Interim Statement for Requests for Shared Care Agreements for Historic Patients

User guides for responding to Shared care Agreements for LPT Only :

Emis Webb 

Systm One

SCA’s are currently listed alphabetically by drug name (or disease). Where a drug doesn’t have it’s own specific request form please use this one Shared Care Request Form.

Some LPT request forms are currently missing due to some ongoing work.

A programme of review of these shared care agreement documents is currently being undertaken. These are the current shared care agreements. If there are any concerns please contact medicines.info@uhl-tr.nhs.uk. Please do not send patient identifiable information as email may be unsecure.

ADHD (adults)   Request form 

ADHD (paediatric)   Request form

Agomelatine

Aliskiren

Amiloride (paediatric cardiology)

Amisulpride     Request form

Antipsychotics (atypical) Request form

Antipsychotics (atypical) in personality disorder   Request form 

Apomorphine for treatment of Parkinsons’s disease     Request form

Aripiprazole long acting injection     Request form

Aripiprazole oral     Request form

Atomoxetine (adults)     Request form

Atomoxetine (paediatric)     Request form

Azathioprine (dermatology)

Azathioprine (adult gastroenterology)     Request form

Azathioprine (paediatric gastroenterology)

Azathioprine (rheumatology)     Request form

Balsalazide

Captopril (paediatric cardiology)

Ciclosporin (dermatology)

Cinacalcet

Denosumab (Prolia) for osteoporosis Request form

Denosumab (Xgeva)  for prevention of skeletal events with bone metastases

Dexamfetamine (adults)     Request form

Dexamfetamine (paediatric)     Request form

Enalapril (paediatric cardiology)

Flupenthixol decanoate     Request form

Fluphenazine decanoate     Request form

Furosemide (paediatric cardiology)

Grazax

Guanfacine (adult)         Request form

Guanfacine (paediatric)    Request form

Haloperidol decanoate     Request form

Hydroxycarbamide

Hydroxychloroquine     Request form

Leflunomide     Request form

Lisdexamfetamine (adults)     Request form

Lisdexamfetamine (paediatric)     Request form

Lisinopril (paediatric cardiology)

Lithium     Request form

Losartan (paediatric cardiology)

Mercaptopurine (paediatric gastroenterology)

Mercaptopurine (adult gastroenterology)   Request form

Mesalazine oral

Mesalazine (paediatric colitis)  Request form

Methotrexate oral (rheumatology)     Request form

Methotrexate oral (dermatology)

Methotrexate oral (Adult Gastroenterology)      Request form

Methylphenidate (adults)     Request form

Methylphenidate (paediatric)     Request form

Modafinil

Mycophenolate (renal transplant)

Olanzapine     Request form

Paliperidone palmitate long acting injection     Request form

Penicillamine (rheumatology)     Request form

Pramipexole

Quetiapine     Request form

Riluzole

Risperidone long acting injection  Request form

Risperidone oral     Request form

Rotigotine

Sacubitril / valsartan     Request form

Spironolactone (paediatric cardiology)

Sulfasalazine oral (rheumatology)     Request form

Sulfasalazine oral and rectal (gastroenterology)

Testosterone (adults)

Testosterone (paediatric) Request form

Venlafaxine (high dose)     Request form

Zuclopenthixol decanoate     Request form