Find it Fast: Search for it

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.

Agreements - South Staffordshire & Shropshire CCG Locality

E051 Antipsychotic Depot & LAIs

E093 Atypical Antipsychotic in Learning Disabilities

E094 ADHD in Children & Adolescents

E095 Lithium

E096 Melatonin

E097 Fluoxetine in Children & Adolescents

E098 Drugs for Dementia

E099 Atypical Antipsychotic

E100 ADHD in Adults


Agreements - Shropshire/Telford and Wrekin Prescribing Information Documents (PIDs) & ESCAs

PID01 Olanzapine

PID02 Quetiapine

PID03 Risperidone

PID04 Aripiprazole

PID05 Fluoxetine 

E101 ADHD in Children and Younger People

E102 Risperidone

Agreements - Inclusion


E070 Disulfiram

Shropcom / Prison ESCA


Community Children's Nurses (CCNs) Administration Agreements

E079 ESCA Cytarabine March 2018 V3

E080 Meropenem for Administration in the Community

E081 Gentamicin for Administration in the Community

E082 Tobramycin for Administration in the Community

E083 Piperacillin with Tazobactam for Administration in the Community

E084 Lenograstim for Administration in the Community

E085 Methotrexate for Administration in the Community

E086 Vancomycin for Administration in the Community

E087 Dalteparin for Administration in the Community

E088 Aciclovir for Administration in the Community

E091 Teicoplanin for Administration in the Community


CCN ESCA Standing Operating Procedure

CCN Administration SOP

Refusal of Repeat Prescribing by GP- Letter Templates

Letter 1

Letter 2


Prescribing Guidelines

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


Lithium Guidelines and Monitoring Booklets

Lithium Pack Order Form  

Guidelines for the Monitoring of Lithium

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