Shared care and Traffic Lights System


Shared Care Information (click on link and see individual chapters)

Specialist initiated drugs require more caution with prescribing than those drugs classed as first or second line choices. They are less frequently prescribed and specialist knowledge is required when initiating therapy.

Amber with Shared Care (S/C):  Drugs which are considered appropriate for responsibility to be transferred from secondary to primary care with the agreement of a GP and a formal ‘shared care’ agreement.  

  • Initiation, prescribing, & monitoring until drug is stabilized is the responsibility of the specialist.
  • Specialist to request GP to take part in ongoing prescribing & associated clinical responsibility according a ‘shared care guideline’
  • Any shared care arrangement should be accompanied with a formal request. A form can be found on  BCAP FORMS AND DOCUMENTS PAGE (3rd form down)
  • GP to respond to the specialist
  • Ongoing communication between primary and secondary care

Amber:  Drugs which are considered appropriate for responsibility to be transferred from secondary to primary care with ongoing communication but where no formal ‘shared care’ agreement is necessary

  • Initiation with 28 day supply (where possible) or recommendation is the responsibility of the specialist. Additional information regarding dosing and monitoring to be supplied by the specialist.
  • GP to respond to the specialist (where necessary).
  • Ongoing communication between primary and secondary care

Hospital only drugs are restricted for use within a hospital environment. Red:  For specialist use in secondary care or competent clinician onlY.

These drugs have been classified as such as it is not deemed appropriate for prescribing in the primary care setting, based on best available evidence. This could be for a number of reasons, for example: new drug therapy with limited safety profile; intravenous preparation; drug has particular cautions or requires specific monitoring.

Change of Traffic Light Status

With increased prescribing knowledge and changes in therapeutic management, it may become appropriate for some drugs to be reclassified.

The committee will consider applications with Change of Traffic Light Form.

In such circumstances, it may be appropriate to provide prescribers without specialist knowledge with supporting information to allow them to take over prescribing responsibility, if they wish to do so.

The Joint Formulary Committee is working together with appropriate specialists to produce Shared Care Information for prescribing.

By providing such supporting information, the Joint Formulary Committee is not expecting general practitioners to take on prescribing of these drugs, but to provide information to support them if they wish to do so. It must be remembered that the clinician who prescribes a drug legally assumes clinical responsibility for that drug and the consequences of its use. For this reason, no prescriber has an obligation to take on prescribing unless they feel clinically competent to do so.

Last updated by: Joy Craine on 24-04-2018 16:00