Shared care, explained.
A three-way agreement between you, GHC, and your GP, designed to bring your hormone costs down to NHS prices and keep your care close to home.
What it is
A three-way pact between you, us, and your GP.
Under a shared-care agreement, GHC remains responsible for the clinical specialism: interpreting your blood results, recommending dose adjustments, and supporting you through transitions. Your GP takes on the prescribing and routine monitoring on the NHS.
For you, the practical effect is that your hormones cost roughly £9.90 per NHS prescription item (or £19/year with an HRT pre-payment certificate, which covers feminising HRT only — testosterone and anti-androgens are not eligible) instead of full private pharmacy prices. Your GP can also administer injections like Nebido, saving you a clinic visit.
Shared care is voluntary on the GP's side. Some surgeries decline, for valid reasons and sometimes for less valid ones. The sections below cover both possibilities.
The setup process
From your first prescription to NHS pricing.
Day 1
After your in-clinic visit
We issue your first private prescription on the same day, then begin drafting the shared-care pack for your GP.
Within 2-3 weeks
Pack arrives at your GP
We send a detailed care plan, drug names, target ranges, dosing schedule, and monitoring intervals, encrypted where possible. You're CC'd on the email.
Around week 4
Follow up with your GP
Contact your GP about a week after we've sent the pack. Ask if they'll sign and start NHS prescribing. GP responses can take up to 8-12 weeks; chase via reception if stalled.
Once signed
NHS pricing kicks in
Your hormones cost ~£9.90 per item (or £19/year with an HRT certificate — feminising HRT only). We continue interpreting your bloods and corresponding with your GP at every review.
If your GP declines
If your GP declines, you still have options.
Reasons GPs decline range from blanket policies against private clinics, unfamiliarity with our medications, workload concerns, or scepticism about nurse-led services. For the record, we are CQC-registered and our consultant endocrinologist Professor Channa Jayasena is at Imperial College London.
Try this first
Ask what would help them say yes
Book a brief consultation with the GP or practice manager. Show them the shared-care pack. Ask specifically what concerns they have. Often a brief call from one of our senior nurses, or a guideline sheet, resolves the objection.
Email us. We'll contact the practice on your behalf, clarify responsibilities, offer training (especially around Nebido), and share supporting letters from our consultant endocrinologist.
If they still won't
Switch GP, or stay private
We maintain a list of trans-friendly UK practices and can email it to you on request. Names like Parkbury House (St Albans), Halcyon Medical, Henfield Medical Centre, East Trees Health Centre Bristol, Unity Health, and WellBN Brighton come up regularly.
Babylon GP at Hand isn't recommended due to capacity issues. If you switch, we re-send the shared-care pack to the new practice within 2-3 weeks, though GP approval can still take 8-12 weeks.
Staying on private prescriptions
Your care doesn't change
If your GP declines and you can't switch, you stay on private prescriptions. On the £55/month plan, prescriptions themselves are free, and you just pay the pharmacy for the medication. We can suggest cheaper formulations (e.g. oestradiol tablets over patches, oral cyproterone over a GnRH analogue like Prostap) to ease the monthly cost.
Your care plan, blood interpretation, and clinical relationship with us remain identical.
Specifically about injections
If your GP nurse won't administer.
Some practices will sign shared care for tablets and gels but decline injection administration. You have several routes:
- Travel to a GHC clinic for in-house injection
- Learn self-administration (Sustanon only, supplied with consent form and training)
- Switch to oral or gel alternatives (often a clinically reasonable trade)
- Use trans-friendly walk-in services: 56 Dean Street (Soho, Wednesdays), CliniQ (King's College, Tuesdays)
GP stalling?
Get in touch and we'll contact your practice directly. Most refusals turn around once a senior nurse has spoken to the practice manager.