescribing Link Worker) GP, MN, MS, AS.

Introductions: Dr Brown introduced himself and explained that today’s meeting would follow a different format as we welcome guest speakers Charles Chapman and John Kelly.

Updates since last meeting:

Dr Brown told members that there has been little change since the last meeting. The main change has been that long standing receptionist Linda had now retired and that we now have 2 new receptionists in post.

John Kelly (Social Prescribing Link Team Lead.)

Dr Brown introduced John to the group. John explained the role of social prescribing link worker and how this service works hand in hand with the 3 GP surgeries in our PCN. John explained that the team can support patients with social issues such as housing, social isolation, debt management etc. Patients can be referred by their GP but can also be referred by other agencies or staff members at the practice. The team then help the patient to identify their needs and signpost them into the correct direction for support. MN asked John how patients know about this service and another PPG member stated this was something they did not know existed. Dr Brown explained that if a patient comes to him and mentions a social problem then he can direct them to John. John explained that posters had been put in all surgery waiting rooms and advertised on social media. John acknowledged that there is a group of patients who do not use social media or come into the surgery that may not be aware of the service and that this was a problem. He explained that this is where CC and the team at AGE UK can help. John also told patients about coffee mornings that are run at Peterlee and Blackhall. John was asked if there were any plans to run one of these at Horden. He explained that Horden had a lot of these already in place but that it was an area that they would be looking at next, to either visit existing groups or set up a group.

AGE UK County Durham

CC introduced himself and explained his role at Age UK County Durham. He explained that one of the projects that Age UK are working in is the Digital Inclusion Programme. This is a service that helps people over the age of 50 with technology training. He explained that they can visit a person’s home and help them to access the internet and train them on safe ways to use this. They offer one to one training and can also visit community groups. It was pointed out that a lot of people will not know about the service and CC acknowledged this and has asked us if we can begin to hand out leaflets to this patient group and explain what they offer.

Actions:

Louise to ask receptionists to actively promote the digital inclusion programme by asking patients if they use the app and if they express that this is difficult for them to signpost to the team.

The next meeting date will be agreed shortly, and we will send this out via text to those with mobile numbers or letters for those who don’t. Please let us know if there is anyone who expresses interest in attending future groups.

Patient Participation Group Meeting Minutes – 18 June 2024

Attendees: Dr Brown, Louise Armstrong, Debbie Bailey (South Durham Health Federation), CC (Age UK) John Kelly, (Social Prescribing Link Worker) GP, MN, MS, AS.

Introductions: Dr Brown introduced himself and explained that today’s meeting would follow a different format as we welcome guest speakers Charles Chapman and John Kelly.

Updates since last meeting:

Dr Brown told members that there has been little change since the last meeting. The main change has been that long standing receptionist Linda had now retired and that we now have 2 new receptionists in post.

John Kelly (Social Prescribing Link Team Lead.)

Dr Brown introduced John to the group. John explained the role of social prescribing link worker and how this service works hand in hand with the 3 GP surgeries in our PCN. John explained that the team can support patients with social issues such as housing, social isolation, debt management etc. Patients can be referred by their GP but can also be referred by other agencies or staff members at the practice. The team then help the patient to identify their needs and signpost them into the correct direction for support. MN asked John how patients know about this service and another PPG member stated this was something they did not know existed. Dr Brown explained that if a patient comes to him and mentions a social problem then he can direct them to John. John explained that posters had been put in all surgery waiting rooms and advertised on social media. John acknowledged that there is a group of patients who do not use social media or come into the surgery that may not be aware of the service and that this was a problem. He explained that this is where CC and the team at AGE UK can help. John also told patients about coffee mornings that are run at Peterlee and Blackhall. John was asked if there were any plans to run one of these at Horden. He explained that Horden had a lot of these already in place but that it was an area that they would be looking at next, to either visit existing groups or set up a group.

