In Devon, formal Shared Care agreements between the primary and secondary care interface which enable continued prescribing and monitoring of specialist medicines in primary care, fall within the scope of Specialised Medicines Service (SMS).

SMS Guidelines set out the responsibilities of the specialist, GP and individual patient. The guidelines detail drug specific requirements including monitoring and other safety arrangements and provide contextual supporting information to prescribers.

NHS Devon does not support formal “Shared Care” arrangements between privately funded and NHS funded clinicians. See Mixed funding (Private and NHS) Shared Care requests for further details.

Current guidelines can be accessed via the individual formulary drug entries below, which also indicate the specialties and populations covered:

• Atomoxetine
• Azathioprine
• Ciclosporin
• Cinacalcet (West Devon only) (existing patients only)
• Dapsone
• Denosumab (Prolia)
• Dexamfetamine sulphate
• Flupentixol decanoate (DPT patients only)
• Gonadorelin analogues (West Devon only)
• Guanfacine
• Haloperidol decanoate (DPT patients only)
• Hydroxycarbamide (North and East Devon only)
• Hydroxychloroquine
• Leflunomide
• Lisdexamfetamine
• Lithium (Priadel)
• Mercaptopurine
• Methotrexate
• Methylphenidate
• Modafinil
• Mycophenolate mofetil (North, East, and West Devon only)
• Penicillamine (North and East Devon only)
• Riluzole
• Sodium oxybate (North, East, and West Devon only)
• Solriamfetol
• Somatropin (North, East, and West Devon only)
• Sulfasalazine
• Zuclopenthixol decanoate (DPT patients only)