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Essential Shared Care Agreements (ESCAs)

Essential Share Care Agreements (ESCA's)

Essential Shared Care Agreements (ESCAs) are written agreements between specialist services and general practitioners, and allow care, specifically prescribing, to be safely shared between them. They are individual to a specific drug, and detail who is responsible for what aspect of care, and when early referral is required back to specialist services. They allow the seamless transfer of prescribing responsibility from the specialist services to general practice.

All ESCAs are agreed by the Trust's Medicines Optimisation Committee whose membership includes representatives from the local Primary Care Trusts. ESCAs are normally developed for all drugs, which are either specialist in nature, or that have specific monitoring requirements, e.g. a blood test is required at regular intervals.

It has been agreed by the Medicines Optimisation Committee, that where general practice refuses to enter into a shared care agreement for a drug that has been pronounced on by NICE as appropriate for shared care, the clinician should complete the Proforma for ESCA Refused by General Practice in order that the Trust can charge the CCG appropriately.

In order that we do not charge the CCG inappropriately it is essential that, when the service is no longer providing the prescription, the clinician informs us by completing the ESCA Refused by General Practice - Service no longer prescribing  as soon as possible.


E042 Lithium

E043 Fluoxetine in Children and Adolescents

E044 ADHD in Adults

E050 Atypical Antipsychotics for Challenging Behaviour in DNLD

E051 Antipsychotic Depots and LAIs

E052 Drugs for Dementia

E053 Atypical Antipsychotics

E056 Melatonin

E057 ADHD in Children and Adolescents

E058 Disulfiram


Prescribing Guidelines

Guidelines for Antipsychotics in Dementia - Shrops and T&W 
Guidelines for Antipsychotics in Dementia - South Staffs Locality 
Prescribing Guidelines - Melatonin

Lithium Monitoring Booklets

Lithium Pack Order Form 
When initiating a patient on Lithium please ensure that you provide a Lithium Monitoring Booklet to the patient/service user/carer and discuss with them the monitoring requirements. Copies of the booklet can be obtained by completing the Lithium Pack Order Form

Community Children's Nurses (CCNs) Administration Agreements

E045 Cytarabine

E046 Meropenem

E047 Gentamicin

E048 Tobramycin

E049 Piperacillin with Tazobactam

CCN ESCA Standing Operating Procedure

CCN Administration SOP

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