AGE UK County Durham

CC introduced himself and explained his role at Age UK County Durham. He explained that one of the projects that Age UK are working in is the Digital Inclusion Programme. This is a service that helps people over the age of 50 with technology training. He explained that they can visit a person’s home and help them to access the internet and train them on safe ways to use this. They offer one to one training and can also visit community groups. It was pointed out that a lot of people will not know about the service and CC acknowledged this and has asked us if we can begin to hand out leaflets to this patient group and explain what they offer.

Actions:

Louise to ask receptionists to actively promote the digital inclusion programme by asking patients if they use the app and if they express that this is difficult for them to signpost to the team.

The next meeting date will be agreed shortly, and we will send this out via text to those with mobile numbers or letters for those who don’t. Please let us know if there is anyone who expresses interest in attending future groups.

PPG Minutes: 27 February 2024

Attended by: Dr Brown, Louise Armstrong, EH, RD, PJ.

Introductions: Dr Brown introduced himself and explained that Louise as the new Deputy Practice Manager would now be assisting in meetings due to Christine retirement.

Updates since last meeting:

Dr Brown told members that he has recently became a GP Trainer meaning that we now have 3 registrars in the practice.  Dr Hashem and Dr Uwa have now moved to other practices, but Dr Uwadia will be staying with us until August.  New registrars are Dr Prabhuswamy who will be with us for 3-6 months and Dr Felix who will be with us until February next year.

Dr Jamieson has recently left the practice to work closer to home and Dr Koganti will be returning as salaried GP. This is in addition to Dr Abu who has remained at the practice taking up post as a salaried GP following completion of his training last year.

Our pre-registration pharmacist Jas has remained with the practice as a qualified pharmacist, and we have a new pre-registration pharmacist Nabiha.

Covid/Flu vaccinations:

RD asked if there was any talk about when the next covid booster would be.  Dr Brown explained that he thinks covid booster will probably remain just like flu vaccinations and be done yearly but that there is not presently a firm plan. We have however been continuing to give boosters throughout the winter, offering Saturday morning clinics which initially helped uptake but the numbers of people wanting vaccines is dropping. Louise mentioned that there has also been an effect on the uptake of other vaccinations such as shingles due to a lot of misinformation in the media regarding vaccinations.  Dr Brown also added that this is also affecting uptake of childhood immunisation and added that having an influx of immigrants registering with the practice is also impacting as vaccination schedules from other countries don’t always match up with our schedule.

Post pandemic working.

Dr Brown explained that we are still dealing with the impact of the pandemic and that although we are totally back to pre-pandemic way of working waiting times at hospitals etc are still very long.  He explained that a lot of surgeries have continued to work with mostly telephone consultations but that we are fully open and seeing patients mostly face to face.  He explained that due to the long waiting lists for hospital treatments we are often seeing patients coming back time and time again with the same problems.  Unfortunately, we feel this is something that will get worse before it gets better due to current situation with strikes etc. We are taking steps to improve access and have increased appointment numbers, especially for urgent on the day problems and the use of eConsult’s etc.

CQC rating

The practice is currently rated as “GOOD,” by the care quality commission.  The CQC are satisfied with the way the practice is running and performing and therefore decided to defer further inspection.  Due to significant changes in management, we were anticipating a visit but as of, yet this has not happened.

Any other business

RD asked if there had been a problem with medication shortages as he had read something about this. Dr Brown explained that there are numerous problems with medication shortages, and this is putting pressure on the practice as we often need to source alternative medications for patients.  Dr Brown explained that there has been a national shortage of B12 injections meaning we have had to adopt a different way of treating patients meaning they have 2 loading dose injections and then take oral supplements.

We discussed how we may be able to increase the group numbers, especially focusing on the younger population.  EH said that she has experience of running a nighttime PPG group and she found younger patients did attend.

Actions:

Dr Brown and Louise to discuss how we try and increase PPG numbers and how we can reach out to the younger population.

The next meeting date will be agreed shortly, and we will send this out via text to those with mobile numbers or letters for those who don’t.  Please let us know if there is anyone who expresses interest in attending future groups.