Shared Care

The NENC Integrated Care System now has one governance procedure through the ICB Medicines Sub-Committee. This is supported by Northern Treatment Advisory Group (NTAG) and its subgroups.  Until guidance can be reviewed by the ICB Medicines Sub-Committee and its sub-groups all guidance and agreements previously approved by the predecessor three Area Prescribing Committees (APCs) of County Durham & Tees Valley; North of Tyne, Gateshead & North Cumbria; and South Tyneside & Sunderland are still valid whilst within their review date. Clinicians referring to this guidance after any expiry date should exercise caution.  ICB approved prescribing guidance and agreements will be hosted on the NTAG website moving forward and this is available publicly at .

The Medicines Guidelines and Use Group sub-group of the APC looks at the development of Shared Care Guidelines and associated issues. Completed guidelines are presented to the main committee for a decision to be made on approval. The approval of the APC will also be sought for any proposed major change in policy.

Red, Amber, Green Plus, Green Drug Classification List

This is a list of drugs currently used in Newcastle, North Tyneside and Northumberland that are categorised under a ‘traffic light’ system of:

RED – Drugs for hospital use only. The responsibility for initiation and monitoring treatment should rest with an appropriate hospital clinician and the drug should be supplied through the hospital throughout the duration of treatment.

In some very exceptional circumstances (e.g. due to distance from the hospital, storage, supply or mobility/transport problems) it may be appropriate for the GP to be asked to prescribe a Red drug. This should be negotiated on an individual patient basis and should only be done with the GP’s prior informed agreement where the roles of the GP and hospital services are clearly defined and agreed. The GP should not feel under pressure to prescribe in these circumstances.

AMBER – Drugs initiated by hospital specialist, but where continuing treatment by GPs may be appropriate under a shared care arrangement. The specialist should send the GP a copy of the shared care agreement to sign. The GP should sign the shared care agreement, or indicate they do not want to be part of such an agreement, and return a copy back to the specialist. Shared care guidelines are available or are being developed for most of the drugs listed as Amber. If no shared care guideline is available, the hospital specialist should provide the patient’s GP with sufficient information and support to allow treatment to be continued and managed safely in primary care.

GREEN PLUS – Drugs normally recommended or initiated by a specialist (hospital or GP with an extended role, but where the provision of additional information, or an information leaflet, may be appropriate to facilitate continuing treatment by GPs.

GREEN – Drugs where prescribing by GPs is appropriate. Drugs not classified as Red, Amber or Green Plus are generally classified as ‘Green’ by default. The Green drugs listed here include those products normally initiated by hospital specialists where there was a need for discussion and debate as to the category in which they should be placed.

Individual shared care guidance is available on the Guidance page of this site.