Shared Care in Somerset
New Collective Action Update – from 1 July 2026, practices are asked to:
- Decline any new Shared Care Arrangements that are not supported by a locally commissioned formal agreement, adequate resourcing and clear clinical responsibilities.
- Review existing Shared Care Arrangements to ensure they remain safe, appropriately commissioned, and are supported by up-to-date protocols.
In Somerset, the position is more nuanced. A number of shared care pathways already form part of commissioned primary care activity and should continue to be delivered in accordance with their agreed specifications. These include:
- Enhanced Drug Monitoring Service for:
- Sulfasalazine
- Azathioprine
- Penicillamine
- Leflunomide
- Methotrexate
- Sodium aurothiomalate (Myocrisin)
- Hydroxychloroquine
- Mercaptopurine
- Dronedarone
- ADHD shared care with locally commissioned NHS providers.
Examples of medicines and pathways that are not currently commissioned under these arrangements include:
- Biological therapies (including etanercept, infliximab and other biologics)
- Ciclosporin
- Chlorambucil
- Lithium
- Antipsychotic monitoring
- Other specialist prescribing or monitoring requests outside agreed commissioned pathways.
Shared care arrangements outside commissioned pathways remain voluntary. Practices may decline new requests under Collective Action where there is no formal commissioned agreement, adequate resourcing or clear governance. Where shared care is not agreed, responsibility for prescribing, monitoring and ongoing clinical management remains with the initiating specialist provider until appropriate arrangements are in place.
Practices should also ensure that any shared care arrangements follow the BMA GPCE’s principles for shared care prescribing.