Is a GP actually required to accept shared care?

No, they are not legally required to. But these letters are professional invitations to collaborate, not bureaucratic impositions. Most specialists send them because shared care is already standard practice across the NHS. The question is less about obligation and more about whether the arrangement serves your care well. Have you had a chance to discuss what shared care would actually look like with your GP?

What does shared care mean for me as a patient?

It means the specialist continues to guide your treatment while your GP handles prescriptions, routine monitoring, and anything that comes up locally. You get both expertise and continuity. It is not about shifting responsibility away from the specialist. It is about two clinicians working together so you do not have to choose between one or the other. Does your GP already know about your gender care, or would this letter be the first they are hearing of it?

GPs should say yes to shared care letters

Substack 12 February 2026

GPs should say yes to shared care letters from specialists

When a gender specialist writes to a GP proposing shared care, that letter is not a request for permission. It is an invitation to collaborate in the ongoing support of someone's health, and it deserves a yes. Shared care is a well-established model across medicine, and gender-affirming care is no different.

General practitioners receive letters from gender specialists proposing shared care arrangements, yet some hesitate to commit. These letters are not requests for permission but invitations to collaborate in the ongoing support of a patient's health.

Shared care is a recognised model in NHS practice across many specialties. It allows a specialist to guide clinical direction whilst a GP provides continuity, accessibility, and local knowledge. For patients navigating gender-affirming care, this partnership offers both expertise and stability.

The full article explores why these arrangements matter, what they ask of GPs, and how they serve patients well. If you've received such a letter, or you're wondering what shared care really means in practice, it's worth a read.

In response to: Dear Doctor, it's just shared care... (Substack)