Shared Care Explained

Following your initial appointment, we will write to your GP requesting that they kindly agree to shared cared management with The Gender Hormone Clinic.

Please Note – Shared Care is, unfortunately, not guaranteed and is at the discretion of your General Practice.

What is Shared Care?

A Shared Care agreement is a contract between The Gender Hormone Clinic, you and your GP, which enables safe care and monitoring of your hormone therapy.

This allows the patient to receive their medication via an NHS prescription, reducing the cost and making the treatment more accessible. For this reason, Shared Care is the ideal pathway for patients.

Your prescription will then ideally be issued by your GP following our guidance and monitoring.

GP’s rely on our specialist advice to continue prescribing therefore, you are required to book follow up appointments with us at the regularity detailed by your nurse in your follow up letter.

Areas Of Responsibility

As part of the Shared Care agreement, certain responsibilities are agreed between the three parties to uphold a patients care, see below for the responsibilities outlined in the document sent to your General Practice.

Our Responsibilities
  • Establish or confirm diagnosis and assess patient’s suitability for treatment.

  • Baseline monitoring of routine requested bloods.

  • Discuss treatment with patient and ensure they have a clear understanding of the benefits and side effects of the treatment, including dose adjustments and how to report any unexpected symptoms. The team provides the patient with information and advice, supported by written information emailed on confirmation of appointment.

  • Obtain signed consent for hormonal treatment.

  • Securely email signed shared care guidelines, with patient details completed to GP for consideration of shared care request.

  • Monitor treatment according to local guidelines and advise patient and GP on dose titration of medicines.

  • Correspond with GP following clinic contacts.

  • Inform GP of abnormal monitoring results and any recommended changes in therapy prescribed by the GP, including the need to discontinue if appropriate.

  • Evaluate adverse events reported by GP or patient and communicate outcome to GP.

  • Communicate arrangements for ongoing monitoring and follow up according to shared care guidelines including continued need for therapy.

GP Responsibilities
  • Consider shared care proposal and if in agreement to respond within 4 weeks of receipt.

  • If you do not agree to share care, please contact the requesting consultant or clinical management team within 4 weeks of receipt of the shared care request so that we can discusshow we can further support you to enable our mutual patient to access care.

  • Prescribe treatment as advised by The Gender Hormone Clinic team as previously discussed with the patient.

  • Inform gender clinic of suspected adverse effects.

  • Stop treatment on advice of gender clinic or immediately if urgent need arises.

  • Check compatibility interactions when prescribing new or stopping existing medication.

  • Forward any abnormal results to The Gender Hormone Clinic and agree any action required.

Patient Responsibilities (additional responsibilities where applicable)
  • Keep a copy of all information provided by The Gender Hormone Clinic.

  • Take medicines as agreed and prescribed.

  • Report any adverse effects to GP or Senior Nurse Prescriber.

  • Attend appointments for review as agreed with The Gender Hormone Clinic

  • Always inform the specialist team and GP of all medication taken, whether prescribed or bought.

What if My GP Refuses Shared Care?

If Shared Care is refused by your General Practice, your treatment will then be solely monitored between yourselves and our practice. This means prescriptions will need to be requested via our prescription request form and will be issued privately.

Prices for medication collected via private prescriptions will be set by the pharmacy you collect from.

We offer in person and remote training sessions for GPs, free of charge, to educate in the safe practice of gender affirming hormone therapy.