Shared Care Prescribing: Wideopen Medical Centre Update
From 1 April 2026, the practice has taken the difficult decision not to participate in the Medicines Local Enhanced Service. The Medicines Local Enhanced Service is an optional NHS scheme under which GP practices may choose to provide services beyond their core GP contract, including the prescribing and monitoring of certain specialist medicines on behalf of hospital or specialist services. This decision affects a limited number of patients registered with the practice.
GP practices operate under a national NHS contract known as the General Medical Services, or GMS, contract. This contract defines the core services that GP practices are required to provide, including consultations, diagnosis, referrals, and routine NHS prescribing. Prescribing and monitoring certain specialist medicines under “shared care” does not form part of the core GMS contract.
Shared care is a voluntary arrangement in which a hospital or specialist initiates a medicine and then requests that a GP practice continues prescribing and undertakes agreed monitoring closer to the patient’s home. Such arrangements can only proceed where a GP practice has explicitly agreed that it is able to assume this role safely and appropriately.
The practice has provided shared care prescribing for many years. However, the local NHS has recently amended the specification for the Medicines Local Enhanced Service. These amendments substantially increase the range and complexity of specialist medicines that GP practices would be expected to manage, including medicines that are infrequently prescribed in general practice and require highly specialised knowledge.
Following careful review, the practice has concluded that participation under the revised arrangements would not be compatible with its clinical governance responsibilities, contractual obligations, and overarching duty to ensure patient safety. Evidence from previous years demonstrates that the majority of shared care activity relates to a small number of commonly used medicines, while the expanded list contains low-volume, highly specialised treatments that fall outside routine general practice expertise. Requiring GP practices to accept responsibility for all such medicines without flexibility introduces unavoidable clinical and governance risk and increases the likelihood of inconsistent decision-making across practices.
The Integrated Care Board has confirmed that participation in the Medicines Local Enhanced Service is optional and that GP practices must decide whether to accept the published specification in full. The practice has therefore exercised its contractual right not to opt in.
As a consequence of this decision, the practice will not enter into any new shared care arrangements. Patients who are currently receiving medicines under shared care will remain under appropriate specialist oversight. These patients will either be transferred to an alternative provider once commissioned by the NHS, or returned to their initiating specialist, who retains responsibility for prescribing and monitoring. Affected patients will be contacted directly once formal arrangements are confirmed.
The practice recognises that this change may cause concern for some patients. However, the decision has been taken to ensure that care is delivered safely, consistently, and fairly across the registered population. The local NHS has confirmed that it is progressing plans to commission alternative providers to ensure continuity of medicines management. The practice will cooperate fully with any transition arrangements and will keep patients informed as further information becomes available.
This decision does not affect the core GP services provided under the GMS contract, which the practice continues to deliver in full.
Frequently Asked Questions (FAQs)
What is the Medicines Local Enhanced Service (LES)?
The Medicines Local Enhanced Service is an optional NHS scheme. It allows GP practices, if they choose to opt in, to take on additional responsibilities beyond their core GP contract, including prescribing and monitoring certain specialist medicines on behalf of hospital or specialist services.
Has the practice stopped providing shared care prescribing?
The practice has not opted into the revised Medicines Local Enhanced Service and therefore will not accept new shared care arrangements under the updated specification. This decision relates specifically to the revised LES and does not affect core GP services.
Why has the practice made this decision?
The local NHS has recently expanded the range and complexity of medicines included in the Medicines Local Enhanced Service. Many of these medicines are highly specialised, prescribed infrequently in general practice, and require specialist expertise.
After careful consideration, the practice concluded that accepting responsibility for all medicines listed under the revised specification would not be compatible with safe clinical governance or consistent decision-making across the practice.
Is shared care part of a GP’s core NHS contract?
No. GP practices work under a national contract known as the General Medical Services (GMS) contract. Shared care prescribing for specialist medicines is not part of the core GMS contract and is always voluntary.
What does this mean for patients currently on shared care medicines?
Patients who are currently receiving medicines under shared care will remain under appropriate specialist oversight. Arrangements will be made for these patients to either:
transfer to an alternative provider once commissioned by the NHS,
or
be returned to their initiating specialist, who retains responsibility for prescribing and monitoring.
Patients affected will be contacted directly once formal arrangements are confirmed.
Will the practice stop my medication?
No. The practice will not make any changes without appropriate arrangements in place. Responsibility for specialist medicines remains with the initiating specialist until a safe alternative provider is confirmed.
Does this decision affect routine GP services?
No. This decision does not affect core GP services provided under the GMS contract. The practice continues to deliver all core NHS GP services in full.
Is the NHS providing an alternative service?
Yes. The local NHS has confirmed that it is progressing plans to commission alternative providers to ensure continuity of medicines management for patients affected by this change.
Can the practice make exceptions?
No. Participation in the Medicines Local Enhanced Service must be accepted in full, and GP practices cannot selectively accept individual medicines. For reasons of safety and fairness, the practice applies this decision consistently.