Essential Shared Care Agreements (ESCAs) are written agreements between specialist services and general practitioners and allow care, specifically prescribing, to be safely shared between them.
They are individual to a specific drug, detail who is responsible for what aspect of care and when early referral is required back to specialist services. They allow the seamless transfer of prescribing responsibility from the specialist services to general practice.
All ESCAs are agreed by the Trust's Medicines Optimisation Committee whose membership includes representatives from the local Clinical Care Groups (CCG). ESCAs are normally developed for all drugs, which are either specialist in nature, or that have specific monitoring requirements, e.g. a blood test is required at regular intervals.
It has been agreed by the Medicines Optimisation Committee, that where general practice refuses to enter into a shared care agreement for a drug that has been pronounced on by NICE as appropriate for shared care, the clinician should complete the Proforma for ESCA Refused by General Practice in order that the Trust can charge the CCG appropriately.
In order that we do not charge the CCG inappropriately it is essential that, when the service is no longer providing the prescription, the clinician informs us by completing the ESCA Refused by General Practice - Service no longer prescribing as soon as possible.